to a different gate to present the very legitimate documents, but he is not even able to get the documents in front of anyone, garrett. >> many more conversations just like that are happening right now. julia, thank you. right now more news with my friend, kris jansing. good morning, i'm in for craig melvin. we have a very special hour for you. you might be wondering why am i standing in the middle of a largely empty office space? it's because this entire hour on msnbc is dedicated to answering your questions about covid-19 and getting back to work. you have been sending us questions all week about everything from social distancing to masking, vaccine requirements, well all hour long

we have a team of doctors standing by to ansz those questions. post them on twitter with the #msnbc answers. one way to address the once in a generation problem, vaccinations. for the first time in nearly seven weeks one million doses of the vaccine were administered on thursday. that includes $560,000 people getting their first dose. ly talk with a small business owner that got 92% of his workforce vaccinated after most of them initially refused. his advice for how other small businesses can do it, too. i know it is a lot to digest, and just thinking about going back to the office with everything going on can give anyone anxiety. we're here to help. ahead, advice on protecting your mental health as you return to

the workplace. we're kicking off the hour on the future of work. jake ward is in san francisco, the first major city to require vaccinations for indoor activities. great to have both of you here. jake, workers there will be required, as i understand it, to show proof their fully vaccinated by october 13th. i know you spoke with a lot of business owners and workers in the city. so what are they saying? both about the vaccine requirements, how they'll be enforced, and staying safe on the job? >> kris, it's extraordinary to be in a city when they are going to require vaccines when others cannot even agree on mask mandates. if i want to meal indoors, have a drink indoors, exercise

indoors, that means all of them have to check my vaccine card before letting me in. as you mentioned on october 13th that kicks in for all employees. we went around the city yesterday asking business owners and employees how do they feel about this? the business owners thinking about how it will affect their bottom line. they wonder if it will help their safety and keep them employed. we put that question to him, how does he balance those two things. >> i think if it is a step towards ending our pandemic and covid, and gets one or two less people sick, i think we should do it a lot of people deal with more adversity than me. i'm lucky that i get to pour a

cocktail for people. this is the first place to have locked down 18 months ago. it makes sense they that would be on the cudding edge of a public policy like this. not everyone has a sign up talking about these requirements. it may not be that this kicks into effect right away. but in the hierarchy of need that an employee looks at here, everybody seems to be vaccinated, and now they're just concerned will it cut down on the customer flow on the door and up 90% this month, but as that is happening, one kwaen

after another is pushing back the dates. give us a overview of how are companies walking these tight ropes? >> just when you thought you could be busting off your shirt and jackets some companies are waiting until the next january 2022. some in february. then you have charles schwab pushing back their return to work in the new year. and we find out, too, ibm is shutting down now because of an increase in covid cases. i can go on with the list, their closing two locations because so

many people have been successfully working from home. this is an ongoing situation and over one-third said they have no idea what is going on. it is difficult to find your schedules, they mentioned masks, the newsroom behind me is empty. we did a survey here. and we spoke to executives and 29% said they, too, will enforce mandates for vaccines. but the next question is do we force people to get booster shots. there is many people that are

pes tant that is leaving a lot of uncertainty. a lot of unanswered questions at the moment. i know it doesn't make it easy. >> thank you to both of you. we want to get right to your questions. we want to answer a lot of those things that they brought up. we have a physician and fellow at the brookings institution. also an nbc news medical contributor and dr. dara cass. let me start with you. millions of americans are getting back to their prepandemic schedules.

how does one stay safe against the virus against trains and busses. >> staying safe on public expectation. wearing a mask if you can, or staggering your scheduled if you can. you can also walk or ride a bike. the federal government has good guidelines with the department of expectation and the cdc on how to stay safe. as long as local authorities follow those, we'll be in good shape. >> you have helped large companies and small businesses with their back to work preparation. >> yes, the biggest piece of advice for leadership and employees alike is that we're trained to work for a new normal or just that feeling of anxiety

that we talked about that is a paradigm shift and how we talk about the workplace for leaders, thinking through and anticipating the unanticipated. the events that might happen if someone is sick at work and how that might effect the rest of the workplace. what you need to do in terms of putting in your own mitt gags measures. most places are doing that, but people still need to know what you're doing to feel comfortable. and for employees it is building on what we have been talking about for months now. and on top of that to feel safe with returning back to the workplace and controlling that anxiety. >> i just talked to a friend of mine, there is a vaccine requirement, but they are testing twice a week. we'll get to some of the legal and mental health issues in an

