-Okay.
Good morning, everybody.
Thank you for being in our headquarters, our fire department's headquarters for
what we think is a very important topic.
Of course, we're here to give a progress report on our Health 99
overdose response unit showing how the city is advancing an innovative
health first approach to the deadly opioid and synthetic drug crisis.
I think many of you are following this work, and because of how
we do this work, sometimes ride alongs are not appropriate.
And so we thought it very appropriate to give you an update
in light of what's happening in our city.
We all know that fentanyl and synthetic drugs are a scourge on our city,
and we don't have to go far to see the effects of what's happening out there.
It's killing people who are using them and creating unsafe
and unwelcoming conditions for all Seattle residents.
We know that our Seattle Fire departments, EMTs
and paramedics are responding to approximately 103
suspected overdose related
emergency calls per week throughout the city.
That's a critical number.
This is why
part of my executive order that I issued in April called for build
building an evidence based public health approach to support people struggling
with addiction to these dangerous and highly addictive substances.
Now health 99, as we've called
it, is a critical component of this health first approach.
It charts a new course for following up with overdose survivors
to make referrals and handoffs to life saving treatment.
Now, by dispatching the Health 99 unit to overdose calls,
dedicated caseworker can quickly engage with an overdose survivor and provide
compassionate outreach and referrals to support.
And we're hopeful that this unit will play a critical role in creating a
a supportive ecosystem where people experiencing addiction
can access treatment to help them recover and live healthier,
optimizing lives.
I've been clear in
how the city has been going about this kind of work.
A dual approach leading with treatment (coughs) excuse me, leading with treatment
from those suffering from substance use disorder,
and focusing our law enforcement
resources on the need on the narcotics traffickers
who are bringing these deadly substances into our communities.
Now we are acting with urgency to build out a bold health first approach
to help those in need and to curtail the impacts of
public drug consumption
and hold dealers and traffickers accountable.
We've been making progress to inter-interrupt
the flow of narcotics into the city and with our federal partners
working collaboratively with them, our police departments.
And some of you have heard me talk about this recently.
We've seized
over 2 million
fentanyl pills so far this year.
Surveys have demonstrated
that 80% of opioid users
say they want to stop.
They want to reduce, reduce their their drug use.
But too often we do know that care is either
not available or too high over barrier for them to access.
So in July, we did announce a spending plan
for $27 million investing in enhanced treatment facilities
and new addiction services, and an improved overdose response.
We continue to make progress on these actions laid out in my executive
order, including launching an innovative Contingency Management System
management program with Plymouth Housing that will kick off next month.
And as this work continues on a post overdose diversion facility,
you also heard us announced our increased mobile
opioid medication delivery and expanded, uh,
naloxone in the city's highest overdose
locations.
So our North Star continues to be saving lives and helping people,
helping people access to treatment they deserve, and
to work to build a safer and a healthier Seattle.
And that's what all of our strategies working together are intended to create.
Next, you're going to hear from Councilmember Lisa Herbold, who,
as many of you know, chairs our Public Safety Committee, has been working
in politics one way or the other for decades and who's
an outstanding and compassionate leader in our city about what she cares about.
And we'd love to hear some words from Councilmember Lisa Herbold.
-Good afternoon.
The creation by Mayor Harrell and Chief
Scoggins of Health 99 continues Seattle's reputation
as a national leader in health initiatives to address the opioid crisis,
a crisis that's faced by cities all across the nation.
Follow up care and warm handoffs
to services are essential to reduce
the likelihood that an overdose is repeated, accessible
emergency care wrapped in inclusive and supportive services,
help more people center
and enter addiction recovery.
Public health and public safety are intertwined issues.
The fire department is doing this work to build
a healthier and safer Seattle
to support, to support the urgent funding for one element of Mayor Harrell's
April executive order, specifically access to mobile
on opioid medication delivery.
Last month, I championed $1 million
in funding to support Treatment in Motion,
which is a mobile medication vehicle that will be available at three
additional locations with a capacity to serve up to 360 people each day.
Next week, I'll be hearing legislation
in my Public Safety and Human
Services Committee to appropriate $7 million in support of Mayor Harrell's
$27 million investment announced in his April executive order.
This-these funds will be used to support an overdose recovery center.
So Health 99 has a location
to take people after non-fatal overdoses so that they can recover,
get stabilized on medications and access resources.
