Board of Health: October 15, 2025

Transcript captured from MHTV’s Vimeo auto-captioning. No speaker labels; proper names and dollar figures occasionally misheard. Click any timecode to jump to that moment in the source video.

0:00 Talk go. Yep. Alright. We had a, um, call leadership meeting this morning, this afternoon. And, um, the outreach to the community is freely going very well. We’ve got multi-level, um, Share this screen. Yeah. How do I do it?

0:31 It’s at the very bottom.

0:34 Uh, you’re sharing something, so then you have to change to what you want. Go to what you wanna look at. Yeah. That’s up. But it’s just not on that screen. I clicked when it said, do you wanna share? Alright, go. Can we Change what screen you share? Yeah. So you, when you share new, new, you should be able to pick the screen.

0:56 Click new share. Yeah, I do

1:03 Share Screen. Screen. Or window. Window. It should Be share screen and then screen. You gotta go see the, Okay. It’s still not going to think by this time.

1:22 I still understand Appeal still. Just assume it’s ridiculous. They should have in person meet and city can look at the plans, not have to make an Appointment.

1:40 Coho some consumers, because You were sharing it.

2:08 Camera. What if you just Click on the presentation. It’s not

2:15 Can you turn the camera off?

2:53 Yeah. This

3:05 Back to handouts. Mm-hmm. I say back to handouts.

3:14 I got a hammer in my truck. Yeah. Right, right. Erox machine copy.

3:26 Stuck in those funerals. Yeah. I wonder if there’s even anyone in the audience. ‘cause at the slackman, half the time there’s nobody. No one ever wants to speak. It’s Very seldom. I think there. I thought it was, uh, fleetingly. Somebody said something. Yeah. There’s eight people online. Oh, yeah, right. Oh, there, that’s good.

4:09 This the new thing. Using his laptop to Object. Usually the camera just goes towards Right. We’ll over again.

4:21 Yeah. Can you turn it off? I wonder if that’s taking the screen.

4:33 Somebody walk this morning, a lot of boats were missing from the harbor. Is that right? And they weren’t rushed up on the beach, so that’s a good thing. Yeah. Well, wasn’t as bad as

4:45 Greenage. We got like 1.7 inches of Yeah, I know. Almost. Yeah. You got, yeah, it just like Bad. A lot of leaves and some branches down. Yeah. Well, I saw our boat. Was that one in, on the Salem side that went up on the ground? I, I didn’t see it. Well, there was one, I guess what Size? There was one up near, from what I heard near or something like that. Over there? Yeah. Wow. No, ‘cause marble had averaged, normally rougher than, like on the Salem side. My brother used to till the boats over there because, Well, it depends on, uh, how much they maintain their marine. Yeah. No, but that Hansen guy, I don’t know if it’s a marine guy. I think it was him. There was a big, like, fishing boat and the thing, and he said he went out the day before and tied it down more and everything. And the big still came off

5:31 That happens. Uh, And I guess it ended up going two different places, but it didn’t, thank God it didn’t say,

5:42 Well, if you’re up in trouble, I don’t feel too bad. But in any event, uh, meeting this afternoon went well. We really have tried to blanket the town, trying to let people know about the survey, the value of it, and how to fill it out. Um, as most of you know, we sent out postcards that were mailed on, um, September 29th, but a lot of people didn’t get them the end of the week or some even in the following party. It’s amazing. So we are not yet two weeks into the survey time, and as of probably tonight we’re a little over 1400 responses.

6:28 Nice. Which is good. Not great, but good. Um, the big challenge that we expected wa w have has been the youngest group. We are one of the very first surveys that UMass Boston has done. They’ve done 80, uh, municipalities. We’re the first group that has gone all the way down to 18, which is the youngest we can go with without parental permission. And the 18 to 30 group is the one that’s least responds, responding to the surveys part of them, because hopefully they’re all semi memorial at college or whatever they’re doing. Um, and, but even, uh, 30 to 39 is well

7:14 below the average in, in the rest of the survey. So the younger people are just busier, um, and have been harder to reach. So we spent a little bit of time trying to figure out how we’re gonna try to focus on that group. The goal is to try to get the number of surveys somewhere close to the, uh, town meeting was, um, during the, the peak of the three A conversations because that everybody thought that was a legitimate, um,

7:49 minority, but, but a legitimate participation of the town. And we’d, we’d like to get somewhere close to that. So, um, it was a good meeting and, um, uh, the guidance group, the council is, is working very well for us. Um, I wanna spend a little bit of time, um, reviewing the two newspaper articles that we have had in the, uh, town recently. I think Marblehead is incredibly fortunate that we have two local newspapers. I think most people would agree that there is an enormous amount of confusion

8:35 that in the public health arena globally and domestically. So we’re fortunate to have those two newspapers that are willing to put in public health, um, articles for us on a regular basis that we hope to clarify, um, some of the confusion for, uh, the residents of the town. Um, we put, we have the two we wanna talk about, um, today. Um, we had an article, a column, and the weekly news last week. Uh, Kristen Tta, uh, and I, uh, put together a

9:22 an assessment of how we can really do better, um, by, in dealing with mental health issues in the town. Um, we are a public health, uh, board and town. We don’t do individual, uh, therapy or treatment or care. We care for communities, populations in groups. And there are, uh, a number, uh, uh, municipalities globally that have adopted what they call is public mental health as an approach to deal with populations rather than individuals. Again, not treatment, but raising the horizon of the public health

10:11 questions in mental wellness. And basically the, the, um, the, the, what we proposed in the article was that the board of health, the town of Marblehead, considered this public mental health approach. And the approach, approach is really to, one, try to prevent mental health, um, and, uh, two, minimize the consequences of, um, the mental health occurs when it exists. And third, to really promote wellness and re uh, resilience, uh, in the town.

10:56 Um, so those are, those are the three components of, um, what, what public mental health it generally handles. There are a couple of slides that I do wanna show, but, uh, one of the really interesting things about mental health when you compare it to other chronic illnesses, um, certainly I at this table understand the reality that chronic illness generally comes the more prominent, the older you get. One of the unique features about mental illness is

11:42 that it peaks much earlier than any of the other chronic illnesses that are out there. All of the other chronic illnesses, whether it be, um, cardiac, pulmonary, renal, um, oncology, any of those all begin to peak after the age of 50. Mental health peaks, well before the age of 50, it actually breaches a 50 50th percentile in the 40 years of age and younger. So that means, in fact, yeah, here we come. That, that, that tells us that, gee,

12:30 if we invest a little bit of, uh, resources, effort in town, thank you very much, then we will, uh, get a much longer period of pay from, from that investment. Um, this is, this is the figure if you, you want, can you all see this? No. Hmm. I can change that. I mean, we could see, but you can’t see the numbers really. All right. Well, the dark blue is the cost of mental health conditions. The, the currency is the number of days that of health, of healthy life that are, that are lost. So the dark blue is greater than the light blue.

13:19 And the light blue is a combination of diabetes and kidney diseases, cardiovascular diseases, chronic respiratory diseases, and cancer. So mental health takes more out of, of normal living from the community than all four of those chronic, chronic, chronic adult issues do, um, combined. So that’s, that’s a very big deal. And this is the slide that I was talking about. On the left hand side, you can see that the light blue bars are higher than midline,

14:05 which means that gra greater than 50% of people with mental health diagnoses are under 50 years of age. Conversely, the right hand, right hand figure shows that, um, the, the, the left hand side, the, the, um, the younger fam, the younger individuals have much less chronic illness than, uh, over 50. So the, the pulmonary cardiac cancer and renal disease peak at the fif at the 60 year of age,

14:51 and mental health peaks at 40. So if we can do things to promote mental health early in the schools, young adults, that sort of thing, you get an enormous payback from, uh, from that investment. So public mental health is a concept, a logical population based program that tries to promote wellness. Obviously, we’re, we’re putting out the comm survey to measure wellness in the town. So again, it’s the same thing. We believe that the, the role of the Board of health

15:32 illness per se, because that we have a, fortunately in Massachusetts an excellent healthcare delivery system, the doctors, hospitals and nurses, doctors, primary care and everywhere else. But, uh, we can do a job with encouraging the community, have the community understand the things that will keep them healthy and keep them healthy for longer periods of time. So that’s the role of something like public mental health. So, um, again, we wanna prevent mental illness, mental problems from occurring. We wanna reduce the consequences of those, um, mental problems.

16:18 Um, if they do exist, then finally, we want to promote wellness across the board and resiliency within our society. So there’ll be fewer incidents to have to treat as we go forward. See, I’m really uncomfortable. You can’t see that the, the basis of, um, our assessment of wellness and resiliency. We, we use a term called social determinants of health. Um, public mental health emphasizes the non-clinical factors that are known as social determinants of health. They are the conditions in the environment

17:04 where people are born, live, learn, work, play worship, and age that affect the wide range of health functioning and the quality of life and outcomes. So if you can increase the positive side of social determinants and reduce the number of negatives, your community will be healthier in, in places where the social determinants of health are more negative. One, social determinant health is obviously poverty. More poorer neighborhoods do less well in any of these environments.