hour. when we announced this a lot of people had questions about booster shots. they might have peace of mind going back to the office. will it be a better fit for the delta variant? >> thinking behind the third shot, is that it increases your immune response. it is the same vaccine you got originally in the first or second dose. the first dose, the same constitution, and the same brand. the recommendation is a third dose of the same vaccine you already got, and that immune boost will provide the protection you're providing. >> if my first and second vaccinations were from pfizer, should my booster also be from

pfizer? does it make a difference if your booster is from a different manufacturer than your original vaccinations? >> overall, it will not make a difference, but you can't get a booster for at least eight months, and you should stick with the brand and the only reason why is because we have good data on what the third shots look like ins intoers for people. we don't quite have the data yet. stick with the brand but do not stress if you can't. remember eight months is the earliest and you can still get it after eight months, it's not a problem if you wait that long. >> we are hearing about the one-shot johnson and johnson vaccine. eight months after the second dose, what about the j&j

vaccine? >> we know there is a lot of anxiety out there for people with the j&j vaccine out there. and really that is a function of time. the mrna vaccines were approved in december, but j&j was approved in february of 2021. what i will say to those with johnson and johnson. you may need a second or you will layer with an mrna on top of that, please be patient, continue to wear a mask. thank you for getting vaccinated. >> you're staying with me, we have a lot more questions for you this hour. if going back to work is not complicated enough. the surge in cases from delta are making it harder. our reporters are covering every angle of how to keep workers feeling safe on the job. for example, what legal options

do employees have if their job isn't requiring vaccines. say you don't want to sit next to someone that is unvaccinated. we'll break all of that down next in our special coverage on msnbc. l coverage on msnbc. 't have it. not my uncle, though. he's taking trulicity for his type 2 diabetes and now, he's really on his game. once-weekly trulicity lowers your a1c by helping your body release the insulin it's already making. most people reached an a1c under 7%. plus, trulicity can lower your risk of cardiovascular events. it can also help you lose up to 10 pounds. trulicity is for type 2 diabetes. it isn't for people with type 1 diabetes. it's not approved for use in children. don't take trulicity if you're allergic to it, you or your family have medullary thyroid cancer, or have multiple endocrine neoplasia syndrome type 2. stop trulicity and call your doctor right away if you have an allergic reaction, a lump or swelling in your neck, severe stomach pain, changes in vision, or diabetic retinopathy. serious side effects may include pancreatitis. taking trulicity with sulfonylurea or

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with a patch work of vaccine and testing requirement that's are different depending on where you live. stephanie ruhle is here to help us make sense of it. we are following real world solutions across america and we're joined by a law professor at vanderbilt. stephanie, it feels like the rules are constantly changing. >> it is complicated yet again. we're seeing more and more businesses say to their employees here is our return to work date and you have o approve you're vaccinated. what does it mean to be vaccinated?

apple pushed back, and we go back to work in february. what if we had both of our original vaccines and no booster. we're know that efficacy goes down overtight. i asked scott gottlieb that this morning and here is what he said. >> i would be surprised to see them qualified for a third dose. as people get further out from their primary series. they will start to require boosters, and i don't they will happen certainly after this epidemic surge. >> i can tell you businesses that i spoke to this week they want people to get the booster. they want people to get safe, but from a human resources

perspective, they say i'm not sure how we will take this one on. >>. >> so if your job requires you to get a vaccine, can i get fired if i refuse? >> the answer is almost certainly yes. especially if you have a job with in-office requirements. they will have to implement some accommodations for individuals that prohibit them from safely getting a vaccine. some individuals with legitimate religious objections may qualify for accommodation. for most american workers, nationwide, the answer is absolutely yes under the strong legal doctrine that exists for every state in this country. employers can require you to do whatever you need them to do.

>> if you work for a company that refuses to put them in place, what could happen if you say i'm not comfortable, i have an underlying condition, i don't want to go back to work with people that are not vaccinated. >> you may need to speak to your bosses and friends. they put out guidance for people are beginning to return to the office and osha requires them. you can't sue under osha for failing to keep your workplace safe because of covid and we know quite a few state legislatures have passed

legislation. so my best advice for employees is to start looking for another job. >> steph what do you think about this? >> i think there is another wrinkle here. more white collar jobs we have heard from ceo's saying if you want to return from work, you have to be vaccinated. more and more workers are saying they don't want to go back to in-person work. they say they'll take a pay cut to continue to work from home. so that carrot, the problem is many, many people don't want to go back to work. remember the inflation situation? in the last 18 months people have not been paying to commute, to buy coffee, and to buy lunch. and they don't want to now spend that money again and that time so they would rather stay home.

