We are going to break this up by age for democrats only. If you are under 25, we want to hear from you at 2027488000 . If you are a democrat between 25. Nd 50, 2027488001 50,ou are a democrat over 2027488002 . You can always text us at 2027488003 and we are always reading on social media and facebook. Here is what he had to say about the accusations. [video clip] excuse the graphic nature but i want to make sure there is no question as to what we are talking about. 1993, he pinned her against the wall, reached under her clothing and penetrated her with your fingers. Would you please go on the record . Did you sexually assault tara reade . Happened. R, never it never happened. Do you remember her . Do you remember any type of complaint she might have made . I do not remember any type of complaint she may have made. And i dontars ago member nor does anyone else and i do not remember any complaint being made. Have you or your campaign reached out to her . No i have not. It was 27 years ago and this never happened. When she first made the claim we made it clear it never happened and it is as simple as that. In past 30 minutes, you wleased a statement and you complaintes only one this could be at, the national archive. Ask the archives to identify any record of the complaint she alleges she filed. If there was any such complaint, the record will be there. Are you preparing for a complaint that might be revealed . Are you confident there is nothing . I am confident there is nothing. No one ever brought it to the attention of me 27 years ago. Of in myam aware campaign, my Senate Office at the time, is aware of any such request. Or any such complaint. I am not worried at all. If there is a complaint, that is where it would be filed and if it is there, put it out but i have never seen it. Interview was an former Vice President joe biden msnbc. Emerson b he also placed a statement on medium. Com responding to the accusations. Tara reade actually did an tverview last month on hill where she talks about these allegations. Heres what she said. [video clip] someone, talking to went away, and then it happened in one motion almost. He happy against the wall and then he was down my skirt and up my skirt. I was not wearing anything. [indiscernible] it was hard to talk about because everything was happening at once. Host we are asking for democrats only on the Sexual Assault allegations. We will start with shirley who was calling from South Carolina. Good morning. Caller good morning. I am going to vote for joe biden. I do not believe this woman. She never should have come out with this comment. She should have come out before. Be votinge and i will for joe biden. All of my friends and family so they are going to vote for joe biden. Host you say you are going to vote for joe biden in spite of allegations . Caller in spite of the allegations because i do not believe it. Host you do not believe they could be true . Caller no somebody put this woman up to this. Look at what we got in the white house . Wives, all those different children, all those complaints about him and all these other women. I am voting for joe biden and that is all i got to say. Host lets go to amos whos calling from texas. Good morning. Caller good morning. I will also vote for joe biden. Choice but heirst is better than trump. Is n concern [indiscernible] bush, biden, trump all have some sexual issue with women. What is it with these wet president s that there is always issues with sex . I dont understand that. I will be voting for joe biden. Stony fromgo to washington, d. C. Caller im a 77yearold democrat and im definitely going to vote for joe biden. I really believe him. He is a great man and i am surprised the president is still in office. My wife was telling me something amendmentrticle 25 or 25 that he could be removed if he seems to be unfit. I really believe in joe biden. He isan honest man and really for america. I dont think it is true and i was surprised mika was hounding him on the program. I was really disgusted with that interview and im definitely going to vote for joe biden. Host lets go to justin who was calling from amarillo, texas. Good morning. Caller hello, jesse. How are you doing this morning . Host i am doing good. Go ahead. Caller i just wanted to say i believe joe biden and i do not believe this woman who suddenly came forward. It is kind of funny president allegationsl these but nobody is up in arms about that. Alongn as biden comes everybody is up in arms and all over him. I dont think the allegations are true. Host lets go to curtis calling from jacksonville, florida. Good morning. Caller good morning. Believeyears old and i Vice President biden. It is ironic that at this time in america, with this president we have an office, with all of his scandals, this should be no surprise to anyone they do not come up with a game, a trick, like this. Host a lead of the conversation has been around why did it take so long for these accusations to come out . We are in a different era where we see more of those accusations. Whether they are true or false they are becoming public. You think there is any chance they are true . Caller not with Vice President biden but when you talk about president trump, yes, i believe all of it is true. You heard with his own words what he would say and do with women because he could get away with it. I do not believe they are true about biden but when it comes to the current president , anything is possible that is illegal. Host lets talk to eddie from georgia. Calling from georgia. , we sawdonald trump this before we got a president. Accusations but they swept that under the rug. Manink joe biden is a good us all inody has their past. They are trying to Say Something very bogus. I dont think he did that. And Everybody Needs to back him because he is a good man. President trump tells 300,000 lies a day but the republicans want to sweep that under the rug. Host do you think former Vice President joe biden needs to continue to talk about this publicly or do you think he should just not say anything else about it . Caller well, i think he came out and said enough. He just needs to do like donald trump. When they get on the subject, he needs to change the subject and tell them what he wants to do for america. That is what he need to do. He needs to return back like obama was in office. Up and donaldame trump wanted to blame somebody else for the problems, so they and do whattogether needs to be done for the american people. That is what i think. Is false because we can hear in his heart he did not do it. They always do that. Bring up something 3040 years ago. Host on friday, nancy pelosi came out and addressed some of the allegations against joe biden. Here is what she had to say. [video clip] as far as biden is concerned, how do democrats they are standing by him but there is a different standard with kavanaugh when a very similar allegation came out. Let me just say, i respect your question and i do not lead lecture. Me ve full respect for the too movement. There is a lot of excitement that women will be listened to. Ande is also due process the fact joe biden is joe biden, there has been statements from his campaign not his campaign but his former employees who rent his offices there was never any record of this. Forward to saye something about it apart from the principle involved. I am so proud the happiest day can be this week which is support joe biden for president. He is a person of great integrity, great concern for the american people, he has authored the violence against women act when he was the chair of the Judiciary Committee in the 1990s. He has been an advocate for funding that since then. I believe he will be a great president of the United States. He is the personification of hope and optimism and authenticity for our country. A person of great values. I want to remove all doubt and anyones mind. I have great Comfort Level with the situation as i see it with all the respect in the world for any woman who comes forward. That is what i have to say about that. Thank you. Host lets see what social media has to think about the Sexual Assault allegations against joe biden. Heres a post from facebook that says he is unelectable. If the goal is to simply remove trump, why are we running the candidate with no chance of beating trump . Wherea text that says were the allegations when joe biden was working with obama . I will be voting for joe biden. Trump 25xt says accuser, biden, one you be the judge. Facebook says, trump is worse. 25 women have accused him of assault and rape. Walking in 19 beauty contest to make sexual comments about his own daughter. Just more republicans line. Trailshould be a paper carefully reviewed. This hour is for democrats only. We want to know what you think about the biden Sexual Assault allegations. If you are under 25, we want to hear from you at 2027488000 . Is50 your number 2027488001 . And if you are over 50, 2027488002 . Victoro to victor from calling from florida. Caller there is a lie detector system that is 90 reliable in detecting lies. Ephos, the politician and video will not talk about it. The police have been using this to get people out of prison who say they are innocent. They test them and proceed from there. If they pass the test, they tried to get them out of jail. There is also a lot of women who have been exploited not by joe biden but people in power. If they use the test and the media promoted it, fox would not have been able to get away with it. Host how do you make politicians take the test . Caller pass a law. They wont pass the law but youve got to pass the law. Write your congressman and tell them you want them to pass a law and you need to bring them on your show. Hos lieple from cep detector. Make it public so people know we have the technology to stop the liars. Host lets go to audrey calling from georgia. Good morning. Caller good morning. Voting for joe biden. This is the third time he has run for president. He was Vice President for eight years. Why did these allegations not come up during all of these other times . I am not saying this lady is lying because i am a mother of two daughters and i think any woman should be heard. But dont drag somebody down. We have got enough of that would donald trump. Donald trump would lie before god got the news. I am not going to say he did not do anything to this lady or any other but i am voting for him because i believe in joe biden. I think the lady should be heard. Heardjust let her be but make sure she is telling the truth and not being paid to do this by the Trump Administration which is what i feel like is happening. Host lets go to renee calling from maryland. Good morning. Caller good morning, america. Thank you cspan and jesse for taking my call. The devil is rampant and i agree with the caller before you. A lot of times we women go through things by higher ups. We may be fearful to Say Something because we might be uncomfortable. If this truly happened, the woman needs to be heard but we cannot hold donald trump accountable and tried to hold joe biden accountable. Both of them would have to be held accountable with the same charges. Host what do you need to hear reade tobiden or tara make up your mind . Caller i need to hear from tara reade. I need to hear this actually happened to her. I need her to say what specifically happened and there seems to have been no cameras, no witnesses, i understand she told people. I understand her mother called in to larry king but as a woman, i do not want to say what she said isnt true and i do not know if there will be anything that will calm my fears or make me believe her. But the fact is if donald trump does not hold accountable for the over 25 women, joe biden should not be either. And durings rampant this pandemic, we still have time to be dredging up 30yearold news . Come on. Host the full interview from tara reade is available via the hill tv on their youtube page. You can always go there and see the entire interview on hill tv. Sonovia from georgia calling from georgia. Caller so many people will automatically assume someone is lying because it is an older allegation. I really hope that did not happen to her but if it did, he should definitely be held accountable. Host how do you find out whether this happened or not . It seems like it will devolve into he said, she said. Joe biden says it did not happen, tara reade says it does, how do you find out what happens . Caller there are measures you can take. One of the caller said there are lie detector tests that could be done. There are ways you can do things. Throughout history there have been many men who have been held accountable for allegations without finding out what happened truly. Words always been her versus his word. I think they should definitely investigate to find out if it actually happened. If it was in a public place or office, there has to be someone who may have seen something or a phone call that was made between the two. Something has to be done if that actually happened to her. Host lets talk to tracy calling from jackson, mississippi. Good morning. I dont believe when i heard the story i did not believe it. Because when a point of goes to the ukraineo bribe or hold without giving them money altogether dirt on hunter biden, this is what got him impeached. , after this man has been Vice President two assaulted have been and i do not believe nobody would wait this long. This man has been a vice why did they not do anything . It is hard to believe it happened. If i saw someone who did this to knowing what hes capable of, i would have done something about it then. Where was she . Im sorry if im wrong but i believe trump has something to do with her coming forward. I think it is a bunch of myths he started to get biden out of the way. I am voting for biden. I will vote for anybody but trump. Host the Republican Party is already trying to take advantage of the allegations by putting out advertisements. Campaign, the trump releases there at addressing the ads addressing the allegations. [video clip] a woman came forward. His hands were on me and underneath my close. You have a right to be believed. We are with you. We believe women . Women should be believed. We believe women. I am disappointed there are those who continue to not believe women who come forward. It is not easy. Shes putting herself out there knowing they are going to excoriate her and she has the courage to come forward. She has nothing to gain. What does she have to gain . I stand with survivors. The woman should be given the benefit of the doubt. These old white men are not protecting women. Show the kind of compassion and caring we need from our bidenent and which joe has been exemplifying throughout his entire life. Host that is a portion of a Trump Campaign at that was put out on friday addressing the assault allegations against joe biden. While the Trump Campaign is putting that out, there was a different message from donald trump according to a Washington Post story. Im going to read a little bit. The what has a president Trumps Campaign are seeking to amplify allegations of Sexual Assault against joe biden. Hoping to tarnish him on an issue with the president s own record is checkered. The effort could be thwarted by trump himself who has taken a different tack from that of his own advisors by indicating false allegations against powerful men are the bigger issue. All of a sudden you become a wealthy guy, youre famous guy, then you become president. People you have never seen, you have never heard of, make charges. Interview a radio that he was sticking up for biden anyway. I was said to joe biden, go out and fight it. Trumps comments stood in contrast to officials from the campaign and