Asa Hutchinson Arkansas April 14 Briefing Transcript

Asa Hutchinson: (04:06) Yeah, Dexter you can have a seat or relax anywhere you want. Thank you for joining me today for today's daily update on our COVID19 response and where we are here in the state of Arkansas. I am delighted to be joined by secretary Nate Smith, the Department of Health, but also today director Dexter Payne, the Director of the Department of Corrections will be joining us from comments as well. Now let me start by saying I got this wonderful Easter blessings for someone in Arkansas and the note goes "To Governor Hutchinson, I'm a 73 year old retired business owner, so now I'm doing cards. I've sent around 100 this past month to friends, neighbors, church members to keep us all connected." And so he was just passing along that word of encouragement and then he added by saying, or she added, I should say "I washed my hands before sending this card." Asa Hutchinson: (05:07) So good health practices as a word of encouragement, it just shows that a lot of Arkansans are doing things that are out there. In terms of the case update, yesterday we reported 1,410 cases of COVID19 in Arkansas. We're up 88 cases to 1,498. We've had two additional deaths, so there's 32 deaths and currently we have 81 hospitalizations. In terms of Cummins Prison, I would report that we've had no new positive cases in Cummins Prison. As you know, we tested everyone in the one particular barrack, I believe it was 43 out of 46 positives. We've continued to test and although we've continued to test, there's been no new positives. In terms of the Federal Correctional Institute in Forrest City, Secretary Smith and I were on the phone today with Attorney General Bill Barr speaking about that facility, and we were assured that their medical team of the Bureau of Prisons is handling that situation in combination with the Center for Disease Control. And so we will simply stand by and let the federal response deal with the FCI in Forrest City. Asa Hutchinson: (06:38) I did want to cover a couple of additional items today. Well actually, let me go to the charts and the first chart is the number of new COVID cases in Arkansas. You've seen this before, and as you can see, it starts to March 11th, increases, it goes up and downs, but it's just generally been a steady increase. It's been fairly between 60 and 80. We had the spike as you can see yesterday, which was a significant spike, and that was because of the increased testing in the congregate facilities that had a large number of positives, not in our general population in Arkansas, but those that were in those facilities. And then today, as you can see, it goes down to more of the normal level of 80 something there. And then if you would go to the next slide, you can see the number of hospitalizations in Arkansas. Asa Hutchinson: (07:40) And I think this is good news as well. You can see that hospitalizations started low obviously and increased. And then you can see that we're, what I am hoping is a plateau in the number of hospitalizations, and that is a marker that a statistic that is constant, it is measurable. It is hard to say, well people are making up. Do they need to go to the hospital? If they don't need to go to the hospital, they're not going. I mean that's a pretty steady measurement stick, and it's plateauing there. We hope that we will eventually see it go down, but right now we see a plateau in the number of hospitalizations. And then if you'll go to I like every once in a while to go to how we're comparing with other States, and this is prepared, this is positives per 100,000 in population as you can see at the top. Asa Hutchinson: (08:38) And so this is per capita, and we compare with other States. And we've got some of the hotspots, New York, Louisiana. You've got California in here as well. And so this is a, and you see it by April 4th continuing onto the current April 14th. And you see the numbers that are reflected there of the positive cases per 100,000. And again, you can see Arkansas is next to the bottom with 49 cases per capita, fairly steady, a little bit of an increase as you can see. And I think that's favorable with the others States. And of course everybody says, "Well how are you doing in testing?" So if you go to the next slide, you'll see the test per 10,000. And we haven't shown this slide in some time. And here you can see New York, Louisiana, Mississippi, all more hot spots. And the more hotspots you have, you try to increase your testing and get more capacity. Asa Hutchinson: (09:45) Tennessee, Florida, Missouri, and so you can see Arkansas is in the mid range. Actually we've moved up a little bit in the higher mid range for our testing per 10,000. This is an encouraging sign. And then you can see how we've increased it from 30 as we started out, 39 44 consistently going up to where we have 69. So our testing is increasing in capacity, performance and that helps us. And then if you'll go to the next slide, which is total deaths today, and I won't spend much time, but it's the same States that are listed that we've talked about. Arkansas is bottom in terms of total deaths today. And this is in as you could see the percent of the last column is per 100,000. We're not at 1% there. And so our numbers are fairly steady gone up. But in terms of the other States, we are holding steady and strong and trying to eliminate those to the extent that we can. Asa Hutchinson: (10:58) And then as you know, we'll go on to the next slide here and I want to explain this a little bit. This is first, as you know, we've tried to decrease travel, and so we've decreased travel among the interstates 55% from a year ago, 70% actually on I-30 from last year to this year post COVID19. So we've reduced the traffic flow, but we've also have really made an effort to stop out-of-state travelers recreationally from coming to Arkansas. And of course if you're coming here because you're a healthcare worker, we welcome you. You're doing business. If you're coming here and essential services and a whole host of other reasons, you need to be here. But we want to eliminate the recreational travelers from coming from out of state into Arkansas. That's why we had the mandate in terms of our, of hotel lodging to out-of-state guests that were