2 Postal Workers Die of Anthrax

eMediaMillWorks
Tuesday, Oct. 23, 2001

Following is a transcript of a news conference with D.C. Mayor Anthony A. Williams (D), the D.C. public health officer, Ivan C.A. Walks and Postal Service officials Deborah Willhite and Rima Khabbaz.

WILLIAMS: Let me thank everyone for being here today in a continuous effort to provide you real-time, factual information and updates on where we are with this incident of anthrax here in our national capital area, to try to provide you information as we're going forward to sort, as we always say, fact from rumor, and to tell you where we are with preventative measures and strategies to get on top of this situation and manage this situation.

I'm pleased to joining me, as always, is the council of the District of Columbia. I have with me Linda Cropp, who is the chair of District council, Kevin Chavous, who is the councilman from Ward 7, Adrian Fenty, a councilman from Ward 4, Carol Schwartz, representing at-large council for the District of Columbia, Sandy Allen, who's the chair of our Human Services Committee from Ward 8, Vincent Orange, a councilman representing Ward 5, where the Brentwood facility is located. And I thank all of our council members for standing united with us at this very difficult time.

Chief health office for the District of Columbia, Ivan Walks, is with me. From the U.S. Postal Service, Deborah Willhite, senior vice president for government relations and public policy. From the National Center for Disease Control, Dr. Rima Khabbaz. As you all know, she's the director of Viral Diseases Branch for the CDC. Fred Blasser (ph) is a public affairs officer, the National Institute of Occupational Therapy for the CDC.

We've now been joined by Jim Graham, who is the councilman for Ward 1. I thank him for joining us as well.

We now know that the two deaths that were reported to you and that you know about now are confirmed cases of inhalational anthrax. So that is information that we're imparting to you now. We know that the Brentwood facility has tested positive for anthrax based on the environmental work that was done, and I'll leave it to Ivan Walks and the Postal Service to talk about that.

Ivan will talk to you about, as we've talked about already and announced already, the expanded treatment of post office employees and folks who have been in certain areas of our postal facilities. And with that in mind, my mother and I will be out at D.C. General today to receive our treatment insofar as we fall within this ambit, within this perimeter. So you'll have more details and more information on that.

This was an effort on my part, my mother and I, to be out there with our postal workers on Friday and we happened to be caught in the ambit of all this, and I think it's appropriate to be out there in the line at D.C. General again showing our solidarity for, as Governor Ridge put it yesterday, another example of uniformed personnel who are doing public duty, who have loved ones and families and are now in harm's way, another example of how this terrorism really knows no place, race, class, income, religious or other lines or distinctions. It's really striking everyone. It's just as hideous as it's always been. And I think it's all the more reason that we work as aggressively and as actively as we can to get on top of this to assure the safety of our workers and the safety of our citizens.

And with that in mind, let me now present to you Ivan Walks, our health policy officer.

Ivan?

WALKS: Good afternoon, everyone.

As the mayor said and has been reported, yesterday we talked about two cases that were highly suspicious for anthrax, and those folks died. Today we can tell you that those two deaths were due to bacillus anthracis. They're confirmed as anthrax deaths.

The other two confirmed anthrax cases--the two gentlemen that are receiving excellent care at Inova Fairfax Hospital--continue to be listed as critical, but stable. We expect them to continue to be listed that way. They are doing well.

We also want to--and I'll have Dr. Khabbaz talk more about this--let you know what we're doing proactively; what is public health doing in conjunction with CDC, in conjunction with our hospitals and our medical professionals to be proactive, to respond to this different day, to respond to the fact that we now know differently about the risks associated with the folks who handle the mail. And Debbie Willhite will talk a little bit about that.

We now have over 40 CDC folks here working with us and we also have some changes to the numbers we gave yesterday.

WALKS: Yesterday we talked about a total of 13 cases that were being investigated. Today we know about four confirmed, the two deaths, the two gentlemen who continue to do well. We have four cases that are listed as suspicious that we are following very closely. And we have another 12 cases that are very low suspicion. We've looked at those cases, the CDC folks have. They've recommend to us that they be in that category. And those cases, though they continue to be followed, they're in a very low suspicion.

What that's allowing us to do is, again, follow the science proactively and work real-time to try to identify better a period of exposure. Because we are working to do that, and inhalation anthrax is quite serious, we have, as the mayor said, expanded our treatment perimeter.