white house who flooded the airwaves to criticize biden over his response to a former Sexual Assault allegation which biden denied. The president s remarks underscore the challenges republicans will have an attacking the nominee on an issue that dogged Trumps Campaign and i which he remains vulnerable. Once again, we are talking to democrats only about the Sexual Assault allegations. Lets go to debbie calling from flint, michigan. Good morning. Caller good morning. I appreciate you letting me speak my mind a little bit. I do not believe anything these republican say. President who stood up this week and said the palms of his hands were a hard surface. Why would anyone vote for a more on like that . I dont care what any of them do sexually. I really dont. I care about the epa, i care about the deficit. Every time he or his Administration Says transparency the hair on the back of my neck stands up. President ,t eight they have kept a visitor log and this president does not. He does not want people to know who comes into the white house and i have a problem with that. It is not his white house, it is ours. Host lets go to emily calling from massachusetts. Caller good morning. What i would like to say about allegations is what was she doing . If he threw her up against the wall, shes not trying to fight him off. She just standing there . I dont get it. I will be voting for joe biden. Herally dont believe because her story changes and i had heard the lady had on a skirt and no underwear. Who does that . I am sorry. Host lets go to brandy calling from ohio. Good morning. Caller good morning. I just want to say it blows my mind the Trump Campaign would have the nerve to even start a Sexual Assault allegation against biden considering trump came into office as an obvious sexist, racist, etc. He had numerous allegations against him. The nerve, right . Whether biden did this or not, everything he has ever stood for is enough for me. The Trump Campaign is reaching for anything they can. I feel like they know he is close and could actually win the campaign. Go biden. Host lets talk to jamie calling from brooklyn, new york. Good morning. Caller good morning. It is frightening trump could win again and he will destroy this country. My take is i dont care but the democrats, because of trump getting reelected, i do not care about the allegation. Democrats will need their own. Lets have him investigated. Going into the archives, doing msnbc will do something and fox will not. We are not the kind of party that would stop a nomination like they did when the Supreme Court they would not allow us to put in our nominee. Enough is enough with the democrats. If we continue along this line, we will eat our own and lose. People will really lose in this country. He will get rid of daca kids if he can. He is going to destroy his country. I do not care about this but we better stop as a party and People Better react to the news who have to be so honest and liberal. No. They are going to get him reelected. It is going to turn into the clinton emails. Host lets talk to linda from charlotte, North Carolina calling from charlotte, North Carolina. Caller i have never voted before. I am guilty of that because i never felt like we really had a problem with russian president over another. This man, i am forced to vote with donald trump being in office. Honestly, i think he needs to be evaluated mentally. There is something wrong with him. Andhanges with the weather i 100 believe he would pay to complain about joe biden. He would put anything out there with his money and i believe joe biden is a good man. Every man and woman has things in their past and i doubt these are true. I do think they need to be investigated. Host lets talk to larry who is calling from louisiana. Caller glad to talk with you. I have been a democrat all my life. I am 61 years old and i maintain that. If there was something in his closet, this information would have been out a long time ago. We do have a great candidate that is running. This country is going to hell in a hand basket. We have somebody different types of issues with racism and everything is coming back. Democrats,ommend all all over the nation, give this nation a chance to redeem itself and vote for joe biden. Thank you for giving me the time. Biden once again what public with his denials friday on msnbc. Here is a little more from what joe biden said yesterday. [video clip] mr. Vice president , as it highlevelo dr. Ford democrats said she should be believed. You said, if someone like dr. Ford were to come out, the essence of what she is saying has to be believed. No why is it real for dr. Ford but not tara reade . I am not suggesting she had no right to come forward and i am not any woman should come forward and it should be investigated. It should be investigated and if there is anything that is consistent with what is being said and she makes the case or the case is made, then it should be believed. Ultimately the truth matters. Life tot my entire change the whole notion of the law and culture on Sexual Assault. I believe we have come a long way and still have a long way to go before we are in a position that there is a fair and unbiased view. At the end of the day, it has to be looked at. These claims are not true. Hey are not true lets go back to some social media followers and see what they are thinking. Facebook says, anyone who voted for trump has no ground to stand on saying anything about biden. There were multiple stories, with credible evidence, against trump. Text, imther concerned why joe biden is so defensive about not allowing the archives to be searched for complaints pickup. None of this is new. Both parties have suffered from it. Behaviors not political. Theres aays difference between touching a shoulder and then Sexual Assault. She changes her story. Did he touch her shoulder . Yes. Did he sexually assault her . No. I became a democrat to vote for sanders. The allegation should be taken seriously. The Democratic Party and joe bidens hubris is evident they should be looking for an alternative nominee and give tara reade the same platform as tar christine ford. We are going to go back to the phone lines on the Sexual Assault allegations against joe biden. Calling to mosys from maryland. Caller i feel sorry for joe. I feel sorry for the lady as joe has to get past this. He will get past this and going to be a good candidate. Beatroblem is, can joe donald trump . My family has been democrats all our lives. Problem is the there and wee him are just throwing in the towel that we have. We have to just hope he will beat donald trump. Obama, who is a good person to be in his corner, now obama will have problems. He has to have better people behind him them pelosi because she has problems and we have to have a better candidate to beat this guy. A lot of people are saying they do not like him. Host lets go to rosie calling from new york city. Good morning. Caller good morning. Host go ahead. Caller i just wanted to say i do not believe her claims because she claimed they put her he put her against a wall and put his hands up her skirt and he penetrated her with a finger. If they did that to , he would have a hard time to penetrate that finger because i would be fighting back. Wayting back there is no theyre going to do Something Like that. I do not believe her. Yourself in her shoes. If you fight back with all your strength, no one would do Something Like that to you. I do not believe her. Rain, which is the largest antisexual violence organization, put out a statement about the allegations against joe biden. Heres what the statement said. We appreciate joe biden theressing accusations. They require an investigation and we urge Vice President biden to release any and all records that may be relevant including those housed at the university of delaware, in addition to any Senate Records at the national archives. Staff tois former cooperate and provide complete transparency. Lets go back to the phones and talk to morietta who is calling from North Carolina. Caller good morning. Aagree with the previous lady couple of people back. What was this lady doing in the middle of a hallway . A public hallway and all of this is going on . Where were other people . What did she have under her dress . Most people have layer so close beneath their dress so i dont know how he could have done what he did in the middle of a hallway in a public building. True,ly that but if it is i dont care. Up withve had to put that stinking thing in the white house all this time, all the things he has done, as far as im concerned joe biden is just fine. He could shoot somebody in the middle of the street and i will not care because this is our nominee and we are going with him. Thank you. Host lets talk to debbie calling from austin, texas. Caller good morning. I just wanted to point out good morning. Host we can hear you go ahead. Joe biden has been vette d so this would have come out before if somebody was digging and allowing to him run for president. Out would have already come and if this were real i think it is another deal of donald like, why is everybody picking on him . It is always this thing with the and trump isbidens always picking and biden. Host let us go to ij calling from maryland. Caller good morning. Storyn as he heard the you could tell they live. There is no way that couldve happened. Youould not Sexual Assault in a hallway. This woman is paid to come out and say what she is saying. Either way, it does not matter. Joe biden has to be our next president. Callingts go to gay from greenville, North Carolina. Caller i definitely plan to vote for joe biden. I think the young ladys accusations should be investigated but i think they will be found to be untrue. I agree with both previous callers from North Carolina. There is something mentally wrong with the current president and i think this is just another shiny object the conservative media is throwing out because downdent trumps polls are and he is doing a completely incompetent job of handling this pandemic. I hope everybody has a wonderful day and stay safe. The new White House Press secretary was asked about joe bidens denial of the allegations. Heres what she had to say. [video clip] former Vice President joe biden denied allegations. Has donaldnt trump taken them as word . We are pleased the former Vice President has decided to go on the record. It took him less than 16 hours to follow the advice of the president. We are glad to see he is on the record. Let me ask you both the president said. He said tara reade is far more compelling than anything they had with respect to Brett Kavanaugh. What did he mean by that . That is his own assessment. I think it was a grave miscarriage of justice what happened with Brett Kavanaugh. There is no need for me to bring awful and false allegations that were made against him. That was an embarrassment for the Democratic Party to drag the name of a respectable man through the mud. I will leave it at that. Host lets go back to some social media followers and see what they are saying. Here is one Facebook Post that says, i find it strange this woman said nothing for the eight years while in office. I find it strange we are just now hearing this after biden is a presumed winner of the primary. I will wait to see if her harassment filing is found in the senate complaints. Heres another one that says, i am embarrassed for my party. Victim shaming time after time. We deserve to lose. Another one that says, ladies, save time stamped copies. I am 72 years old and retired but i still copies of personal complaint from actions of 1965. She said she filed a written complaint . It wouldve helped her tremendously if she had retained a copy. Says i speak that as a survivor of attempted rape. I listened to people who come forward with accusations but after listening to the hourlong interview, i cannot believe her. On her own, without being asked, she mentioned she had been through bankruptcy. Financial difficulties can lead to accuse those in power. If she had a complaint, why did she not come forward when he was etted for vp . From talk to keith calling madison, wisconsin. Caller good morning. I agree with anna from texas who is on your social media. She nailed it. This is complete hypocrisy on the part of the Democratic Party. I agree with tara reade. I think he actually did it. Joe biden voted for the war. He was a vocal supporter of the war. Anybody who would vote for that carnage in iraq would do Something Like this. He has no character. He is scum. Host what do you think should happen at this point . Do you think biden should drop out . Do you think the democrats should go forward with him as nominee . Caller this is an old story. Media decided to go with the story two months after she came forward after sanders drops out. Yes, biden should step down and let somebody else be the nominee. Callingts go to nell from South Carolina. Caller good morning. Joe bidenas a whole is campaigning with obama when i was at the sheraton hotel. Believe he is a good man trump can listen to saying all of these things, grabbing a woman by the you know what, this man has never done this. Give this man a fair chance. If you can give a man that says things the way trump said them, he can run for president. He can do what we need done. Callingts talk to jd from madison, illinois. Caller how are you today . Host just fine. Go ahead. Caller i agree with some other callers. Be dictionaryould on all the steps he has done but you have people who are going to believe this phony nonsense this woman has put out. Walks and talks like a duck, it is a duck. I think this woman was planted to do this. By 45 and hisdone people who areet more upset sanders did not get the nomination and they put this one up to sabotage biden. This was on a liberal program and promoney program. To sevenhose set up touch biden. Sabotage biden. Theyre trying to get back at biden when we have the most dangerous president sitting there. Risa callingalk to from iowa. Caller good morning. Host go ahead. Caller i will be supporting biden and i do not believe this lady at all. Why did she not come forward when he was Vice President . Barack picked him for Vice President she should have come forward. He should not have even been Vice President. That is all i have to say. Thank you. Host lets talk to garth calling for mississippi. Caller good morning. The only people that really know the truth are biden and ms. Reade. Everybody calling everybody liars is not right. Speaking of the president , they need to vet the president more than they worry about joe biden. He is the one that is going to oversee 2. 