17:50 So our, our goal will be to try to encourage, um, those things that promote increased more positive social determinants of health. Um, let me give an example. The, the, we have a, we can make a, a big list of where social determinants enter into the life course. And on the left hand side of those of you can see it. But the, the life course is divided into four timeframes for activity levels. Starting out well means prenatal and perinatal. Um, the time before and around birth.

18:36 Um, developing well means young children through adolescents living well, adult through senior period in life. There are a whole lot of social determinants that work around your job, how well you prosper the financial security your job provides. So that’s under working well. And then aging well is how do you manage to, uh, deal with your senior years in as healthy and environment as possible. The list for all, all of those life course elements is, was too long for me to figure out how to put it on any two slides. So I’ve taken the one, the starting, well, as a neonatologist, I spent a lot of time thinking about newborns.

19:23 And so, uh, the starting, well, five programs that could affect mental health for young children, um, parenting programs, parental leave opportunities, child tax credits. The child tax credit may look a little bit outside of normal public health thought, but in fact, um, the, the national CDC actually has a public health foundation, which spends a lot of time lobbying states to try. Does Massachusetts have a child tax credit? I don’t think it does, does it? Well, in any event, the the example of what that we’re going to use, we have a small grant.

20:10 Dr. Urbana and I, uh, have been going around and visiting various providers in the community, the people that take care of kids, and the people that that take care of. Um, um, um, moms and one of the, one of the visits to, uh, pediatrics group that we visited, we asked them how the Board of Health could help. And the first thing they said, um, do some parent education. So we’re looking into now how we might be able to use some little bit of grant money. We have to be able to find, provide some scholarships for the parenting classes that are taught in the town. Um, we hear good things about that,

20:55 but that’s the kind of approach that a, that a, a board of health like ours, when it wants to promote the health services in town, it wants to play in the public mental health world. That’s the kind of things that you look at to try to make the, the reality of life a little bit softer, a little more gentler for people going, what it would take, what it would take for us to, uh, to really make it viable in, in Marblehead. I know that we have made, what, 375 years of, uh, self-governance.

21:41 And by and large, in my three years here, my observation is that most of our board’s, committees and commissions, uh, are very comfortable being siloed, acting on their own. If you really wanna do public mental health, we would probably have to be a better partner than perhaps we have in the past. Not only we, but probably the other, the other, uh, town groups as well. We would have to learn to be a much better partner. And by that I mean we would want to be a valued consultant. Um, we can, we can be a partner to

22:26 another agency without owning the project that we are working on with them. In the article, we talk about, um, a, um, the, the tragedy that occurred in town and the school committee’s interest in looking at, uh, what might be possible in town to deal with, uh, particularly alcohol driving in young people in a public mental health world. The school committee would feel very comfortable almost automatically saying, oh, we may need a few research papers. We need, we may need to understand what towns

23:12 and cities have done in other places like that. Why don’t we ask the Board of Health to give us a white paper on how to proceed? We’ll use that in our environment and we’ll go forward. Another example, which I I like a, a lot. There’s a, there’s a, uh, child psychologist that, uh, be safe who, who has a pretty good reputation. Um, he believes that the biggest problem that kids face, he actually sees it as equal to the screen time that the children, the adolescents have these days, is, um, when we’re really, when kids, these kids are really young. Uh, they don’t have the free play that, um, certainly I had when I was I’m sure all three of you had when you were young.

23:58 Um, I would think the free play started to be reduced at the time that you all, uh, com It was the later. Yeah. Well, I would say, I can remember leaving a house when I was seven or eight years old. There was an empty lot, half a block away that my friend, his name was Butler Butzer, and I would go and we could play there for day hours at a time that our moms would call us for lunch. Then we’d go back and we’d play and we’d come back for dinner. I mean, I was 10 years old taking the trolley to, uh, Forbes Field to see Roberto Clemente play for the Pirates. Uh, and no one worried about it. And that’s a very different world, well say, the Parks

24:45 and recreation people wanted to say, gee, what can we do about increasing free play in young people today with all the top order football and little leagues and all the importance of athletics, parents are involved. The kids really never have the flexibility and the freedom. But Peter Gray, the, the psychologist is one of the big deals, is that if, if kids are in free play with each other, they learn. Sometimes you win, sometimes you lose, you fail, you succeed well, and you get over it. You move on. You, you, you can become a mature adult expecting the world not to be perfect. Whereas helicopter parenting these days have taken some of those issues away. I would love to have to, to to do a literature search on

25:34 free play in various municipalities if Park Andrex ever wanted us to. But anyway, that’s my, that’s my particular thing. We would need resources to do this. Well, my view of this, and I, we’ve talked about this and I may be in the minority. My view is the only way we will get there is to develop a 5 0 1 C3, a nonprofit agency, whether we call friends of public health, whether we call it com, dot org, or anything else, that we have the ability to go out and raise money by writing grants. Uh, this is a very generous as a, we, we raised the money to do this comm survey. There’s no, there’s no tax money that came into that survey.

26:20 I think that that, that, that would be the only way that we could get the long-term viability to make, uh, um, public mental health work in the, not the only, but we, we may have a very, uh, fortunate donor at some point, or, um, in any event, that’s my view of how we would make it work. Uh, they don’t wanna shift. Last week, um, Dr and I published a, a little paper talking about autism and, um, and acetaminophen, i, I, as a recover, not recover former scientist. I have to tell you, reviewing the autism science literature

27:08 was close to exciting. The, the things that are happening in that literature. Now, maybe, maybe that’s Mr. Kennedy’s goal, to just kick the cage and make people a little more creative. I don’t know. But the literature that’s out there all of a sudden now looking at autism is, is unbelievable. And I’ll walk through that in a minute. But the background for all of this, for me anyway, is the 1998 a, a paper came out of the Journal of the Lancet, which is a pretty high powered one globally. Um, and it, there’s an article in there that suggested that measles, mumps, rubella vaccine was causing autism. Uh, the paper was found to be fraudulent.

27:55 The, the GI doc who wrote it was eventually did lost his medical license. He, he was trying to, uh, be negative about that vaccine, uh, that those vaccines, ‘cause he had his own vaccine, uh, that he wanted to sell. But anyway, he was discredited. He lost his license. But there continues to be a confusion around autism to this day. So what I have seen is that, um,

28:29 some of the people who wanted to believe, well, everybody’s looking for what’s causing autism, and it would be nice if we found a simple answer, oh, that vaccine doesn’t work. Or, now Mr. Kennedy is talking about, um, uh, perhaps acetaminophen, uh, Tylenol being the, the trigger. Well, let’s take a step back. Autism is an incredibly complex condition, first described in 1908 by a Swiss psychiatrist, when he saw some social withdrawing that occurred with people with schizophrenia. Um, lots of people made contributions.

29:14 We talk about Asperger’s syndromes as Dr. Asperger was in involved in that for many years. A a lot of the heavy hitters in the psychiatric and psychological world have tried to understand the issue of autism. In 2013, the, the, the guidelines for psychiatry in this country moved away from the simple term of autism and began to talk about, uh, autism spectrum disorder spectrum meanings, meaning accepting the fact that this re this, this issue is, is a much broader diagnosis than, um, the Asperger

30:01 and others thought when they were working on this in the early part of the 20th century. So we now have this umbrella term for autism spectrum disorder. Parenthetically, we’re now talking, uh, in some places about neurodiversity and Bill Gates and Elon Musk say that they’re on the autistic spectrum disorder. Um, and there are, there have been lots of papers talking about some autistic kids have some very special skills in terms of artistic and music and things like that. So it’s an incredibly interesting area from a scientific point of view. But the science that’s going on now is really amazing.

30:48 Um, the, the, the acetaminophen is, is, is interesting. There have been some small studies that suggest that acetaminophen, Tylenol, uh, may cause autism, but they have generally been relatively straightforward studies asking a bunch of moms who have children who are autistic, oh, did you take Tylenol while you were, uh, carrying your baby? Uh, they, they didn’t go into, um, the next level because we know that autism, the broad term autism, very, very determined by genetics.

31:34 Somewhere between 60 and 80% of the predictive power of, um, uh, uh, of predicting autism comes from the gene pool that the child is in. Now, normally, when docs or scientists will try to study something like that, they would do a randomized clinical trial. They’d take a whole bunch of people, divide those people into two pots, try to make sure that the pots were level in terms of gender, in terms of age, in terms of everything it could, and then give the questionable compound to one of those pots and not give the questionable compound to the other pot. They’d wait a little bit of time that measured what happened to the pot that got the questionable compound.