>> yes, you have medical, legal, and personal -- but there is complications. you have been looking at actual solutions. companies are trying to keep workers safe, what have you learned in your reporting? >> i think the best and most responsive are taking an evolving approach to this. one solution here is flexibility with return to work dates. we saw that with our own rates. it is cities where the workforces live. i spoke with the chief council of google. another solution is many companies testing. something the doctor told me was so interesting and resonated. it's one thing to make it safer, right? to improve your ventilation,

require vaccinations for those coming back. it's another to make people feel safe. so this rapid testing, the pcr testing for people at home is a big solution. every employee, their contract workers, all have access to convenient testing. we know there are brake through cases, we know there are people that can come into the workplace and infect others. so you're allowing your workers to have piece of mind with this testing solution. they're doing at the space needle. they do this multiple times per day. he says doing that test at home and getting results every few minutes knowing that he is not

infected gives him incredible piece of mind. i think you will see city bank, goldman, and more will do it many said in addition to vaccination, rapid at-home testing or pcr testing, whatever you can do to make it helpful to people. >> and if the company will pick up the tab another aspect of it. what can bosses do if their employees say they will not get the covid vaccine. sometimes can people be convinced. next, a business owner that persuaded more than 90% of employees to get vaccinated after most of them initially refused. how he did it and what advice he has for other business owners, next. owners, next

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let's remember the key to keeping our economy going is

getting people back to work. >> persuading blows is a uphill battle. one arkansas company may have found the secret sauce. one employer got 92% of his workforce vaccinated. what makes it more of an accomplishment is just 46% of folks in arkansas are fully vaccinated. so the people that work for him are not getting vaxed. joining me is the owner and who is also a state senator and a veteran. a lot of folks hearing those

numbers are considered when you pushed for your workforce to be vaccinated. >> it is such a comforting feeling to know that most of your team is vaccinated. and i meal the compelling motivation for me is that i know these people and i have worked for these people, some of them for two or three decades. they're like family. some have conditions that might make them very susceptible to complications. i wanted them for safety. there is also the business part of it. i mean, it is so easy to get four or five infections. we're a manufacturing if i felt and working at home is not an option for us. there is practical consideration. so there is a big barrier to overcome. there is a lot of people that have incredible hesitancy.

and i was saying i was shocked to find one in five, 25% of the staff was vaccinated to begin the process of arkansas. >> i thought it was shocking for people that are showing up for enticing incentives. >> that was interesting to me as well. state governments, and i said i will give a $100 gift card, i sent a come belling giftcard, and i had about 70 that were not vaccinated and that effort led to two. i got almost no response for the $100 gift card. we were going to give it to them at work, no, you know, no one was going to lose any pay. but they were just not interested.

i realized they had to find a different approach and that involved getting my leadership team to buy into this. including my corporate leader who was not vaxed and had a lot of concerns. i think what made a difference is this is not about you. you may be afraid and willing to take that risk, but you're also putting others at risk. your coworkers and your family, and our livelihoods. if we have to make hard economic decisions. when they understood it was about something besides themselves they took operation and they communicated this effort with the team. my plant manager they brought me other concerns. one was they had a particular concern about the manufacturer of one vaccine and they wanted another. our partnership with the hospital here was tremendous. they said they would come and change the brand of the

manufacturer. people here were more comfortable. we tried to listen and accommodate their concerns and it went from two to 70. we offered and i'm just so proud of the people. several of them came to me in the last couple weeks and they said i was opposed to it but i can't tell you how relieved i am. so i hope it is in other places, it is great having a workplace that you know they are protected. >> the doctors on our air say the two most important things getting people convinced to be vaccinated is take their concerns seriously. don't make them feel stupid, and answer their questions which is exactly what you did. congratulations and thank you so much, jim, for sharing your

story and your workers story, we appreciate it. >> thank you for having me on, i appreciate it. >> i want to bring back my doctors for some questions. a lot of employees returning to work will be required to follow specific protocols including wearing masks. how many times can i safely wear my kn 95 mask before discarding it? >> yeah, great question. i love that story with jim by the way, it gives me such hope. you can safely reuse your mask. you should try to just make sure one, that it doesn't get dirty, crushed, or debris. one tip i used personally is i hang it on my coat rack. it can get air, and if you see it getting dirty you should toss it. some people say about five times, but you can safely reuse it and just make sure it is not dirty. when the is throw it away. >> i did not know that.