One of the things I hear most from the fire department is when they
successfully reverse an overdose of somebody
who is living unsheltered, they saved their lives
and then they move on and leave that individual on the street.
There's no place to take those folks.
The overdose recovery center,
which we'll be working on again next week, will
respond to that call that we're hearing from firefighters,
a data finding in the public use
and possession bill that the council is voting on today.
Documents that between January and July of this year, there were 11
overdose responses on average each and every day
in a public place.
We hope if we hope that by adding an enforcement tool that successfully
prioritizes diversion over arrest, we hope that it will help people.
We must increase the number of places for people to go.
If you have someone that you care about and you love who's an addict,
what you care about most in first is that they do not die
in the throes of their addiction. By investing in Health
One treatment in Motion in a post overdose recovery center,
we are expanding access and breaking down barriers
to proven treatment for our most vulnerable residents.
We cannot end the fentanyl epidemic and drug overdose crisis
without treatment, and we need more treatment options, not fewer.
There's so much more work for us to do.
I'd like to introduce Fire Chief Scoggins to to the dais.
I've really had a great pleasure working with him over the last
last four years, and he is really a driver in
elevating Seattle's
reputation as an emergency responder.
-Good morning.
My name is Harold Scoggins, fire chief of the Seattle Fire Department.
I want to lead with a thank you to Mayor Harold and Councilmember Herbold
for your ongoing support of the Seattle Fire Department.
You know, it's really important to note that this isn't just the fire department
and Seattle Fire Department,
Human Services Department and so many other community partnerships.
We're living Mayor Harrell's One Seattle Vision
in the work that we do every single day.
Our pilot began on July 7th of this year.
We have continued to see a steady
increase of Seattle firefighter EMTs, paramedics
responding to suspected overdoses in the city.
Current Seattle fire overdose data reads like this.
We're going on about 15 a day, a little bit over 15 overdoses a day.
Now, to put that in perspective, so far this year,
we have responded to over 4000 overdoses of all kinds.
And once again, to ground you a little bit more.
All of 22, we responded to just over 3,700.
So we're in September, mid-September, we're over 4,000
and we've already exceeded 2022’s number significantly in 2021,
we had about 1,700.
So the problem is getting bigger
and it's important to deploy resources to help with that.
Frontline Seattle firefighter EMTs or paramedics
are dispatched initially to overdoses
to provide emergency medical care and the new post Overdose
Response team is added to these responses as available.
The role of the post overdose response team
begins once the patient is awake.
It's important to note so the firefighter EMTs and medics have got there.
They've done their thing.
They've stabilized the patient and now Health 99 is on the scene.
The post overdose response team is part of the fire department's Mobile
Integrated Health Program and responds out as Health 99.
And just to give you a little bit about our Mobile Integrated Health team,
you know, we all know we launched that program in 2019 with Health One.
We have a Vulnerable Adult Program.
Our case managers do an amazing job responding to vulnerable adults.
So this is another component of that team.
But Health 99 is staffed with the firefighter, EMT,
and a Human Resources, Human Services Department case manager.
And Riley is here today.
Riley goes on most of these responses.
A single unit typically operates Monday to Thursday from 9 a.m.
to 7 p.m..
Health 99 works with a wide array
of service providers to connect individuals who have experienced
an overdose with outpatient substance use services, primary care,
homeless outreach services and so much more.
The pilot program focuses on
Pioneer Square, Chinatown-International District,
Belltown, the downtown business district, and Capitol Hill.
But the team has discretion
to respond elsewhere in the city Health 99 stats,
since becoming operational, they've responded to sixty eight overdoses.
They've conducted 20 client outreach visits.
That's after the overdose, during follow up
with the person who has had an overdose.
From combined overdose responses and follow up visits.
The unit has provided services to a total of 52 individuals.
Some of the clients served by Health 99
have been seen numerous times by the unit.
That means the same person is overdosing over and over again and the team is on
scene, still doing the work, still trying to get them into the services.
77% of those served by Health, 99 are male.
The majority are also experiencing homelessness
and have a mental health history in addition to battling the addiction.
The team averages 3 to 5
overdose responses per 10 hour shift.
And as you can imagine, when they find someone that says yes
and they actually start getting them in the services,
that is a very long response where they providing the care
and needed services to get them connected that you're going to hear
a little bit later. With the success
we have had thus far within the pilot.
