Researching environmental toxins in Houston

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Two years after Hurricane Harvey unleashed torrential rains on Houston Texas, join us as a public health researcher explains his years of studying environmental contaminants in the city and what changed after the hurricane.

Episode Transcript

Christina Sumners: Welcome to Science Sound Off. I’m Christina Sumners.

Tim Schnettler: And I’m her co-host, Tim Schnettler.

Christina Sumners: And we’re here today with Dr. Garett Sansom. He’s from the Texas A&M School of Public Health. Welcome to the show.

Garret Sansom: It’s so great to be here. Thanks for having me.

Christina Sumners: So, we’re here today to talk a little bit about some of your research on environmental hazards in cities, especially… I know you’ve done a lot of work in Houston. So, I guess let’s just start there. Why have you been looking at Houston?

Garret Sansom: Well, Houston is good from a research perspective because it is where the nexus of natural and anthropogenic disasters, potential for pollutant and exposures, environmental exposures and there’s a large amount of vulnerable populations. So, all three of those things kind of come together in Houston and it makes for research really possible on the health implications of those exposures.

Christina Sumners: Great. So, how did you first get started? What sort of research did you begin with in Houston?

Garret Sansom: I began working in Houston through the Institute for Sustainable Communities, which was the answer to the Texas A&M Environmental Grand Challenge a few years ago. And we operate in communities and neighborhoods. And we call them living laboratories. And it’s by invitation.

So, it takes a long time to sort of build local trust with stakeholders and other community-based organizations, specifically the Texas Environmental Justice Advocacy Services, or t.e.j.a.s., and Charity Productions, Charity Productions in Sunnyside, sort of South Houston. And t.e.j.a.s. operates predominantly in sort of Eastern Houston, mostly along the Houston Ship channel. And they had known some folks that work within the Institute for Sustainable Communities, specifically Dr. John Cooper Jr. had been working with Juan Parras, who’s the director of t.e.j.a.s., for quite a bit.

They knew about our expertise and our interests. And we wanted to learn about their expertise and their local knowledge. And we had a series of community meetings that took place in churches and schools, starting… I think the first one was late 2014 but then we definitely had a few in 2015 and they were hosted by our community partners. And we sort of brought together public health, with myself and some others, as well as engineering, folks from geosciences, urban planning and Galveston, Texas A&M Galveston. So, we had some folks over there.

And we were talking sort of about what kind of work we do and then we just… most of it was spent just listening. And they began to talk about concerns of the environment, concerns of industry. They’re worried about the health of their children. And then they really started to lay out really specific issues in their community and, at this time, it was mostly in the Harrisburg/Manchester’s super neighborhood of Houston. In case you don’t know, Houston’s split up in these super neighborhoods, where I think there’s 88 of them. And Harrisburg/Manchester is one of those. We took what they said and sort of the common knowledge of public health in the past has always been “we’re going to prescribe what you need to do and what the issues are and hopefully you’ll adopt them into your lives.” As the years have gone by, and especially now, it’s become clearer and clearer, that it really needs to be a bottom-up approach. So, it’s us learning with the communities.

So, the first thing we set to do was to either confirm, find or not find, the issues that they said were problems. So, one of the things they said was, “Gosh, every time we get a minor rain, it floods. Our cars flood because they have poor drainage in some of these neighborhoods. And we’re worried about what’s in the water. Our kids, they’re playing in this park, they’re eating the soil, as kids do. What’s in the soil? We’re worried about that. We’re worried about the air quality.” A lot of people were saying they don’t go outside at night because sometimes the industry sort of flares more at night, so it smells a little bit stronger. Now, smell, just to be clear, smell doesn’t necessarily correlate to a health issue but that is part of their life. They’re worried about the drinking water. Is it safe? And this was all before Harvey, our first meetings.

And so, the urban planners really began to sketch out, “Okay, how can we do better storm water drainage in these communities? How can we get the water out of here?” And then myself and the public health folks were saying, “All right, well, is there an issue with the standing water? Is there an issue with the soil that the kids are playing in, especially in the parks? Is it in the homes? Is the drinking water safe?” Which has led to many years now, so gosh, so I guess five years now, of continual monitoring and sampling and public health surveys and community health assessments of Houston Ship Channel Communities. And as the time has gone by, we’ve really built a productive, trusting relationship with the community and with our community partners that is kind of unique in this sort of research because it took a long time.