2 trillion. Im sure if he was not a billionaire, he is by now. Host you are in ashland which is down the road from holly springs. What is the weather like in ashland today . It is a Beautiful Day today. I am about ready to go fishing. Host i do miss the fishing at home. What do you think you need to hear from Vice President biden or tara reade to put this issue to rest . Caller this issue is put to rest for me. Own mouth president s he tells how he likes to assault women and walk it on teenagers as they dress for pageants. This is easy to me. I was a republican but i am blue for you now. Host lets talk to roger calling from virginia. Good morning. Caller good morning. Hello . Host go ahead. I believe they would have found something long before now. Ago, i wouldhs like to comment on his or marks of a what biden did with the iraq war. They were lied to about the Republican Party. Hillary clinton and the rest really thought that was true. They were lied to and im sick and tired of hearing you guys trash them down because you believe it. Go back and look at the records. They were lied to. All i can say is go biden. Host lets talk to george calling from fort wayne, indiana. Good morning. Reade i think the tara accusations definitely deserve skepticism. There was a great oped written in usa today written by a prosecutor were he laid out the inconsistencies and reasons there should be skepticism of the accusations. I thought it was a very balanced piece. To the there is truth hypocrisy claims when it comes to the Democratic Party as well. I thought there were reasons for skepticism with the Brett Kavanaugh accusations. I think there are people who believe the accusations have validity. There was room for a nuanced view. However, democrats were so gung ho in believing the accusations they painted themselves into a corner when something comes out about the presumptive nominee. How can you be nuanced about biden when you were not about kavanaugh . Host we would like to thank al of our callers and social media followers for chiming in. Coming up, we are going to have a discussion on primary Health Care Access during the pandemic with dr. Rebekah bernard. Later on, American Psychological associations arthur evans will talk about coping strategies during the pandemic. But first, yesterday new York Governor Andrew Cuomo announced schools in his state would remain closed for the rest of the school year and elaborated on related services around his state. Here is what he said. [video clip] we must protect our children. Every parent, every citizen feels that. We must protect our students. We have to protect our educators and given the circumstances we are in and the precautions that would have to be put in place, come up with a plan to reopen schools with all the new protocols. How to operate a school that is socially distanced with masks, without gatherings, with the Public Transportation system that has a lower number of students on it . How would you get that plan up and running . We do not think it is possible to do that in a way that would keep our children and students and educators safe. We are going to have the schools remained closed for the rest of the year. We will continue the distancelearning programs. Schools have asked about Summer School and whether we will have any attendance in school. That decision will be made by the end of this month. Predict what can the situation is going to be 34 weeks from now. Decisionsing to stage at intervals that give us the information but also enough time for people to make the preparations they need to make. Any decisions on Summer School will be made by the end of this month. In the meantime, meal programs will continue, childcare for essential workers will continue. We want schools to start andloping a plan to reopen the plan has to have protocols in place that incorporate everything we are now doing in society and everything we learned. We are going to be asking businesses to come up with plans that safeguard workers when they reopen. We need schools to come up with plans also that bring those precautions into the schoolroom. That is for schools and also colleges. The state will approve those plans. Announcer washington journal continues. Host we are back, and we are speaking with dr. Rebekah bernard to talk about the challenges in primary Health Care Access during the covid19 pandemic. Good morning. Guest good morning. Thank you for having me. What first of all, tell us positions for Patient Protection is, who are the members, and where do you get funding . Guest it is a Grassroots Organization of about 11,000 physicians. We have one mission, and that is to advocate for physician led care for all patients across the country, and we want to see truth and transparency regarding health care practitioners. We believe patients need to know if they are being treated by a physician or a nonphysician practitioner like a nurse position practitioner or physician assistant. Our members are physicians, retired, resident physicians and students. Our funding comes from artificial supporters, which are people who pay dues or give us donations to do our work. Host you are a primary care physician and do direct primary care. What do primary care physicians do, and what is direct primary care . Guest i am a family physician, which is one of the types of primary care positions. Pediatrics,nclude obstetrics and gynecology, and primary care doctors are responsible for being the first line of defense for patients. We take care of chronic conditions patients have. For example, diabetes, high Blood Pressure. We also care for acute issues like colds and coughs, and covid19, as well as other things. I am a direct primary care physician. There are about 1000 practices like mine across the country, and we are unique in that instead of charging money to Insurance Companies or government payers, we are paid directly by patients, usually with a monthly membership. That has been a unique situation with this pandemic, while many physicians and primary care has been negatively affected by a payment issue, many direct primary care practices are holding out ok because we do get this monthly membership, and we have already been pretty well set up to take telemedicine, do phone calls, do web videos because we do not rely on money from Insurance Companies just patients directly. What type of challenges are primary care doctors facing during the pandemic . I know we have had a lot of talk of first responders, Emergency Rooms, and hospitals, but what challenges are primary care doctors facing . Guest i have been talking with my colleagues across the country and there almost universally affected severely by the pandemic. What we are seeing is that many physicians are facing severe loss of income, partly because patients are afraid to come in, and sometimes they do need to come in for a particular issue, but they do not heal comfortable coming in, or could be a possibility there physician does not have the proper personal protective equipment in their office to care for patients if they are sick in particular. We are seeing economic downturn for primary care physicians. It is interesting because right now, more physicians are owned by corporations than owned themselves. And what we are seeing from doctors owned by companies, many are being furloughed, many are facing pay cuts and cut hours, but also, even doctors that own their own practices, are having negative repercussions. Many people ive spoken with with small practices have not receive their paycheck protection loans to help them pay for their staff and their overhead, so really across the board we are seeing problems economically without primary care physician. Host do you expect to see primary care physicians offices closing permanently because of the pandemic, or do you think a lot will bounce back once these social distancing roles are lifted . Guest i think that is the fear for many. There are small restaurants, many physician offices may be small momandpop operations, and if they are to negatively affected over time, they may decide to close their practice, especially of pushing retirement age. The other possibility is many practices may say, this isnt sustainable and sell out to a larger corporation. Although, that may not necessarily be the fantasy they hope it will be. I think most practices will try to hold on and see it through. They are getting some support. They have expanded rules for telemedicine, so that has increased the ability of some doctors to see extra income, but we do not know how many are going to have to close their doors. Host you just mentioned telemedicine. We understand a lot of doctors are moving toward telemedicine before the pandemic began. Do you see that as a major shift in how people go to the doctors . That more and more people will now depend on telemedicine instead of going into a Doctors Office . Guest i think you will see that. I want to mention that telemedicine has been something weve seen an increase in recently, but not generally as much for primary care offices as much as from some Services Like teledock and doctors teledoc and doctors on demand. Part of that comes from Insurance Companies encouraging patients rather than going to Doctors Offices to use the telemedicine services. There is no substitute for relationships with their own primary care physician. Studies show when patients have the same doctor over time, they actually have lower mortality rate. If you are skipping your primary care doctor and just using phone services or online services, where you are speaking with somebody you dont have a relationship with, you may get a different person every time and then you will lose that continuity of care. For example, if i talked to a regular patient and i noticed that they have a higher Blood Pressure reading or they have not had their Screening Test done for cancer, then as their primary care doctor, i will address that. Whereas if you are just calling a service that specifically is for acute problems, youre going to miss out on those opportunities. That being said, some doctors, primary care doctors, have been trying to move toward telemedicine. The biggest challenge has been reimbursement. Traditionally, physicians are not paid for time they are ding with patients face to face in the office. The covid19 pandemic change that because insurers are starting to pay for services. Initially, they had to require a video component. Because that has been challenging for many patients that may not have video savvy, as i or tech believe yesterday, medicare expanded that payment suppositions can be paid for time theyve been on the telephone with patients without needing a video component. Host even before the pandemic began, there was a projected shortage of physicians in america, both primary care and Specialty Care. Here is a report that says there is a projected shortage of between 46,900 and 121,900 physicians by 2032, including both primary care, between 21,100 and 55,200, and Specialty Care between 24,800 and 65,800. First of all, why do we have a shortage in primary care and specialist, and will the pandemic make this worse . Aest first of all, there is debate on whether we truly have a shortage of physicians across the board. Some people argue it is a distribution problem, that we need to have more physicians spread out across the country. However, i will say there is absolutely no doubt we have a shortage of primary care physicians. The reason being, just like Nurse Practitioners and physician assistants, physicians are increasingly choosing not to go into primary care because it tends to be the lowest reimbursed type of practice for physicians. It tends to be the type of practice that sees a high burden of regulatory, administrative type roles that have to be followed. It is very difficult to be a primary care doctor. There are so many medical problems that primary care physicians are expected to solve, yet, we are often not given enough time to do that. There is a very good reason that many doctors are choosing not to enter into primary care, even though they may want to do that type of work because they know it is so important, but because it is less reimbursed and the different challenges, some doctors may choose to enter into Specialty Care. Host lets let our viewers join in. We will open our phone lines by region. That means if you are in the eastern or central time zones, your telephone number is going to be 202 7488000. If you are in the mountain and pacific time zones, your telephone number is going to be 202 7488001. Open up a going to special line for medical professionals this morning. I especially want to hear from primary care physicians. What are you seeing out there . Going . Your practice what changes are you making because of the coronavirus pandemic . Medical professionals, your number is 202 7488002. Keep in mind, you can always text as act 202 7488003, and we are always reading twitter and facebook. Changes do youat see in the office set up for primary care physicians going into the future . Do you see people waiting in their car and waiting to be called up to the offices . Do you see barricades between the patients inside the office . One thing we do know is that the people at the Doctors Office, a lot of them, are sick. Right now, nobody wants to get sick. What changes do you see in the future . Guest i will tell you what ive done for my practice. I have restricted access to people who are sick by working with them by telephone and video to screen them to determine if they really do need to be seen and come into the office. If i have a person who really needs to come in because they require an examination or bloodwork, than asking them to come in individually. We are keeping the waiting room free of other people, so patients come in one at a time. I am able to schedule them to make that happen. If i was in a bigger practice, i would probably ask them to it in their car and then escort them. When patients come in the office, we are asking them to wear a cloth math covering mask covering, and i am also wearing a mask to prevent as symptomatic spread. A surgicalwas ill, mask may not be adequate, and we are also wiping down surfaces. There is always handwashing going on. I think we are going to see more spacing out of patience and more dependence on telemedicine and webbased is its and more safety precautions. I do not see barriers going up and things like that, just because of logistical reasons, but i think there will be precautions in place. Host i know for a lot of people one of the biggest complaints they have going to their primary care physician is that it seems to take so long to get an appointment, and once you get to the waiting room, it seems to take so long to get from the waiting room into to see the actual dr. All of this seems like it will add to that time period. Is there any solution that will help that . Guest such a good question. In my old practice, i traditionally ran late all the time. One of the main reasons is because there are so many administrative issues that need to be taken care of when a patient checks in. You have to verify their insurance and do all sorts of paperwork. I do not have that anymore because i do not take insurance. The other reason is because we dont give patients enough time in the schedule. Sometimes we schedule them for 15 minutes, but they really need 30 minutes or 45 minutes. One of the solutions, in my opinion, is switching to a model like direct primary care, so you have or time with patients. It is a very affordable way of treating patients for the patients, and it also makes their office visit much smoother and faster. The difference is that they cannot use their Health Insurance, which not everybody likes that idea, but the benefit is the lack of waiting and more time with your doctor. Host lets let some of our viewers join the conversation. We will start with dan from jackson heights, new york. Dan is a medical professional. What do you do in medicine . Caller i see that this young lady is making a mistake, which is probably responsible for the fate of medicine today. First of all, the primary care notician of this call is the first to seize the patient because you can go to a specialist with almost any ppo insurance company. The importance of the primary care physician or the intern is that he or she sees the patients all the time to coordinate any other specialties. If you look at specialties, they make tremendous errors because they do not field the particularities of patients. The other expression she has made so far, has explained right Nurse Practitioners have replaced you because you undercut the difficulty of internal medicine. Physicians, after all the specialist, make mistakes because they dont understand the particularity of the patient or do not grasp the complexities of a