There are so many difficulties and barriers to this work.
A sizable
percentage of clients served by Health 99
can't and won't engage in services, but that doesn't mean we stop.
Our team stays on it. Experiencing overdose
or have need it or have a need to go to the hospital.
Many of them are using meth at the same time,
which makes this work much harder.
So it could be fentanyl, it could be meth, it could be opioids,
a combination thereof.
And it makes the work much more complicated.
There are also challenges with finding clients
after the first contact since so many are unhoused.
And this is where our Health One program comes into play.
They help with that.
We work really hard to find the person after the overdose.
Additionally, finding destinations for all hours clinics, places
to do buprenorphine induction and shelters also prevents difficulties.
So finding a place to take a person to get the needed care can be a challenge
sometimes.
Success for this unit so far includes connecting clients with resources,
but it also encompasses harm reduction
or even having a conversation with individuals after the overdose.
And sometimes that mean Health 99 is doing a leave behind with Narcan or Naloxone.
So just as our health one units are doing also.
So if they haven't said yes, let us give you this in case it happens again.
Since this is a pilot, much of our work to date has resolved-
-esolved-revolved around establishing partnerships and learning
about characteristics of overdose and overdose reversals.
It's important that we understand what that is.
Because we have personnel who are on the front lines,
we think the fire department is well-equipped
to be a part of the multi-system response
to this drug epidemic we are facing.
Next, I'd like to introduce
Seattle Fire’s Mobile Integrated Health Program
John Ehrendfeld, who does much of the critical
thinking with his team on how we respond to overdoses.
And it's important to note that members of his team
came up with the idea and concept of actually putting Health 99 on the street.
So now I'll turn it over to John.
-Good morning.
My name is John Ehrenfeld.
I'm the program manager for Mobile Integrated Health here at Fire
and I'm going to try to be brief and thank you, of course, to Mayor Harrell,
Councilmember Herbold and Chief Scoggins.
We founded Health One about four years ago.
Our hypothesis was that the fire department
was uniquely positioned to identify and locate people in crisis
without adequate social or medical supports and connect them with resources.
We believe that the fire department, with its rapid response, adaptability
and deep trust in the community,
could reach out to people who were falling through every other gap in the system.
We believe that we have validated that model in the last four years.
Now we are testing a similar hypothesis around the opioid and fentanyl crisis,
drawing on models from around the country.
We see an opportunity for the fire department
partnering with the human services department
to reach people who might otherwise
be unreachable and intervene swiftly after they have overdosed.
And we have certainly encountered success
so far in this, and it is by no means the majority of our clients.
But we have found clients
who have overdosed on the street or in their residence, connected with them,
had a trauma-informed conversation with them, and obtained
their consent to bring them to an alternative, non-emergency department
based clinical setting, such as a buprenorphine clinic.
Again, not the majority of the overdoses, but we have validated the model showing
that this is, in some circumstances a possible alternative for these clients.
The scholarly literature shows unambiguously that surviving an overdose
dramatically raises your likelihood of death within the next year.
So this population is particularly vulnerable and particularly in need
of support.
The literature also shows that connections of medications for opioid use
disorder prescribers offers the best chance for recovery.
But this connection cannot happen in a vacuum.
Just as our Health One teams work with a huge ecosystem of services
to address behavioral health, homelessness and poverty,
we will need to do the same with the opioid crisis.
We acknowledge that we are not dealing with a single crisis, but rather
a set of overlapping needs, including homelessness, mental health care, poly-
substance use, lack of housing and shelter options and more.
We are committed to thinking deeply about how this team can be part
of a supportive ecosystem and refining our approach led by data and evidence
to best use our unique skills and-and access to reduce morbidity
and mortality
from overdoses and connect our clients with the supports that they need.
And so to talk a little bit
more about the wider ecosystem that we work
in, I'd like to introduce my colleague, Dr.
Callan Fockele from Harborview.
-Thank you
to the health team for inviting me to participate in today's discussion.
My name is Callan Fockele, and I'm an emergency and addiction
medicine physician at Harborview Medical Center.
In the emergency room, we see firsthand
the impact of the opioid overdose crisis.
Five years ago, I was working in the E.R.
when I saw a young man who presented for an accidental heroin overdose.
I discharged him with available resources at the time.
A take-home naloxone kit and a one-800 number.