Let me review one thing: We do nasal swabs to establish a treatment perimeter. They are a public health tool. Those swabs, that testing is not a way for us to tell the individual who's being tested whether they have anthrax. It is not a way for us to confirm whether that person will get sick with anthrax. We do the swabs, we do the testing, and based on some of the test results we establish a treatment perimeter.

We have decided as of today, based on the confirmed anthrax incident, the gentlemen, the postal workers who have been confirmed, we do not need to do further testing, but we need to treat. And we need to treat quickly. We, again, are asking for immediate, immediately, people to be brought or to come to D.C. General to receive the medication they need, so we can help keep them safe and protect the public health.

The treatment perimeter has been expanded since yesterday. Yesterday we talked about folks who worked in the back area of the Brentwood facility needing to be treated. And people whose work brought them to that back area, those employees of the media, those employees of our own health department, those employees of the CDC and the FBI, who were back there doing their jobs to help protect the public health, they needed to be treated. But also yesterday, we received confirmatory environmental tests of the Brentwood facility. We learned yesterday that there is confirmed anthrax at that site on material in that back employee work area.

Because of that, we are now saying that the postal workers in the District who work in employee work areas, and again, the media crews-and here's where the mayor falls in--those whose work brought them to those back work areas in our postal facilities now need to come in, not for testing--the testing is a tool to tell us who to treat, we already know that--we want those folks to come in immediately and receive their treatment.

The reason we want people to come to D.C. General is, again, good public health. We don't want you going and picking up anthrax from a doctor you know, from a friend you know, we want to get your name, we want to make sure we know who you are, we want to make sure that we have one database and we can track all of these individuals.

And let me say this. The Postal Service has been a tremendous partner. We are asking postal workers to go to work. The Postal Service will bring you from your work to D.C. General, and Debbie will talk a little bit more about that. They have been consistently with us, working closely with CDC.

The federal government's Office of Emergency Preparedness has been terrific. They have brought the medication we're using. They've brought the swabs that we did use when we were testing. And they've brought the people to make sure that everyone here gets good care.

It's a good public health message. It's a demonstration of cooperation. It's a regional approach, including those folks who are in Maryland, that work at the air mail facility, that need to be tested.

And with that, I'm going to turn things back over to the mayor and have him call on the next person. Thank you.

WILLIAMS: Thank you, Ivan.

And at this point I'd like to ask Debbie Willhite to come forward now and speak to this from the point of view of the post office, what they're doing and what they're finding.

Debbie?

WILLHITE: Thank you, Mayor.

First of all, on behalf of the postmaster general and the 800,000 employees of the United States Postal Service, we want to express our condolences to the family of Thomas L. Morris, Jr. and Joseph P. Curseen, two individuals who in service of their country have lost their lives because they were doing what the people of the United States expects each and every one of you to do--for them to do every day. We will be working with the families to make appropriate arrangements. And we will be making announcements later on about those arrangements, working in conjunction with the families.

Many of you have sent people to their homes to talk with the families. We have sent folks to assist the families in making their arrangements and dealing with your questions. We would ask for your cooperation as we are making arrangements with the families and helping them. And we will all get this done in due time. We would hope that your prayers and your sympathies would go out to them.

We would really like to ask everyone, be they a postal worker or be they a contractor or be they an individual who has a reason to visit or have business in the mail processing area of a postal facility that receives mail from the Brentwood mail processing plant, to please go to D.C. General Hospital to get your treatment of Cipro.

Any postal employee who is concerned about making those arrangements, please call the 866-545-USPS number. This treatment will be available today and tomorrow. If you are going on a later shift at the Postal Service today, report to work. Your postmaster, your supervisor, will make arrangements for transportation. Please call and make arrangements to get this done.

WILLHITE: If you have questions about whether or not you should go, please call the facility that you do business with so that they can answer those questions. This is very, very important. We're trying to be proactive and trying to take care of the needs of our customers.

As the mayor and Dr. Walks indicated, we did get the environmental testing that the Postal Service contracted independently to have done last Thursday. We got back late yesterday afternoon. We can tell you that out of 29 swabs that we got reports back on, 14 indicated what they call hot spots within the plant.