multidisease problem has to clean up everything and keep it going. I do not know how they train you guys now, but, believe me, in and wheneveres, the patient comes back after seeing a specialist, you have to clear up mistakes or errors made by the specialist because they think in a narrow myopic lane. The job you described as the primary care physicians job can be done by a Nurse Practitioner who has no medical training at all. It is just a nurse with a little extra. Host go ahead and respond, dr. Bernard. Guest i think its interesting. What im hearing is a lack of appreciation for what primary care does. I would say i keep most of my patients out of Specialty Care offices. A patient with diabetes does not need to see an endocrinologist. Those are things i handle in my office every single day. I do not agree with you that primary care can be replaced with a nurse tactician or because it takes us many years to learn primary care. It is one of the most complicated specialties that exist. We have to take all of the patient aspects and put it together and treat the patient as a whole person, and i do think the caller makes a good point that specialist can sometimes have a myopic view, although, i believe many of our specialists are actually excellent and focused on treating the particular problem that we are asking them to consult on and then returning the patient back to us as primary care physicians to be able to put the care together and be as comprehensive as we can. Host dr. Bernard, you wrote an opinion article in the inquirer that addressed the Nurse Practitioner issue, where a lot of people are saying, and we see it often that nurse petitioners should be used more instead of primary care physicians Nurse Practitioners should be used more instead of primary care physicians and that they could be cheaper and provide the same services. You disagree with that. Amplifier point little bit. Guest i am a board member as physician protection paperwork members, and we believe that care for all patients should be led by a physician. We believe Nurse Practitioners and physician assistants make an excellent adjunct to care, and they are very important in the health care system. However, we believe patients deserve to be diagnosed and treated by a physician because we have additional training. Oftors train for a minimum 15,000 hours before we are permitted to treat patients independently. Nurse practitioners, so may have many years of experience, but you do not need to have that experience before you practice. A nurse tactician a right now can attend school online, they can do their clinical hours with a minimum of 500 hours that they are required to sit further licensing examination, and then in some states and across the country, in 23 states, Nurse Practitioners are then permitted to care for patients independently. Physicians in no way are permitted to do the same, even though they may have significantly more training than Nurse Practitioners. Of course, they have to go through Residency Training for many years before we are e permitted to care for patients independently. I dont understand how it is that anyone could imagine that someone with less training could perform the same job as someone who requires significantly more years. It does not seem logical. We also know that although there are studies that show Nurse Practitioners can be effective when working in a team, there are absolutely no studies that show that they can provide the physicianwithout supervision or following physician led protocol. Host here is a question we got from one of our social media followers who wants to know, dr. Bernard, where we warned him enough time to protect ourselves from covid19 . Why or why not . Guest i think we had some warning. This is such a new experience for us as a society that we really had to respond in real time as we have got more information. I know my recommendations to my patients have been as they have learned more about the virus and the different symptoms of it and what we need to do to protect ourselves, i would say could we have had more warning . Could we have been more proactive . Could we even be more proactive now . Yes. That being said, i think we are responding the best we can to a new threat. Host do primary care physicians right now have access to the equipment and tests they need to test for covid19 . Or is it something we are still waiting on . Guest most primary care physicians, in my personal experience and many of those im speaking with, do not have access to tests and proper equipment. In my experience, i received about 20 swabs from my local lab. However, i have a limited supply of n95 masks and face shields and gallons because those are all required if a person and gallons because they are all required if a person is acutely ill and they need a swab done. That requires you wear protective equipment at the risk of transmitting infection to yourself. Many physicians i know may have some ppe and tests, but they do not always have everything they need. We have been directed to refer patients to the department of health where they have proper equipment, but i know theyre testing is limited and they have been restricting up to this point test for patients who meet certain criteria. That was recently opened up, and i believe they will do more testing. In primary care offices, the answer is no. The other thing i find interesting is that some pharmacy chains like cvs are being preferred and receiving preferred access to test. The rapid antibody tests went to cvs compared to going to physician offices. I think that is interesting because we are looking at patients using retail chains for care, like going to a cvs Minute Clinic versus going to a primary care office. This is another incentive for patients to use that kind of care, which we consider fragmented care versus going to the regular Doctors Office to have the test done. Host lets talk to david calling from birmingham, alabama. Good morning. Caller good morning. That the state of alabama does not accept Affordable Health care. We have 17 hospitals closed within the last couple of years. Cooper green is one that was closed in the city of birmingham, and cooper green was a Public Hospital that anyone could go, but it closed. Birmingham is a unique place. Birmingham has one of the largest hospitals in alabama,uab , with the largest employees. Nurses, doctors, and also we have a Junior College called laws and state, so if these hospitals have been opened in the state of alabama, we could have taken some of the sick patients from new orleans, new jersey and let the doctors from uab and lawson state provide them with doctors and nurses. What do you think we need to do in terms of correcting these problems in alabama . I will hang up and listen to your response. Guest thank you for that question. We are seeing world hospitals in underserved areas been shut down because of funding issues. I think your point is well taken, and i think its a problem across the country needs to be addressed. Deb callingtalk to from houston, texas. Caller good morning thank you, dr. Bernard, for everything you do. A little change appear. I know we are talking about the pandemic and primary health care, but from a doctor standpoint, wouldnt you say that the fact that we have a fragmented way of looking at health care to begin with, we do not have a National Healthcare service. It is like if you go to the butcher, each part of the body is priced out and accordingly treated a different way, so we do not have dental and mental wrapped in in a holistic way. I make that point because telemedicine is not going to help the people around where i live in the urban blight with the digital divide. Even a phone call with no video is going to help. We need medical homes, and we dont really think we need medicare insurance, but United Health care is the de facto medicaid here in texas. They called me yesterday to tell me they were going to take my provider hours from 25 to 24, and they are not the medicaid but the insurance. They were saying they were going to tighten up, but my question i guess to you is as a doctor, is there not a way to take this medicare andis or make it more like a system where we all utilize all of the assets and use everything instead of fighting over which part of the body and watch subspecialty and what more advanced care . We are leaving everybody behind who needs basic care. Thats all i wanted to say and thank you. Guest your point is really well taken. You are right. We are very fragmented. The challenge i see when you start looking at well, what system should we all use, that everybody wants to get in on the action, and who was going to be the company that gets that big business . Because that would be a huge amount of money. And what kind of oversight would we have to make sure they are doing their job. I do agree we need an improved systems so doctors can communicate with each other and patients can understand what is going on. This is one of the reasons i chose to go into direct primary care because i did see that fragmentation. The last company i worked at, a large hospital, decided to change their Electronic Health records and they told the doctors we would be responsible for just entering in the patients data all over again. There were thousands of medical records. I decided that was not something i wanted to be involved in, and i decided i was going to back to oldtime medicine. Back in the old days, doctors were just right notes on a four by six index card. We have come a long way from that and i do use a computer, but it is simplified, it is something i can print or email to my patients, or text them even, and give them the information they need, and i can also communicate with other doctors in that way. I also feel although there is as much to begin from technology, sometimes it is good to go back to our roots, get simpler ways of practicing medicine, and that may allow us to give care to more people. Even in underserved communities, i take care of many patients that are underemployed, that have no Health Insurance, and because we set our prices fairly at most primary care practices, most patients are able to gain access to us. Host dr. Bernard, i want to read you something from the Commonwealth Fund and then i will have a question. According to the Commonwealth Fund, altogether, outpatient betweeneclined by 57 march 1 and march 29. Although the trend appears to have moderated since then with visits down 54 as of april 12. 17 and adultsen over 75 were much more likely than average to avoid such visits. , ourwith that known primary care businesses considered to be Small Businesses and getting federal relief from the Paycheck Protection Program . Act andes the cares other legislation passed to help Small Businesses, did any of that money go to primary care providers and to help relieve the problems they are seeing . Guest some primary care doctors work for corporations. More doctors work for employers than they were for themselves. However, the doctors that i have spoken with who own their practices, they do tend to be Small Business owners of less than 50 employees and usually much less than that. Some of them i have spoken with have received a ppp check so they can keep paying their overhead, but not everyone. Some doctors i have spoken with have not received it yet. Ueey are still waiting in a c from their banks. They missed the first round because the money ran out and some are waiting for the second round right now. Payment forpanding telemedicine, that is something that doctors are trying to take advantage of, although, i will tell you i just heard from a doctor this morning who told me she has been feeling telephone visits since march 1 and received a letter from the insurance carrier telling her that because they gave her the wrong code, she needs to go back and rebill the visits with a new code to get paid. That will delay the payment by another 30 to 45 days. Of course, bills are going out and money is not coming in. You made a point about children being less likely to receive care. Part of that is because it is hard for pediatricians to do child visits, which is a big base of their visits, virtually. Of course you need to lay hands on a child to examine them. That is something they have not been able to do. For older patients, we are seeing anxiety and fear because they realize they are in a higher risk category if they contract the infection, so they are erring on the side of caution and deferring doctor visits. Host lets go back to our phone lines and talk to david, who is in pittsburgh, pennsylvania. David is a medical professional, as well. Good morning. Caller thank you for taking my call. I agree with a lot of what dr. Bernard has been saying. Want to thank cspan for addressing this topic. Actually, primary care has been a crisis probably for a decade or more in this country, and im glad you are bringing light to it in this crisis, but there is a broader set of issues dr. Bernard has mentioned. Andve a couple of comments dr. Bernard may want to react to it. I think what dr. Bernard is doing and others doing the direct primary Care Movement is a good individual response for physicians to do, but the real issues are more structural and systematic. She has alluded to. It probably caused her to move in this direction. Mentioned the ridiculous burden administrative and bureaucratic that primary doctors have been encumbered with. I think an important structural step is to eliminate or diminish ofstically the amount Administrative Burden has no value at all. That would be a great first step. Secondly, i think we should use primary care more as a learning platform rather than as a permanent, systematic solution. Thirdly, i think we need to use this experience in the pandemic to learn what really is appropriate and what is inappropriate care. When you have large level issues such as this, all kind of care both appropriate and inappropriate care. We should take this opportunity to learn as much as we can about the inappropriate care that has been eliminated, and that is a good thing, while balancing that against the appropriate care that has been related and that is a bad thing. There was so much more to say. Authors have written about this, especially don berwick. He talks about health care and one of his main point is to get rid of a lot of the Administrative Burden. That is just the gist of my comments for now, and i would encourage citizens to support supportcare issues, and things that bring value to health care, rather than having it generate revenue for certain segments of the economy. Host go ahead and respond, dr. Bernard. Guest the caller makes excellent points. I did not choose direct primary care as my first option. I work for a government clinic and did that work for 15 years, and i fought very hard to work within the system, dealing with the regulatory burdens and barriers, figuring out workarounds. It was a last resort for me, like many colleagues who have chosen that route. It was because we cannot feel like we could do it anymore, it was leading us down, and it was either going through a different model or get out of medicine entirely. The caller a 100 right point that we need to slash a lot of regulatory burdens on physicians, especially primary care, but across the board. It is estimated there are 10 Health Care Administrators for everyone physician. When you see the growth of physicians compared to the growth of administrators, you will see a tiny growth of physicians and an exponential jump in administrators. That is something that needs to be addressed. The caller also mentioned that we are seeing a downturn in Office Visits and emergency room visits across the board. The question is how many of