32:22 And compare it. You can’t do that with a pregnant mom. You can’t do that with a fetus that you, if, if in fact, the compound is not a good compound. That’s the last thing you wanna do, um, is give it as part of a scientific experiment. So the, the challenge that has has been out there, how do you design an experiment that is sophisticated enough to take somewhere between 60 and 80% of the genetic drivers about autism? Take that out of the experiment and isolate only the acetaminophen compound. And the fascinating part, we could not do this sta this study in the United States

33:09 because we do not have as robust a medical information system as some countries too. The first study was done out of Sweden using Swedish data, where they were able to cover 2.5 million children over a 20 year period, and were able to go in to the medical records and find families where they had at least two children, one of whom the mom had taken acetaminophen while she was carrying that child. Um, and, uh, had another child where the child got no acetaminophen. So they had a, a clinical comparison within families.

33:57 So it’s a sibling control rather than a randomized control. The, the Japanese followed that study from Sweden and did, uh, a smaller study with only 217, uh, um, pairs in their study, but got exactly the same thing. Inter interestingly, in both studies, when you just took the raw data, by and large, there was a small increase in autism of the moms who took acetaminophen. But when you corrected for the, her, the, the genes, the, the heredity that vanished, which said

34:46 that in those cases, the, the gene pool made a big difference. So when you take, when you take the genetic drivers away, the results were, um, that acetaminophen did not cause autism. You wanna add anything to?

35:08 Um, no, I just, um, There are a couple of things. When, when, whenever they say increase, the, the thing is, is it’s very, very using, uh, percentages. You actually have to have the real numbers because sometimes an increase can be two or three people. And tech, technically, Well, that’s like two and a half million an Increase. So I think it’s very important, just even saying words like increase, you really have to know the dimension of the increase because it can be inconsequential, basically, or strictly by using statistical measures. It is significant, but you have to understand what significant means because it’s not our common day version of

35:56 what significant means. The other thing that really bothers me is, as a pediatrician who practiced it from numbers of years, 40 years ago, women were taking acetaminophen. We had a few autistic kids, and they’ve been taking it for a long time. Now, suddenly we’re saying that all these kids, uh, potentially these kids are, uh, uh, getting autism from acetaminophen. It’s been around forever. If it had been, uh, such a cause, why wasn’t it causing it 40 years ago or 50 years ago? These are things that none of the media has talked about because it’s very significant. We’ve had a lot of experience with this

36:43 and this whole, uh, idea of autism. Back to the whole idea of the whole concept, uh, having had a number of severely autistic kids in my practice, the idea of how this definition expanded because it’s not, You’re given the rest of my, you’re given the rest of my talks. Okay? It’s not, the slides not, It is not the same thing. It, it was a, to even use the word autism spectrum was awful.

37:22 Okay? But we, together, the four of us, and you and others, we want the town to understand it a little better than they, before we wrote the paper, th we’re not going win any prizes on the, the little column. You’re not going to feel all that much better going home tonight that you, but I off my Chest Har them Patriots will understand what they read or what they hear a little bit better. I I actually think that the best thing about the, the two newspapers willing to take public health, public health, uh, columns from us will, will be that we will rise. We’ll raise the, the, the literacy, the health literacy

38:10 of the town and the town then will the town, the young people in town will be better parents. They’ll be able to talk to each other. And all of the things we talk about in public mental health will be better. You’re absolutely right. But let me get into the really powerful science, in fact. Okay. Um, all right, well, let me let, let me go. Okay. You talked about, okay, this is your slide. Uh, you gotta be able to see it. The blue line. I i, I I got the drift. Well, no, thi do maybe this, this was in the New York Times. Yeah, I know that’s last week, right? Yeah. Where saw, okay, well, what, what the, this article in the Times, it was published first,

38:57 I think on October 1st, and then republished on the, on the seventh. But it, it, it, it is making the hypothesis that by putting this umbrella term out there, autism spectrum disorder, um, I don’t mean to be cynical, but it just meant that more docs could bill for that diagnosis than they were previously able to bill before. Um, um, but what this article says is, if you take the profoundly involved children, the ones that were diagnosed very early in their life, that number has not risen very high. That’s the dark, the dark line in that curve.

39:45 And over a 20 year period, it goes up by a factor of maybe 30%, 50% maximum, as opposed to the non profound children. They went from four per thousand children, uh, um, in 2020 to 14 in 2016. So they, they, they, a factor of times four. And so what this article is saying that there’s this fundamentally a difference, um, that that’s out there, that we have to be a little more

40:32 granular in our diagnoses. And the remarkable thing that’s occurred is that in, um, no, more than a month and a half ago, a a a paper came out of nature, which is another good journal that actually took those two curves and did, uh, develop genetic analysis for those kids. And they actually were able to determine that, that there is, you can’t see it, but on, on, on that curve, um, there are are two

41:20 hierarchies in effect. One, the left hand side is the early diagnosed, uh, autisms, uh, the ones that Dr. Kruger would’ve been taking care of during his entire practice, because once they were in his practice, they weren’t gonna get any better. They weren’t going, they weren’t going to college. Um, but on the right hand side of that curve, they, they, they did the genetic analysis for the, uh, kids who were late diagnosis, less severely involved. Maybe they were the Eon Musks or the, the, uh, uh, the bill Gates of their time. And they showed, uh, statist, well, I won’t, that wouldn’t allow me to say statistically the showed a,

42:08 a difference between the gene pools. And, and I can tell you this, these kind of experiments could not have been done, I would guess five years ago, certainly not 10 years ago, we did not have the capacity to do these kind of micro analysis at the genetic level. So it, so this is a paper that was published, I think in July. It, it, it hasn’t yet been delivered hard copy in the mail, and it’s competing with the next slide. I’ll show, uh, for maybe not Nobel Prize, but certainly lot of grant money to show that it can do this kind of thing. So, um, so we, we, now, we could, we can show that,

42:57 that the difference between the profound and the non profound autistic kids, it, it can be determined genetically. Okay? The next, the next, uh, set, set of, uh, studies, uh, a a different group. I think this is the Princeton group, and the other one’s Cambridge Group might be vice, uh, Cambridge, the other Cambridge, um, very different. What they did is they took 2000, um, uh, kids, uh, who have the autism spectrum disorder. And they were able, they looked at their behaviors, the, the, the signs and, uh, signals that the kids were giving from,

43:43 from their presentation. Um, um, and the, the, the, the pH, we, the term we use is phenotype. The, the expression that the, the genes produced in these kids. And they found rather than two, they found four relative groups of behavioral differences and, uh, outcome differences. And they, they have, well, I’ll just read on the, on the, the orange bar. The orange curve is moderate challenges. The whatever, that’s a red purple. Uh, the left hand side is broadly affected. The green one may be the Elon Musk social and behavioral,

44:29 but otherwise not perfectly fine. And then, uh, the, the blue on the far corner, um, is mixed, uh, fewer autism with, uh, developmental delays. So they found these four different groups in, in this population that they assessed. So it, it’s kind of like high science, public health, because they were using populations we’re dealing with each of the individual. And then what they did is they looked at how these kids behaved. And again, uh, we have to figure out if we’re either I have to stop giving slags like this, or we have to figure out how people can see it. Uh, then they plotted each of the, what, what those kids,

45:18 how they behaved. And you, if you could see that, you could see across the, um, abcess, the, the x axis, you, you go from anxiety and mood symptoms through attention deficit to disruptive behavior, to restricted and repetitive behavior and limited social communication. And they took those four peaks here, and they tried to see what each of those, how what each of those peaks looked like. And then they were able to plot where, where they fit on the curve of plus or minus, um, uh, on, on the, uh, ordinance. So now all of a sudden they’ve got these four populations out there that they see expressions

46:06 of these diagnoses. And of course, now in today’s world, you can do the genotyping of everything. And so what they did, they went in, and I, I, I cannot explain all the details, believe me. Um, I found that the article fascinating, but there was a little more technology and a little more science than I, I’m familiar with. But basically, they went in and they’re able to, um, look at all of the probably 150, 200 genes that we know that influence autistic, uh, spectrum disorder and relate the individual genes to those behavior patterns. So we’ve now gone to a place that,

46:52 when I was in medical school, when we got to the ca cadaver in the brain, the, the, the, uh, pathologist said, the brain is a black box. Doctors will never understand that. Now we’re in the position that we can go down in a public health type population environment, uh, uh, uh, do this kind of detailed science in populations. And anyone who can feel comfortable at cutting the research funding to people like this in this environment, uh, is different than I am. Let’s just say it that way. But it was fascinating for, uh, for me

47:38 to see how far things have come along and, and now the public health docs of the future will actually be doing this kind of rigor as well as the sort of observational stuff that, uh, it was, uh, really a, a the only thing that was out there in the past. Now, Well, a couple of Comments. Well, one is that, and something back to the, the broad definition, by having a broad definition, the insurance companies would pay for services and you would get services. And people forget that Because let me interrupt you. If you give you the, I didn’t read the broad definition. The broad definition now is, um,

48:27 where, where, where is it? Uh, how do I have it in here?

