Dr. Mandy Cohen discusses progress, challenges in fight against COVID-19
Dr. Mandy Cohen, secretary of the state Department of Health and Human Services, remarks on progress made during the pandemic and the challenges to come as COVID-19 cases spike again.
from outside. Um so if you want to hold you know a staff meeting, hold it outside, luckily we have great weather here in north Carolina. Well into the fall. Um so please please think about, you know, indoor ventilation but moving things outside that certainly reduces risk doesn't mean that there's no risk outside, but it does reduce risk cleaning surfaces, hand sanitizer. And then you know, there are other things that you can do and using your voice as an employer, you have a lot of sway in your community and I'd love for you to use it. Thinking about what you could do to articulate, Hey, this is what we are doing to promote vaccine. This is what we want everyone to be. Um doing. So for example, we have this great partnership with heroines um to reach our, our young adult population who frequents carol carol wins. Um and you know they are promoting vaccination and are even brought a vaccine event um to, to the heroine's uh uh right where you go to the amusement park area and you can get vaccinated and get a free ticket that day as well as the second ticket to come back. So those are the kinds of things. Um so we love your support and sharing this information. All right, that was that was a lot of like where we are, what you can do. Why don't I pause there and molly? I don't know if you're going to moderate for us. I'm happy to answer any questions that folks may have. Yeah, I can't hear you molly, but maybe other scan. Well what is the most common phrase in the midst of the pandemic? You are on mute. Alright so here we go. A quick question came from Susan the data that you showed on slide three. Just want to verify. Is that national level or state level? Oh um I want to I want to make sure I knew what slide three was if that's our vaccine it's all state level data. Sorry I don't even need to go back. So that is all north Carolina specific data but it does track too the national data as well. Okay great. I assume so. But wanted to verify. All right so we have our Sorry that is that is north Carolina specific data. Fantastic. Fantastic. Okay so a couple of questions and I'm fairly curious about this myself on the monoclonal antibody therapy. The question came in from Lori about the C. D. C. Recommendation to test 3 to 5 days after exposure. Is that then too late for the anti body therapy. So the anti body therapy has to be within the 1st 10 days of sipped symptoms. So if you are having symptoms you should get tested right away. You don't need to wait to your 3 to 5 days. The 3 to 5 days is more you had an exposure. You're feeling fine because it is possible for you to get Covid and feel fine again. Something we don't yet understand. Why do some people have no symptoms but still have covid and other people get super sick. The monoclonal antibodies are really tied to when do your symptoms start. So it could be, you know, clogged nose tickle in your throat. When, when is that first thing that you notice? So I feel a little crummy. That's the start of your symptoms. And then within that 10 day that within 10 days is really when you have to get the treatment, which is why any time you're not feeling well, go get a covid test because if it's covid you want to be able to get that treatment right away. And and the sooner you get it in that 10 days, the better it works right because it's helping your body fight things off before um, your your own body frankly overly aggressively reacts to the virus. So you're actually trying to get treatment as soon as possible as soon as you do it the better. Great. Okay. And is that going to be available at urgent care centers or just in doctor's offices? Urgent care? Yes. Are are are doing it? Sometimes outpatient hospital settings will have it. Um, we do have a website with a locator of where the monoclonal antibodies are as well as a hotline that folks can call. But I think your first call can always be to your doctor to say, do you have it? I think that's always best and they can probably get you in. Um, and if not, they probably know where you can go as well and help you navigate it. But you can always go to our web, you know, google north Carolina monoclonal antibody and it'll come up for you. Great. Great. Alright. Crystal. So there's your answer. All right. Susan has a question and I've heard this a number of times recently is around the reliability of the home covid test dr cohen. What are your thoughts on that? Yeah. So they're they're not there's there's two different kinds of tests. There's what's called a PCR tests. That is I would call the gold standard is the one that's done in a lab you send away. Then there's the ones that are rapid tests you can do at home and you get the results in 15 minutes. Those are called antigen tests. They're pretty good. They're not great, meaning that they that They take probably 24 more hours to actually show a positive than than the PCR test. So a PCR test would turn positive 24 hours before it could pick it up a little sooner than a home test. But I think home tests are good. Um I I think it's a belt and suspenders thing. So um so I think that that I have some home, you know, tests at home and if anyone is not feeling well we you know, whip one