the visits are more for things that like goingcessary, into the emergency room for an ingrown toenail that could have been an agenda primary care Office Versus people neglecting Serious Problems like chest pain . I could be a sign of cardiac condition, stroke symptoms, and talk of appendicitis. Clearly, there are people staying home that really should be going into the office or emergency room, but on the other hand, we are seeing people wait out symptoms that they might rush into an urgent care or Minute Clinic. I get patients all the time who want to be seen for one or two days of symptoms, which are going to run their course and begun within another day or two. I am talking about precoronavirus even. There has to be a balance between helping patients know when they need to receive care, versus what can be rated on, and not seen out of fear. Host here is another question from one of our social media followers. I will modify it. I will read it but modify it for you. They want to know how much do you charge monthly to be on call for your patience . How manys the patients does the average concierge primary doctor need to maintain a practice . So how much does the average primary care physician need to maintain their practice . I will let you answer either one. Guest sure. Most direct care primary practices max out at 600 patients. I have about 700, and i just added a new position. Some parttime panels may have 300 patients. The average charges 75 a month. My practice is right about at that. It depends on usually the patient age. For children, we charge 39 a month and as people get older, we charge more because we know they will need more time and attention. And that is all they need in that monthly membership, they can see me as many times as they need, call on the phone, or do a web chat, and we also offer discounted blood and radiology test and i also sell lowcost generic education, so with most direct primary care practices is keeping care affordable and accessible. Not quite the same as concierge. That is a higher level of care. Usually, concierge doctors will for visits and insurance and patients pay a membership fee to have access to that practice. Direct primary care is different intoat it is all bundled one fee, and that gets you access to your doctor. Host one more quick thing before we get back to callers. The Economic Policy institute says 12. 7 million workers have likely lost their employerprovided Health Insurance since the coronavirus shock began. What is going to happen to those workers who no longer have their employer provided Health Insurance . Who should they go see . How can they go see a parttime primary care physician . Guest when you lose your job, that becomes an opportunity to enroll into the Health Care Exchange or obamacare. That is considered a qualifying event. I would recommend a check because they may qualify for subsidies and be able to find an Insurance Plan they can afford. If that isnt an option, i recommend them to look for a direct primary care practice in the area. In my area, we tend to be a little more bluecollar workers, Small Business people that often do not have Health Insurance plans because it is so expensive for them. We specialize in helping patients that do not have Health Insurance. We encourage our patients to try catastrophic wraparound policy because i cannot take care of people that have appendicitis or a broken everything,o almost but there are a few things we cannot do. We cannot hospitalize our patients, so we encourage them to look into a lower catastrophic plan. Host lets talk to laura calling from fort myers, florida. Good morning. Caller good morning. Host go ahead, laura. Caller hi, dr. Bernard. I am your patient, laura bradshaw. Guest [laughter] caller i wanted to call and tell everybody what a wonderful practice direct primary care is. I would never have gone to a doctor. I did not have Health Insurance. I went to you, and you save your life. I found out i had diabetes, and me took the time to talk to going into your practice, it is beautiful, it is like you are the only one there, and you have time for me. You taught me with what to do with my disease, and im almost cured. I lost another 10 pounds, dr. Bernard. I am so thankful for you having this practice. I would never have gone to a doctor otherwise, especially one that listens and has time for me. Im kind of nervous talking on the phone, but you have to turn it off. Doctor, and iu, appreciate what you do, and you made it affordable for me to take care my disease. I love you. Guest thank you. She is going to make me cry. That was not planned, and i appreciate hearing that. And that is what doctors across the country that do this model, and just primary care doctors. I think this patients story exemplifies what patients across the country feel for their primary care doctors and the way that primary care doctors want to provide care because we do care about our patients and one thing to do well. We want to take the time to spend with them, but because of the problems within our system and the barriers, it is becoming increasingly difficult for doctors to be able to do that. We really do need that systematic change, like the caller before mentioned, so more doctors can provide care for patients like laura. Host lets talk to beverly, calling from prospect, kentucky. Good morning. Caller yes, good morning. Thank you for this presentation and dr. Bernard for your comments. I am a primary care physician that is selfemployed, and i have 20 employees. I am more like what happens across the country. Not necessarily in medicine, but most people work for Small Businesses. In business 35 years and all of my employees have Health Insurance, all of them, and they have had since 1986, two years after i started my practice. On. E is a lot going i would encourage them to do another show on primary care, not just related to the pandemic, but there were so much disruption and fragmentation going on in health care. People are fighting over patients, whether they are Insurance Companies. I know most of us get 10 calls a day about let me sell you more Health Insurance. Part of the Corporate Health care has a different driver. These guys are going on a different kind of system. A primaryre as care physician, i patients, and im sure my patients, as im sure across the country, are getting the care they get dr. Bernards office. As people lose or change Health Insurance, their relationships with their primary care, who know them, who have documentation of what has been done, that is disruptive because somebody decides where they go, to a different doctor, different hospital, whatever. There is so much going on. I think the pandemic, since that is the topic, the pandemic blindsided me. I think there were people that were looking into the future and saw it coming, but it blindsided us. It shut us down in 30 days. Our visits went down 49 . I have four providers, and we take up about 7000 square feet. Medicine, iack to do not know what it is going to be because we will never probably need 7000 square feet office is again. We will probably do more telemedicine, and telemedicine does have limitations. People like myself love to touch the patient and know what is going on in the family, listen to the heart, and check the Blood Pressure themselves. I think we really need to focus on what is going to happen after the pandemic, but what are we really going to do to reintegrate and bring and defragment health care . Host go ahead and respond, dr. Bernard. Guest i think the caller makes a perfect point, and she is probably similar to many, many practices across the country, and people ive spoken with are in difficult situations right now. Many of them were not set up to do telemedicine or web visits because they were never paid for that, so why would they invest in that infrastructure . She is absolutely right. I think this will cause probably some longterm changes in primary care. Some will be good. We will see some innovations, but some may take a long time to recover from. Host lets see if we can get one more caller. Lets talk to brian from grandview, pennsylvania. Good morning. Caller thank you. I appreciate your show. Isnt this a time we should be talking about National Healthcare . If you look at the deaths and specifically the deaths in the , everybodymmunities has or a lot of people have Heart Disease or diabetes. It will be interesting to see if the people who have died, had they been to doctors previously . Is that something we need to be looking at . Once again, when you lose your job, you lose your insurance, and there is a lag. I would love to see with these covid19 hospital bills are for these people, whether insured or not. I truly believe we need to go to National Healthcare right now, and that is my feeling, and that is economically something we need to get to. Host go ahead and respond, dr. Bernard. Guest i think what we are seeing is almost a version of a National Catastrophic insurance because what we are hearing from the government is that they are going to pay for illnesses and tests and things like that related to covid19. The caller makes a good point. What happens to people when something catastrophic happens and they require hospitalization and they need care . I would argue that for primary care services, they do not need to get insurance is involved. I believe that is why it has gotten so expensive and it so long to get to doctors with the bureaucratic regulation. However, i would not object to the idea of some universal catastrophic coverage, kind of like with covid19. Something more structured, so that when patients do play something serious, there could be help for them. Host we would like to thank dr. Revekah bernard dr. Rebekah bernard for being with us this morning and talking with us about primary care physicians. Dr. Bernard, thank you for your time. Guest thank you. Host coming up, a discussion on stress and coping strategies during the pandemic with dr. Evans. Medical updates were provided and here is what he said. [video clip] the fourth, we are going to move to a safer athome order instead of a stayathome order, that will go into effect at 12 01 a. M. Monday. The order strongly encourages all of West Virginians to remain at home, but no longer orders you to stay at home. Again, i encourage all businesses that are allowed to open to do so only if they follow the guidelines and keep West Virginians safe. We continue to work with business groups to help them establish protocols. You should continue to stayathome if you have symptoms of covid19 or have come into contact with someone who has. Want to congratulate our state today. S and the dhhr 20 state troopers working together with the dhr have orchestrated the delivery of lifesustaining medicines or medications to every hospital across our state in one day. Do you know, and i do not have a list of what these medications are, but they are from the United StatesStrategic National stockpile, and these medications that have shortages nationwide but have been delivered quickly by our troopers to make sure that they get to the people of west virginia, and this shows a great great cooperation between our agencies and i thank them so much for that. Just talk auld second about as we move forward about her hotspot counties. We have 11 counties that are hotspot counties, and we have been in clean with all levels, and we are continuing to have feedback from our experts, from the counties, and, you know, the people that are on the ground and the Health Departments and everything. Theset of feedback from counties. As we go forward, what we want to do is we are going to release over the weekend some additional guidelines in regard to the hotspot counties. Washington journal continues. Host we are back with dr. Arthur evans, the ceo of the American Psychological association, back with us to talk about coping strategies and reducing stress during the coronavirus pandemic. Good to see you again. Guest thank you for having me back. Host first of all, you were here with us at the beginning of the coronavirus pandemic. We were talking about the coping strategies for everyone who was stuck at home. We are about a month, a month and a half in, have we learned anything new about coping with being at home during a pandemic . Ofst well, you know, one the things we have learned, and i think i mentioned this when i was on the show previously is that we expected things would get much more difficult for people and people would experience more stress, and that is exactly what we are seeing. People are experiencing stress, or people are feeling the effects and really understanding the reality of how long this situation is going to be with us and how we have to adapt, so i think we are learning a lot about what is happening, but the important thing is for us to continue to understand that this has a Mental Health impact and Health Applications for us. In the beginning of their practices, all of our energy and focus was on the virus and trying to address that as it should have been, but i think there is growing recognition that this has psychological impacts on us, and we have to Pay Attention to that. Host what are the greatest psychological challenges facing americans who are social isolating . What is it that we are facing that we need to address . Guest well, you mentioned a very important word, social isolation. What we know from research is that social isolation is very bad for our physical health, until health, and we just do not do well when we are socially isolated. In fact, one of the things we should start to do is stop talking about social distancing and talking about physical distancing. We are talking about being physically distant but we have to remain socially connected because that is one of our primary coping strategies as what is complicating the Current Situation is that one of our most important coping strategies is something that is more challenging during the crisis, so we have to Pay Attention to that and we have to make sure that we are staying socially connected because we know that is important for Mental Health, but we also have to make sure we are paying attention to how we are doing mentally in the same way that we want to Pay Attention to how we are doing physically. Host i know we have been talking about a lot, last time and this time, we will talk about the social isolation that americans feel when they are quarantined at home, but there is another set of americans, the first responders, doctors, and physicians under unique pressures because of the coronavirus pandemic. They are out there risking themselves every day. What type of social and psychological pressures are our first responders, people who are essential workers, people delivering our food, bagging groceries in stores, what type of social and psychological pressures are they under . Aest they are under tremendous psychological pressure. We have seen some of that being recorded in the media. They do not have the controller being able to turn off what is happening. They do not have the ability often to be in situations where they feel that they are protected physically from the they have some very unique challenges. It is one of the reasons the American Psychological association is really trying to partner with organizations that are connected to those groups. We are working with nursing associations and creating materials that nurses can use to help them cope with stress is that they have. Not only nurses but all health care workers. We are doing similar work with journalists. We did a webinar talking about journalists who are also in a situation where they cannot turn it off, and they are often in situations where they are highrisk with other essential