48:32 Did you go back? No. Well, it, it’s basically developmental changes that have occurred that influenced the way people, way, way people inter interact with each other or feel about each other. I have it in here somewhere, but, um,

48:59 conditions related to brain development that affect how people see each other and socialize with each other. So that’s now become the big definition of autistic spectrum disorder and neuro, neuro neurodiversity. And so the, the, the ability for a broad, much broader group of professionals, uh, of caregivers, uh, to bill for these services, um, is, is, is under that umbrella. So, I’m sorry, I interrupted, please. No, no, No. It was just that when I noticed the increase, a lot of parents would actually be pushing for this diagnosis so their child could get services rather than, you know, and you couldn’t call it just something else.

49:47 You couldn’t call it, you know, uh, uh, you know, developmental, um, variation. You know, you couldn’t use some sort of more general term if you threw autism on top of it. And aut, especially autism spectrum. So it wasn’t then they absolutely got services. And for the, the milder kids, the services were phenomenal about what they could do for these kids. Phenomenal. But these were, each of these kids would get 20 hours of one 20 hours per week of one to one hair. And, you know, by, by talented therapists, I mean, and it’s, it’s you, you watch them from, they come in and three months later and you’re going

50:32 and the mother’s starting to smile, and you’re going, you’re starting to interact with again, you’re going, well, wow, you know, this is really, but that’s why I’m saying they had to get this diagnosis. And so it gets, it muddies the whole field. Do you see what I’m saying? Because people think, um, that, you know, they’ll never get out of it, or that they’ll never be functional. Well, It, it, it, it muddies it in the United States, right? In Sweden, where everyone else would get, everyone would get the care and all the care would be pretty equal for everyone. They have the medical records that cover all 2 million people, uh, 2 million versus over 20 years. And, and the, the, the requirement to get a particular

51:20 diagnosis, to be able to get certain things paid for is not as great in those countries as it is in ours. So it’s a, it’s a big picture. Okay. So if this is too much, tell Andrew to tell me to stop doing it.

51:41 Everyone else, I’m, I’m, I’m not sure I’ll listen to him, but I need to know if, if, if any, any people who are, who are paying attention to when we write things like this, how exciting it can be for those of us that are in the field, to see the field progressing the way it is and making things better for Cho Are you done with the slides? You just wanna stop sharing and then we’ll go back or, Okay. Can I just say one other thing? My, I wish this were off record, but my worry is, is that because genetic testing is so available now, if you have a kid, if you have a kid who comes to your practice, uh, Dr.

52:27 Uh, are you gonna, will it be in five years, you’re gonna be sending off blood for genetic testing so that they, uh, do, you know, uh, can determine what level this is? This is, this is, I think, I think medicine’s always gonna be, you know, the art of it about how people present. And there’s like That, Let’s hope so That subjective Component, let’s hope so As well, hopefully.

52:52 But the technology, yeah, it, it, it is a very difficult disease, right? Yes. To, to be clear. I mean, if you need a knee replacement, it’s pretty straightforward. Uh, to, to deal with a compound that we already know is influenced by 200 gene sites is gonna take enormous amounts of, uh, computing power and, and technology. And, and, but, but the very fact that we have, we have this capacity now, if we use it wisely and we give it to the tools of the young physicians, then the young caregivers out there, um,

53:37 if we handle it well, the children will be better. Yes, definitely. I mean, yeah, that’s the goal. All right. Well, thank you for, uh, um, sorry, I’m supposed to be the observer, but I can’t, we, we all sat through a, um, open meeting law, uh, lectured this this afternoon, and we were told that, uh, um, boards, boards don’t have to have public comment at all. And it’s up to the chair. And I know that our board is, I wish we had a full audience out here, and the board would, would, could be taking questions. I hope that we are writing papers to the newspaper.

54:24 What we really would like is that people out there writing letters to the editor or write letters to us and say, Hey, why don’t you write an article about why don’t you do a column on this or that? Because we’re, I, I, I am nerdy enough that I enjoy literature searching. And it, I learned it was just an exciting time to read these kind of papers. Um, because I, I spent 20 years doing this kind of work and the progression that’s taken place. It was a big deal for me to measure a little isotope of hydrogen floating along a platinum surface when I, to get my PhD. But these people are digging down into the most fundamental

55:12 nature of what it’s like. So for me, amazing practice life. Okay. Thank you. Giving me that, uh, that opportunity. Well, thanks for the report. Interesting. Did you happen to have read either of those papers? Do we do, yeah, I’ve read in the, The Okay. Read in The, uh, If if there are things that you think we can write about, let us know. Yeah. Um, Well, what I’d like to be more interesting, you know, what we’re gonna do on Marblehead, you, you mentioned the papers earlier on. Thank God we have the papers. ‘cause when the reporters dropped several years ago, we didn’t have one for quite a while. And these two local papers came in.

55:57 The, the town was, uh, most people in town didn’t know what was going on. So having it in the paper, everyone thinks when something’s in the paper it’s bad. No, it’s good because it gets people talking and then maybe you can make a change. But he, here’s something, what’s going on in Marble Hood that I saw on the paper, the Glover School back a couple in the past couple of years on restraining a student up there several times. Okay. Uh, just recently, uh, the bad accident on Atlantic Avenue. Okay, the, the other one is the church on Atlantic Avenue. And, and then I’m appalled about what happened in the high school, you know, in the past few days. So all these, most of these people are very young.

56:44 They’re we’re, we’re spending a lot of money in the schools. We supposedly have the best teachers, the education, we’re losing it someplace. So what the, do the, are these people mentally ill? Or, or why aren’t these people getting the resources? Do they just decide one day to do this thing? Because it, it, it’s even like the adults, not nothing against the Glover School, but professional people that went to college were watching what went on at the Glover School and they just, just go on one episode. It went on several episodes before it ballooned into a really, really serious thing. So, so I wanna help the people before it turns into a problem. And you mentioned earlier you went to a meeting today.

57:29 Um, you know, and I know the state requires you now to all the boards take in services, you know, that’s why, uh, I’ve gone tolemans meetings before 1974. I’m 65 years old at 14 years old. Okay? There used to be a lot of people there because they could get up and speak about things. And now it’s just public comment in the very beginning and then don’t speak over two minutes. The same thing at the school. That, that’s part of the problem that you, people on these boards are losing because people can’t, um, you know, I’d rather come in front of a board. There’s three of you. I could all talk to you individually, but then I gotta track you all down. So if you come to the meeting and you participate,

58:17 and um, you know, I know some things, some people might think they’re boring, but, but the thing is, is, uh, when some citizen takes the time to come to these meetings or goes and proposes something, I give them the same consideration. If I was to, they might not be interested in what I’m talking about. But, you know, you have views on what you’re saying, a little of what you were saying. I’m a little, I’m more concerned what’s going on in Marblehead. So, so I mean, is, so are, are you gonna try to help these people, like the school department for example? I see several examples, um, things going on at kids at a very, very young age. And I don’t think they just that, uh, were there, these kids must have been in the radar before. I just don’t think it would elevate.

59:03 Um, you know, I can’t understand on the fatality how someone that had a 13-year-old child was out at two o’clock in the morning. That, that, that you can’t, that you can’t convince me. I don’t wanna put anyone down, but, and I can’t believe that someone that was in therapy that lived on the neck, it doesn’t matter if you live on the neck or you live down the housing authority, bad things happen. So we need to figure out a way to, you’re, you’re even saying on your survey earlier that I’m listening to that these kids are back in college, you’d like more participation in people younger ages. That’s where we’re really, really having a, that’s where you have to start. You have to find out what the problems are at a younger age. We went to 18, but maybe we should be going to 10 years old or something. There’s HIPAA separate.