out and it doesn't say I'm done there right. Certainly if it was positive then you're like okay that would make me say, I know that is positive, it's negative and if someone has ongoing symptoms, I would want to go have them get a lab test as well to confirm that that is is it truly negative? Is there something else going on? I might even repeat the home test because again, if you do it twice, you actually make the reliability of that test even better. Great. Thank you. Question came in here from J. D. We know that there's a large percentage of people who are never going to get the vaccination. Do you think that there's a chance that we'll see mandates for people who perhaps are on Medicaid or Medicare Social Security. I mean, are there things that are going to happen more from a governmental perspective here? Um, I don't know if that's the case. I don't know that any insurance company, whether it's Medicaid, Medicare, Blue Cross has ever mandated a certain type of medical care. They pay for the care. Um, but I think what we're seeing is different employers are doing it as a condition of you participating in work. Um, As I mentioned again, I just saw the news alert that the biden administration is going to do that for the Feds. Um, We are doing it, as I mentioned for our healthcare workers. I know many um, of our hospital systems and other health care workers have have gone to mandates because we are in such close personal contact with folks all the time and they're high risk settings? Um So I think that's the first place where mandates that that is something that is not new to a lot of these spaces. I will say in healthcare we are required to get the flu vaccine every year for example. So this is not new for us. So I think it's just layering on. Um and so that that is what I I anticipate more is that it's going to be in the employer space rather driven not driven by the insurance coverage space? That would be pretty unusual. Okay. Um a couple of questions have come in about the for Children in particular. So can the antibiotic therapy be used for Children is a question that Grace has. Oh I think that that is only authorized for 18 and up. But that is a good question. And I'll I want to just double check that with my pharmacist but I'm pretty sure it is Spur 18 and up and I apologize for not knowing that with more clarity. That's okay. That's okay. What do you think about Lisa has a question here about vaccinations for Children? Under 12? Is there any movement in that space? Yes. So they're doing clinical trials right now for those under 12 and once you get under 12, that's when the dozing changes? They're small enough and that their weights are smaller, where they start to think about, do we do a half dose do we do a quarter dose. Um So it does take a little bit longer for folks to figure out exactly what the dozing is going to be the time frames. So they're going through all that clinical trials happening here in north Carolina. Thank you. Too many families who have participated in those. Um So what I anticipate is that Pfizer again will probably be the first to put their their data forward to the FDA. Um I think they have announced that they probably will have that data by the first week of october. That means through october, the FDA will review that. So I think the earliest is november for kids under 12 and I think it will likely be 5-12, maybe 7-12. 1st and then when we get even younger than that. Again, that's when we really get into like really fine tuning the dose, dozing amounts so that's going to take a little bit longer. So I think November the earliest I'd say. I would not be surprised if it took longer and we're into january before we see vaccine. So November the earliest I hope no later than January of 2022. Great. Great. Alright, I'm gonna ask you one last question that that has come in from Liz uh just reiterating I guess your position around mandates of vaccines for employers in north Carolina where well so look, I think that you are seeing a variety of ways in which employee employers are doing this. I have mandates for certain employees, right in their high risk settings like health care. I have vaccine verification and weekly testing for my office based employees. I think you're seeing things like Delta Airlines do um uh you know financial penalties. Um right. They're not mandating it, but then they find, so I do think that there are a variety of ways what I would say is do something, do something, be part of the solution here. Um and you know the culture of your organization as well as the risk of what the action is while someone is at the workplace. Right. Are they in close quarters with each other in high risk settings. Um Right. Do you you know you know what what you you know, you know we know what those settings are now. Um and I would say if you have high risk settings. Absolutely. I think mandates might be the right place to go otherwise. Maybe there are other mechanisms carrots and sticks um that you want to think about to adapt to your culture, but please please do do more um and certainly be leaning in as much as you can to make it accessible and um and use carrots. I don't know if sticks are right for every organization, but I'd love to see more do it and I think that leadership is going to be important. Absolutely. There are so many reasons why I respect you and appreciate the guidance that you provide to our employers. It is practical, it