And they’ll tell you… so, I’ve been to several conferences now with our community partners. They’ve invited us. And they’ll typically start it off saying, “Look at this guy. Look at Garett Sansom. We did not trust this guy in this community.”

Christina Sumners: You look so trustworthy.

Garret Sansom: But apparently, I look like a science shill or something, I don’t know but they didn’t… So, it took a long time to build the trust, which is understandable because they have… It’s sometimes called research exhaustion because a lot of people know there’s issues in many Houston Ship Channel Communities. There’s also a lot of great things. There’s a lot of employment opportunities, so it’s certainly not all bad, but it has a reputation. The reputation’s there for a reason. So, a lot of researchers go in and what our community partners and our residents were saying that when we work with them is like, “Listen, a lot of times these groups come in, we’ll give them survey data, we’ll give them wipes from our floors and then they’re gone and we never see them again. And we get nothing out of this.”

Whereas we operate, we share in all data. It belongs to the community so they get it as we get it. And we’re in it for the long-haul. So, we weren’t done in 2014, 2015, 2016. And we’re not done now. So, at these conferences, they always say, “At first, we didn’t trust this guy at all but now we do.” And it’s really become wonderful for the reputation with A&M, at least within these communities, because they always tout us as the ones who are actually walking the walk instead of just talking to talk. So, that’s how specifically I got into Houston. Yeah, it’s by invitation, it’s by opportunity. And then the research and the work really just took off after Hurricane Harvey.

Tim Schnettler: You mentioned drinking water and obviously one of the big things that you guys have looked at is lead in drinking water. First off, let’s talk about lead a little bit because that’s kind of a scary word to a lot of people. I mean, you think about it, lead in paint, lead in this, lead in that. And I think probably, as a kid, I probably ate some lead paint chips. I think I turned out all right. I know some people may disagree. But let’s talk about why there’s that stigma or what’s the deal with lead and why it’s such a hot topic.

Garret Sansom: Yeah. Well, so you are probably fine from exposure as a kid. Toxicology 101 is dose makes the poison so it’s all about how much of a dose you get. Also, with many exposures, lead included, there’s windows of susceptibility. There’s time periods in which the exposure can be a lot more damaging than other times in your life. So, as adults, it’s not as big a deal as if we were three or even prenatal. But the reason lead is in the zeitgeist right now is most likely due to the realities of Flint, Michigan. We’ve all heard that over and over again. But it’s been with us for a while.

So, the common knowledge, the accepted knowledge, was our drinking water’s fine because it’s tested when it leaves the purification plants. And the water is very clean. Houston does a fantastic job of cleaning its water if you test it as it leaves the plant.

But what happened in Flint, Michigan is they moved to a different water source that was a surface water. And surface water has a lot of particulate matter. And one way to very effectively clean and purify water is by the use of chloramines instead of chlorine alone. And chloramines, the potential downside of that is it increases the corrosivity of the water. And so, if you have older piping that have lead in it, then all of a sudden, you’re leaching lead from the pipes. So, it’s clean coming out, really gets contaminated typically within people’s private property or within buildings. It’s rarely actually the city’s pipes.

So, the reason with Flint, Michigan it was so egregious is because it had not been using chloramines and then it switched. So, it was a sort of a lead dump all at once, like a huge amount kind of fell out. So, then you were getting levels, kind of unprecedented, really high levels with very clear health implications. And then the question became, all right, well is this an issue everywhere else?

And the only unfortunate part of this is lead paint kind of went on the back burner. And all of a sudden, we’re talking about water, which is good but we can chew gum and walk at the same time. So, by far, your children are more likely to be exposed to paint. If they’re going to have a lead exposure, it’s typically by paint. Up until ’78, before lead paint was banned… so, if you live in a home that was built before 1978, there’s a really good chance, underneath one or two layers-

Tim Schnettler: There’s some lead.

Garret Sansom: … there’s some lead paint. And when it’s in there, behind the other layers of paint, you’re probably fine. Really, the issue becomes is when it starts to flake and then kids pull it off and they eat it. Like you were saying. It can be sweet. It can actually taste good. So, you can kinda suck on paint chips. So, that’s a big issue or if you try to do the renovations yourself, that’s a huge issue. So, some people actually sand off a layer of paint and that’s when the exposure chance just skyrockets because now you’re having paint-contaminated dust and you can breathe that in. So, you can get a really high exposure really quickly with that.