59:49 Yeah, no, there’s HIPAA laws and everything. But I’m saying you’re putting, no, you’re not tracing, you’re not tracing these things back to any person that you, you know what I mean? It’s all, it’s all, and I, I wouldn’t mind putting my name on it, the survey. ‘cause I deal with people that have, uh, issues with kids and stuff and they just, they, they just wanna vent. They wanna talk to people and they wanna feel that they can go to some place and get the resource. We’re first person board, we can’t solve everything. No, no. I, the first thing we’re gonna hopefully we’ll do, if we can get better at being good partners, the school board will come. Well, Tom will talk a little bit later about, he is working with the school committee, um, at, at even The school resource officer that works

1:00:34 with these kids should be coming to meetings like this if you really wanna have a program. And the Marvel Aid Counseling Center has some wonderful, they’ve done some wonderful things for the town. So I don’t know if you, I think the comm survey did say like people in your household too, right? Yeah. So yeah, so it’s gonna, I mean you can’t, you can’t give the thing to kids, but if you say people in your household, you’re getting, you’re getting an Idea. Okay. Our goal, our goal, public health lost a lot of trust in COVID. We have to show the town that a new board with a different perspective of what our role is and how to go forward is worthy of trial trust. Once people begin to trust us, then doing some of the things

1:01:22 that you’re talking about will be a whole lot easier. So stay tuned. Okay. Alright. Thank you again for tolerating. Um, No, it was very interesting Tolerating. Okay. Um, speaking of, of the associate chair for waste management. Okay, so the first, yeah, the, uh, I did meet with the school, uh, with the select board member of school committee member and park and rec. And we were talking about the recent tragedy and like next steps. So I think some of them, and I’ve learned a lot at that meeting and since then about how things have changed in this town since when I was in school here.

1:02:07 And I think some, some of the steps we’re talking about taking are, you know, I, I described that, um, arrive alive thing with the car. So that’s one that that’s gonna be looked into possibly some um, VR goggle type things, uh, in increased education, which would include that. But there’s talk about making it a requirement for parents to come to, um, you know, kind of like pre-prom meetings about um, uh, social hosting and things like that. And also really having the athletic department crack down on, on players. Like, you know, if, if you get caught you lose games. And that’s, and you know, like,

1:02:53 so you’re on the football team, you get caught drinking, you’re not playing in the next football game actually having real consequences. You know, and when I was in school, this wasn’t part of the, a big deal, but like all I found out now is that the, the worst offenders I’d say are not even the kids, it’s the parents. Parents. Like, your kid gets busted drinking and then they come to school and just insists that he has no consequences or else you’ll sue the whole mar. I mean, hey, like that gives the whole I’ll sue you, gives Marblehead the worst g*****n look. It’s so embarrassing. But then the social hosting, you know, I know this weekend, this weekend, you know, no one got arrested, no one, it didn’t make the papers. I know there was parents hosting a party on Abbot Street,

1:03:41 you know, and I think it’s gonna take a lot of it. I hear about parents now, it’s a major problem with parents showing up to the football games, sneaking in flasks, leaving legless. You can’t watch your, your kid play football sober. It’s pathetic. And it is like the parent level has gotten to a pathetic degree and you know, I, I honestly think that like, you know, you can only do so much for the kids, but when I was talking before, I didn’t even realize what I was, you know, getting to when I said like, you know, I wanna be a good example for my kids. So I just, you know, I wasn’t a big drinker these days anyway, but I just cut it out totally so they wouldn’t have to see it. I think parents really have to step up to other parents and if they know that they’re hosting, they know,

1:04:27 they all know the parents that are hosting and they really gotta like, we can only do so much, but the parents have to go to those parents and really have a talk with them. Because I’ll tell you, if those hosting parents, you know, they’re hosting because they either a wanna be appear to be the cool parent or they want their kid to be safe. So they do not care about anyone else’s kid. It’s the most selfish thing you can, they can do. They don’t care. They either wanna be cool or they want their kid to be safe with us. That’s it. So I think parents need to, you know, step up in their own rules, you know, tell people it’s inappropriate to be drinking at at school games. It is a high school sports game. You do not need to be drunk at it. That’s crazy.

1:05:14 And then if you know that parent that’s hosting the parties, say something to ‘em, get together a bunch of parents, have a little talk with them, tell ‘em it’s not okay. But, so we’ll keep going. We’ll keep meeting and doing what we can, but I think a lot of the parents in this town really need to step up. And I was just surprised at how big of a problem it is because I don’t remember the parents being like that when I was in high school and that wasn’t that long ago. So, you know, so that’s my little rant on that. Dunno if you guys have anything on that. But, um, so the efforts to get residents input on trash and recycling. We talked about this previously. Um, Andrew, um, I kind of told you that I’m free on the 29th, 30th, 31st of October.

1:06:02 Yep. All day. So wide open those three days. Yeah, so I mean, we definitely have some time, you know, this isn’t, you know, we’re not rushing into this. We’re not signing contracts by the end of October. Um, obviously like once we get past kind of the first week in November, um, we kinda get crazy with holidays and people and stuff like that. Right. Um, so yeah, let’s try to figure out a time. Yeah, possibly like the COA might be a good space. Exactly. Just Get a time Block and just get a Time block. People Can come and talk. Um, Probably, you know, I think some of the people that really wanna talk to us might be more like early afternoon or, you know, early evening time. Um, so we can definitely set, set something up. Okay. And I, when I look at curbside collection, um, there’s really three options that we’re looking at.

1:06:48 Mm-hmm. So I’m gonna call regular collection. So very similar to what we have now. People are able to use their own barrel, but we have a limit for curbside trash, which we have a limit now. Um, it’s 70 gallons or so, 2 35 gallon containers or 1 65 gallon toter. Um, but we need, we will be limiting the recycling side ‘cause it’s unlimited now. Right. And we’ll need to limit that. So you’d be looking at limited the same size. So two 30 fives or 1 65 gallon total? No, we did the estimate. You, you put the estimate at about like 60%, you know, on the low end of what. So the high end would be kind of what we’re doing now and just continuing what we’re doing now. What do you put that percentage at? Is it closer to a hundred

1:07:33 As far as What increase? So that’s a pretty large increase. The, the, it’s a large increase ‘cause it’s an unlimited amount of recycling. Yeah. So it’s not a huge increase. ‘cause really when people put stuff out there, it really comes in around the 65 gallons for recycling and stuff like that. Mm-hmm. So but you are, what you’re trying to capture is that I think Cost to increase. Yeah. That that’s a pretty large cost increase. Um, it, it is gonna be close to a hundred percent. ‘cause what, what you’re doing is that you’re taking and, and it’s more for the, the processing costs, right. Because right now there is no processing cost. We don’t have to pay for any kind of disposal recycling. We pay for the disposal of the trash and now you’re gonna have to pay for the recycling side.

1:08:18 So yeah, that’s a pretty large, So we’re talking like the best we could do is probably around 60%. And if we were just to do what we’re doing now and just, you know Yeah. Pay the extra amount, it’s about a hundred percent. Yeah. And I think what people need to realize is like, this is not an override thing. This is, and if you do profit two and a half, you know, a hundred percent is what, 1.2 million increase. Yeah. So It’s not even gonna be that because you know, you have to, you, you have to, there’s a lot of things that are factored in. So you have the cost of collection, the cost of disposal for the trash. Mm-hmm. And the cost of disposal of the recycling. Mm-hmm. The cost of disposal of the recycling is, that’s where you’re gonna see your largest increase in costs, right? Yeah. But even if you limit it, people can still drop off their recycling. Correct. Correct. So it’s not

1:09:04 really gonna change the amount. Correct. It’s not really gonna change the amount, but you’re, you’re limiting. So there’s kind of two sources of re revenue too. So when we look at curbside collection, I look at that as the town’s responsibility that’s paying for the collection and the disposal of that material. Mm-hmm. So that’s paid for by taxes and stuff like that. When we sell, when people bring material up to the transfer station, the facility sticker sales offset those costs. Yeah. Okay. Now the facility sticker sales don’t come directly to us, but they go into the general fund. Um, and that really covers the cost and you’ve done a really good job of like, you know, promoting stick sticker sales. We now have cameras, um, we’re gonna be pretty close

1:09:52 to $600,000 in sales this year. Yeah. Um, so you know, we are at the 300 to 400 and we’re getting close to 600 now. So that’s a huge, you know, that that really covers a huge portion of the cost to run the transfer station. Yeah. For the residential side of things. Um, and so that, that is a big piece of it. The other two kind of pieces for curbside collection is then going to automated collection. Um, obviously with automated collection we would have to provide the barrels. Um, and again, you know, when we look at it, you would offer the 65 and the 65. Um, and then the third kind of option would be to do that automated collection, but with the o every other week of recycling.