is reasonable and it is founded in data Dr Cohen. Thank you so very much. This is a perfect segue um, for you to wrap up and then we move into some of those employment issues that Kerry can help us with. Thank you again. DR Cohen, thank you. Carrie. Welcome. Welcome. Welcome. Hi everybody. All right, Carrie, why don't you do a quick introduction and then we'll get started. So, thanks molly. I am carry 70. I am an employment lawyer and an Arista attorney and I am very busy talking about Covid vaccines, incentives mandates Delta Airlines today. United Airlines. Um, so hopefully I can take all of the really good information and advice from DR Cohen. It was such a great half hour. I really enjoyed thank you for letting me be part of it molly. Um, and hopefully I can take that and help you operationalize that and turn that into action. Great. So while you're getting ready and we start, I'm going to ask you a question about first and foremost because we have we have over 750 people registered for this event. So we have a great data source for us. So we're going to ask a poll. So tucker if you can pull up the number one first question that we have Is your organization currently mandating the COVID-19 vaccine. So while you're pulling that up. Thank you so much. If everybody would help us by responding there, we will give you the results in a minute and carry. Let's maybe start there while we're waiting for those results to come in. What are your thoughts about mandating? Just given what your own individual thoughts and what you're seeing? But also what what Dr Cohen has just shared with us. So I think DR Cohen gave just like you said, molly some really terrific practical advice. You know, your organization, you know, your culture, you know, your risk factors, you also know your staffing recruitment and retention challenges or maybe you're lucky and don't have those challenges right now in this labor market. And so a mandate is really part of a much larger conversation. Right. Do you have the HR staff and talent to manage a mandate in a compliant way? Do you have the organization, organizational cultural appetite. I can't do that again. Um to manage a mandate. And do you have staffing levels that would allow you to unfortunately potentially say goodbye to some people who would not meet that mandate. Yeah. Yeah. There's so many. I like her answer. I like your answer. I mean it is the HR answer. It's very much dependant upon what your population is, what kind of risk you have, what kind of work you're doing and how we need to now readjust I think to moving forward in the midst of this ongoing unfortunate on ongoing situation with the pandemic and the variant. Oh okay, so let's pull up the results. So here we go. We've got 91% saying that they are currently not mandating the vaccine. We know that mostly. Um, Okay, tucker you can pull that down. Thank you. Um, we, we know that mostly what we're seeing is that it's been happening in health care. Is that your experience as well carry? Yes, but what's really interesting is you're seeing that I kind of think of health care as the beta test for the mandate and I think a lot of other industries are now starting to follow suit. So for example Tyson foods just announced that in their meat packing and production facilities, they are going to be mandating. So you're starting to see other industries step into the mandate pool. I think the other thing that's happening molly is a lot of companies tried real hard initially to avoid going right to mandate. So there was a lot of educate, there was a lot of motivate, there were a lot of incentive conversations and there are some industries that have simply arrived at a spot in time. Maybe because of delta maybe because delta variant um, maybe because there are so many headlines around mandates that you're starting to see other industries also engage in the mandatory conversation. Now I want to be really clear about one thing mandates are coming in different shapes, sizes and flavors and I've come across what I consider the three categories so far. There's the purest right? The mandate, the mandatory vaccine approach is um, your employment is contingent on becoming vaccinated, right? You're not going to be hired and or you're not going to be able to continue to be employed unless you become vaccinated. The next flavor if you will is you can't come back into the office unless you were vaccinated. We saw a lot of financial institutions doing this initially out of the gate. If you want to continue to work from home, that's fine. But if you want to come in the office, you must be man, you must be vaccinated. The last is what I'll call the higher scrutiny mandate, meaning if you don't get vaccinated, you're subject to regular testing. Your subject to mask mandates that you have certain safety protocols if you will. Um, but you can continue to be employed. So when you read the headlines about mandates and you hear about companies doing mandates, you gotta read deeper because they're not all, but I would consider a purist approach, which is the employment ends. If you don't become vaccinated. Yeah. And one of the things that, that we're hearing is that as employers are looking at who actually on their teams are not vaccinated. They're growing concerns, uh, about really good people leaving. And is that what you're hearing as well, 100%. I believe it or not. I know that there's all kinds of headlines out