COVID-19 05292020



GOVERNOR JON BEL EDWARDS: My daughter hates it when I take my mint out of my mouth and put it in my pocket. Good afternoon, everybody, and thank you for being here today. As you can see, I don't have Dr.?Alex Billeaux with me, but I do have Dr.?Courtney Philips, the secretary of department of health. She's here pitch hitting for him today. He had a family obligation and was very, very well deserving of a few hours off, given how much he's been working and how well he's been working as well. About the numbers today, you may have noticed we didn't update them. We're having a technical issue dealing with the domain. We're working through that. As soon as we can, we will get that information to you in terms of the number of new COVID19?cases we have based on tests to be reported over the last 24?hours, the number of tests, and so forth. And I apologize. We just don't have those for you today. However, we do get information from other sources so we do have some information for you, and that information actually rather positive. The number of people hospitalized with COVID19 actually took a big dip over the last 24?hours, down to 714, which is very good news. Y'all remember several weeks ago, we were well over 2,000. So 714. We have fewer than 100 people on ventilators for the first time since March the 23rd. And, in fact, we have 90 individuals on ventilators. Obviously anybody in the hospital with COVID19 has a very serious medical condition, and those people on ventilators, especially so. So we need to lift all of those individuals up in prayer. I do remember it wasn't that long ago, based on the modeling and the case growth that we were experiencing in Louisiana, we thought it was very likely that early in April we would actually not have ventilators available for people who needed them, and that turned out not to be the case. And we are very, very thankful. And the reason it didn't become the case is because the people of Louisiana did what was necessary to flatten the curve and reduce the demand on our hospitals. So COVID19 is still here. We are doing better, but we still have a long ways to go, and that's part of the message. I think we can take some satisfaction in the improvement that we have seen over the last several weeks, but we need to understand that continued improvement is going to mean that we continue to do things that are smart and follow CDC recommendations when it comes to sanitation, when it comes to distancing, when it comes to mask usage, and so forth. Sadly, we do also have today's death count. It's 26. Again, these are 26 Louisianians. These are our brothers and sisters, our mothers and aunts and uncles and children and so forth. Obviously very sad, and would ask people to always remember that these are not numbers. These are human beings. And so we would ask you to lift the families and friends of those individuals up in prayer. What we thought we would do today is get a little bit into the testing plan going forward that the department of health under secretary Philips' leadership will be submitting to Health and Human Services in Washington this weekend. So it was just a few days ago, HHS sent down a template for a testing plan that we've? were already working on, quite frankly, but we needed to complete that template, get that plan back to them. In exchange, we also know that HHS has some funding available for the state of Louisiana for testing and contact tracing. I think that maximum amount? and I think the plan is for that to suffice to the end of the year is 180? I'm sorry, $190?million. So this is part of what we need to do to access and keep those funds coming is to submit this plan. The good news is under Dr.?Philips' leadership we had already been working for a long time on a comprehensive testing plan that was very much in line with what the HHS wanted us to report on. Increasing testing across the state is important as we ease restrictions, open up more of our economy, get more people back to work, get more shoppers in our stores, diners in our restaurants, and so forth, because we want to do it safely, and we need to know what's going on over time. And the testing capacity increase is an integral part of the White House's phased reopening plan for the United States, for that reason. To date, we have 347,647 tests reported to the state. That doesn't include today's numbers because we don't have today's numbers yet. And I will tell you that just over 11?percent of those tests have been positive. Now, the World Health Organization and the experts here in the United States talk about a 10?percent positivity rate. Anything below 10 is good. So we're getting really close. And I will tell you, it's been more than 20?days since we reported tests that had a positivity rate that exceeded 10. So it will tell you that we've been moving in the right direction, but we still have a ways to go. And if we all work together effectively to slow the spread, expand our testing, we're going to see those positivity rates continue to come down. You know, that we had a plan in the month of May to test 200,000 people in Louisiana. That's 4.3 percent of the state's population. I will tell you that with just? I guess I didn't tell three days now left in May, we're on track to make that happen, and we feel good about what we've been able to do. But it's not just about getting the right number of tests. It's making sure you're testing in the right places. The state's comprehensive plan includes four goals. They'll help us to know not only that we've ramped up testing, but we have done so in a way that reaches all communities and also shows that we're slowing the spread of the coronavirus. So we have to feel confident as we move