A few hours later, I was called by the paramedics
there, performing CPR on a patient who had been found, pulled pulseless
and surrounded by drug paraphernalia and hospital paperwork.
They wanted permission to cease efforts.
Before hanging up the phone,
they identified the deceased and the growing knot in my stomach tightened.
It was the same patient I had just discharged.
Research shows
that an overdose survivor like my patient is more than 100 times
more likely to die in the next year than the average person.
This is comparable to the risk of death in the year after a severe heart attack.
Think about all the things we do
for patients who suffered a heart attack.
They come in as a code, the emergency room.
We rush them to the cath lab.
They're hospitalized, started on medications
and discharged with close outpatient follow up.
What did I do for my patient?
I gave him a naloxone kit and a turkey sandwich.
We need to do better, especially since we had safe and effective medications
to treat opioid use disorder like buprenorphine and methadone.
Fentanyl has also, unfortunately changed the landscape.
This year's number of overdose deaths associated with fentanyl
has already surpassed last year's count.
Because of the way fentanyl acts in the body,
patients often have difficulty getting on these medications as an outpatient.
However, the minutes after an overdose survivor receives
naloxone could provide a critical time to initiate treatment with buprenorphine.
Not everyone will want medications to treat opioid use disorder,
but everyone should have access to them,
especially immediately after overdose.
When patients are at the highest risk of death.
Establishing the post overdose response team is an incredibly important step
to bring evidence-based interventions into the field where they can save lives.
This team will provide a strong foundation
to build on as we continue to reimagine our community's overdose
response, providing people effective and compassionate care
at the moment of crisis.
Thank you.
-Thank you, Doctor Fockele.
At this point, I believe I want to-
before I take some questions, I want to thank all of you for being in this space.
This is critical work we're doing for the city.
And I want to thank you from the bottom of my heart.
And with that we’ll take some some questions.
Please.
And I'll just call on-go ahead.
-Hi. (unintelligible)
-Sure. -Thank you for the question.
What I understood is that a reflect an increase in calls.
We are seeing an increase in calls. Last year,
the Seattle Fire Department ran over 106,000 emergencies.
This year, we're tracking about four or 5% higher.
But our overdose responses are actually tracking higher, too.
So I don't know if there's a direct correlation,
but we're seeing an increase in both in the department.
-Yes sir.
-Today you mentioned that the council’s going to vote on
(unintelligible)
negatively.
(unintelligible)
-The-whether
the legislation is a missing piece.
Just trying to-
well, I have an appreciation
for the what the council's doing.
This is significant legislation
and whether the delay has hurt us or helped us at this point,
I can't concentrate on that and I'm hopeful
that we'll have some good legislation passed out of the council.
Then we're and assuming that it is passed, I'm not going to waste
a lot of time on signing it quite candidly.
And hopefully we'll have our
our continuum of services on
how we approach the fentanyl crisis ready to rock and roll. And
Councilmember Herbold, if you want to add anything to that, feel free to.
So they have an important decision
to make. We're optimistic based on the committee discussion.
And I welcome that discussion and hopefully we'll be ready
to to help people who urgently need help in this city.
-Mayor (unintelligible).
-Yes, I plan on
signing an
executive order and we are monitoring all the conversations on the council,
listening to communities impacted communities, health providers,
and our executive order.
I'm looking at my director of communications,
and if he goes like this, that means I'm not supposed to talk about
when we're going to release that but in all seriousness,
we're after our discussion after the council discussion today,
um, they will be ready to release it in a short time,
short period right after.
-(unintelligible) I'm sorry, I couldn't hear you.
-What would the executive order look like?
-A few things.
Number one is, as I've said repeatedly,
what our police department are really looking for is clarity.
When they see certain activities
and it hopefully helps them with this threat of harm standard,
get some clarity on at least what the executive branch is thinking about it.
Also start off with a baseline approach on who are
who's impacted, how many people are using drugs, impacted drugs, where's this,
where does this activity
where does this activity,
where are we talking about what we see every single day?
I think it's critical
to have a baseline approach on data on what we're trying to accomplish.
And then after that, we'll be able to look at the outcomes in one year,
how many people were diverted, how many lives were saved, how many
people were arrested with an arrest
strategy. We’ll open up the data for the entire city to see.
But most importantly, for the decision makers and electeds to see,
to see how well we are doing to help people.
And so the executive order sort of outlines that those parameters,
and it'll be public here very shortly. Yes.