workers. We know they are under unique stresses. We know we have to do Something Special for those individuals, and it is important as we think about the nations Mental Health response that we are not only thinking about generically how do we address this issue, but how do we address the unique needs of people on the front lines dealing with this crisis . Host lets let some of our viewers take part in the conversation. We will open up regional lines for our conversation with dr. Evans. That means if you are in the Eastern Central time zones, we want to hear from you at 202 7488000. If you are in the mountain or pacific time zones, your number is going to be 202 7488001. And we are going to open up a special line for medical professionals. Once again, medical professionals, we want to hear from you. Your special line will be 202 7488002. Keep in mind you can always text at 202 7488003. We are always reading on social media on twitter and cspanwj and on facebook. Com cspan. We have been socially isolating ourselves for about six weeks now, dr. Evans. What suggestions would you have for americans who are still social distancing to relieve some of the stresses and social isolations without breaking the social isolation that some states are still doing . Guest very good question. The first thing that i mentioned earlier where is important to stay socially connected even though we are physically separated. There are a lot of ways to do that using technology, and being creative. You see a lot of that happening and that is really important. I would put that at the top of the list. It is the most important coping strategy we have, being socially connected to people important to us in our lives. Beyond that, i think there are other things we can do. We can make sure we are having structure in our lives, that we have some routine. It is easy when your work, your play, and everything is happening in your home that those things sort of bleed into each other and you dont have enough separation between work and your social life, so it is important to have some routines that help you to keep those things separated. It is important to limit the amount of media you are paying attention to. One thing we know is that paying attention to a lot of media can be harmful to us from a psychological standpoint, and so limiting that, particularly social media, some Interesting Research shows social media is even more impactful from a negative standpoint than regular media if we consume a lot of that. So Pay Attention to that. There are things that we can do from a physical standpoint that are really important. Our mental and physical health are inextricably tied. Physically,tired when we are fatigued, those things have a direct impact on our Mental Health, so getting enough sleep, eating, trying to exercise under these circumstances is very important. All of those things contribute to our Overall Health and the impact on our Mental Health. Host here are some of the suggestions you all had about how to cope under social imitation measures. I will read these and ask you about them when im done. One of the first suggestions as to limit News Consumption to reliable sources. The second suggestion was to create and follow a daily routine. Stay virtually connected with others. Maintain a healthy lifestyle. You psychological strategies to manage stress and stay positive. You are saying limit News Consumption to reliable sources. I think you mentioned that earlier about getting off twitter, facebook, cutting down the amount of news you are consuming when you are stuck in the same place for 24 hours a day. Hurt of all, how does that , and why will stopping that help . Guest if you look at particularly on social media, first of all, there is a lot of misinformation on social media. When you couple that with a lot of contradictory information, it creates more anxiety for people, media,ou look at social for example, you see conspiracy theories, misinformation. Some of that information is contradicting what we are hearing from professionals who really know and understand these issues, and that creates more anxiety for us. So limiting the information to reliable sources, sources you can trust, goes a long way in helping manage that stress. Host lets let some of our viewers get into this conversation, and we will start with donna finn from rand view, missouri start with jonathan from grandview, missouri. Caller good morning. Host jonathan, are you there . We lost jonathan, so we will go to cynthia, calling from humble, texas. Good morning. Caller hi. I just wanted to make a statement. I think it is so uncertain to continue to reach out, even though we cannot be completely there with our loved ones and friends to get those outlets to make sure we are doing what is best for our mental help. Me and my friends are doing is zooms every week to stay in contact. Ande is a lot of fear unknown and things that are changing every day about the virus and things that we know and we do not know. I think it is important to keep i also wanted to say how important it is that people are coming together. People are making masks and using their talents in order to fit other people and benefit other people and health care professionals. Guest she made some really good commons. Especially the point she made at the end about social behavior and helping people in the community. We know that that has a positive impact on our Mental Health. You are not only helping your aighbors, but it also has positive impact on our own Mental Health. That is another really important social strategy. One of the things we know distancing isial it is time to get closer to the families that we live with. Some of us are finding out that maybe the people we live with are not always great for our Mental Health. What do you say to people who think they have been isolated in a situation that is not helpful for them with the people who are there . How do you deal with that now, especially at a time where most of them are still at home . Guest another good question. That is one of the issues that we hear about quite often, is the impact of being in a close quarters in close quarters and being at home. It is not really a healthy situation. For many people, being able to negotiate some of that is an important strategy. The situations are very different. Sometimes, it could be that you have a young adult coming home. They may have been at college and now they are coming home. They have to follow the direction of their parents in ways they may not have had to for several years. There are all kinds of situations like that that are happening that are treating stress, and tension. I think it is important for us to have opportunities to talk through those situations, to negotiate new rules, new rules of engagement so to speak. Participant active to try and manage those relationships. Host how does someone get in contact with someone who can help them talk through this problem right now . Maybe you have not been to see a psychologist. How do you find one now when you cannot leave your house and no one wants anyone in their office . How do you find help right now . Guest you would find help the same weight you would if you could go to a persons office. What most Mental Health professionals are doing telehealth is telehealth. Again, whether you are in a telehealth situation, as we are now, at some point, this is going to be over. You want to first call whoever pays the bill. That will be the most effective and efficient way to figure out what services you can have access to. If you have private Health Insurance, you want to call your insurance company. There will be a number on the back of your card for Behavioral Health services or Mental Health services. Ou want to call that number say what the problem is that you are experiencing and they will tell you who the providers are in your area. If you are uninsured, every state of the union has the ability to provide services for people who are uninsured or maybe underinsured. Those are looking for types of services, you can call your state Mental Health agency. You can google that and they can tell you how to access those services. You also have, in almost every state, state psychological associations that have Locator Services on their website. If you go to those websites, it will tell you who some of those psychologists are in your community. There are also other kinds of lines like that that help you identify Mental Health officials in the community. Host one of the other advantages of being isolated with our friends is, sometimes, we begin to recognized that a loved one or a friend or Family Member does need help and they have the isolation has made their problems worse. What do you say to someone that you think needs to talk to a psychologist . How do you broach that conversation . What do you say to them . That ione of the things think is important is to be able to first recognize when people are in psychological distress. One of the things that has been important that has happened over the last several years is more emphasis on psychological literacy. In the same way that we recognize that when we have physical problems, we have some sense of how we deal with that help,w we can help get whether it is having a broken toe or having heart palpitations, we generally know what to do in those situations. When it comes to Mental Health situations, we often dont know what to do. We dont know what to do if a Family Member says i dont know if i can take this anymore or i want to hurt myself or other people. I think the first thing is for all of us to have some basic understanding of Mental Health issues. We put a lot of information on our website, apa. Org, about signs and symptoms of Mental Health, having a Mental Health challenge. We put strategies around how you seek out help. We put information on there about strategies we can use to address our own Mental Health. I think there has to be some basic education that all of us invest in around how we maintain our Mental Health and how we who might bes experiencing a Mental Health challenge. Host lets go to the phones and talk to diane, who is calling from cordova, tennessee. Good morning. Caller good morning. My comment is i work in a Behavioral Health facility. I have been in health care for over 40 years. Acutedo appreciate the side, the hospital side. I have heard all of the appreciation of acute care facilities and with the pandemic, everyone is talking about Mental Health and where to go and what you should do for your Mental Health. I have yet to hear anyone highlight and appreciate the professionals that work in health care in the Mental Health facility. I have yet to see anyone say how much they are appreciated. These are people that go above day and it isery hard. It is hard working in a Mental Health facility, a Behavioral Health facility. I would like to see someone reach out to these people, even in my own city, we have had people go to the acute care facilities and hold up thank you signs. I have yet to see that happen in a Behavioral Health setting. I want to give a shout out to those who do work in Behavioral Health. They give a lot. I see it with my own eyes and i appreciate you giving me the opportunity. Really agree with those comments. Mental Health Professionals do very important work in our community. It often goes unnoticed. I think one of the things we have to do in the Mental Health community is get out of the black box of treatment. So much of what Mental Health professionals do is behind the wall of confidentiality. We have to maintain confidentiality. I think that gets in the way of the public seeing what Mental Health professionals do. I really agree with the caller. People do very important work. I think it should be acknowledged. We should makeat sure that we are bringing those professionals out into the and to do talks. A lot of what we hear now is about fatigue. Whether it is fatigued from being on videoconferencing calls or fatigue from being socially isolated from our friends during this pandemic or fatigue from seeing some states opening up and other states are still being told to stay at home. How do you battle all these different fatigues and stress when you are still dealing with this pandemic . Guest the first thing is to that we are fatigue. Things aboutique this crisis is the we do not always see it coming. , whennot always realize there is a hurricane or some other disaster, we know we have been traumatized. In this situation, most of us are still in our homes. Most of us are still around our families. Even though our lives have been disrupted in significant ways, we do not have those cues from the environment that say we are experiencing trauma. And so there is this insidious nature where we are under stressed. Before we know it, it will start to have a negative impact on us under stress. Before we know it, it will start to have a negative impact on us. We know the level of uncertainty people are experiencing has an impact. We know the stresses from the disruption in our life adds to that. We know that the economic stress adds to that. Anxiety and the different messages that people are getting adds to that. All of these things are additive and it creates a real load on us. Cognitiveout having a load and the impact that all of these things are having on our ability to think and our emotions. I think the first thing is to recognize that and to make sure that you are taking steps to manage that. One of the most important messages that i think we have to get out of in the Mental Health procession is that we dont have to be passive participants in what is happening to us. We can be active participants in the same way that any of us will exercise, eat right, sleep to help ensure our physical health, there are things that we can do to help ensure our Mental Health. Recognizertant to that we dont just have to let these things happen. We can be active and play an active role in that, do the type of things that we have talked about today. Those things will go a long way in helping to address the fatigue and stress that many of us are experiencing right now. Host dr. Evans, we have a question from one of our followers who has texted in. From stamford, connecticut says she tends to be a nervous person. The pandemic has served to heighten that anxiety. Can you suggest some strategies for dealing with anxiety . Guest a few things. The first thing that i would say is that if you are a person who has had a history of having a Mental Health condition like anxiety, like an anxiety disorder, we know that under these circumstances, if you have a preexisting condition, you are more likely to have a recurrence of that, if you have been in recovery from that. That would be the first thing. I think the other thing is for anxiety disorders, it is important to manage our stress. There are a number of things we can do to manage our stress. We talked about the importance of managing the kind of information that is coming in, how much information we are taking in, making sure we are not having a lot of contradictory information that raises our anxiety levels. Those are the kinds of things we can do between mindfulness and thoseties, exercising, of kinds of things that reduce our stress level will help us to manage anxiety that we might have as a result of what is happening. Host lets talk to harry, who is calling from buffalo, new york. Caller thank you for taking my call. I have two questions. Undue stress caused by money problems because Unemployment Insurance is not coming the way it should. People are working for weeks at a time and no money coming in. Stress, itses undue would, besides the isolation, can it be diagnosed and taken to the court of law and hold someone responsible