Six weeks after we first heard from Baptist Health South Florida physicians and leaders on the front lines of the Coronavirus pandemic, we checked in with them again for an update. In the wake of this summer’s surge in cases, find out where we stand now, what has been learned and what’s next for our patients, our healthcare system and the communities we serve.
The panel discussion, moderated by Dr. Jonathan Fialkow, included Michael Zinner, M.D., Chief Executive Officer and Executive Medical Director at Miami Cancer Institute; Yvonne Johnson, M.D., Chief Medical Officer at South Miami Hospital; Samer Fahmy, M.D., Chief Medical Officer at Boca Raton Regional Hospital and Rachel Evers, MSN, Director of Surgical Services at Baptist Hospital.
(Note: This discussion is excerpted from a Resource Live streaming event which can be viewed on Baptist Health South Florida’s Facebook page.)
For more information about COVID-19 please visit BaptistHealth-coronavirus.com
Six weeks after we first heard from Baptist Health South Florida physicians and leaders on the front lines of the Coronavirus pandemic, we checked in with them again for an update. In the wake of this summer’s surge in cases, find out where we stand now, what has been learned and what’s next for our patients, our healthcare system and the communities we serve.
The panel discussion, moderated by Dr. Jonathan Fialkow, included Michael Zinner, M.D., Chief Executive Officer and Executive Medical Director at Miami Cancer Institute; Yvonne Johnson, M.D., Chief Medical Officer at South Miami Hospital; Samer Fahmy, M.D., Chief Medical Officer at Boca Raton Regional Hospital and Rachel Evers, MSN, Director of Surgical Services at Baptist Hospital.
(Note: This discussion is excerpted from a Resource Live streaming event which can be viewed on Baptist Health South Florida’s Facebook page.)
For more information about COVID-19 please visit BaptistHealth-coronavirus.com
Announcer:
At Baptist Health South Florida it's our mission to care for you when you're injured or sick and help you stay healthy and fit. Welcome to the Baptist HealthTalk podcast, where our respected experts bring you timely, practical health and wellness information to improve your family's quality of life.
Dr. Jonathan Fialkow: Hi everyone, I’m your host, Dr. Jonathan Fialkow, I’m the chief population health officer at Baptist Health South Florida and a cardiologist and certified lipid specialist at Miami Cardiac and Vascular Institute. Back in July, at the height of this summer’s COVID-19 surge, we brought you a discussion with some of our physicians and leaders about the realities they faced while battling this pandemic on the front lines. They shared their expertise and their personal experiences with treating patients during this crisis, in a very emotional and powerful episode.
Dr. Jonathan Fialkow: It’s nearly six weeks later, and while the pandemic is still with us, the numbers of COVID cases are now returning to pre-surge levels. We thought it was a good time to revisit our discussion to see where we stand now, what we’ve learned and what’s next for our patients, our healthcare system and the communities we serve. Once again, the venue was an episode of Baptist Health’s Resource Live program. You can find a l-nk to that video in the notes for this podcast.
Dr. Jonathan Fialkow: As the host, it was my pleasure to welcome back three of our original guests: Dr. Yvonne Johnson, Chief Medical Officer for South Miami Hospital; Dr. Samer Fahmy, Chief Medical Officer for Boca Raton Regional Hospital; Rachael Evers, Director of Surgical Services at Baptist Hospital. And we were honored to be joined by Dr. Michael Zinner, Chief Executive Officer and Executive Medical Director at Miami Cancer Institute. Let’s listen in:
Dr. Fialkow: So, let's get started both as an update. And again, I'm asking you to share your knowledge as well as your personal experiences in dealing with COVID as leaders. What are we seeing at Baptist Health across the system now? I'll ask Yvonne little update compared to a few weeks ago. What are our trends? What are we seeing from a number standpoint? Can you update the viewers?
Dr. Johnson: Sure, I'm really pleased to tell you that after a very crazy late June, July through mid August, we are finally seeing our numbers decline of COVID patients that have to be hospitalized. So we're really pleased that our numbers are down probably about 30% compared with a couple of weeks ago. But I do wanna say that even with that decline, the numbers that we still have in our hospital is about at the same level as our peak was back in March and April. So that just tells you how bad things were but how much better they are now. So that's great news.