forward that we know where the virus is, where the hot spots are, what we can do to tamp down on them. So the four goals of the testing plan that Dr.?Philips is submitting is to increase the baseline testing by 100,000 tests by the end of May. We are today 13,224 tests short, not counting whatever today's numbers would have been. So we will meet that goal. Secondly, to achieve monthly statewide testing at 4 percent per capita. I just told you 200,000 actually gives us a little bit of a fudge factor because 4.3 percent is 200,000. But to make sure that we're testing at least 4 percent and we feel like we're in a good place to make sure that that happens. Achieve a 2?percent per capita tested in all parishes by the end of May. Now, this is important. You remember I told you, we don't want to just have the statewide count be what we want it to be. We need to make sure that we're testing adequately in every area, and that means that no parish, regardless of what the hospitalizations look like, the deaths look like, or anything else, we want to make sure that we're testing at least 2?percent in those parishes. Right now, we've got 41 parishes that are above 4 percent; 20 parishes are between 2 and 3.9?percent. There are three parishes below 2?percent, but they're making steady progress, and our efforts will be to increase testing there to get them above that 2?percent. But those parishes are Beauregard, Cameron, and Vernon. The fourth goal is to achieve that positivity of 10?percent or less as a state and for each region of our state. I told you that's the goal of the federal government. If you look at all the tests that we've conducted right now, we're just slightly over 11?percent. But as I mentioned earlier, it's been more than 20?days now since any single day exceeded the 10?percent. So we're moving in the right direction currently. So the testing plan features a multipronged approach to test vulnerable populations that include congregate settings such as nursing homes and correctional facilities, communities with insufficient access to testing, such as some of the African American communities around the state of Louisiana, some of the rural communities, and populations that require specialized approaches to testing, such as populations with special needs individuals. I appreciate the work of the health equity task force because their input has been critical to us forming our plan to ensure increased testing across the state does, in fact, address and reach these communities. And to show you what all this looks like, I'll talk a little bit more about nursing homes. So Louisiana continues to expand overall testing capacity through the state lab, through partnerships across the state, and with contracts to meet any gaps in testing capacity. So the state, again, under Dr.?Philips' leadership has recently executed contracts with 11 partners for lab services, community testing, congregate facility testing, and infection control assessment and response. So what this means is that laboratory services will quickly, efficiently, and correctly test and report COVID19PCR results. So this is not the serology testing. This is for the actual COVID19. Community testing teams will work within their communities to staff mobile and diagnostic testing sites. Congregate facility testing teams will work in those settings as needed, which include nursing homes, intermediate care facilities, group homes, jails, prisons, state facility, adult residential care providers, including assisted living, and homeless shelters. And then also infection control teams will provide information, tools, and resources to control and prevent the spread of COVID19 in healthcare settings. Infection control assessments will be conducted onsite at facilities and include review of safety and cleaning practices, visitor restrictions, monitoring, and screening of residents and staff, the use and availability of PPE, and a plan for resident grouping based on positivity rates. The partners were selected through a request for rotation process. I want to tell you who some of those partners are. They are Acadian, Safety Management Systems, Louisiana Children's Medical Center, LSU Health Shreveport, New Orleans East Hospital, Omega Diagnostics LLC, Ochsner Clinic Foundation, Pafford, premiere service? I'm sorry, Premier Lab Services, Southwest Louisiana AHEC, Stone Clinical Laboratories, and Tulane University Health Science Center. The department of health, Office of Public Health will deploy partners to communities and regions where needs are identified. Additional details about what each of these partners will contribute to the state's plan in a news release being issued shortly and will also be on LDH's website. As I mentioned before, we'll be submitting this plan this weekend. I think it's due tomorrow, Saturday, May?30th, to HHS. But we did want to give a sneak peek to the people of Louisiana. That's why we talked about it today. The LDH will post all materials submitted to the federal government, including contracts associated with this plan, on its website tomorrow. I know that that was a lot of information. There's a lot more to be gleaned from the website itself and so forth. But I thought it was important that we talk about that because we've been talking about testing for so long, and we know that this is something that we're going to have to improve, not just our capacity but our strategic plan as to when and where and how we test. So with that information, I will now take your questions. Yes, sir?AUDIENCE MEMBER: (Inaudible). GOVERNOR JON BEL EDWARDS: Well, no, the plan is going to be to look at basically the same gating criteria that was set forth in the White House phased approach, the guidelines