for it . There will be costs for some of these people for sure, with the fallout from the money stress. Promising the money is no help when you go to the Grocery Store if you dont have money in your pocket. It does not directly affect me but i know people in that situation. I appreciate your comment on this. Know, in fact my doctor visitation was looking at economic stressors. There are literally studies that go back decades that show there is a link between economic downturn, economic stress and psychological distress and physical problems as well. The caller is pointing out, that there is a connection. And we would expect, as we continue to see a lot of the economic challenges that people are having, we will see more and more people have Mental Health issues related to that. Whether or notd you consume someone because of someone can sue because of that is a different question. I will leave that to my lawyer friends. I think the caller is right. There is that connection. We need to Pay Attention to that like any other stress we are experiencing in our lives right now. Host here is another question that was texted into us. Would you address elder and children abuse who are isolated with abusers . Really gooder question. We know that the levels of Domestic Violence are going up. Psychological association, we have been talking to our Partner Organizations around the world and all of us are seeing increased reports of the mystic violence. Domestic violence. In this situation, it is , unlike,ng because before this pandemic, people had the ability to leave their homes and report that kind of abuse. Now, people are in situations where it is difficult to get away often and report that kind of abuse. Communitiesays that and states are responding to that is by making sure that people are putting that , the hotlinest that people can use. To tryy encourage people to do that. This is another reason why social connectedness is important. If you are isolated and in an abusive situation, it is often much harder to get out of those kinds of situations. I think that understanding what those resources are in the community, staying closely connected so that people are not isolated, if you suspect someone is in that situation, reaching out to them and trying to make sure that we are checking in on those individuals and just understanding that we are under extraordinary conditions that make dealing with this issue much harder. We are going to have to make sure we are doing things to overcome that. Lets go to spotsylvania, virginia. Caller good morning. I would be interested to know how our congressman are coping with this situation. They have essential jobs but they are not at their jobs. I wonder if they are even in the country. Heard from one of our reppo synonyms, and that was regarding representatives, and that was regarding our schools. At least she was in our country. Seemnes that are in d. C. To be a handful of the whole congress. They should be at their essential jobs. We have depended on them. We elected them. Host let me expand her question. Not just the members of congress, but Public Officials, people who are out there in front of the microphones, the school board officials, the superintendents, the mayors, the governors, what type of stresses are they under and how should they be dealing with it . Guest they are under a lot of stress. One of the things that we did at the American Psychological association was due a webinar for political leaders and our public leaders because they are under a lot of stress. Like. What it is you have very long days. You are trying to make sure the public is safe. You still have your own family to deal with. Often, it is difficult for people to manage all of that. We did a special webinar on how they can help to do their job, how they can do their jobs more effectively. We talked about commune occasion, for example. If you are a mayor communication, for example. If you are a mayor, you have to talk to the public and make sure the public is hearing those messages and you are delivering those messages in such a way that you are minimizing peoples anxiety and making sure that people are understanding the. Nformation so, we are partnering with organizations like the National League of cities. We are talking to the National Governors association because there are unique kinds of challenges that our Public Officials are facing. Role of have this dual making sure they are taking care of themselves and their workforces. There are things we can do, we will be working with those kinds of organizations on those issues. They have this tremendous responsibility to make sure that communities are doing well. There is Psychological Research that can help them do that work better. We are working with them to make sure that they are addressing both of those. Their public and response builds to the community. Host dr. Evans, before we run out of time, i want to make sure i ask you this question. What should we, as parents, be looking for in our children, who have been looked going through all of the same stresses we have but maybe not have the same words to express it, like an adult would. What should we be looking for in our children, who have also been stuck at home with us, not just our elementary, middle school and high school students, but also our College Students who have been sent home from their universities . What should we be looking for . What should we be worried about . Guest there are a lot of different issues, depending on where your child is developmentally. They are missing a lot of Important Development milestones. They are missing prom, graduation ceremonies, they are missing a lot of things. There are a lot of issues that they are dealing with. It is important to first acknowledge that and then to do things to compensate for that. Those things can be both things that you can do now. We have good friends in atlanta. Their son, who is a senior, is missing his prom. The whole family dressed up, mom, dad, siblings, and they celebrated his prom. Those kinds of things can go a long way in helping to compensate. They dont replace your prom. But, they help people to deal with that loss. It is also important that some of those things can be delayed. We know on number of universities are starting to are starting to invite people who are missing their commencement this year back to next years commencement. Those ways of compensating are really important. For younger children, i think it is important to provide information about what is going on. Parents are good at understanding how to talk to their children in a way that they understand. I think they should use that knowledge to be able to talk to your child about what is happening. Program that books imagination these are books for Young Children and they are focused on issues related to their mental wellness. They talk about anger and loss and those kinds of things. Have a reading by authors of those books on a regular basis. You can go to our website, apa. Org, to get that information. I think parents paying attention to what are the unique issues your child is dealing with. They might be fearful and have anxiety about what is going on, or older children, and adolescents, they might be missing these milestones. Understanding that and addressing that with them is going to be important. Host lets take a couple more phone calls. Iswill start with mary, who calling from washington. Good morning. Caller good morning, gentlemen. Whent wanted to say that this first came on, it was like an overdose of too much information. Have been ii just limit myself to maybe two programs. Of course, if it is really , or something that comes on, i try to catch it and i try to listen to the governor. The other thing is, when you were talking about children, i am a widow and i am disabled and i have a service dog. With animals, they dont understand it either. It is hard to explain it to your animals because they are looking to you. The thing is, i just feel like give a little bit more and take a little bit less and try and pass it on and think of other people, that is the way my mother and father always taught me. You feel so much better when you do something good. It does my heart good. Yeah. You know, i think you are raising another really important thing that we have not spent enough time talking about today. That is the issue of resilience and people being able to bounce back. I hope that the message that people are getting about until health issues, yes, they are very significant. People are very adaptable. People are very resilient. We are going to bounce back. There are lots of things people can do to manage what has happened to us. We do not have to be passive participants. To recognize that we all have strength that we bring to this situation, we all have skills and relationships, now is the time to call on those. A mentalhat there is health purge that is going to happen. Curve that is going to happen. We did things to flatten that curve. We are starting to see the signs of that. It is going to be important for us to flatten the Mental Health coming, and by educating ourselves about these things, i want to refer to our website. We have an in normas amount enormous amount of information that will help the public to better understand things that they can do. We know that if we do that, we can flatten this curve and make sure we come out on the other end of this, not only as good as we were, but maybe even better. Because we have gone through something, we have overcome it and we have come out stronger as a result of that. Callerets take one more , that will be marva from new orleans, louisiana. Caller good morning. One thing i would love to hear you emphasize can you hear me . Host go ahead. Caller i didnt know. As well as the strengths. I am happy to hear you talk about the resilience. Many people of color, African Americans are working as Service Providers and first responders, in direct contact with the covid virus. ,f you could talk about apas andrencing rape and stress the impact of grace and stress and the impact of. Iscrimination finally, if you could talk about resources theand National Agency is dealing with. And understanding what small, Young Children need in terms of the Mental Health, pandemic. Finally, the various resources, black psychologists, latino psychologists, there are a lot of resources that people may not think about that could be referenced. Thank you. Guest yes. Thank you for the question. I will see if i can remember all of the questions that you asked. Those are very good questions. I think the issue of disparities we are seeing in terms of outcome, the morbidity and mortality of African Americans and latinx communities is important. What it is exposing is that exist already. Es what we have seen is that when you layer on to those disparities, the pandemic, it exposes that. What it means is we have to Pay Attention to that. We have been in conversations with the white house and with other people in the government about what kinds of things we can do to address that. One of them is to make sure we have good data, because, in the absence of that, we dont have the information we need to guide our interventions. The disparities we have seen are complex. Some of them have to do with structural issues in our health care system. Some of them have to do with preexisting conditions that people have. Some of them have to do with, of color working in environments where there is greater exposure. There are lots of Different Reasons for that. One of the things we know from the Disparities Research is that it varies from community to community. What might be causing a disparity in l. A. May be different than what is calling causing the same kind of disparity in rural mississippi. You have to have the data in order to understand what is going on. So, that is something we are advocating for and working with the government around that. On that. Risk factorsout and protective factors. Every community has things that put them at greater risks for certain kinds of conditions and things that protect them from those type of things. Communities of color, one of the greatest protective factors are those social connectedness that we talk about. Are a verynities important aspect of that. And thingsituals that people do in those communities that are protective factors. And the point, which is a good one that you are making, even when we have these kinds of disproportionate impacts, we also have to look at not only what are the challenges but what are the strengths that people bring to those situations that can help. There were a number of other questions. I cannot remember all of the questions. The points that you are making about understanding differences within the population and designing interventions and strategies faced on those differences is an important point, a policy point and a Public Policy point. Host we would like to thank dr. Ceo of thes, American Psychological association, for coming here and helping us get through these troubled times. Hopefully, the next time we see maybe some of this will be over with. Will i certainly hope we be able to talk about how we have flattened the Mental Health curve and how we are better for it as a nation. Host once again, thank you. Coming up next, we will go back to the phone lines and we will let you talk to us about how your states reopening has gone so far. You will see the numbers there on the screen. We want to hear from you about how the reopening of your state has gone. Yesterday, louisiana Governor John Bel Edwards provided an update on covid19 in his state. Here is what he had to say. [video clip] we are proud of the progress that has been made, overall. Especially in region one, the Jefferson Parish area. Especially when you consider where we were a few weeks ago, with case growth leading the country and leading the world in louisiana. Almost all of it focused down in that particular area. If you just focus on orleans and Jefferson Parish and you see the improvements there, then your perception of reality is actually skewed, if you try to look at what is happening across the state as a whole. The progress is not even. The good news is that where we have growing cases and hospitalizations, it is not the rapid rise that we were seeing in new orleans at one time. It is still very concerning. Obviously, we have more work to do. That is what i am trying to get the people across louisiana to focus on. As we move through the next two weeks, good things will be here before we know it. We have work to do to continue to slow the spread. That is why we need to follow the stayathome order, continue to social distance and follow the hygiene practices that we have been talking about. I would remind individuals that the white house guidelines had the three criteria that we need to meet. One is symptoms, covid19 like symptoms that are being reported in Emergency Rooms across the state of louisiana. The number of cases across the state and certainly hospitalizations. You heard us talk about flattening the coronavirus curve. I want everyone to understand that i appreciate and they should all appreciate the work that louisiana is putting together to make this happen. Just like this past sunday, when you dig into the data, you see some areas where it is not quite so rosy. Announcer washington journal continues. Host once again, to close the show today, we want to hear from you on how your states reopening has gone so far. We will open up regional lines again for this. If you are in the eastern or central time zone, we want to hear from you at 202 7488000. If youre in the mountain or pacific time zone, your number will be 202 7488001. We want to know what is going on in your state, if your state is reopening, how is it going . Are people back out . Are you worried that people are out too soon . Knownt to hear from you from you how it is going. Lets hear from carol in san diego, california. Good morning. Caller thanks for taking my call. Diego, we have uneven opening. We lose you . Did caller no, i am here. s opening things up very unevenly. We have beauty shops closed but acupunctures are open. It just doesnt make any sense to me what he is opening up or not opening up. Usinesses are closed i have a friend who is a firm. Gal at a large law they cannot open up, even though they would wear masks and gloves and go in on a freight elevator and be 10 feet apart, at least. He is refusing to open up these businesses and i just dont get it. Host california seems to be one of the places that is having a bit of a problem right now. Here is a story from business insiders. Thousands of protesters swarmed the huntington beach, worldrenowned for its surfing protests to california stayathome orders. Gavin newsom made the decision to close all beaches in orange county, after the previous swarms ofd seen people ignoring Public Health guidelines. 