1:10:37 So you’d offer that, you’d give them the 65 gallons for the trash and then you’d give them the, the 96 gallons for the recycling. Um, and again, by doing the 96 and the every other week, that’s another cost savings for itself. Now with the both the two automated collection sides, there is a cost where we have to purchase barrels for the whole community. Now people are like, well, why can’t I just buy my own barrel? It’s a cost saving for all of us to buy the barrels together. And it’s a significant cost savings. So if we buy ‘em as a community buying 8,000, technically 16,000 at a time, you’re getting down to 65, 55 do dollars of a container where if you went out

1:11:22 and bought that I think the cheapest you could probably buy today is around $110 per for one. So that’s a significant savings. So when we look at things overall, we have to take all these things into account, looking at Mrs. Smith living by herself. If we do these things, there’s, you have to take a look at all those costs. Because if I say, Mrs. Smith, now you gotta, we’re gonna do automated collection, but you’re responsible, you gotta go buy that barrel. You, she’s gonna see a cost increase in her taxes just for the automated collection, and then she’s gotta buy the barrel. And so yeah, there’s a one-time cost to that where we can move some of those costs out over several years. Mm-hmm. But so the idea is to put out the RFP, obviously get, get the proposals,

1:12:09 and then decide what is really best for the community. But one main thing I was trying to, you know, get out there is that, like, this is, as you said, it’s something that you’ve been talking to the finance committee about. They’re ready for, you know, all the time. But you, we are limited by prop two and a half. So depending when you go on the higher cost end, yeah. You are gonna lose other services in town. So it’s like, you know, they’re gonna be reduced. That, that is the hardest thing is that the town is really up against the wall with our finances right now. Mm-hmm. Where we, you know, last year, you know, we were right on the fence with it. Then we had to make some reductions at the end. You know, we had put in a, a budget for public health, um, where we wanted to give the Counciling Center $120,000 rather than the 60,000 bucks.

1:12:55 Well, the town could afford that. So we had to drop that down to $60,000 on the wayside. The town should be covering the cost of the disposal for all the items, in this case, the solid waste collected, curbside, the town’s not able to afford that right now. And we have to use waste revolving the funds to support that. That needs to change. Where the town needs to be responsible for their costs, the transfer station be, should be responsible for their costs. Mm-hmm. And those are the two big pieces. Um, so, you know, that’s kind of what I have to say about the recycling or about the, the, the collection contracts. Yeah. Um, but yes, we should set up another time where we can have people and, and I’ve gotten some questions and email and I will go back

1:13:41 and forth with people as much as you know they need so they can ask their questions and I can provide the answers, find my fault. No, that, that’s total, that’s totally fine. Step out there. That is the idea with this is that, yeah, people get to ask their questions, I will give them the answers. It doesn’t mean that they have to agree with it. We just wanna make sure that we’re providing them with all the information. Mm-hmm. And then we will make the best decision for the community. And yeah. Again, like in a perfect world, we knew 10 years ago that this contract was at a, a, you know, a huge savings. We, they should have been building up my account to essentially deal with this at this time, where it really wouldn’t be here in the community. That’s not always how towns work. Um, but so at this point, this is gonna be a very tough financial year

1:14:27 for the Yeah. The community. I mean, any of the teachers strike in that, in that, so it gets even tighter. Yep. So, Alright. Okay. Yeah. And so I’ll just rattle off the bills quick little while. Um, so, uh, a one exterminators for route control at the transfer station, $350 Agri Source for, uh, the grinding of the compost removal 800, um, Amazon for other disposal costs. Um, $202 82 cents at T Mobile for internet access, $80 Atlantic Vet for testing services, $240 black earth compost for residential food, composting pickup and replacement bags. $2,362 88 cents. Um, gamblers for uniforms $386 61 cents.

1:15:13 Haley Ward, Inc. For, uh, engineering firm for the transfer station. Uh, $3,300 Home Depot for disposal area maintenance supplies, uh, $288 52 cents, Marblehead Light Department for electricity, uh, $1,942 29 cents. Marblehead Vinyl graphics, um, for some graphic designs. Uh, uh, 9,009 80. What, what were those on? So the, uh, the vinyl graphic should only be like, um, $600. I was gonna say, it looks like I, I did a typo on that. Yeah. Yeah. I Type, so that’s for, that’s several, uh, several vehicles. Okay. Yeah. So 600 shall say, uh, Republic Services, uh, $86,102 64 cents. Um, Sanofi, and I don’t know how

1:16:02 To pronounce Santa Fe past years. Yeah, it’s flu. Yeah. Yeah, because that’s the flu reimbursement. Uh, that’s, That’s flu vaccine. Yeah. $4,043 49 cents. And Steve Moody for, um, internal service training. $67 38 cents while not printing for printing forms $456 67 cents. And WB Mason for office supplies $194 14 cents. Okay,

1:16:30 Dr. Chair for community health. Yes. So, so following your speech before, so, uh, I’d like to give, um, kind of an overview of, um, influenzas we’re approaching our next flu season. Um, so, and I, you know, thinking about, we are talking about, um, putting out more articles, I’ll, I’ll put this out into one of the papers as well. This what I’m sharing with you now. Um, so influenza is something that we face every year. Um, and there’s this kind of psychological phenomenon that’s something that we’re familiar with, becomes less concerning. Um, but I think, but, and, but it is this, it does significantly impact us year after year.

1:17:16 Um, it can cause, um, it, well, it affects millions of Americans every year and can cause severe illness, hospitalizations, and even deaths. Um, so our, the flu season in the Northern Hemisphere for us occurs between October and May. Um, and it peaks typically between December and February, um, with the timing and severity can vary year by year. Um, but it, it’s, it’s significant every year. Um, and just to note, uh, last season’s impact. So last season’s flu, uh, was categorized as severe. Uh, there were 47 million illnesses, 610. This is in the us, um, 610,000 hospitalizations, and it’s still prelim data, but about 38,000 to 43,000 deaths, um,

1:18:04 nationwide from influenza. And, um, across all age groups. The, um, hospitalizations were about 1.8 to 2.8 times higher than, uh, in the last 15 years. Um, the most notable thing was that there was the highest, uh, amount of pediatric flu deaths. Uh, since tracking began in about 2004, there were about 288, uh, pediatric flu deaths. Um, and although this may seem like a small number, every, every death is, is awful. And, um, only 80 and 89% of these children, um, had not been vaccinated. Um, so just to kind of do an overview of what influenza is. So it’s acute viral respiratory infection, which typically causes fever, cough, uh, muscle aches,

1:18:50 chills and fatigue. Um, most people recover within a week, uh, without treatment, but young children, older adults, and those with chronic conditions, um, are at a higher risk for complications such as pneumonia, uh, respiratory failure and death. Um, so there’s three main types of influenza that affect humans. There’s, uh, types A, B, and C. Um, influenza A is responsible for major pandemics as it can mutate, uh, most, most effectively, more rapidly. Um, and it has, um, it, it, uh, mutates its surface proteins, which are hemagglutinin and neuraminidase. Um, and by mutating these surface proteins, it can evade, uh, the immune system for antibodies we’ve already produced for other strains.

1:19:36 Um, and so these subtypes are named for these proteins. So your H five N one is bird flu, uh, for example. So, um, flu is mainly spread through respiratory droplets, uh, large droplets, but can also be spread through talking, um, airborne, but also through touching contaminated surfaces, which just highlights how important good hand washing is, um, all throughout the winter months. So, um, this is kinda interesting to research, but, so, uh, each year the World Health Organization reviews global surveillance from about 152, uh, national influenza centers in over 129 countries. And they do this in February to predict which strains are most likely to circulate. And when they pick these strains, those then go

1:20:22 to production and make our, um, flu vaccines. So there’s three main types of, um, flu vaccine that’s available. The first is the most common, it’s the inactivated or the killed vaccine. And it comes in the regular and the high dose, which is recommended for everyone 65 plus. And it has four times the amount of, um, antigen, um, to give people, um, who are older, more, um, similar robust response than, um, people who are younger. Um, and, um, this is one of my favorite myths that, uh, people tell me in the office all the time, I’ve had the flu vaccine before and it made me sick. And I tell ‘em, no, it’s physically impossible to make you sick with the flu, um, with the actual flu because it is a dead virus. Um, and, and, but what you’re experiencing are more side effects, but it’s not the actual influenza it can cause.

1:21:09 Um, so that’s the first one. The in the killed virus, the inactivated. Um, then there’s the recombinant. So this is made, uh, with pieces of the virus. It’s made, um, into a protein. So no live virus is, is made. Um, so people who are immunocompromised for those with severe egg allergies, um, can use the recombinant. But, um, important to note that people with egg allergies can generally receive any of the flu vaccine because they’re, the amount of egg protein in these vaccines is so minimal, um, that really, even having an egg allergy, you can still get really any of the vaccines you’d like. Um, then there’s also the live attenuated. This is the nasal, uh, um, attenuated means weakened and it comes in a, uh, a nasal spray.