i just saved a little money here. dr. cass this time last year there was a frenzy to purchase masks. now with the rising cases a lot of questions are resurfacing about the level of protection. mckayla asks i'm not able to have a vaccination because of a medical condition. does double masks and social distancing still protect me against the delta virus? >> first and foremost, the best protection is if everyone around them is vaccinated. adult children, spouses, anyone over the age of 12. masks and distancing, that still works for this virus. those are the measures we have been using since the beginning. i would say keep masking, keep distancing. and if for some reason things change, and you can get vaccinated, please get vaccinated yourself. >> as people are returning to

work there is a rising threat, right? of the breakthrough cases. kyle asks do people with breakthrough cases have an increased antibody response? >> we see in limited studies that we had so far, breakthroughs are rare so far, but in limited studies we see increased antibody levels. we think those people have lower antibody levels before they moved for. >> if people want a little good news, we just got this in. we now, today hit a milestone, 200 million people with at least one dose. get vaccinated. does just the thought of going back to in-person work make you anxious? maybe you're already in the office and it is stressing you out. we'll talk to a psychologist about the toll that all of this

is taking on our mental health and how you can make it easier. next.

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. throughout the pandemic mental health experts have reported a record level of anxiety. half of people questioned said they anticipated negative mental health impacts once they were back in the office. for those that have gone back more than one-third said the return did negatively impact their mental health. for more on this and what you need to know, i want to bring in a psychologist and parents expert. good to see you. that survey found that workers that experienced declined in their mental health were five times more likely to report taking on less responsibility at work. are you surprised and what advice do you suggest for people that are struggling to transition back? >> i'm not surprised at all.

you know everyone is experiencing secondary trauma. and the anxiety is the fear of the unknown if is a natural reaction. it is a normal reaction to the circumstances. >> 40% of parents say they negatively impacted their mental health. i want to play part of an interview that stephanie ruhle did with a mom who is trying to balance her responsibilities at home and in the office. >> i'm trying to find if i can do a combination of working and watching her. >> you have parents whose kids are not eligible yet to be vaccinated. what would you tell her or other parents with similar concerns? >> validate, empathize, those

are concerns even for me as a parent. really the more we know, the more we're educated especially about finding the right daycare, the right childcare, and schooling. and so relate, i, too, work with a lot of families who are concerned, and we want to feel protected. so ask your employer. ask them what mitigation procedures do they have in place. do i have to share a workstation. is there opportunities to be flexibility if i need to step away and protect my child? those are the questions that we should feel comfortable asking our employees. >> three u.s. senators that experienced breakthrough cases of covid-19, seen here, a republican, an independent, and a democrat, they all reported varying degrees of illness. there is something about the delta variant that feels more

unpredictable like the early days of the pandemic. obviously delta is so much more aggressive. again, how can people reassure themselves they're doing everything that they can to stay safe, especially when they're returning to work even if they're vaccinated. >> practice what you were doing right when the pandemic hit. wear your facemask, make sure those around you are vaccinated. we can't highly emphasize that any more. do it for your children not vaccinated yet. what safety measures are in place and it is egtting yourself, being informed, and protecting those you love. >> work just got started this week on what florida officials

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check this out, crews just broke ground on the first covid conscious skyscraper. it has ten floors of homes, hotel rooms, and developers say they're using hospital grade ventilation systems, uv robots, and touchless tobl and antimicrobial material on all of the furniture. that is a fascinating choice. i think it will make a lot of us more aware of the surfaces that we touch over day. your phone, your keyboard, your house, you're going to find stuff when you get back to your office, right? dr. cass, at the beginning of

the pandemic we were tirelessly cleaning our surfaces. does delta, which is far more contagious, than previous variant, is transmissible on surfaces? if so, does this change the current advice that the virus is only transmitted through the air? do we go back cleaning surfaces? >> versus the fact that it is definitely more transmissible and that has to do with where it hangs out on your body and on your nose and throat, and the practices that you've been doing that keep you comfortable and safe, keep doing that. if you feel comfortable wiping down surfaces when you get back to your office. i wipe down at work and hospital where everything gets wiped down, so that's okay. don't be so anxious that every surface you touch is potentially dangerous. we have not seen surface transmission, and so i would say