As we discussed yesterday, we tested areas of the plant that would have been involved in processing mail that went to Capitol Hill. Mail processing machines, the government mail processing areas of the plant that would have specifically come into contact with Senator Daschle's letter and mail going to the House and Senate Post Office.

Since that time, CDC has come in and tested more areas of the plant--the ventilation system, the priority mail processing area of the plant. Those tests have not come back at this time. And there has been a great deal more areas of the plant that are being looked at.

Since these deaths have been confirmed to be deaths caused by anthrax, the plant has been officially determined to be a crime scene, which changes the reporting nature of the information that we get back.

I'm going to turn the microphone back over to the mayor so that he can introduce the next speaker, and then we will be available for questions.

WILLIAMS: This is Rima Khabbaz. She's from the CDC.

Rima?

KHABBAZ: I'd like to clarify the expanded recommendations for offering antibiotic prophylaxis to postal workers outside the Brentwood facility that were mentioned. There is no evidence of contamination or risk to postal workers beyond the Brentwood facility. The reason for the recommendation to offer that prophylaxis is a precautionary measure until we complete our assessment of any risk.

WILLIAMS: Thank you, Rima.

And with this, we'd be happy to answer some questions.

Yes?

QUESTION: (OFF-MIKE)

WALKS: I think that's a very good question. One of the most critical things that we have to preserve is confidence in our public health system.

We tested and treated over Sunday and Monday more than 3,000 individuals. Initially, all of the hardworking doctors, nurses, pharmacists and others were told we were going to limit this to the postal employees. That was critical because we wanted those folks to get in and not stand in the line of 10,000 or 20,000 people who did not need to be there.

As we changed--and, again, real-time--what I think happened is that person got caught during the change. We certainly regret that. I expect that that person has come back and has been tested by now.

But this is what we're doing now. We are working together, public health and the media, as partners and we're working together real-time.

QUESTION: (OFF-MIKE)

(CROSSTALK)

WALKS: One of the other things--let me mention this. On Sunday Senator Frist and his wife came down and looked at the work that we were doing here. We've had other folks from our federal government come down and look at the work we're doing at D.C. General, and this is really a model for cooperative public health.

QUESTION: You are asking people in this expanded area not to trust their own doctors but to come to D.C. General Hospital for the antibiotics. Do you really expect, given the track record that you have here, for people to bypass their own physicians to come to D.C. General?

WALKS: Let me clarify what I think is the question. If it is are we asking people to bypass their own physicians, the answer is absolutely not. We are not asking people to bypass their own physicians.

What we are asking people to do is this. If you are ill, go to where you receive medical care. Our system has received an upgrade. In September, we asked doctors to report symptoms to us, not diagnoses. We knew real time when that first gentleman was admitted to Inova Fairfax Hospital.

But what we are saying is, if you are not ill but you fall into this category that has been very well described by Debbie Willhite, we want you to come to D.C. General. There are a couple of very good reasons for that. One is, we have the medication there. We have the right medication there and we'll make sure you get the right amount of medication. The other thing we have there is that we will take a medical history to make sure that you can tolerate the medication you get. One site, one central database.

You had a follow-up?

QUESTION: We have heard from the politicians on talk radio this morning, but we have not heard from health officials, even in hindsight can you now concede that you should have started testing the postal workers a lot earlier?

WALKS: All of us can look in hindsight and look at what we should have done better. I want to be very clear, because I was asked this question earlier today. The question was, ``Dr. Walks, do you still trust the CDC?'' Absolutely. We worked on the best science that we had at the time and we made the best decisions we could at the time, and I think we are continuing to make the best decisions we can.

QUESTION: (OFF-MIKE)

WALKS: The decision about when to begin testing at the Brentwood facility was certainly not a decision that involved the District of Columbia Department of Health. At the time those decisions were being made, they were being made in relation to the Senator Daschle letter and the tracking back. We had not been brought into those decisions. The mayor is absolutely right.

QUESTION: Can you tell us when CDC made that decision please? We'd like to hear from the CDC.

KHABBAZ: CDC has always and continues to make public health recommendations based on the best available science. Until this gentleman who was our first patient with inhalation anthrax in the facility was confirmed, our best available science--and this, as you know, has been accumulating and we've been on a steep curve of learning--but the accumulating science from the Florida postal worker investigation, New York investigation, and our investigation at the Hill did not lead us to believe that there was a risk of inhalation anthrax in postal workers.