-(unintelligible) -Do I think there's harm from secondhand
fentanyl smoke?
I don't know.
I have a doctor here.
Well, how would you respond to that?
How would you help the mayor out on all one of these tough questions?
I'll tell you, I don't want to be around it, but
if you would like to discuss if this is out of your expertise.
-Well, I’m just going to say I,
I, I don't think there is.
-If-if-if I'm putting you on the spot.
-Well, I- -I’m a politician, I'm paid to do this kind of stuff.
-This whole thing is putting me on the spot.
But I do I do feel like when we think about exposure out of the community,
the really the only exposure we're seeing when we know
that they're not impacts people is through direct inhalation and ingestion.
So this kind of contact of fentanyl puts people at very low risk.
I don't know if that answers your question.
-Unintelligible.
-I'll I'll answer your question directly.
I want to have a little medical expertise.
I'll I'll just speak from a personal example.
I don't want to be around it.
I don't think I haven't heard of anyone that's not using it.
It wants to be around it.
So just as though there was a smoking ban in our state, I think that
we have to be really, really concerned about, particularly in transit in a
in a bus station around a transit area where people have a right to be
who wants to be around toxic-exposed to toxic chemicals.
And so I think that's almost a common sense.
And I just wanted to hear a little medical
perspective on that. Yes.
Yes. Oh, yes.
Chris jumped ahead about three times.
I'm coming back to you.
-(unintelligible)
-Sure the question was around Health 99’s hours of operations.
And you're, you’re correct, that is a direct relationship
when there are service providers available.
If, um, there were service providers available seven days a week all around the clock,
I would be going to the mayor and Councilmember Herbold and communicating that.
But the reality is that's not the case.
So the team works in a in a time frame
where they can take someone somewhere to get some help.
And that's important to know that.
-Chief, while you’re still there, you mentioned (unintelligible)
What are-what’s your team doing (unintelligible).
-Well, it's it's a lot bigger than that, the team does
drive around and try to find them in their last known location
or where they say they may be.
But our other health, one units can help with that, too.
Our other firefighters around the city can help with that.
So we generally deploy all the resources we can to find the person.
John and his team does an excellent job in trying to relocate.
But if a person is unhoused and they move their tent
from one block to the next, it's hard to find them.
But they know who they're looking for.
And oftentimes they do find them, but sometimes they don't.
-(unintelligible)
-If we're on duty between 9 a.m. and 7 p.m.
and someone says they want treatment,
The Health 99 team will will literally put them in the vehicle
and take them to a location so we can start that location.
We have
a partnership with the clinic in Belltown that's been helping us out on that front.
So that's been good.
Just like our Health One units, if someone says,
Hey, I don't want to be on the street anymore and they
they need a lift to the shelter, our Health
One teams will put them in the vehicle and go find a location to take them to.
So we deploy all of those resources we can to find
whatever help is needed for the person that needs the help.
-(unintelligible)
-I'll be a lot simpler than that.
If we can get one person into treatment and change their life,
I view this program as a success because if it was my family member
and they made that significant change in their life and they get healthy
and they have a positive outlook on life, that's a success.
We have had more than one, but that's one of the ways we will measure success.
We measure success by if someone says, you know
what, I will accept that leave behind or I will accept that education
or I will sit and talk with you a minute because what all those things are doing,
it's building the relationship possibly for the next time it happens.
And then they will be willing because there's trust and there's a relationship.
And then maybe we we may not get them in the service
the first time, but maybe it's a second time.
So all those are measurements of success.
That's why we track all of those things.
-Yes. -I was just going to ask,
do you have a particular area where you are seeing success?
We know total overdose rates are higher this year than before, but
is there a particular area
where you're going to see that you mentioned a clinic in Belltown, but
is there a success story you can share?
-No, we don't have a geographic boundary where we're seeing success.
But as I mentioned, we're operating in Pioneer Square,
the Chinatown International District downtown, Belltown, or any other place.
Any of our fire units will, um, call us to.
But we do have some success stories.
Maybe I'll ask John to come up and share a success story.
John, you mind come on up to share a success story? Because we have them, they’re real.
-Yeah. So, you know, we
responded
to an overdose out in the community was a gentleman was unconscious, unresponsive,
quickly resuscitated by our EMS crews,
our Health One team came in very rapidly.
Were able to quickly build rapport with him, which, you know, is
certainly does not always happen.