So really, actually just recently, earlier this week, Secretary Ben Carson with the Housing and Urban Development gave a million bucks to Bryan to help renovate some older public housing homes with kids in it for paint specifically. Now, that’s great. I’m thrilled that Bryan’s getting that money. Now, what does a million bucks mean? Well, who knows, right?

Tim Schnettler: Right.

Garret Sansom: Probably not a ton but I’m glad anything’s happening. So, lead paint: big issue, especially in older homes with children.

Now, again, if you go back far enough, everybody lived with lead paint. So, again, the dose is a big deal issue. But with kids, it really has been linked in most… Many people could be totally fine living in these homes but population-wise, when we’re thinking, “Yeah, okay, a kid’s getting exposed,” even prenatally… prenatal has increased risk of spontaneous abortion, neurodevelopment issues. And then that continues as a kid. The IQ drops if you have lead exposure, as well as behavioral issues. And those, unlike some outcomes that you get from certain exposures, a drop in your IQ is something you live with the rest of your life, right?

Tim Schnettler: Right.

Garret Sansom: … or behavioral issue’s something live with rest of your life. So, you follow that person from the exposure and you had two paths: the path where they weren’t exposes, sort of productivity, how much were they giving back to society, how much are they working, how much did we get in taxes? All sorts of things, right?

Tim Schnettler: Mm-hmm (affirmative).

Garret Sansom: … that you can calculate versus the path where they had a reduced IQ from what they would’ve had had they not had that exposure. And then you can sort of see how big of a deal that can become when you talk about millions of people being exposed.

So, I guess that leads to Houston. So, what we did, again… This wasn’t me saying, “Hey, I’ve got an idea. Let’s look for lead in Houston.” This was really meant to be, this particular study was meant to be, a response to community requests. So, they’re the ones that said, “Hey, I think we might have lead in our water.”

You’re hearing that a lot now because of Flint and a lot of the times it’s not true. If you have a house that’s built recently, and by recently, I mean all the way up until about ’86 you could have had lead piping. So, if your house was built after that, the risk is astronomically low. If your house was built before that, well then, okay, maybe you might want to get it checked out.

So, what we did is we went to random homes… And this was a small pilot study. So, we went to a random collection of homes and we asked them if they’d be willing for us to both do a survey with them and then if we can take their water. Now, lead, again, like I said, this particular part of Houston uses chloramines, right?

Tim Schnettler: Mm-hmm (affirmative).

Garret Sansom: … because they get it from surface water. So, there was the potential risk because the corrosivity could’ve been high enough if they were in an older home. But because of that, because the water’s leaving clean, and then becomes lead-contaminated in the piping, what we wanted to do was get the first draw of the morning. So, the water had been sitting in the pipes overnight, right?

Christina Sumners: Oh, in the lead pipes, okay.

Garret Sansom: So, the idea was to get sort of a hot sample. We were looking for it, if it was available. So, we gave them some containers with instructions. And we said, “All right, we’re going to be back between 6:00 and 8:00 AM the next morning.” And everybody got a $10 gift card. And they filled out our survey and then we came back the next day and picked it up and then ran to the lab. And then we found that 30% of the homes had detectable levels of lead in the water. Now, like I started conversation off saying dose makes the poison. So, just the presence of lead is a different story than how strong it is. So, a little history on that.

So, we have, right now, if lead reaches 15 parts per billion, it’s an action level. So, there’s the chance that it could begin to free up options for the homeowners from the state or the federal government to do something about it. But the EPA has the maximum contaminant level goals of zero. So, the goal is nobody’s being exposed to lead at all. So, in Flint, Michigan, many of those samples went over 15. Several didn’t but several spiked very high. We were finding none of them went over 15. All the levels were far lower. We were getting between about 0.5 and 2.5 roughly.

So, they’re in a weird spot, where we say, “Yes, we’ve found lead in your drinking water. It’s not high enough for us to really do anything about it. Yes, it’s higher than you want it and it’s higher than the EPA wants it.” And then they say, “Okay, well what does that mean?” Well, the real answer is we’re not totally sure. We have really good animal models that don’t necessarily translate to humans. But the lead exposure with humans is all mostly population and observational research-

Christina Sumners: Because you can’t just give humans lead and see what happens.