QUESTION: (OFF-MIKE)

KHABBAZ: The investigation of the Hill event, you know, let me go a step above it. The postal facility that serves the Hill, again, in terms of inhalation anthrax, was completely reassuring.

In terms of cutaneous anthrax, the process that we have taken to define a risk is based on environmental sampling of a facility, and that environmental sampling was done, as was reported, and the result came just yesterday.

QUESTION: That wasn't CDC sampling, that was their own private sampling. The CDC didn't do sampling.

QUESTION: Have you done spot testing for the 36 other postal facilities? You said there is no evidence that there was any additional contamination.

(CROSSTALK)

WILLIAMS: Has there been spot testing for the other facilities, was the question.

KHABBAZ: No. The testing, environmental testing of facilities have been conducted going back from any identified events, a letter opened or a case of infection.

With regard the question on nasal swab?

QUESTION: (OFF-MIKE)

KHABBAZ: Nasal swabs allow us to define an area of possible exposure to spores that were aerosolized in relation to a release of anthrax from an opened letter or from the--with regard to the facilities that are served by Brentwood, at this point, as I said, we do not believe that there's even--that there is the evidence of the link to Brentwood. And what we are doing is an investigation, an environmental sampling is being done to define if, you know--to be able to come up with answers.

I think the important thing is our move to prophylax people and put them on antibiotics until we get some answers there. The nasal swabs would not have...

WILLIAMS: OK. Yes, sir, go ahead.

QUESTION: Yes, Dr. Walks, can you give us the institutional breakdown on the 18 living patients at this point? Where are they? How many in specific hospitals?

(CROSSTALK)

WALKS: Actually, the CDC is investigating if they have that information.

QUESTION: Has CDC got that information on where these patients are, whether they're being treated at home, treated at hospitals?

WALKS: Let me take this opportunity, while I'm at the mike, it sounds like that information is not available. Or...

KHABBAZ: Your question whether they were at home. Actually, the way we find out about these patients, I think Dr. Walks here alluded to it, is the enhanced, we have a very active surveillance link to hospitals, emergency room physicians, laboratories, and there are triggers to look at case. And so the cases that were mentioned that were under active investigations are patients that presented to hospitals with symptoms which may or may not even be suggestive of anthrax.

(CROSSTALK)

QUESTION: ... how they're now going to treat the next letter that shows up?

KHABBAZ: Yes, the Brentwood situation has led us to reevaluate the science base regarding the anthrax.

QUESTION: (OFF-MIKE) postal employees have stated that they're upset because they feel that they weren't tested early enough, especially when they found out that the letter to Senator Daschle came from their postal office. They're saying it's because favoritism that Capitol Hill staff was tested before they were. What do you think?

WILLIAMS: If you're asking me what I think, I think that we can all stand here today and all commit, and I think we've always been committed to making sure that all of our people, regardless of where they work and what they look like and what their income is, are receiving the quality of care they deserve.

And I think all of us can stand today and say that in light of the information we have today, in retrospect we should have done a number of things earlier. I happen to think that if we knew then what we know now, we would have acted earlier, but we didn't know then what we know now.

I think we have new information now, there's been new experience now. My understanding from talking to health professionals is that the science is changing now.

And so I think that it's very, very important that we, rather than--I think it's important to have an inquiry on what we've learned, it's important for us to learn from our experiences, it's important, as we learn from those experiences, to continue to expand our treatment and care.

All those are legitimate sources of inquiry and review, and all government agencies ought to be subject to that. But I don't think it's helpful to be pointing fingers among government agencies and pointing fingers among one another, when we all ought to be really pointing our fingers at somebody or some group, somewhere, that's essentially out killing innocent people.

(CROSSTALK)

WILLIAMS: You're asking me my opinion. I'm giving you my opinion. That does not represent...

(CROSSTALK)

WILLIAMS: Hold on. That does not--my opinions do not represent those of the CDC, they don't represent those of the Postal Service. They're the opinions of Tony Williams, who's gainfully employed as mayor of the District of Columbia.

QUESTION: If you don't test the other 36 facilities, the other 36 postal facilities in the city, how are you going to know if the contamination has spread?

KHABBAZ: We are going to be testing the facilities. I think there's a confusion here between sampling of facilities and nasal swabs that people have, you know, come to expect, which have nothing to do with whether we think that they were exposed or whether we think they ought to be on antibiotics.