Dr. Fialkow: And I think the amount of people being discharged is more than the amount of people coming in, which helps us take care of anyone with medical problems, which always remains the concern when we fill up with COVID patients, is how can people get care otherwise? So that is very encouraging. Rachel, again, you were very impassioned in relaying the experience of the nursing staff. Talk a little bit about what's the mood at the hospital and the health system now from your experiences and the people that you work with?
Rachael Evers: Sure, every day we see those discharged numbers goes up and we celebrate. We watched the numbers of the admitted patients closely. As we see those numbers go down like Dr. Johnson said, we are very hopeful that maybe we can get through this. We're here, we're taking care of patients like we do best and happy to serve our community. The overall mood of the nurses and the healthcare provider team, is overall hopeful that we're gonna get through this but we need everybody's help out there in the community, as things do start to open that we don't have a surge again. So we need to stay vigilant and we need to not relax in our practices and make sure we really do the things that we know work to prevent the spread of this disease, 'cause we all wanna go back to finding our normal.
Dr. Fialkow: So again, optimistic but not complacent. I think it's always remember that messaging. We're not out of it, it's more controlled but the measures we put in place need to be continued and enforced. Samer, can you speak a little bit about, and again, I'm bringing up questions related to what's out there in the community. The age of the patients, there's a, there was some reporting that these were younger patients, is that true in our ICU? So what are we seeing from the patient population that we have at the hospital right now?
Dr. Fahmy: Yeah, that is a good question because there is a misconception out there that if we're getting a lot more younger patients getting infected, that we may be having a milder outbreak of the disease. But it doesn't always translate that way. The problem is the people that end up getting really sick are the older patients. So if there's a lot more younger patients getting, catching COVID-19, than the transmission to older folks results in more older folks being admitted to the hospitals. And we know that when somebody that's elderly gets really sick with COVID-19, they ended up in the ICU and if they end up in ICU, it could be a prolonged illness. It could be three, four weeks before they're leaving the hospital. And honestly, after that long in the hospital, in the ICU, you don't leave the same person as when you came in, you're much weaker and you need much more time to recover. So yes, the overall trend in the countries that we're seeing the average age of infection being around 40-41 years old, but the average age of those being hospitalized is older. And the average age of those being truly impacted by it, really negatively to the point of where they pass away from the disease. Those are the much older folks. You get to the '70s and '80s and your chances of survival are much, much less.
Dr. Fialkow: So following through on what the viewers are gonna see us pounding into their brains is that don't get complacent. You were mentioning that the people who are sick still remain very sick, there is a certain percentage especially the older you are, the higher the risk of dying from COVID. So we don't wanna think that's changed necessarily. And going back to complacency again, I'm gonna throw this at Yvonne and anyone else who wants to add anything. Miami-Dade, it was just announced that our restaurants will have a limited opening next week. And this was after months of closing other than outdoors. It kinda sends a message of normalcy. Is it normal, Yvonne? What, how do we make sure this doesn't lead to another surge like we had a few months ago?
Dr. Johnson: Yeah, I think that we have to accept that until we have a vaccine for this disease, we have to have a new normal. So we are going to get to go back to restaurants and there'll be opening the inside of restaurants. And we also know that it's much easier to transmit this disease when you're inside as opposed to being outside. So you have to be extra careful. You have to make sure that the seating is appropriate so that you are apart from the people at other tables who are not part of your seating group. You wanna make sure that whenever you get up from your table, that you're courteous to the other diners, so that your, put your mask back on while you're going, walking around the restaurant or going to the restroom. It's really difficult to socially-distance inside of a restroom. So make sure that you're wearing your mask when you go in. And really the only time that you should have your mask off is when you're eating and drinking at your table. So we really wanna be careful because we don't want to have an increase in the transmission of this virus as a result of opening up 'cause we wanna be able to stay open, we wanna be able to have our new normal and allow the hospitals to be able to function the way we want to function, as you mentioned, to take care of all of those other things besides COVID-19.
Dr. Fialkow: That's great, we do recognize that certainly months into this people are stressed, they're anxious. Again, they want that sense of normalcy, which goes back to why we want people to exercise, we want people to go outside. We don't want them to be locked in their houses but again, with reason, with proper precautions and going to a restaurant could be okay but obviously, it's not that we're back to normalcy. There's still a lot of COVID and COVID related concerns we still have. I'd like to turn it over to Mike Zinner, who's led a lot of the efforts towards our surgical recovery, as well as of course the Cancer Institute, we're seeing lower numbers of COVID certainly in the hospitals. Mike, how about an update about where we are with elective procedures and how we're addressing, who should have something surgically done to them, that's necessary where before we might have been very strict about who would be able to come to the hospital for a procedure?