Garret Sansom: That’s exactly… Yeah, you hit the nail on the head. So, if it was we’re looking to see if we increase your vitamin A by a certain amount, sure we can do a clinical trial, we can randomly assign people, we can… We can’t do that with lead. Yeah, exactly right. So, it’s muddy. It’s difficult. This kind of research is actually hard. Epidemiology is difficult because of that. We don’t have a lot of control over much, especially with something like this.

We know that we don’t want them to have it but they’re in a rough spot because a lot of these communities can’t afford to make these kinds of renovations.

Christina Sumners: Yeah. To rip out all their pipes and replace them with-

Garret Sansom: Yeah. The cost is huge. I mean, middle-class well-to-do folks might not be able to do that. In some of these homes, it probably costs less just to tear the whole house down and build a new house. So, what does that mean for them?

Well, for them personally, what we did is we recommended some sort of band-aid options. So, I lead the Capstone course along with my colleague Dr. Paris for the environmental occupational health students who are getting their master’s in public health. And we have reworked it the last several years to be a project-based learning opportunity or an active learning opportunity. So, they’ll actually go out and do stuff for the Health Department, for maybe some of our community partners.

But one of the things they did is we had them assess the efficacy of some big brand pitcher filters. So, a lot of them have a claim of removing 99.9% of lead. And so we’re like, “All right, well, is that true?” So, I’m not going to mention any names but some of the… I’ll say the good news is all of the big name ones, that everyone I’m sure is familiar with, work. Yeah. Maybe not exactly. We didn’t find the exact results but they’re very effective. Even some of the hiking ones worked really well, the different types of straws, the big name one worked well.

So, a few things that you can do if you’re in an area like this. Again, temporary fix. You can use those. All right. That can help. And they certainly handed out a lot of those in Flint, Michigan. Also, because you’re getting the lead from the corrosivity and the pipings, sitting in it, takes longer, well just make sure the first thing in the morning, you let your water run. Get the water out of the pipes. So, that’s something you can do. A lot of times, the little metal mesh that goes into your faucet at the very… that aerates it, lead often collects there. So, maybe rip that out, put in a new one every six months or so. And I’m just making that six up in my head. I don’t actually know exactly how long that takes. But often, maybe once a year. Yeah.

When I was doing this, I started thinking about our house and I was like, “Probably been there for 30 years.” So, put in new ones-

Tim Schnettler: And those thing, I mean, they’re not expensive. It’s-

Garret Sansom: Cheap.

Tim Schnettler: Yeah. It’s not a big cost to the person. I mean, they’re something you just screw on, screw off. And they’re probably, what, less than $5 I think for most of them.

Garret Sansom: Yeah. Oh yeah. So, there’s something you can do. One more thing could you do is don’t use the hot water from the pipes because that actually increases the risk of lead exposure. So, pour cold water and then heat that up if you have a kettle or something like that.

Christina Sumners: And we’re talking about drinking water-

Garret Sansom: Drinking water.

Christina Sumners: … not like showering water.

Garret Sansom: No.

Christina Sumners: Yeah.

Garret Sansom: No.

Christina Sumners: Okay.

Tim Schnettler: And is that why they suggest boiling water when there’s contamination? Is it similar to that?

Garret Sansom: No, actually.

Tim Schnettler: No.

Garret Sansom: So, boiling the water is not going to do anything for the metals but using the hot water faucet might increase the leaching of the metals into it. So, we pour cold water and then heat it up but… yeah. So, I was actually in Boston when we had a… it was like a 10-foot diameter… So, I mean, that is quite a pipe of our water blue. So, they had to get some emergency water from a giant pond and then we had to boil because it definitely takes care of the living organisms in the water.

Christina Sumners: So, bacteria and things like-

Garret Sansom: Exactly. So, I mean, if you’re hiking or camping or something and you’re concerned… you don’t want Giardia or something, then yeah, you can boil your water. That’s certainly good. But it’s not going to take care of metals or uranium or anything that might be in there. But we had pond water coming out. When we took a shower, it smelled like we were in a pond. Yeah. It was really intense but no. That is a good thing but it’s separate from this.

Tim Schnettler: Got you.

Garret Sansom: So, those are a couple things you can do just if you’re concerned about it. In my experience, for good or ill, a lot of times when I say this, it’s kind of like, “Oh, okay, great. That’s not exactly what I wanted to hear. We’d really like a permanent solution.” And that makes sense, especially… I mean, I’ve got two kids. I can put myself in their situation. I’m hearing that, okay, it’s low, that’s good. They’re not totally sure what it means though, that’s bad. We’re hearing about lead all the time, especially with kids. I’ve got kids. And now, we’re going to live… They’ve been living here their whole life. I was pregnant here, they’re going to be here until they’re 18. What does that mean? So, in my experience, this isn’t exactly what they want to hear and, truth be told, I get that.