(CROSSTALK)

QUESTION: Dr. Walks, a number of medical facilities continue to take into their emergency room, and some private doctors, people who for some reason don't want to go to D.C. General and become part of the centralized operation that's going on down there. In fact, yesterday I spoke to one hospital that tested 25 people. Are you somehow gaining control of that data? And are they cooperating or are you getting resistance from local health providers participating in the epidemiological study that you're doing?

KHABBAZ: Can reassure you that we are not--we don't have any--we have complete cooperation from everybody that's been involved here.

(CROSSTALK)

WALKS: Let me respond to that question first. The hospital association is here, Bob Malson (ph) is here representing them. We have conference calls with them.

Again, let me emphasize, we learned about the patient who was at Inova real time because of the cooperative nature of how we work. But let me stress, we are not--not--asking people when they are sick not to go to their hospital and not to go to their doctor. What we expect and what we have been getting and the reason we have a list of people that are under investigation, kind of suspicious, those kinds of things, that's real-time public health. We are getting information back from the places people go so we can create what is really critical, one centralized database.

And while I'm on the patients, let me correct something I said. I did say that the two gentlemen who are alive at Inova Fairfax Hospital with confirmed anthrax and who are receiving excellent care, I did say that. What I did say that was wrong is that they were in critical condition. They, in fact, are better than that. They are in serious condition. That is not a change. They have been in serious but stable condition. I misspoke, and I want to correct that. The gentlemen continue to be in serious but stable condition.

QUESTION: Can you tell us more about the designation of Brentwood as a crime scene? Specifically, what crime in particular. And also, is there any common denominator about the people who have suspicious symptoms of anthrax, about where they worked in that facility? I mean, are they all from the same area?

WILLHITE: It's a crime scene because someone has been murdered. And the relationship of where people worked within the facility is now part of a criminal investigation. And as that investigation unfolds, the FBI task force, the Postal Inspection Service, will be speaking more about the relationship of where they all work.

Because when I first spoke we were really emphasizing the employees of the other mail facilities, postal facilities in the city getting in to pick up their Cipro, I neglected to say that there would be environmental testing in those facilities, and it is just a precautionary measure that is being taken on behalf of the Postal Service and the CDC.

CDC, Postal Service, the District Department of Health are not the enemy here. Whoever have sent these letters are the enemy. One of the greatest and one of the best message coming out of this press conference is that a lot has been learned, and the treatment of this type of letter, this type of anthrax being sent through the mail will be handled differently. This has been a learning experience for CDC, for the local health department to share with other health departments, for the Postal Service. And that is a very important lesson.

The enemy is whoever sent this letter, because they have now murdered two people and two people are seriously ill. That's the important thing that people need to keep in focus.

QUESTION: Are all the people, are the expanded area postal workers, are they all getting full treatment, 60-day treatment of antibiotics, or just a short term while you do more investigation?

And also, have many of the four highly suspicious patients are postal workers?

KHABBAZ: To answer your question, give you an idea of the changing pattern that the Brentwood facility, these cases have made, when we identified the first patient with inhalation anthrax, or actually when we became suspicious that could this be inhalation anthrax, we moved quickly to identify, working with the Postal Services, to examine.

And we focused on the postal workers at work in the immediate vicinity of this gentleman, because the existing science told us that that is where, you know, our efforts should be. And we recommended that all the workers, or people that had come in and out (inaudible) be put on antibiotics, started on antibiotics, as a measure to give us time to define the area where something.

Now, the additional cases of inhalation anthrax that have confirmed have made us change that pattern, because they were not all restricted to that immediate area. With regard to the workers outside the Brentwood facility, they have been started on antibiotics, and the decision as to whether they should even continue to be on it will depend on what our investigation...

(CROSSTALK)

QUESTION: Dr. Khabbaz, could you tell us what analysis, if any, is being done right now of any other postal worker deaths beyond these (inaudible)?

KHABBAZ: You know, I've been here for a week concentrating on what's going on in the city, so I think you'd have to refer that question from somebody, one of the people in Atlanta tracking the--I cannot answer that.

QUESTION: Do you expect that more than one letter is in the contamination at Brentwood? And if so, how could it be spreading in the facility if the letters are sealed? How do you think that (inaudible)?