Dr. Zinner: Yeah, thanks Jonathan. So we've gone through two cycles in the last two months. And the first cycle was when the first wave hit us in mid April. We shut down all elective surgery. Now certain kinds of surgery were permitted, certain kinds of cancer surgeries really can't be delayed. And then when we got into a lull in may, early may, we opened a backup only to hit this second surge again. And then we had to shut down again for elective surgery. And during that period of time, though, we still needed to do certain kinds of cancer patients, cancer patients by definition are a special group of patients and we couldn't delay them. We could delay many of them by changing the order of chemotherapy versus radiation versus surgery. A lot of patients get all three. And so if we did the chemotherapy upfront and delayed surgery for a couple of months, we bought some time for these patients, so we didn't think they were affected. But now we're entering the phase where pretty much through the system, we're opening it up to elective surgery.
Dr. Fialkow: And that's true at all the hospitals in the system, or…?
Dr. Zinner: Yeah, I was just gonna say that. Not 100% all through. So, at the flagship hospital, which still has a lot of patients in the ICU, I mean more patients in the ICU, then we feel comfortable bringing in other patients that may require ICU care. We're still holding certain kinds of cases that may require intensive care monitoring. But if a patient has day surgery or overnight surgery across the system, we're totally open. Through most of the system, and I'd say 8 out of the 11 hospitals have pretty much opened up to all kinds of surgery. And so what I tell patients is, it's now time to come back, it's safe to come back and it's important to come back for your own care.
Dr. Fialkow: What would you say the experiences of the Miami Cancer Institute team has been through at the COVID pandemic?
Dr. Zinner: I would say 85 to 90% of the patients that were under active treatment, continued under active treatment. They had to, it's the nature of the disease. Now, what did we change? Well, the things we had to change like, in-person meetings with your doctor, we switched to tele-health so that we were now doing 40, 50, 60% tele-health in those patients that we could. In addition, what really has been a challenge for all of us is the preventive screening activities associated with cancer. So, we know at our own institution and we also know nationwide that screening for cancer is down as much as 40%. And that was during the peaks of the COVID period. And so now it's time for those patients who need breast imaging, who need mammography, who need colonoscopy, who need chest CT scans for their potential lung cancer. Those patients need to come back. It's safe, it's timely and you need to be responsible for your care in those areas.
Dr. Fialkow: I can't tell you how much I appreciate that. And flu vaccines and all the other preventive strategies need to continue and actually be even more importantly performed as people might've been afraid to do those things during COVID.
Dr. Zinner: Absolutely.
Dr. Johnson: Jonathan, I'd like to just add to what Dr. Zinner has said because I went and had my mammogram and other studies done that I do on a yearly basis. So I just wanna assure the public that we really have a safe environment. In fact, I feel safer coming to work everyday than I do going anywhere else in my day. I, whether it's going to the grocery store or anywhere else, this really, we take extreme precautions. This really is a safe environment and we absolutely need people to get the kind of screening that we recommend on a yearly basis. So I did it personally, I just wanna encourage that.
Dr. Zinner: Jonathan, let me give you a couple of numbers that sort of put that in perspective. So here at the Miami Cancer Institute, we have 1600 employees. In the six-month period since COVID, we've had only about 5% of the patients testing, I mean, of the staff testing positive. Of those that tested positive, we, by identity and contact tracing know that two thirds of those were actually picked up in the community, not at the building. We have 23,000 employees system-wide all through our 11-hospital system. We know we only had 4% of those patients, I mean, sorry, again staff that tested positive. And we know by contact tracing that 80% of those were picked up in the community. So, I can really look the public in the eye and say, it is a safe place to come back to. And it's time to come back.