for reopening America again. Those gating criteria were vetted by the CDC. They've been vetted by the folks here at the department of health as well. And basically they are symptoms, how many people are going to emergency rooms around the state of Louisiana with symptoms that are COVIDlike. How many people are being hospitalized across the state of Louisiana, what does that capacity look like with respect to the hospitalization of COVID19 patients. And then cases. And you look at cases both as a raw number of cases in Louisiana, looking at active cases more than the historical information about every case from the inception. Because you want to know how much COVID you have. But you also want to look at your cases as a percentage of all tests administered. Then you look at your testing capacity, which continues to improve, as we talked about today, and your ability to do contact tracing. And I think the other thing that I'm not sure that this is in the guidelines? and it may be; it's certainly talked about? but we will be looking at personal protective equipment, its availability and so forth, which, by the way, that situation has improved dramatically over what it was several weeks ago. I'm not going to tell you it's all figured out and so forth, but it's much, much better than it was. So we'll be looking at those criteria over the period of time since we've gone into Phase I in order to make a decision about Phase II. You all know that Phase I terminates on the order that I've had in place, next Friday a week from today. It is my expectation that sometime on Monday that I will be making an announcement as to what happens next Friday. So that's the timeline we're on, and that's, generally speaking, the information that we're going to be looking at to make the decision. Yes, sir?AUDIENCE MEMBER: You mentioned a 13,000 number as far as testing in your remarks. I know we don't have today's testing numbers, but we haven't seen you (inaudible) how close are we to 200,000 tests?GOVERNOR JON BEL EDWARDS: Yeah. So we're reporting 13,000 or so short, but that doesn't include today's numbers. And I really don't want to hazard a guess as to what today will look like, but I will tell you that as of yesterday, we needed just over 5,000 tests per day in order to get to the 200,000, and I have every reason to believe that we are going to get there. The other thing I wanted to point out and remind you, the 200,000 is our goal, and it's important to have as much testing as we can. That's 4.3 percent of the state's population to be tested in a given month. We really want to make sure we're testing at least 4 percent. And so we set a higher goal, in case we came up short. We're already over the 4 percent. But we're going to get to the full 200,000 and 4.3 percent, I really believe. I can't tell you with any more precision exactly how far we have to go because we didn't get today's numbers, but as soon as we have them, we will certainly let y'all know. Yes, sir?AUDIENCE MEMBER: What was the stile for mobile testing, (inaudible) and what does that look like?GOVERNOR JON BEL EDWARDS: First of all, we've been doing a lot of mobile testing already, and we're doing that with a partnership between the Office of Public Health, GOHSEP, and the Louisiana National Guard. There may be multiple models, but the one that's most common in terms of this particular operation is a mobile home that is outfitted with the people who can conduct the testing and all the test collection kits and so forth. They go to a community in Louisiana. And in advance of that, they announce to the community, we're going to be testing from 8:00?a.m. to 12:00?p.m., for example, at the Amite community center. I just made that up. For the next several days or whatever. And they put that out as best we can to communicate it to the public, and then they run that testing there. And then in consultation with the local government and the local office of emergency preparedness, we will move that mobile testing to where we need it to be in order to make sure that we are adequately testing those areas, to make sure that we're getting the tests per parish that we think we needed, and per community. Sometimes I get a request from a mayor of a town or from a parish President and they ask me to make sure that we can make sure that we can get some additional testing in there. We will do that sometimes with a mobile app. Sometimes we will bring on a partner which might be a health clinic or a hospital. Sometimes it's a private sector. And we've been able to get Walmart, for example, to go into parishes? and this was particularly important if you remember back region 3, the River Parishes, between Baton Rouge and New Orleans, were really spiking at one time and we didn't yet have the test collection kits coming in in the numbers that we needed them. We were able to get Walmart, for example, to go to LaPlace. So that's what we're doing. And it's a multifaceted approach, and it's something that's working really well. And we're not the only ones going out into the community. For example, we just signed the contract with Ochsner, but people like Ochsner and Children's Medical Center, they've been doing walkup testing in various communities in and around their hospitals for many weeks now. So it's a detailed process, and it's something that quite frankly I'm never going to say anything that we do is perfect, but the people at the Office of Public Health and our department of health has spent an awful a lot of time, and we're really getting good participates in place all across the state of Louisiana. Everybody is interested in having more testing, not less testing. Courtney, I don't know if you had anything you wanted to add to