1:21:55 Um, so in this could be used from for patients ages two through 49. And this is the first year that you can order it and self-administer at home. I got a few kids for my family, just ‘cause it’s hard for us to schedule appointments and, um, easier to shoot something on my two year old’s nose and strap ‘em down for a vaccine. Um, and it was very easy. They take insurance. Um, so it was an interesting process. So for those don’t, that don’t have time, you can order that to your house at two through 49, um, and without any resp, um, respiratory illnesses. Um, so risks and side effects. So, um, important to know that most side effects are very mild and temporary, such as, um, a localized reaction of arm redness, soreness, and swelling. Um, you can get a mild fever and a headache that typically resolved in,

1:22:42 in a a day or two. Um, severe effects are incredibly rare. Guion Barre syndrome, which is an ascending paralysis, um, we see about one to 2 million, uh, or one to two per million people, uh, vaccinated per year, which is far lower than the amount we see after people have the influenza virus, um, infection because you can get GABA syndrome following influenza itself. Um, rare cases of febrile seizures in kids, um, that can be scary to witness, but are self, are self-limiting. They resolve. And, and those are also incredibly rare. Um, so overall the influence, the influenza vaccine is incredibly safe with benefits, uh, far outweighing the risks. Um, so for timing, um,

1:23:28 flu vaccine is typically offered in pharmacies too early, I think in, in kind of August. But Sept, September through October are the key months to get vaccinated. Um, immunity lasts about six months. You wanna make sure it covers those peak months of, um, December and February, but even we see cases into April and even May. Um, so, but this is a good time to get it. And, and it does take two weeks to develop full immunity. So you wanna schedule that, think about that when scheduling vacations, um, and at the CDC offer, uh, recommends flu vaccine for everyone six months and up. Um, and that the, uh, the flu vaccine is the most important tool to prevent, spread and protect against severe illness. Um, and I highly recommend everyone get vaccinated this season.

1:24:17 Great. You, Any questions? Could you date that? Could it just, I know I was looking at this. I have like the bulk Topics. 10 minutes. Get it done and we’ll put it. Yeah, yeah. We’ll put it together. Sources, we, uh, again, worth coming to the meeting. Just stay here whether you wanna get your flu vaccine right, and why raise the, raise the level of what people are, are thinking about in town. And I already did it three weeks ago, so I do it for you. The, the other aspect is if you get the flu vaccine and you get the flu, you tend to have a milder case. Yeah. And I think that people Yes, yes. You know, oh, it didn’t work. I got the flu. Trust me, if you’ve ever had flu, real flu,

1:25:04 it can be horrendous. Oh, I skipped over a paragraph. Can I share that? I said perfect. Um, I was like, I did, I talk about the effectiveness. Um, so, um, so the last season effectiveness data, um, so it ranged from about 32 to 60% in children and 36 to 54% in adults, um, with even higher protection against hospitalization. Um, so it was protective for, um, 78% of children and 55%, um, in adults. So, which, um, means that in a typical year, vaccination reduces flu illness risk that’s kind of medically attended, where you have to go see a doctor or, or go to the hospital, um, by about 40 to 60%, which is pretty amazing.

1:25:51 And we do see it every year. The, the more severe cases are the ones that aren’t vaccinated. Can I? Yes, please. Another thing is that now you can literally be tested for flu, which, which you can with a nasal swab, you can test to see if you truly have flu. Yes. Because as a, as a pediatrician, as a doctor, a lot of people came in saying they had flu, but they had a virus and they didn’t have influenza. And I think that’s important because lots of things get called flu when they’re a little bit more than sniffles or something. In fact, people have fever. ‘cause real influenza, having had it once I, I missed a year of getting my vaccine and it was awful.

1:26:37 Wow. A hundred, 104 for four days oof days, uh, aches. It was made me religious,

1:26:48 truly made me religious. And I also hear from people, well, I’ve never gotten it before or, or I’ve always been healthy every flu season, so I don’t need it. But it’s, it’s kind of the equivalent of just because you’ve never gotten in a car accident doesn’t mean you shouldn’t wear your seatbelt. It’s, it’ll likely happen to everyone at some point. So, and it also can reduce, um, common colds by 30%. It’s been interesting. Think it revs up your immune system. Great. Thank you.

1:27:19 Transfer station updates. Mm-hmm. Great. Well, I, one, one of the things transfer station Great. Ahead. At the, uh, at at the open meeting law, we learned that the three of us can make the tour of the transfer station to see what you’re gonna talk about. Yep. Without calling an open meeting, we get a chance to meet all the people up there. I’ve still not, I don’t think I’ve met everybody. And so WW why don’t we try to make an arrangement that one, we, we now have a contract. Well, we’ll get to that. Yep. But to, to get a meeting up there so that we see what exactly is gonna be done and we can get a chance to meet, make sure everybody that works up there is there the day that we’re gonna come up and should take a half hour or an hour.

1:28:04 But we really need to, do we need to do that? Uh, so I think so, yes. Uh, yesterday we had our first pre-construction meeting with the contractor. Um, the contractor was planning this to be applying for permits this week. Uh, permits should, process should be pretty quick. Um, so again, we’re in the process of, um, going into construction. We have a press release that will go out to all commercial account holders. It’ll be hand handed out to anybody that comes up to the scale. Uh, we’ll put this in the, under the website, under our news item to remind people. Um, but again, with the construction, there will be some downtime, um, especially around the, the compactor pit. The main goal is to keep the operation for the residents ongoing.

1:28:52 So residents use the back of the facility. They have trash disposal, they have all the recycling, they have the swap shop, they have the yard waste. What they won’t have necessarily access to is weigh and pay. That’s really the commercial side. But the goal really through most of the construction, there will be a couple days where we will be down, is to keep and maintain operations for the residential side of the transfer station. Are we recommending anywhere for way of pay? What’s the closest? No, we, we can’t recommend. Oh, okay. Okay. Yeah. Um, so again, that will be going, um, it is technically a 90 day contract with the contract, you know, with this, this builder, there’s certain things that will fall outside of that. Um, paving is really the, the big piece, um,

1:29:39 that’s gonna fall outside of that as the 90 days is gonna be during the winter. Um, and so the ping, um, will most likely be completed in the springtime. Um, but again, you’ll have drive aisles, you’ll have areas that, um, people continue to use the facility. And again, the residents are our primary responsibility, uh, to keep operations up there for them. Um, there might be some differences of how you exit the facility, um, but we’re gonna try to keep everything to a minimum. Um, again, we talked about the trash and recycling contracts. We’re working on the RFP currently. Um, once that goes out, we will continue to have discussions, uh, with the residents. We’ll figure out a time for you and I to meet with residents at the CLA. That would be great. Um, we’ll do

1:30:24 that towards the end of October. Um, and that will allow us to kinda answer some of the questions from the residents. The concerns, I’m sure a lot of it’s gonna be around barrel size, re of barrels and stuff like that. Um, I’ll make sure that I bring a 35 gallon barrel, a 65 gallon barrel, and a 90 96 gallon barrel, as we call it, a 95 gallon barrel. When we have those discussions, people can take a look exactly at the products and the sizing for everything. Um, one of the things that I do want to talk base about is bloom. Um, so recently, um, we joined, um, or bought into an app. Um, so this is an app that you can get on your cell phone. Uh, it’s called Bloom. And this is available to all Marblehead residents

1:31:10 and all Marblehead employees. Um, bloom is an easy to use app and platform connecting residents directly to coordinated services, 24 hours a day for 24 7 crisis support therapy, root recovering recovery services. Um, it’s connected to Boston Children’s Hospital. Um, McLean Hospital. McLean’s has asked the expert, um, and over 500 on-demand resources. Um, ensuring mental and behavioral healthcare is accessible anytime and anywhere. Um, there’s a lot of great things on here. Um, they have so many different things to offer individuals. Um, and that now is gonna be available to everybody in Han.

1:31:56 I mean, we get down to mental health navigation and therapy, substance use and recovery coaching, grief and loss support, parent coaching, elder care, consulting life and ex executive coaching. Uh, and even fitness and Nutri Nutrition. Um, so it’s a great extra benefit for the community. Um, and we’ll really begin to push that out in the next couple of weeks. Um, but that is now available to residents. How do you, how do you sign up for it? Like how do they know you’re a resident? So we essentially, all we have to do is pass around a flyer. Okay. So it, it’s really about, we told them there’s 20,000 residents. We have so many employees, it’s about, you know, I forget the number, 1200 employees and they gave us a number based on that.

1:32:43 Mm-hmm. Yes. There might be some outside residents or obviously again, you have employees that are from outside of town. Um, it’s more about getting services into people’s hands. Mm-hmm. Um, so yeah. And you would scan on the QR code and be able to access the app. Um, this is, again, it’s all for free. Can you post the QR on the Website? I will be able to post the QR on the website, yes. Okay. Um, but again, we, you know, we’re focusing on the comm survey, which is a QR code. I’ll make sure that this, this is very separate and stuff like that. Um, but again, when we’re talking about all these services and building mental health support, this is a great addition to that. Um, especially with this comes, each resident has access to four therapy sessions or mental health support, um, through telehealth.