Dr. Fialkow: Well said, I was gonna bring that up exactly, the same thing in our cardiovascular experience, the positive employees are traced to actually have the context, it's safer to come to work than it is to go do what they're doing at home in terms of getting exposed. And as a practitioner and the others as well, we constantly have to answer from people. Is it safe to get this test done? Is it safe to get this done? And quite honestly, we can tell them, yes, the test is important or the procedure is important. You will be safe. And I wanna bring something else out that doctors and I brought up is, the telemedicine, think how rapidly the medical community had to convert from thousands of patients scheduled for visits to rapidly change them to using technology to virtually have those visits. I would say the safest PPE, the safest protection is a telemedicine visit. So, keeping that in mind again, when we look at how Baptist and the medical staff and the centers of excellence have rapidly adapted to the needs of the COVID experience. Rachel, again, patients were concerned about being in the hospital. They weren't allowed visitors. You spoke about, and you can reiterate, what's been done to make that person feel cared about, the nursing staff, a connection, video screens. Where we are with visitor policies from your, for a Baptist and the other hospitals right now?
Rachael Evers: Well, each entity is looking at the visitor policy and each entity is setting their own guidelines depending on kind of like Dr. Zinner was talking about, what the population is looking at in actual hospital? So some hospitals are open to visitors. Some hospitals have certain visiting hours, others haven't opened yet but are planning to in the next few weeks. It's important just to check with the hospital. We obviously, always have those exceptions for labor and delivery patients. Major surgeries, we allow exceptions for because we understand the importance of your support in healing. And so, in the instance that a family can't be here, of course we do updates through the patient experience team with the intensivists . We have zoom calls, we have virtual visits. And like I said the last time, no healthcare provider in this hospital will ever allow your family to be alone. We step in, the nurses, the respiratory therapists, the turn teams, every single, the people who work in the cafeteria and deliver your tray. No one in this hospital is alone. We all treat them like they're our own family because if the roles were reversed and we were here in the hospital, we would want that same love and care and connection 'cause it's so important in the healing process.
Dr. Fialkow: In a sense, I'm gonna ask each of you guys this question. We've learned a lot over the last couple of months from not just the virus and the physiological and clinical aspect but how we as a community and as healthcare providers deal with it. Can you speak a little bit to what you've seen as the market changes? And it can be very broad. It can be about testing, it could be about contact and transmissibility. Do masks work? Yvonne, I'll ask you first, where are some of the things that you think are the most, I'll say exciting but the most important things we've learned over the last couple of months?
Dr. Johnson: Well, I think we've definitely learned that masks work and social distancing because those are the practices that supported exactly the numbers that Dr. Zinner pointed out that this is a safe place. But I'll tell you what I've learned is really about the people that I work with. And how committed they are to their jobs and-* this community. The physicians, the nurses, the respiratory techs, the environmental services people, the dietary people, it was something that we talked about before that we took an oath but I have watched my colleagues live that oath now. And I have been so impressed and so proud to be a colleague of all of the staff who work within our health system because they have really stepped up. They've put themselves out there, they've taken risks at a point where they didn't know what the risk is. At that time, and they've cared for this community. And exactly what Rachel said, that you watch the nurses become the families of those patients because the families couldn't be there. And it's just been an amazing display of humanity and professionalism.
Dr. Zinner: Yvonne, I echo your sentiments. I tell you one of the other lessons learned though, and this is a challenging time more than just COVID. But it's so important to follow the science and medicine about this. And the problem about following the science and medicine is, it does change as we learn more about this unusual disease. And I think that's a message I wanna make sure people get out. Follow the science and the medicine. It's really important.
Dr. Fialkow: Right, and it may, as you said, change, so what might be expressed and recommended one month with more knowledge, we may change that, it doesn't was wrong at the original time, at the original recommendation. So I think that's well said.
Dr. Zinner: We know so much more now than we knew in April, in March and April. And we're treating people with things we didn't even know we had before when we used to throw the kitchen sink at them. And prayed that they would work. Now, we're better at it now. And I'm very optimistic about it.
Dr. Fialkow: Rachel, anything from your space that we've learned that is very encouraging?
Rachael Evers: I will tell you along with Dr. Johnson, just the beautiful resiliency of the people who work in this facility. We've asked people to do things that they've never done before. People have grown, they've changed, they've blossomed. They've shown their true skills. And also I've learned that you have to celebrate just the small, beautiful parts of life and don't take anything for granted. And really enjoy that quality with your family. And be a little unplugged, and stuff and enjoy the world.