that even with delta, the better steps are to stay vaccine aid, stay distanced and not worry as much about the surfaces you touch. >> so dr. patel, a lot of major companies offer the flu vaccine and they're requiring people to get the covid vaccine before going back to work. we've got a couple of questions about both. how do we coordinate the booster shot and the flu vaccine if both are due at the same time? are there counter indications to getting them both at the same time? >> great question. so you can safely get any vaccines you need with that booster shot or even with the first or second shots, chris, our thinking and knowledge has evolved and my only practical tip for patients, get them in different arms and that's one thing i tell people to do, and of course, if you had previous issues with flu shots and allergies with certain issues that can be a question to bring them up with your doctor. >> good to know. dr. cass, a lot of people experienced side effects after

getting the first or second dose with the vaccine and now people are taking a day off when they get a booster shot. a viewer asked on twitter, i experienced flu-like symptoms 24 hours after my second moderna shot and am i likely to have the same experience with the booster. >> we are seeing immunocompromised and they are having some side effects similar to what they had after the second one, and what i would tell them is that's your immune system working. we also recommend socially that people, if they can, get the vaccine the day before they're not going to be going into work because it may be hard to get your workplace to pay you for that day off. in the state of iowa you can get paid time off to get the vaccine, but you need to use sick time to potentially recover from the vaccine and know that you may have limited symptom, but all of that is better than getting covid. >> dr. patel, we received a question about vaccinations and

long-term effects of covid. are people who are vaccinated and get mild cases of delta covid getting long hauler symptoms? >> chris, we are seeing people that have the breakthrough cases albeit mild and some asymptomatic who are reporting weeks to months later some of these symptoms, anything from headaches to skin changes. here's what i would say, chris, that's an unfolding area of science. if you have something that feels off after a breakthrough infection, a mild one or asymptomatic one, seek out help or people that have had covid as we're calling them. very important question and always something we need to keep on top of. >> great question we just got. i'll read it off my phone. my son and his wife are both high school teachers in different schools and going back to in-person teaching next week. my 72-year-old wife has volunteered to be there every day to drive the two grandkids to school and pick them up when

needed. we need good advice, grandpa vlad, what do you say? dr. cass? >> what's the question? >> the question is what should i do to keep my grandkids safe if i'm taking them to and from school and how do i stay safe because my wife is 72 and we're both older. >> with school exposure, we have policies in place to keep kids safe in school. we are not looking for zero covid in school. we're looking for zero transmission in school. lunch place policies and ultimately means if grandparents are driving their kids to school every day, they may choose to wear a mask in the car during those periods of time when they may not know if everyone is negative. i'll remind everyone that vaccinated results keep kids safe. as long as those kids are going back and forth to school, vaccinated and the third vaccine as needed to keep everybody

protecting each other which is what i think vlad is really asking. >> last question, back to the future, dr. patel. the masking issue, the mask everybody's wearing now, given the delta variant particularly if you'll be in an indoor space, flying or on a subway, do we need to upgrade? >> so upgrading in terms of quality of -- >> n95, masks that are more than this basic 50-cent mask. >> sure. i would say if you're definitely in an area which is basically the whole country right now of high transmissibility, the better the mask, the better off you are protecting on top of the double masking. i know there's a short supply on the kn95s and they're not easy to get and they can be pricey. what i'd like to see is more people acknowledging that we need them properly, nose and mouth and make sure you can't see through the masks because if you can, not good enough and if

you have the luxury and ability to, upgrading can always be a benefit. >> dr. patel and dr. cass, you are awesome. thank you for answering so many questions in one hour. that does it for me this hour. thank you for joining me on this q and a as we head back to work. we'll be answering questions next friday, focused on getting safely back to school. "andrea mitchell reports" starts next. have a great weekend, everybody. stay safe. uncharted waters, and not only make new discoveries, but get there faster, with better outcomes. with app, cloud and anywhere workspace solutions, vmware helps companies navigate change-- meeting them where they are, and getting them where they want to be. faster. vmware. welcome change. ♪

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good day. this is "andrea mitchell reports" in washington, where president biden will be delivering his first speech on the chaotic afghanistan evacuation since monday when he defended the u.s. withdrawal and blamed the afghan army and government for the taliban's rapid takeover. this morning mr. biden has been meeting with his national security cabinet amidst tough questions about the state department's role after a cable revealed u.s. diplomats in kabul had warned in july about the taliban's rapid advance. the state department issuing a warning about the dangers of getting to the kabul airport and still has no way to get them there. despite assurances from the national security adviser to lester holt on "nightly news". >> i just want to be clear. are you saying that any american in afghanistan right now who wants to leave, that their government will not leave them behind? >> we will get any american who wants to get to the airport and who we get in