1:33:31 And once that’s complete, they will assist you, um, with finding permanent solutions. So it, it is a great, um, addition to some of the things that we have in town. Um, the last thing I kind have is we’ve talked a lot about the beaches, um, and assigned for, um, the, um, Riverhead. Yeah. Riverhead. The, uh, the boat ramp. Um, so a couple different things came. So this is one of the beach signs that we hang out. Uh, this is always up at the beach. Um, it lists the name of the beach, the dates of operation, obviously the beach operator is us. Um, the permit number, we have five bathing beaches in town. And then the big thing is the dates of operation. So when we list the dates of operation, they tend

1:34:17 to be beginning of June through the beginning of September. This is the time that we are sampling the beach.

1:34:25 Bacterial levels are not monitored outside of these times. Obviously when we do the sampling and stuff like that, if we do have a high bacterial account, we post the beach. No swimming. So what you would host at Riverhead is a notice, you know, this would be your sign. Bacterial levels are not monitored at this location. And then it just gives the, the state regulation on bathing beaches. That’s confusing though, because that’s like, is it a bathing beach? It is not a baby beach. Yeah. But you’re saying like this minimum standards for bathing beaches Yep. Pertains to this beach. It doesn’t, doesn’t it does not. Yeah. So This, Right. So we can talk about this about exactly how we wanna,

1:35:11 you know, post us there. Um, but that’s how, you know that notice is really the big piece. Yeah. So I can put that on the agenda Underneath maybe, but this is not enough. Yeah, correct. But this is not a meeting. Yeah. So I can put this on the agenda for our next meeting in October. Um, and we can kind of finish this discussion, um, and finalize the wording that we want on this line. Any questions? And the waiver will be handled by the clerks and records? Yep, That’s correct. Yep. And that’s everything I have. Okay. It’s the end of September or beginning of September? No, it tends to be the second week in September. Is that flexible? So the state pays for

1:35:57 so many samples, um, and then we pay for all the samples after it. The state gets us to, um, what is it, labor day essentially, and that’s it. So that every week past that. And, and you have to remember that if you run the bacterial problems you’re testing, so you’re paying for all those samples. How much is it per week? Uh, so it’s $300 per sample I believe. I mean maybe if, if it continues to get warmer or stay, I mean global warming Thing. So, so obviously as the season progresses and the water warms you have more failures. So Yeah, I mean we, we can, you know, look at sampling into middle a little bit middle of September, um, which would be essentially an additional week.

1:36:42 Um, but I wouldn’t suggest to any, you know, you’re gonna have to increase your budget for that. Okay. Yeah. And obviously we’ll, we’ll continue to monitor this as, yes, as we experience some increasing water temperatures, um, you might see some increasing bacteria and some increasing closures in testing, in virus testing.

1:37:06 So when does it start to get cooler again? So it doesn’t start to get cooler? So there’s two things that play into it, obviously. Um, the current. And so as these storms coming and out, the actually currents move a little bit. And sometimes, so like two weeks ago our water temperature was 66, so pretty warm for September. Um, and then it sh quickly shifted out a little bit and so we got down to 6 61 and it will slowly decrease over, you know, over the next couple weeks and, and through the winter. Um, in the springtime again, you’re starting pretty cool. Um, we have one beach, grace Olivers we had that tends to have some early issues in June and we’re not really sure where that’s coming from. Um, it tends to be pushed in most likely from

1:37:51 a storm and stuff like that. Um, but we often see an issue in June there. That’s kind of hard to explain with the water temperature.

1:38:03 I have that our next meeting is October 27th. Is that right? The fourth Monday of the month? That would be correct. We Didn’t make that cha any change. We did make a change for the first meeting in November. Right. Because the 11th is pharmacist holiday. Yep. And what did we decide to do the 12th or did we not decide? I don’t think we decided, but the 12th would be fine for me, but we can’t do the 12th can do the 10th.

1:38:36 Uh,

1:38:43 let’s send out an email and see what people can do for that week. Um, but you know, that might be the best.

1:38:58 We, we had actually had some audience participation. Is there any, any further questions, comments?

1:39:07 Well now that you mention it, um, the articles you guys have done, I’ve read them. Oh, quite a few other people I know have read them and we’ve talked about. It’s a good thing. I think there’s one more type of article that Andrew could give that would be very beneficial for the general public, but more importantly for the guys up there at the transfer station. Okay. If you get an article sort of explaining how the transfer station works, a lot of people have no clue what they should do or shouldn’t do. What they, you’ll go up there and you’ll see things that should be paid Crash people just leave them wherever, then your guys have to deal with it. You’ll see a giant sign the other day on the big bulk

1:39:55 plastic dumpster. Do not leave anything outside. I had a move stop. So you could just see the DM sign. It’s ridiculous. Some people don’t realize you can get rid of clothing type materials, which you’re not supposed to throw in the rubbish up there. And the book thing that works out really good. A lot of people have no idea what happens upstairs. You go up the other day, get rid of a load of brush from the coffin school and I said, Hmm. Sign tells me no bags of leaves, but I counted like 15 bags. People either can’t read, don’t understand English or just jerks. But if you have like some sort of an article that gives people, uh, a little gist of it so

1:40:41 that they’re not screaming at your workers so much, I mean, uh, I think that would be beneficial just as your articles have been beneficial and somebody makes Facebook postings that are very beneficial, make people more aware of what’s going on up there. If it’s, We are not a shy group, The, uh, bulk of town had no real thoughts about the transfer station until the strike. Right. And then all of a sudden they said, wow, we really have something pretty neat here. It works out good. Uh Right. People are much more appreciative of it now. That’s great. So I just wanna keep getting the good will out there because you have a lot of bad will from a previous experience up there. I’m gonna leave it at that Sounds good. Thank you.

1:41:27 I think you good. I Yeah, I I I agree with you. Yeah. I think it’s important to make sure everybody understand how it works, where the material goes, um, all the different options. Yeah. Traffic flow, um, why we have signs in certain places, why material shouldn’t go in that places and stuff like that. So Yeah. Yeah. Actually what you take value do take air conditioner as a mattress or so be before one time I had to go over to line. That’s correct. Yep. That’s, uh, but I don’t know if residents know that. So it, it might be a good idea. No, I think it’s a great idea to make sure everybody, uh, understands all the different things. ‘cause you forget Yeah, Andrew, if you could even do a video kind of showing. Yeah. So we’ve done it in the past, so I mean we can, um, yeah, I mean we can definitely work on some of that stuff.

1:42:14 Um, I’ve definitely done some videos in the past. Um, we worked with mht woman that worked for MHTV, um, and they would do different segments and stuff like that so we can see if we can bring some of that stuff back. Yeah, that’d be great. And post it on the website. Uh, but it is amazing, you know, clothes, I mean the amount of clothes that gets donated up there is incredible. Mm-hmm. Yeah. Really. Oh my god. I want to say I think we’re up to 80,000 pounds right now for, um, for three quarters. Yeah. I saw in the lin yesterday and they put in these boxes. I don’t know where they are, but you’re gonna be able to throw your banana peels in and stuff. Yep. We have food composting up there. Yep. Yeah. You know. No, no. But you’re Gonna be able to do this in Lin

1:43:00 that people don’t just have something little a chicken bone or something. Yep. Um, they’re going to, they’re trying it out. I guess they’re gonna grant someplace. So Yeah, we’ll definitely do that. Steven, the other thing I was gonna mention is, uh, how you were saying like some people, well I’ve never had the flu before, so I shouldn’t bother to get the shot. Uh, I was 74 years old before I had my first headache. Uh, had never had a headache was 74 and I had a headache for three days. Wow. So it, uh, some people are just, they don’t get ‘em. Right. Same with the flu. Wow.

1:43:39 Things you do get. Is there any way we can move the screen here? So the p I’m not gonna be able to do that. You’re not? No. No. Yeah. What, how can we, can we move the seat? I mean, we Can definitely move the seats bus. Yeah. Yeah. Maybe we can. But Yeah, that, that is permanently there. Okay. Um, okay. Well we say either inside or over there and then the, the public have this three ways, but it doesn’t matter. We, we Yeah, But you have a friendly audience tonight. You might not want everyone that close in the It’s our job to make them friendly.

1:44:23 I mean, I can talk to them about moving it over here.

1:44:28 I think if we can get 15 people to see, does it even just Pivot a little? It does not. It’s totally just pivot it slightly. That would make a difference. Okay. No, I think that’s really, I just go like this. I think we Just move over there. That’s, If you did have an audience, you, you would never be able to get everybody here. Yeah,

1:44:56 We can hear you good. So that’s good. You got a deep voice though, compared to some of the other meetings. He’s printing some of the key slides that Yeah, but it’s still not the same. I mean that this Room is used to be the operating room, so it echo has an echo To it. We took the tables out of here and put the seats this way. Put the tables down there. Well anyway, we can talk about, I mean, we have something to think about. Thank you for Any questions. No, I don’t have any raised hands on mine. Certainly Preparing a little talk for us and having an audience makes it great. So thank you for your questions. Thanks. Don’t letting That with us.