Dr. Fialkow: Well, Samer, I'm gonna have you answer that question and then I'm gonna get back to you 'cause I haven't heard from in a while about some science. So first, where would you see, from your experiences we've learned that, what we've learned has made the most impact?
Dr. Fahmy: Yeah, so looking back at how we approach treatment in March versus how we approach treatment today, I think it's quite a bit of difference. Like Dr. Zinner said, we've learned a lot as the pandemic progressed, we've learned a lot from trials that have been ongoing for the last six months. Now a patient comes into the hospital that has COVID, they're getting things like dexamethasone, which we know now works. They're getting things like remdemsivir, which we know that for certain populations works. And they're getting things like convalescent plasma, which again, there's more encouraging evidence that, that works. We're able to get test results much faster than we did even a month and a half ago. So things have been progressing. And as the science available changes, we're changing our treatment plans. We're changing the approach to somebody that's in the ICU versus not in ICU and how do you treat them? Somebody that's coming into the ER and not very sick, how do you treat them? And one of the main things is, initially we thought that an early intubation strategy would work really well. So if somebody is really having a tough time breathing that it's better to get them on a ventilator quick, so you can help them breathe and help them recover faster. And the more we've learned, we've learned that delaying that a little bit and giving somebody a chance to fight through it on their own, actually has more potential benefits. So, again, our strategy towards our approach towards treating somebody who's sick with COVID-19 has been constantly changing over the last six months. And I think we're in a better place now than we were.
Dr. Fialkow: And I think we're all confident in a couple of months, we'll be even better than where we are now in terms of our knowledge of what works and what not to do, as well as what to do. So talk a little bit about plasma, you mentioned a convalescent plasma. We spoke about it last time. The FDA issued the emergency use authorization of convalescent plasma. First, can you explain what the EUA is? and why is that significant versus some of the other measures you mentioned?
Dr. Fahmy: Sure, so the FDA did issue the emergency use authorization for convalescent plasma just on several days ago. And, and just to be clear, that is not an FDA approval. An FDA approval requires an extremely high degree of certainty that something would work. And that's why it's approved. An emergency use authorization is a promising therapy that has enough data to be able to push it to that level of emergency use. In the setting of a response to a national emergency or an emergency in an area. So, we know that COVID-19 is impacting society in multiple ways. We know that lots of people are suffering and dying from it. So any promising drug that has, again, encouraging evidence behind it could rise to the level of this emergency use authorization. So , what we know from plasma is that, at Baptist Health, we have been using it since March and April, since the onset of the pandemic. We've infused over 800 patients with convalescent plasma thus far, but we continue to do that. And in short, convalescence is the recovery period, after you get over or recover from a disease. If you take the plasma which is blood that has spun down, and you just take that, you take all the cells out and you leave the serum behind, that serum has antibodies that can help others fight the disease. Several days prior to this emergency use authorization, one of the bigger clinical trials that Baptist Health participated in, the Mayo Clinic trial with over 35,000 patients being reviewed in April, May and June, were found to have some mortality benefit depending on the level of antibodies in the plasma that they received. So, for those people that got higher level of antibodies, they seem to have lower rates of mortality. And for those that got plasma that had lower levels of antibody or not as much antibody, then they got a, they didn't have as much benefit in terms of mortality, less mortality benefit. So that's not the typical type of trial that would lead to an emergency use authorization. Normally you would need to divide up two groups, give plasma to one group and not give it to the other group and then see who does better. This was done in a way where you look back at people who were treated and try to extrapolate whether that was, whether there was a real difference in those who got high level versus low level antibody plasma. And it was just enough evidence to push it through the EUA threshold. But we're still anticipating that we need randomized control trials to be able to prove this therapy works. We're optimistic that it works. We're optimistic that it helps but there's no doubt there needs to be a higher level of evidence and randomized controlled trials for us to know for certain that it helps people.
Dr. Fialkow: I got a question from a viewer, it's a loaded one. So, I'm not gonna pick on someone. I'll ask for a volunteer but I will pick on someone if we don't get one. And it says specifically, thoughts on the CDC surprise guidelines that people without COVID-19 symptoms don't need testing? Who'd like to tackle that one?