there about Florida, my home state. Um but I have a number of clients in Florida going to a mandatory program and these are purest hardcore mandatory programs and they're becoming effective September 30. So if you're not fully vaccinated by September 30, a number of my clients are saying goodbye to employees and they're letting go some some top talent and leadership is really freaking out is not the right word but concerned right and stressed. Honestly we're all stressed right now about a lot of things. Um but really stressed about the fact that they're saying goodbye to some real high quality top performers but they understand or have accepted that that's the price you have to pay to have a As fully vaccinated workforce as you can have. Of course minus religion -80 a allergies, those sorts of things. All right, so let's talk a little bit more. There's some questions coming in about how how do you mandate if you're looking to create a program carry? Can you give us some advice and guidance on how to do that? Well, I think the first thing is be sure that you have a plan have this written out, have a solid communication. Be prepared to communicate both with your candidates and your employees. I don't want candidates left out of the conversation. And I think sometimes we forget that the A. D. A entitled seven apply both to candidates and two employees. So that written communication is going to be very important to be clear about your deadlines. Be clear about how they submit proof, who they submit proof to be clear about the confidential confidentiality rights obligations um and assurances for the employees and have a very clear path to request an accommodation. Be sure that those rights are spelled out clearly and the path to accommodation is spelled out. Clearly employees and candidates must have an avenue to raise their hand. Go to somebody who knows understands and appreciates the complexities. And ask for those accommodations if you're going to involve people outside of HR in the process. Training is absolutely key managers, frontline support interviewers, recruiters all must be very clear on both your program and the candidate and employee rights. And the last piece is document and engage. That interactive process is going to be key to defending yourselves later and having a successful program. And remember you're engaging in an interactive process both on Title Seven. Religion and data. And we know that Title Seven. With respect to religion is a little Lussier goose, easier on the interactive process. But we are recommending you follow those best practices as you do in the A. D. A. World. And have those cooperative collaborative conversations and boy, I just said a whole lot. Sorry molly to Those are really great points. Those are really great points. You and I shared last week some stories about being able to find on the internet, uh, reasons why you might have uh, some kind of exception or, or seeking that out. So I thought you give really good advice on that. And so talk about your last point there carry and how do you engage in good conversation with people? Um, given all the emotion. That's a surrounding vaccines, the, the tense place that everyone is from an emotional perspective right now, what are your thoughts on that? You know, it's it's a difficult conversation to navigate and to unpack and you've got to go into it from an open minded standpoint. Help me understand. Give me more information. Help me better understand your religion. Your belief. The medical conversation is actually a bit easier because that's a bit more prescribed in the process. No pun intended prescribed. Um, but there are clear documentation. There's accommodation request forms. There's documentation that you can provide to the employee to bring to their doctor. There's documentation that the doctor can provide. Religion is really where we're seeing the most difficult uncharted territory and conversations and here's my two cents. Um, world according to garp, whatever that may be worth. But I think seeking to understand Stephen Covey is one of my heroes seeking to understand is the first out of the gate conversation with the employee. There are an amazing amount of how to request religious accommodations out on the internet. In fact, I've got a client I'm talking to tomorrow. Who sent in the employee's request for accommodation form under religion. And half of the content on that form was clearly copy paste from one of those sites. And there's nothing wrong with calling the employee out on it. There's nothing wrong with saying, listen, you know, I've seen this content elsewhere, out on an internet site. Just tell me in your own words, the tenants, your foundational beliefs, the religion, the direction. And there's also nothing wrong with researching some more. So, I went out to the evangelical christian website where there's some very clear guidance from evangelical christian leadership that they believe that their constituency should be vaccinated. The pope has come out in support of vaccinations. So there's nothing wrong with having that conversation with employees to better understand the foundational concern. And oftentimes employees will say, listen, I am just afraid of the vaccine or I just don't believe in vaccinations. And at that point, at least you have clarity on what you're dealing with because personal beliefs, political beliefs, they are not protected by law. And once you