1, following day, on may weres of californians demanding that the beaches reopen. . Ow is it going in your state do you see the same protests . Are people going back out again as normal . Calling to jim, who is from chapel hill, North Carolina. Caller i think it is sort of the same thing in North Carolina. Governor cooper, it has been uneven. You have places like Raleigh Durham and charlotte that have a higher population of people that can work from home. You have a majority of the state that is not like that. There businesses are closed. Gastonia has opened up a case against cooper, saying we want to reopen. He said if you reopen, i will pull money for a public works project that has been going on for a decade. You have beaches that apparently are reopening, while others are not. You have localities that are saying we are going to reopen and others that arent. You have protests that are taking place here each tuesday. Our hospital, i live in a neighborhood full of doctors and nurses, our hospitals are empty. We have floors in raleigh and charlotte, that are dedicated to covid that have a handful of patients. It seems like he does not have a plan to reopen the state and it is causing a lot of financial issues. Host according to my math, it says that North Carolina will be reopening on may 8, which i believe is next week. Do you think that is not soon enough or do you think it should be done right now . The order extended from april 30 to may 8. I see no reason why North Carolina cannot reopen right now. It is not that we dont care about the people that are sick. There are 11 million to 12 Million People that are here and reachks like we will not as high as flu season. I think North Carolina needs to reopen now. I think most experts are thinking the phases of reopening are going to be so slow that it will cripple the economy. Raleigh will be fine, charlotte will be fine. It is those other places, winstonsalem and asheville that are going to struggle. Host that was going to be my next question. Should there be different reopenings for different parts of the state . North carolina is diverse. You have mountains, cities and beaches. What is good for the outer banks by not be good for the mountain areas. Should they make the decision based on different parts of the state or just say we are open or everyone should be closed . Caller no, i agree with exactly what you are saying. I think different parts of the state, western North Carolina is more mountainous, the piedmont does not have as many cases. I think we could do a staggered reopening. Those beaches in eastern North Carolina that need the revenue, i think that is a better way to do it and it seems to make more sense, rather than saying here is a blanket closure. Host lets go to carl, who is calling from kansas city, missouri. Carl, how is your state doing . Caller it is pretty good, i guess. You know what . It is a major thing. I am a 76yearold x veteran. Veteran. I have a suggestion. Please dont cut me off. I have is problems the constant propaganda against the masks. Why do all of these Health People wear them . The problem is there is not enough masks to go around. Longjohnse a pair of or a long sleeve, cut yourself a mask and dry off some lysol wipes. The chemical is not good. Put them in there and tie them around you. A far as as far as our state or any state dealing with this problem, they need to mandate Wearing Masks because this stuff is not going to go away. They are not doing that and they are not being up right. I think there might be a profitability to the masks. Anybody that cares about themselves can make a mask out. I am not trump, i dont think you should take the chemical. If you dry it out, you have a tough fabric that will wear well. I put them in my regular masks. There is no mandate for masks and this stuff is not going to go away. Host lets talk to roger, who is calling from ana, illinois. Caller i am from illinois. All of our counties around us have probably less than 30 cases of positive covid19. There is no reason we need a stayathome order at all. People here in our area, i could in illinois,usands our governor is doing a terrible job of saying we need to stay where we are at. Are streaming live at a church where i go. Whole, our state is in trouble. That on my, i see map here, it says illinois is going to open on may 30. You guys have another month to deal with these stayathome orders. How is it going to affect you . Caller i think that it is wrong. It is not right. We dont have any cases. We have a total of 20 cases. We have no deaths. We have people that are in isolation. We have eight that have recovered. Host what about the larger cities in illinois that have larger numbers of people . Do you think there should be different rules for different parts of the state . Caller i think so. I think our city should be reopened and everybody back doing their normal thing. Masksve to wear are wear a mask at walmart. There is a shortage in that area. I really think that if he looks at the deep south, which he is not doing, he is looking at cook payingand he is not attention down here to our people. He is not hearing what we are saying. The question was asked to him, why havent you looked at the deep south a little different and he turned and laughed like it was a joke. Ist lets talk to john, who calling from middleton, new york. Morning. Caller how are you doing . Host just fine. Go ahead. Caller thank you for the work you do and thank you for cspan. The honest news comes from cspan. I live in orange county, new york. For those folks out there that are talking and saying that they , withhave a problem all sincerity, god bless you. You are lucky. My wife is a nurse at a local hospital, and icu. We live in a county that is somewhat rural. It has rural roots. We are hit harder than most states. We are closing in on 9000 confirmed cases. Over 300 deaths. This is nothing to be taken lightly. That is coming from the words of a man that knows the seriousness of this because i see what it has done to our local hospitals and what it has done to the morale of the people that work there. We have to be locked down. I can understand, you look at , young and other states look at new york state, these counties have very few. They are lucky. They are blessed. When you live in a county that you see the numbers that we have , going up every day, we have to stay locked down in parts of our county. Some of ourlook at social media followers and what they are saying about what states should do and how their state is doing. Here is one tweet that says states need to be smart, not selfish. Open areas slowly that if rates increase, be ready to shut back down. Here is another text that says gulf coast beaches around tampa are opening money monday. Swimming and walking, only. We will see how it goes. One from South Carolina says that the problem with reopening is the public has no confidence in anything the president says. The president is a liar. The only thing we see the president is doing is backing the courts in a way to protect criminal activities. Here is another tweet that says there should never be a statewide reopening system. It should go county by county or town by town. Everything starts local, including a deadly virus. One last one says we are currently in arizona, people are out and about. Very few wear masks. The people are taking back their state. Lets see if we can get a few more calls in the for the end of the show. Jan from san antonio, florida. Morning. Caller i am a little nervous. I have never called. And i came from a store was surprised to see the line was a mile long. I dont think families should bring the whole family to do shopping. Either the mother or the father, but not all of the kids. I could not help but notice they did not have masks on. You have six people with no mass. Maybe they could turn you away if you dont have a mask or provide a mask if you come. But, encourage people not to bring the whole family to do the shopping. That is just my opinion. , who ists go to dave calling from irvine, california. Good morning. Caller good morning. You should not make it mandatory that people cant go to the beach. People want to go, go. They dont want to go, stayathome. If anything, they should close the restaurant. You go through a drive through and people are sick, you are going to get sick. I dont understand it. By telling people they cant go to the beach you dont want to go to the beach, dont go to the beach. You want to go, let people go. It is stupid. Host should there be a cost for people who ignore social distancing guidelines and go to the beaches and then end up in the hospital . Thatr i mean, the people are all working, they are going. Be a guideline, where your mask. If you dont want to wear your mask, dont wear it but stay away from those people. It is pretty simple. For thing is going to go on a long, long time. They let this thing come into the United States. Now, we have a problem. Now, everybody is sick. Host lets go to chuck, who is calling from winchester, virginia. Chuck, good morning. Caller good morning. I live in winchester, virginia, which is frederick county, virginia. It seems to me that most cases are east of the blue ridge mountains. We live in the northwestern part virginia and i dont think the cases here are anything like down there. I dont i wonder why Governor Northam cant allow this part of the state to reopen and enjoy life. I am a senior citizen. But that is basically my comment. Governor northam has basically closed virginia down until june. How will it affect you to have the state still under the stayathome orders all the way into june . Is very inconvenient. You are afraid to go anywhere. Us,e now, just south of they have reopened the drivein theater with a limit of 200 cars. That is great. You are in your car. It is hurting churches and veterans clubs, especially, that cannot be opened. That is their livelihood. Let them open up to a limited basis. Winchester, frederick county, where we live, i dont believe the cases are that high. I believe the cases are very low. Everything seems to be east of here, down by washington, richmond, that whole area. The population is very high there. Here, it is not. Host lets talk to lynn, who is calling from las vegas, nevada. Good morning. Caller i would like to comment on the face masks, i agree with a few callers calling in. Peopling Wearing Masks people are not Wearing Masks and i have ,een screaming on social media sites these different since march 1. Everybody, wear a mask. Nobody wants to Pay Attention. Fauci can even make his mind up. He is following the who guidelines. Yesterday, and we are following this guy. To openvada is going back up on may 15. That is about two weeks from now. When nevada opens back up on may 15, do you plan to go out without your face mask . Or, will you continue to do will you continue wearing face masks and gloves when you go out in public . Wearr i will continue to a face mask and gloves. If anybody approaches me without and has their mouth raised, they better use it to protect their nose because i might break it. Host i assume that you are not going out. Has there been any other changes that you can attribute to the stayathome order in nevada . Caller no. Than, a high stress level. You go to social media and you on theven get an update cdc guidelines, without having to go through all of these different ads. It is outdated. Host lets talk to elizabeth, who is calling from massachusetts. Good morning. Caller good morning. Host massachusetts. What do you think yall should be doing there . The governor is going to open the state back up on may 18. Is that too soon or too early . Not, have not been watching the news. The sun is shining, the sky is i would turnought on cnn for punishment. I did not get to cnn because i got to a fascinating show. Apparently, it is connected to the Washington Post. And it is quite fascinating. And then i saw just now this on how is your area doing and now, i guess i have a liveperson. Ist lets go to rachel, who calling from michigan. Rachel, good morning. Caller good morning. I have a comment on the gentleman that called about opening the part of the state where there is not that many cases. I was in an area where there have not been too many. Governor has a duty to protect us all. I think if a place in the state peopleopen, i think would flock. I amour governor glad that she is protecting us and protecting me and my family. I dont agree with everything that has happened. Iknow that that is a position would not want to be in. I hear a lot of people saying aboutre angry and upset not being able to have the freedom to go around. I see more people Wearing Masks now. I spend very little time out and about. I have pretty much been doing the quarantine with my family. Host we would like to thank all of our viewers, all of our callers, all of our guests and all of our social media followers for being with us for another cspan washington journal. Join us again tomorrow morning at 7 00 for another show. Have a great saturday and stay safe. Announcer television has changed since cspan began, but our mission continues, to provide an unfiltered view of government. Already we brought your primary election coverage, the impeachment process, now the federal response to the coronavirus. Watch all Public Affairs programming on television, online, or listen on our free radio app. Be part of the conversation through washington journal, more through our social media feeds. Cspan, created by private industry. A public service. Brought to you today by your television provider. Announcer sunday night, how a videogame creator is bringing peace and resolution to a wider audience. That country, the country i live in, 70 is all young people. They were raised in war. A communist era, they think about war. I thought, what if these people Start Playing this videogame, not because it is too violent, but the same thing is happening in my country, killing people. It will be like how things are done. I was like, what about creating a game for peace. Announcer what sunday night on cspan. Watch sunday night on cspan. Announcer adam schiff discusses the federal governments response to the coronavirus pandemic. He also talks about his belief in the impeachment trial showed president trumps leadership style, which in his opinion has led to the mismanagement of the pandemic. This is about one hour. Welcome toeffery the program with the commonwealth club, coming to you virtually. I am clara jeffery. We are addressing the impact of covid19 on society at large. We want to thank the