that.SECRETARY COURTNEY PHILLIPS: Sure. As the Governor mentioned, we have multiple community partners who are already providing testing in the communities, so the hospital systems, our community clinics, as well as RHCs. And so we do want to continue to acknowledge the work that they're doing, in addition to the new CEAs that we've assigned. So the Governor outlined eleven partners, including LCMC. One of the things we do want to talk about is the congregate at thing as well. And so while community testing hasn't been happening, we haven't had those congregate teams in place yet. We've had the Office of Public Health who's been going out and assisting some of the nursing home settings, so we've been into 30 facilities doing testing already. Now that we have the CEAs in place, we have 28 teams that will be available to us to deploy to our congregate settings, first starting with the nursing home facility. So wee excited for those partners who are signing up with us to be able to increase our testing efforts in some of the high volume populations that the Governor ERNOR JON BEL EDWARDS: Anybody have another question for Courtney?AUDIENCE MEMBER: We understand ride share services like Uber and Lyft are changing the way they operate (inaudible). Should people be comfortable getting into an Uber right now, and how should they behave themselves.SECRETARY COURTNEY PHILLIPS: So that's one of the things that, you know, we are looking at constantly in terms of what is the guidance around those elements? I don't have that specific guidance for you in terms of Uber, Lyft, and other ride share. We can pull some information and provide it to you. But, again, in any type of setting, we want to make sure that we're putting out proper guidance so people are encouraged and are aware of what they should be utilizing. Again, masking, of course, in any type of situation is encouraged, but we can get you specific guidance around ride ERNOR JON BEL EDWARDS: I will tell you that although I don't utilize the services of Lyft and Uber, I would not get in one where the driver wasn't masked because we know that the greatest likelihood of transmission now is not touching surfaces, although we need to be careful of that; it is the aerosol transmission. And so I wouldn't get in one when I wasn't wearing a mask in order to protect the driver from me, and I wouldn't get in there if he wasn't or she wasn't wearing a mask in order to protect me from them. And then if you were to do that and then don't unnecessarily touch any of the services and then use your hand sanitizer, I can't tell you that that was entirely safe, but I can tell you it was much, much safer if you didn't do those things. Yes, sir?AUDIENCE MEMBER: I know in the run to moving to Phase I two weeks ago, you and Dr.?Billeaux? Dr.?Billeaux, especially? had pointed out some concern in certain regions of the state (inaudible) that are still cause for concern or that (inaudible). GOVERNOR JON BEL EDWARDS: Yeah. Your question comes about 30?minutes too early for me. I have a briefing later this afternoon where we're going to get into all of the numbers for the state and per region. And I'm not going to hazard a guess right now. I will tell you that I feel pretty good about what I believe the presentation is going to be because I get partial presentations several times a week by region. I will tell you, for example, that based on hospitalizations, that we're seeing? are declining rapidly, as we pointed out? that's one of the ways that we model what the rate of spread is, the R0, the R0 for most regions today is below 1. And below 1 is critical, because if it stays below 1, it's on the way to disappearing. Now, I'm not saying it's about to disappear in Louisiana, because there's still a lot of COVID here, around the country, and around the world, and so it's going to continue circulating for a while. But those R0 numbers that we're seeing now are much better than they were just several weeks ago. But I can't tell you that we don't have certain parishes or certain regions where we're? you know, they're somewhat of an outlier. I'll have more information about this, I suspect, on Monday, and we'll get into that in more detail. Yes, sir?AUDIENCE MEMBER: (Inaudible). GOVERNOR JON BEL EDWARDS: There's always a possibility of a compromise so long as you have people who are willing to do that. I hope that will be the case. It's on the floor now in the house, and so I've been in here with you. I can't tell you what has happened or what hasn't happened, but obviously I would prefer a bill get signed into law, one that I think is reasonable and balanced. And that will take some compromise, and that's always a possibility. And there's plenty of time left to get it done so long as individuals want that to happen. Yes, sir?AUDIENCE MEMBER: At what point do you anticipate the numbers will change or perhaps get worse based on the reopening or moving into Phase I?GOVERNOR JON BEL EDWARDS: Well, we've always known that there was a lag between when an exposure happens and when a case develops, and especially when that case becomes symptomatic and so forth. And I think the numbers have varied a little bit, but I think I didn't tell somewhere between 7, 10, and 14?days. And, you know, I will tell you that Mother's Day weekend came, and I saw an awful a lot of people who were visiting with mama. And entire families came together, and I thought we might see a spike. And we may have in a few places, but it didn't turn out to be anything that was really terribly concerning. Then you have the next big one is Memorial Day, which was last weekend, and I think we all know that there was a lot more activity, a lot more people driving and so forth. And so you would