have a better understanding of where they're sitting, you can make business decisions and start compartmentalizing that conversation. Great advice. Great advice. Okay, so here are a couple of questions we're going to take from the crowd before we shift over. I want to talk about incentives. Next. So, um, while I'm asking this question, tucker, can you pull up the second question, Which is, thank you very much. All right. Um so we're going to talk about it. Are you considering mandating the vaccine? So, uh, tucker just keep that open for another maybe 30 seconds or so and then pull that down. I'm gonna ask Kerry this question that has come in from Suzanne, can you establish different vaccine requirements for different roles? So if you have maybe client facing versus office versus working from home, can you give us some guidance on that carry? Absolutely. So listen people who work from home are not subject to vaccine requirements or any covid safety protocols from the employer because they're working from home. So there is no legitimate business reason. It would be a prohibited medical inquiry. So your pure tele work remote work people, easy peasy carve them out of your program. The people that you have a right to address that you can address and should address or the people who are coming into the office or otherwise engaging in live business meetings. I work in a very heavy sales organization and a lot of our sales people are having lunches and going to dinners and going to golf outings in that case while not going into an office, still engaging in work in live settings. Still liable to or potentially subject to covid health and safety rules by our organization. There's absolutely nothing wrong with addressing the various or varying risks associated with employees roles and responsibilities and building responsive programs meaning employees who come into a corporate office setting versus people who are face to face with customers. Interestingly, walmart walmart is always interesting to talk about walmart. Corporate office is getting fully vaccinated vaccine mandate, walmart service, retail employees are not in large part because of the recruitment and retention challenge. The caution I will provide is you want to be sure that whatever program you build does not have a disparate impact. So I had a hospitality client call me and say we want to mandate the vaccine for all corporate but our housekeeping and our staff level folks. No vaccine mandate. And I said, well, think of it this way argue, having an unintended disparate impact on your staff level housekeeping level folks because they generally occupy a predominant protected class or classes versus your corporate office set. Another way. Are they subject to an unsafe or a less safe working environment than your corporate employees? I said you have to do the analysis, talk to outside counsel, but you've got to go through that process and consider whether or not you're very neutral policy will have some kind of negative unintended consequences on the basis of a protected class. Iii disparate impact. So let me, let me say this back. You can look at different populations in a different way, but you have to be able to substantiate both. Uh really the reasons for doing it as well as protecting yourself against any kind of despair. Impact Much more eloquently said with a lot less words. Well, you know, as a career hR person. I've worked with a lot of attorneys and I am I interpret for you and get it down to to hopefully help out our members. Okay, so here we have a question from Kendra and this is uh states, what's the best recommendation for candidates and accompany with mandated vaccine? Should it be in the job posting? Uh What what's the time frame for the vaccination in terms of before you start those kinds of things? Okay, so remember Kendra that you cannot engage in any kind of medical inquiries with a candidate until it is post offer pre start in that window. You can then ask them if they're vaccinated, send them for a covid test and require that they become vaccinated before they start. I think it is a wonderful idea. I think it's important. I think it's necessary. I'm a huge fan of putting in the job ad um whether or not you are a mandatory vaccine workplace, you can't ask questions in the interview. You can't engage in covid dialogue during the interview process but there's nothing wrong with having a sentence in your job. Ad that says we are a mandatory vaccine workplace. Okay, great. Okay, good. Alright. Let's move on to some questions about incentives. Mhm. Um What? Oh wait, hold on. Um Tucker can you pull up the results almost forgot. Let's just see how many are thinking about it. So what's everyone's response here strongly considering is at 13%, somewhat 18 not going to 31 unsure. 