KHABBAZ: Understand that this is part of the criminal investigation. My response to you as a scientist is that we are still investigating and we cannot rule in or out any possibility.

(CROSSTALK)

QUESTION: ... contamination of mail. Citizens are worried now they're getting mail in their mailbox, could it spread from the mail facility that had anthrax through it? I mean is there cross-contamination of envelope to envelope, letter to letter?

KHABBAZ: With regard to cross-contamination of letter to letter, what you're talking about is spores on the outside of a letter. Basically with regard to concerns of letters arriving, the CDC has recommended that anyone receiving a letter that looks suspicious in any way handle that with precaution.

QUESTION: What if that suspicious letter rubs up in the mailing process against a bill that somebody expects? I mean, can it spread from a suspicious letter (inaudible)?

KHABBAZ: Based on our best available science, there is no such risk from handling letters.

WILLIAMS: OK, we're going to do two more questions.

QUESTION: How many post offices anywhere do you suspect this contamination is? Just Brentwood? And are you checking every post office in the United States?

WILLHITE: When you say anywhere, you mean outside of the Washington, D.C., area?

QUESTION: Correct.

WILLHITE: The current investigation includes Brentwood, Trenton, West Trenton and Morgan (ph) Station in New York City. There may be an expansion as the day goes on. But there are no areas--and of course you know that Boca Raton post office has already been investigated and sanitized.

QUESTION: Why not test every post office in the United States routinely now?

WILLHITE: I believe that that is something we'll up to the CDC and the FBI. There has been no indication that that is, as the good doctors would say, that the scientific evidence leads us to do that.

QUESTION: Dr. Walks, just a question here. If you're saying you're no longer going to test people to find out if they test positive for exposure to anthrax and you're giving them a two-week supply, is that enough? I mean, I've heard you need a month of this particular drug. So if you're just handing them medicine, aren't they still at risk for coming down with the disease?

WALKS: If we were to just hand people medicine and send them off with a 10-day supply, you'd be exactly right. We know that for up to several weeks after exposure it is possible to actually come down with an illness like inhalation anthrax.

The reason we are giving people only a 10-day supply but also collecting the data so we know who got that 10-day supply is so that when we do the confirmatory tests, when we know exactly the strain of the bacillus anthracis at that level, we can make decisions about should they continue on Cipro or should they be switched to another antibiotic. That's the reason for not giving the full treatment.

However, everyone will get the full treatment. I think that's important.

(CROSSTALK)

WALKS: Let me be very clear on this point. We will treat everyone for the entire length of time they should be treated. That is critical. We are not sending anyone off with a 10-day supply that we don't know how to get a hold of.

And one final point I want to make. Let me make one final point. I'll make two, since Sam said, How do you know if you're treating the right people? We do not have a test. The nasal swab does not, if it is negative, tell you that you are not at risk. And the nasal swab, if it's positive, does not tell you that you will come down with inhalation anthrax. The nasal swab are an epidemiologic tool used to define a treatment perimeter.

One last thing about inhalation anthrax, and I want to make this point. This is a disease that though we saw rarely, we always thought was almost invariably fatal. That was the science. We have two gentlemen receiving excellent care, with a confirmed diagnosis, who are not right now in that category of this is always fatal. I think it's an important point to make.

You may question some of the science that went on two weeks ago, but what's going on today is people in an excellent hospital receiving good care, hospital association, health department, federal government, Postal Service, CDC working together, putting the public health first.

QUESTION: Dr. Khabbaz, you're saying that right now your best science is indicting that a letter touching another letter can't pass anthrax. However, your best science has been changing every single day. Why not take wider precautions?

KHABBAZ: There is science and there is science. We don't fully understand. And that's the focus of the investigation. The circumstances of the Brentwood post office that has led to us being in this tragic situation of inhalation anthrax, as I said, we have science from other postal services that pertain to the question of a letter coming in or a letter contaminating, and that does not--that's still solid science.

WILLIAMS: OK, I have one final announcement. I'm going to be down at 5:30 at D.C. General with my mother to get my treatment. I believe that some members of Congress will be there with me who will be visiting, and I'm sure I will be joined by members of the council, I'm not sure exactly who. But this will be at 5:30 at D.C. General. We appreciate all of you being here. As always, we appreciate your indulgence and apologize for being a little late. Thank you all very much.