And I think if we can have something akin to a large lead abatement program moving forward, that’d be great. And it really depends on just how serious we want to be with this. Is this something that we really want to dedicate our time to, to protect public health or not? I mean, it’s going to be a deep cut. It’s going to hurt. It’s going to cost a lot to really deal with it once and for all on a broad, broad scale.

Going back to Secretary Carson’s work here, a million bucks. Sounds pretty good but I mean, that might… Who knows? That might be like 10, 20 homes. We don’t know.

Tim Schnettler: Yeah. It goes quick.

Garret Sansom: That million dollars is going to go. I mean, it’s great for the people there and I’m glad Bryan’s getting the money for sure. But my worry is all right, so we’ve got a couple houses fixed and then we’re going to call it a day. But really, we’ve just begun to really to look at this.

Christina Sumners: So, you mentioned Hurricane Harvey a few minutes ago. Did you do any work after the hurricane came through on what sort of toxins and environmental exposures might’ve happened after it?

Garret Sansom: Yeah. We did quite a bit of work. There’s some serendipity in the world. We applied to have a superfund research center here on campus, which is a pretty big deal. It took several years to put it together. And I’m part of the engagement corps of the superfund center. So, we do a lot of outreach and environmental sampling and health assessments there. We got funding a few days before Harvey hit. And we, our group… and I say “our,” so, I mean, it is a broad group. I’m reluctant to mention names because I know I’m going to miss somebody. But suffice it to say many different people from a bunch of different colleges did a lot, a lot of work on this. Don’t take how I speak… just me and my team. It’s definitely not true.

However, we, the collective we, we went out there. We were the first groups actually to be on the ground doing environmental sampling post-Harvey. And we had a lot of advantages. So, I was talking earlier about our partnerships, our community partnerships, it really came into play post-Harvey. So, we work in a lot of neighborhoods that have a reputation for violence, whether or not that’s deserved or not is another question. I think a lot of times it’s overblown but it has that reputation. A lot of researchers don’t want to go in there.

And anybody, yourself or anybody listening, who’s either experienced a tragedy on Harvey’s scale or even sort of local major flash flooding or if any of the folks who had to deal with any of the wildfires in Bastrop or anything like that, know that post-disaster of that kind, post-those sorts of hazards, your nerves are really raw. There’s a beauty to it because there’s a lot of people who are like, “All right, let’s roll up our sleeves and come together.” But there’s also a lot of danger from looters. There’s a lot of risk of people thinking you’re a looter. So, there’s a lot of actual dangers that you don’t often think of with this type of research following things like major flooding like Harvey.

So, we went in. We had already had a pretty good baseline of polycyclic aromatic hydrocarbons in Houston Ship Channel Communities and so we always assess for… EPA has their priority 16 PAHs so we’ve been collecting that for several years prior to this so we had a good level of that. We’d also looked at metals in the soil and metals in the standing service water, so not drinking water but potential recreational exposures in parks and stuff like that. So, we had a decent, not amazing, but a decent baseline for a lot of these areas.

So then Harvey happens. Major, 52 inches of rain. So, we went back and were collecting water samples and soil samples, looking for the same types of things to see what we’re going to find. And when we’re out there, we had a group. Our community partners decided to come with us. And we invited, we said, “Hey, we’re coming out, please come with us.” And as we were out there, we had a group of… They appeared to be angry, coming up to us in a sort of a threatening and violent way. And our community partner walked up to them, they had a conversation. And they knew him and they turned and they walked away and they left us alone. And I was with my grad students. I was like, “That is an example of why having these partnerships is so important.” I was like, “The last thing I want to do is deal with a group of five guys who were looking super mad.”

Christina Sumners: Confront an angry group of-

Garret Sansom: Yeah.

Tim Schnettler: And they may deal with you differently. I mean, they don’t know who you are.

Garret Sansom: Yeah, like I said, our partner went up there, was like, “Oh, hey guys, I’m so-and-so.” They’re like, “Oh, we know about you from this and that.” And they had a little talk and they left us alone so that was good.

So, what did we find? Well, we found it moved the exposures all around Houston, as would be expected. Most of the levels actually went down. Turns out 52 inches of rain can wash away a lot, right?