30 And then the remainder are looking at mandating are already mandating. Excuse me. Okay, so interesting. So we've got some folks who are who are really considering it. Right. So that's 2031%. So almost equal in in terms of those who are who are going to not do it. Gosh, isn't that right? Right. So it's like 30, 30, 30. Yeah, interesting. All right, thanks Tucker. You can pull that down. All right, let's talk about incentive. So one of the things certainly that we know Dr. Cohen said is you know carrot stick. So I I know you've got some thoughts on that. We can't believe we only have 10 minutes left. But let's talk a little bit about your thoughts and perspectives on incentives. Okay, so I am going to make a very bold statement because that's what that's why I'm here. That's what you're doing Kerry. We love that about you. I do listen guys, this is a incredibly complex time and you know, I've said this to some of you before. I thought a C. A. Was difficult. I'm excited when I do a CIA questions these days. Right. This is a really complex time when you start talking about carrots and sticks and wellness programs and health insurance and surcharges and higher premiums and higher deductibles. The complexity of your incentive program or surcharge program goes off the charts, gina, hip hop, affordable care act affordability, marissa, health plan, incentive limitations. It's just compounding itself. So here's what we recommend. If you're going to do an incentive program, do an incentive program, reward good behavior, morale is down. People are unhappy or mental health issues are off the charts these days. Let's have positive conversations. That's just my world. According to garp. From a design standpoint, build a program associated with covid vaccinations. From an incentive standpoint, separate And apart from your health and welfare program, totally create a wall between the two. The goal is to vaccinate your workforce, not vaccinate just the people who are in the health insurance. That's just kind of a practical approach. When you build an incentive program separate from the group, health and welfare program, you do not have all of those complexities. And in fact, you don't even have incentive limitations so long as the plan is voluntary and your employees can go to a provider of their choice. I love dr Cohen's advice about making this accessible and easy and on site vaccinations. The challenge with on site vaccinations as you are limited to a de minimus incentive, water bottles, t shirts, it can't be coercive. So the balance here is what's the priority accessibility or financial incentive to get them vaccinated. I have clients who have built out incentive programs, voluntary go to the provider that you choose separate and apart from the health insurance and they're doing $10,000 raffles. $250 incentives. I have one client that's doing $100,000 raffle at the end of the vaccine initiative. You know their program, I've got another client That's doing $150 per fully vaccinated person and then a five star vacation, fully paid by the employer. And that's a raffle. So you can really get creative in your incentive program. If you keep it super simple. Let the employee go to a location of their choice and provide proof of the vaccine. Of course that's confidential information. Okay, great advice. I just had a roundtable yesterday with a group of senior HR folks and one of the things that a woman recommended was in in addition to offering the incentive for those who are unvaccinated as a company, they gave the reward if you will to those who had previously been vaccinated. So there was a goodwill element of it as well. So that's just something I thought was an interesting way of involving everyone in rewarding behavior that ultimately the company felt is an important, important step and more importantly, that probably the culture that they want to, that they want to instill. Let's do a find. The final poll of question here is if you're not mandating the vaccine, but encouraging the vaccine, What actions have you taken. So this will be just a way for us to get a sense of how many people are doing what, what we've described here, which is the cash or gift cards, doing the on site vaccine clinics. Getting paid some time off providing additional information, et cetera. And you know, molly while we're waiting for the results. We all had such a great conversation last week about these surcharges and health plans and how to do it. And can we do it? And should we do it? And Certainly there is a way to do it. You can build a wellness program. It's an activity based wellness program. It's subject to the 30 maximum for that surcharge. The plan still must be affordable. Um, so remember that you can do it. But you really want to go through building that program with advice and guidance of experts in the world of health and welfare programs, especially wellness programs and wellness incentives and surcharges because there are some important compliance complexities to make sure you follow. Okay, great. All right, tucker. How about the results of that whole? All right, interesting. So obviously giving information that's key. We all need to be educated. Giving time off certainly 53 23 or providing that on site incentive? Excuse me. The on site vaccine clinics and then 15% are doing uh, either a cash or gift cards cards. What are you, what are your thoughts about that? Does that seem about reasonable and what you would have expected carry? Um yeah, that makes a lot of sense to me. And a lot of companies are still at that education that education spot and there's a whole lot I want to unpack here and I know I'm tight on time so I'll try to be distinct. I love what the HR person said in your roundtable about going backwards to the people who had already become incentivized and a lot of employers feel kind of stuck right now. All right. I really want to build an incentive program, but I feel compelled to make the people who were excited and eager and ran out and got vaccinated in the beginning. I feel like I need to make them whole and