Dr. Fahmy: So maybe I'll take a stab at it. So we know that asymptomatic transmission from COVID-19 exists. We have seen it, we have traced back contacts that have been positive with no symptoms after being in contact with somebody else that has no symptoms. So, we know that, that exists. M any of us believe that the transmission from asymptomatic people is lower than the transmission from somebody that has symptoms. So, there's a level of optimism there that if you're not coughing and if you're not sneezing, and if you're not having a fever, short of breath, that you should be transmitting it less. Does that mean we should be not testing everybody without symptoms? I still believe that if you have a high-risk exposure, if you were in really close contact with somebody that did become sick with COVID-19, then you should get evaluated by a doctor and you should decide how high a risk that is. And based on your and your physicians conversation, depending on the level of exposure, you should make that individualized decision whether to get tested or not. And I think that's a decision between a patient that has been exposed and their healthcare provider.
Dr. Zinner: Jonathan, I feel like I wanna weigh in on that too. At the Cancer Institute, we treat a group of patients that, by definition, have compromised immune system, by definition have compromised immune system. I wanna know whether or not the patients coming in and the visitors coming in, that are accompanying them have COVID or not because they could be in proximity to the patients that I'm worried about caring for under treatment for cancer. So I read the CDC guidelines but frankly, at our institution, we're gonna be a little more conservative than that.
Dr. Johnson: And Jonathan, I think that people need to make that decision as well for themselves and their families. If you go home to somebody like Dr. Zinner just noted, whether it's cancer or heart disease or somebody who's at high risk, then you need to know that whether or not you have COVID and are potentially bringing that back home. So, I think we need to keep our bubbles safe.
Dr. Fialkow: Let's just wrap it up with a few other points. So Yvonne, let's talk about what we would recommend to someone who has mild symptoms. I mean, the person just feels on the like, and feverish. Would we want them to go to the emergency room 'cause they may have COVID, where would we let's say mild symptoms, modeled with little shortness of breath, and of course the person who really can't breathe or is really having trouble. What pathway should they take to get evaluated?
Dr. Johnson: Well, I think that anybody who has mild symptoms should call their doctor. And if you don't have a private doctor, you can certainly go to an urgent care. The other thing is, if you're having concerns and you do decide to go to the emergency department, they may not decide to keep you but they can monitor you.
Dr. Fahmy: One other area to add is that, one of the tools we have at our disposal now is telemedicine. And I think the Baptist Health offers Care on Demand, which is an outstanding service as a first-line in terms of, if you're not sure where to go or whether to go into an ER or whether to go into the doctor's office, Care on Demand demand can help guide you. It can help guide you in that direction. It can help tell you whether you need to escalate and go to the emergency room, whether things look concerning or whether you can wait and monitor your symptoms. So I would highly advise that as a first line.
Dr. Fialkow: Very well said, and again, the cardiology speaking, at the same time if you feel you can't breathe, if you're having crushing chest pain, if you have weakness on the side of the body, call 911, don't delay getting Care or other medical conditions because you're concerned about a COVID exposure in emergency room. You will not be exposed to COVID patients in the emergency room. That's not the way we set up at Baptist. Again, great information, again, a testament to our leaders and our team at Baptist and the organization. Any final comments, I'm gonna go to each of you. And I want you all to say, wear masks, social distance, wash your hands. Yvonne?
Dr. Johnson: Absolutely do all of those things. That's what gives you power. We wanna stay open this time. We want to, as things keep opening up, we need to do it safely, wear your mask. Do all of those things because that's the power that keeps us in our new normal.
Dr. Fialkow: Mike?
Dr. Zinner: I totally agree with those three elements. Three more: be proactive about your health, realize this is a safe place and don't delay care.
Dr. Fialkow: Sam?
Dr. Fahmy: As we start opening up more and as restaurants start opening, and as we start maybe going up some football games, with social distancing, I think people just have to be conscious of who's around them and how close they are. And avoid these large crowds and not standing in line close to each other. Some of these things if you're aware of your surroundings and you keep your distance a bit more from others, it'll protect everybody.
Dr. Fialkow: And Rachel.
Rachael Evers: Yes, please wear your mask. Don't let your guard down. Remember to keep your circle close and tight but stay safe apart. And just remember to keep to the basics and make sure we don't have this surge again.
Dr. Fialkow: Thank you for listening. I hope you found this episode informative and enlightening. As always, if you have any thoughts, ideas or topic requests, please email us at BaptistHealthTalk@BaptistHealth.net. Until next time: Stay safe and mask up!
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