Tim Schnettler: Yeah.

Garret Sansom: So, the soil and the surface water stuff moved into areas that it wasn’t before, so maybe you weren’t being exposed and now the potential is there, but overall a lot of it kind of got washed away into the ocean into the different waterways.

And then, however, we did start to see spikes of air issues like air pollution. The big one that most people may or may not know about is the Arkema plant. So, Arkema was interesting because they store volatile compounds and so you have to keep it refrigerated. And the power went out and then their backup, generator kicked in. And then their backup generator got flooded. So, then they issued a statement saying, “Hey, maybe you want to clear out. There might be an issue here.” And sure enough, it exploded, caught fire and then volatile organic compounds kind of went through the roof. And so, you can see a mixture of anthropogenic and then natural disaster sort of coming together in the Gulf Coast. And so, we found that a lot. And so, as far as the environmental health issues of it, those were the main takeaways.

We did maintain and work with also the Houston Health Department, Rice University, their Kinder Institute, keeping tabs on where people were sampling so then we could share that information. Another thing that happens a lot of times post-this is you’ll have somebody come into your backyard wearing a lab coat or some sort of orange vest and they’re taking water samples. And then a few hours later, you’ve got a group of what look like grad students coming and taking water samples. And you’re like, “Get off my property.” So, we maintain this mapping database so we’re not going in the same spot, hitting it over and over again, which has been an issue in the past.

But we followed that with a bunch of health surveys and environmental perceptions and we find people do perceive this to be a really big risk. And then we also find that Houston Ship Channel Communities do have a reduced health score and that goes down the longer they live there. Now, does that mean it’s any specific exposure? We don’t know at this point. This is very, very, very broad, totally pilot data. But it’s hypothesis-generating. So, as we move forward, we’re thinking about that. And really the goal is to have some sort of really good longitudinal study in Houston Ship Channel Communities so we can really make some good causal arguments on what’s going on there. But that was the Harvey.

What really the community partners wanted more information about the anthropogenic disasters, which unfortunately Houston has made possible, especially, I mean, one of the more recent… the ITC petrochemical fire. We were assisting the Galveston Bay Foundation as well as TCEQ in collecting data. And, as the news said, we found benzine levels at a level that you typically only see in occupational settings. And that’s where we had all of the shelter-in-place commands.

So, a lot of what we’re doing right now is actually following up with those and continuing looking for also for PFOS associated with use in the firefighter foam. They use a series of chemicals and it’s in the waterway now. So, we’re monitoring the waters into the Trinity Bay, Galveston Bay and ultimately into the Gulf of Mexico. And we’re taking air samplings this whole time and we’ll probably do it for another year, looking for total of volatile organic compounds and then benzene specifically.

And then we’re matching that up with more surveys, specifically in Galena Park and Deer Park because one of the things we found out following that is we went in and we did some more community meetings and we’re invited to one that the city council held like two… like a day… no, two days after the second eruption of another one of the tanks. This is like day four of the fire. And they were saying, “Okay, we… ” They were concerned that elderly folks weren’t getting the shelter-in-place command because they use a thing, I think it’s called red alert, something like that, it’s very close to that, where they will text you and say, “Hey, shelter-in-place.”

There’s also a siren that goes off. And I’ve been there when the siren’s gone. They test it a lot. And then you hear it going and then you have a voice say, “This is just a test. You don’t have to worry about anything right now.” But if you’re far, if you’re too far away-

Christina Sumners: To hear the siren.

Garret Sansom: … all you hear is the siren. You don’t hear the “this is just a test” part. So, the folks who hear the siren, they know it’s running a test, have no idea to differentiate the real thing from the test. So, that was mentioned a lot too.

So, we’re truly trying to pin down knowledge, see how people receive their knowledge, and then if they know what a proper shelter-in-place means so, moving forward, if it happens again, what’s the best way, what’s the low-hanging fruit to make sure the folks there can do a good job of that and not potentially be exposed unnecessarily?

Christina Sumners: That’s fantastic and really amazing research. Can’t wait to hear what else you find out over the next year or so you’re doing this monitoring.

Garret Sansom: Yeah, thank you.

Christina Sumners: And thank you so much for being here today. It’s been really great to talk to you.

Garret Sansom: It’s been great for me too. Thank you so much.

Christina Sumners: And thank you all so much for listening, and we’ll see you next time.