reward their good behavior along with everyone else. So it's definitely consideration Walmart or Walmart I picked on them all the time. But this is a good walmart example. They had initially come out of the gate with $75, bumped it up to 150 and went backwards and made everybody whole who had been previously vaccinated. So I thought that was crazy for those of you who are doing the on site clinics remember that that process has to be separate and apart meaning the employees should be able to meet with the health care official have the vaccine administered in a confidential quiet location where nobody can over here the conversation because the health care officials asking medical questions prior to administering the vaccine. Also remember for the on site folks that your incentive must be de Minimus. It cannot be coercive. So you don't have the same freedoms that a voluntary program would have from an incentive standpoint. And lastly for those of you doing cash programs. Remember that anything more than de Minimus is taxable under the I. R. S. Code. De Minimus under the I. R. S. Code is 2025 bucks. So anything above that is taxable wages. Um It must be included in their W. Two gross wage program from a PTO standpoint. I know that we saw a headline from another airline that's denying um Actually two of the airlines are denying Covid paid time off for people who become sick with Covid and are unvaccinated. Be very very careful here. Think about what happens when you become sick with Covid and need paid time off for wage replacement benefits. It's possible. You're also FMLA or you're also a D. A. So then do you create a risk of discrimination under a D. A. Or a family by denying the wage replacement benefits? Um I think that's that's all I had to unpack there? Well that's fantastic at the clock and like oh no no that's that's fantastic. That's fantastic. I was just screwing around because my back my laptop was about, my laptop was about to go out. All right. Carrie final comments or thoughts for the crowd, I mean this has been particularly helpful, I think. Certainly hearing and getting a framework from dr Cullen, uh, hearing your practical advice as well. What's your parting thought to employers at this point? As I see it the role of the employer. We've moved from whatever can be or has been the encouragement, the education of the government. Right? I mean, so government officials are really trying have been leading the charge. They're almost like shifting now to the employer and really focusing in on, uh, the role that the employer can play. What are your parting thoughts on that? I mean, how do we best embrace that? So, I think, you know, Winter's coming literally and figuratively, and we are seeing government involvement on an increasing rate around the mandatory vaccines. Were seeing states, we're seeing cities and we're seeing both sides of the fence. Guys, we're seeing states and cities come out against employer mandates and prohibiting employer mandates. And we're seeing states and cities require it or require it for certain industries. So, this is not a try this at home. Right? Don't try this at home. Talk to your outside counsel. Talk to the catapult folks, proceed with caution. Get good guidance. Get good support. Um, and make sure that your program is built in a way that's compliant and provides the health and safety for your employees. That you're striving to provide the other party thought I'll have and I'll do it in 30 seconds. I'm getting tons of emails about employers administering the home based rapid test. Please do not get involved in swapping your employees or having your employees swab themselves in the workplace. It triggers OSHA, it triggers specific healthcare regulations under OSHA. Our recommendation is right in line with DR Cohen. The pcR test is the gold standard. It's the most reliable. Please send employees to labs workout contract pricing and rely on medical professionals. Great, great, great, great, great advice. A couple of things in in wrapping up. Certainly Dr Cohen slides, we will make those available to everyone. There's a follow up email that comes as a result of your participation in today's event. There will also be a link for recording so feel free to watch it again, pick up some of those tidbits that dr Cohen or carry shared as well, share it with other people in your in your workforce. We do these kinds of sessions so that it is in fact helpful and impactful in your organization and sometimes you're hearing it and then saying, hey, I heard this really cool thing. Um this is what other employers are doing. We will also share that poll information and probably look to make that live uh in other events that we're having so that we can continue to have robust data for you as an employer as you're making decisions on these critical and and so important issues carry you have as always been um, and will continue to be one of my most favorite guests. We have a great time, I think, trying to work through those issues and, and sharing that. We do have a set of resources that are available to all of our member companies through our Covid site, so feel free to get there will also give you some of those links when we send out the follow up Kerry and certainly to dr cohen this has been a particularly productive and helpful and timely event I think for all of us. So thank you so much and we'll see you soon. Take care and be safe, everybody. Bye.