But in this case, they were, he indicated that he was amenable to treatment.
They phoned over to a clinic that we're working
with very closely right now out of Kin County Public Health.
He agreed to go and take a ride up to the clinic.
We were able to do a pass off to them.
They get him started on some medication to control his nausea,
because a lot of these folks are feeling extremely bad
because they're in withdrawal and after the resuscitation.
And so, you know that subsequently,
you know, it gets much more complicated in terms
of, you know, are they able to start on medications?
Are they able to establish a relationship?
But just in that sort of very minimal case, it's a success because we show,
you know, there is going to be a subset of folks who we can divert, again,
away from either remaining in the community or going to an ER.
We can divert them to a clinical setting.
And so again,
with the understanding that this is not going to be every encounter, it is, it is a success.
-But do you see the step one like this is the triage, but
you see this step one in turning a corner and stopping this epidemic?
-I think it's, it's part of it’s part of a wider ecosystem.
So.
-(unintelligible)
-You know, as I said, when this was announced several months
back, once we conclude the pilot, we'll look at all the information
and we'll put the we’ll present the information to the mayor and
and and we'll go from there.
But right now, we think it's positive.
It's a part of our Health
One overall program, and we think we are having some positive outcomes.
So we'll present all that once we wrap up.
-We'll take two more questions up, uh, I guess three.
So go ahead.
-Can you just expand a little bit on the (unintelligible)
-Well, I could
-(unintelligible) overdoses are happening int he city?
Overdoses are happening in the city all around the clock.
It could be two in the morning, two in the afternoon.
We have crews that come on right on shift early in the morning
and they're going out the door on an overdose overdose.
So it's happening all around the clock.
-Is there any day or any day of the week when you see an increase?
-We can probably run that data,
I just don't have it right now.
We have the data on where we're going and for what we're going.
But I didn't run that before this.
-Sarah Grace?
-What is the term of the pilot, and then are there any
other geographical areas where you (unintelligible).
-So our goal is to run the pilot
for I think what I said a few months ago between three and six months.
And the reason why I put that window on is we didn't know how many calls
we would actually have.
So we want to have a nice subset of information
before we present that further.
And right now we're concentrating in the areas I mentioned because that's
where most of the overdoses are happening in the city, that that's
why in that core and the downtown
core in all the areas I mentioned, that's why we're concentrating there.
Thank you.
-This sounds like what might be part of the new drug possession public drug use law
is is is one (unintelligible) or the other
(unintelligible) place to take people.
-I'm sorry, (unintelligible).
-The question is,
this sounds a lot like what's been discussed for weeks
regarding the new drug possession and public drug use law.
Is one dependent on the other?
You mentioned the $27 million that would be used
to create the aftercare for drug overdose victims.
-I think the question is, is
is is this one
uh, method
by which we address the fentanyl crisis dependent upon the other?
That's a good question.
So I look at it sort of in three phases.
One is all the work we're doing, even in the Education Department,
even in the Parks Department, on the preventive work
towards someone striving toward health, positive health.
That's all of the preventive work.
The second phase would be in the crisis
mode, where a person is using and they're in a crisis mode.
And a third phase sort of being is after the crisis mode.
How do we not only save that life, but make sure they're on an ongoing path
to recovery? And we are.
And so they are somewhat dependent on one another.
The continuum continuum of health
that I've been talking about since I've been mayor.
And right now this critical piece is when someone's in the crisis mode,
because it's all critical that we're there quickly
and we're responding with best practices.
And so we're sort of in that middle phase
getting to
the third pace on sustainable ongoing recovery.
So they are somewhat dependent upon each other.
You can't do too much preventative work.
When I go to schools, as I often go
to, sometimes I'll look at the children and I'll ask the educators
and academicians will wear on their path, might they go wrong?
Where are we losing them?
Because all of these people that are in these health crises,
they were children once they were playing on play fields once.
And so the preventative work we do, I can't say enough about
how we're trying to do on a very granular basis, looking at the safeguards in place
to help everyone.
But in the meantime,
until we have all of that five, ten, 15 year work, figured out,
we have to respond efficiently because we don't want to lose lives in Seattle.
So we're going to we're going to have a tour of the Health 99 apparatus next
so you can really see what's going on here and how we're doing this great work.
And I want to thank all of you for coming out for our presser on this event.
Thank you very much.