typically think that between 7, 10, 14?days, if you were going to see something, that you would see it. And one of the challenges that we have is that? and I've said this over and over? if someone is symptomatic, they're much more likely to be tested, and they're much more likely to go to the hospital and so forth. So you happen about those folks, and, you know, about those cases. The challenge with this particular disease is a significant percentage of the population that has it we don't know that they have it. They remain either asymptomatic or so mildly symptomatic that they don't really change their behavior. They don't get tested. And they're out there circulating as a COVID case, and they are contagious. Now, there are studies from earlier this week that suggested that could be as high as 40?percent of all COVID cases. I've seen it 25 percent. I've seen it 30, as high as 40. If there was anything that was somewhat reassuring about the latest studies is they believe the asymptomatic people, while they are contagious, they're less contagious, their viral load is smaller. And so that would be, I guess, a little bit helpful. Yes, sir. AUDIENCE MEMBER: (Inaudible). GOVERNOR JON BEL EDWARDS: Good.AUDIENCE MEMBER: (Inaudible).SECRETARY COURTNEY PHILLIPS: So you're going to see an increased number because of COVID in those same underlying conditions. So that's going to be the increase that you will see, is that relation to COVID. GOVERNOR JON BEL EDWARDS: Yeah. And I think that's good question. I know that that question was put to someone at the national level the other day, and they just looked historically at the number of people who would typically die on any given day across the country and then how many are dying now. And it's an increase of about 1,000 per day around the country. And so Louisiana is going to bear its part of that. And we know that a disproportionate number of those individuals are going to have died because of complications related to COVID. And principally within that group are those individuals with those underlying comorbid health conditions that you just mentioned. Okay. Another question and then we'll? yes, sir?AUDIENCE MEMBER: What needs to happen between now and Monday for us to enter Phase II?GOVERNOR JON BEL EDWARDS: Well, as we look at the data, we need to see that we meet the gating criteria. And it really is that simple. I think the first question from will today, we went through what that criteria is. It hasn't changed. And we'll look at that data statewide. We're going to look at it by region. And I will get a recommendation, and I will process that, make a decision, share that with you all early next week. But whether we go to Phase II or not, understand that COVID19 is here. The virus is alive and well. It is still circulating in our state and in every community of our state. It remains contagious. It remains deadly. So we still have a role to play, everybody, in trying to make sure that we do control the spread as best we can, and that we literally save lives. And it's more important than ever? the more we learn about this particular virus and how it is spread, the more important it is that people wear those masks. Anytime you're out of your home, outdoors or indoors, and within 6 feet of people who are not part of your immediate household, you need to have that mask on. That's going to protect others. And when they wear that mask, it's going to protect you, in addition to keeping distance, washing your hands frequently with soap and water. These are things that, you know, are just important. And when you think about? you know, I was at Baton Rouge General MidCity today. And there were hundreds of hearts on the wall behind me. Those were all COVID patients who had been treated at that facility. And many of the folks there didn't make it. You know, they died. And when you think about just how serious this virus is, this disease is, and how many people are dying from it and how many people are being severely impacted and how many families and so forth, if you put it all into context, the mask is a pretty small price to pay to protect yourself and your family and others and to drive those numbers down and make sure that we're not putting an unnecessary strain on our healthcare delivery system, especially those doctors and nurses and respiratory therapists and EMTs and paramedics and all those other heroic professionals who have done so much. And I was really happy to go over there today because we've had 104 Navy personnel treating Louisiana's COVID population at that hospital, and they just did a tremendous job. And the folks at Baton Rouge General, standing up that campus the way that they did and the excellent care that was delivered there and the tremendous results that they achieved? that was a gratifying moment for me to be able to go over there and thank those 104 Navy personnel, thank all the people at Baton Rouge General. But what we were celebrating today there has been happening all over the state of Louisiana. And there is no doubt, we're in a much better place today, but there's also no doubt that the virus is still very much in control, and we are not, except to the degree that we do the things that we're asking people to do, all these CDC recommended things. And if we do, we're going to be just fine. And we're going to get back to normal sooner than we otherwise will, although that's not coming especially soon. And between now and then, there is a new normal. But the new normal isn't so bad in light of what the alternative is. So thank you all very much. We will so you I think Monday at the same time. Monday back here at the same time. ................
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