recreational travelers. So- Asa Hutchinson: (12:03) ... we're adding a new component to that today, which is a message board that is developed by the Arkansas State Police and the Arkansas Highway Police, the Department of Transportation. So these are on the red dots, as you can see, our permanent over head message boards that the traveling vehicles and passengers can see coming into our state, and reminding them as they travel into the entry points in our state, both in most of the directions from the East, and from the West and from the North. The blue dots are the mobile message boards. And so, you combine the red with the blue, you're going to get message boards all across Arkansas. And the message boards will reflect this message, no rec lodging for out-of-state travelers. That will be on the mobile messaging board. Asa Hutchinson: (13:07) On the permanent message board it will be, out of state rec lodging prohibited. Very simple messages that will help our out-of-state travelers and remind them we're not here for recreational purposes, and that helps us to protect ourselves, to reduce that spread coming in to Arkansas. And so thank you. I think that covers those charts that I wanted to give you today. And from this you can see that Arkansas is not yet at its peak. We're still going up in the number of cases. I do think we're getting close to the plateau, but we're not yet at the peak yet. And so that means we're not ready to relax our social distancing efforts. And further as you look and the national debate continues to increase about how do we get out of this? What's our future hold? When are we going to be able to get back to business? Asa Hutchinson: (14:02) Let me assure everyone that we will make decisions based upon the best public health advice. That's what we're going to listen to, balanced with the essential needs of our society to move and to make a living. Arkansas has positioned itself to fight this battle for the long haul, and we understand this is not a 30 day battle or a 60 day fight, but it will continue in some fashion into the future. And that's the reason that I've asked our medical advisory committee for post peak plans to help us set the criteria for how we reduce the burden of the executive orders to change those, how do we re-engage in business? But it's going to be from a healthcare perspective. Arkansas had a targeted response, and so our ability to sustain these public health measures should be greater, and we need to look at it from the long distance running standpoint. Asa Hutchinson: (15:06) I welcome national guidance and assistance. We've been a good partner, we've tried to follow CDC guidelines. But we will do what is needed in the best interest of Arkansans, and I think that's what the people expect. With that, I do have two announcements today. First, I'm issuing an executive order for first responders and frontline healthcare workers so that they can file workers' compensation claims if there's a causal relationship between being COVID-19, catching that virus, and their work responsibilities. It's hard to believe, but right now a contagious disease or a virus cannot be used to file a workers' comp claim unless it's in a hospital environment or a sanatorium. And so this helps our firefighters, our first responders, so if there is a causal connection, they can actually file a workers' comp claim. Asa Hutchinson: (16:08) The second executive order is on liability immunity for medical emergency responders during the COVID-19 emergency. This includes physicians, physician's assistants, specialist's assistants, nurse practitioners, licensed registered nurses and licensed practical nurses. We don't want them to worry about them performing their responsibilities in emergency circumstances about being sued, about a liability. They're out there trying to act in this emergency in an emergency fashion. So those are two executive orders that I have issue today. With that, I know that was a little bit longer than usual. Dr. Smith, thank you for being patient and I'll turn it over to you. Dr. Nathaniel Smith: (16:56) Thank you governor and thank you for your leadership during this time. I'd like to give a little bit more detail on some of the numbers. As the governor mentioned, we've had 88 new cases, bringing our total 1,498 cumulative cases. Of those, 1,024 are active cases. We have no new counties. We have 81 currently hospitalized and we have 29 currently on a vent. And as the governor mentioned, we've had two new deaths, so our total is 32. One of those individuals was less than age 65 in the 50s, and the other was greater than age 65. We now have 444 who have recovered, and that's 53 more than yesterday. And we have 65 healthcare workers who have recovered. We've had a total of 206 healthcare who have been infected with COVID-19, again, 65 of those have recovered. Dr. Nathaniel Smith: (18:03) I want to talk a little bit about our nursing homes. Nursing homes, we've had a total of 93 residents who have been infected and 71 workers. We've had unfortunately six deaths total, and that's not changed from yesterday. And we have a total of 28 nursing homes where we have active contact investigations going on. And I mentioned the nursing homes particularly for two reasons. First of all, the nursing home related cases, both residents as well as workers, are 11% of our total cases. So a significant portion. I also mentioned it because we've had relatively few deaths despite having at least one positive resident or worker in 28 nursing homes. And I think part of why our death rate is so low compared with other states is because of the very aggressive contact investigations that have been going on in these nursing homes and other longterm care facilities. And I want to give a shout out to Dr. Naveen Patil and his team who are leading those efforts. Dr. Nathaniel Smith: (19:18) The second I want to talk about prisons a little bit, because combining the federal and the state facilities, they make up 10% of our total cases. 4% of our total cases are from that federal facility. The governor's already mentioned that our federal partners will be taking the lead on that contact investigation and control. The state facilities have had been a total 6% of our total cases. For that Forest City Federal Correctional Institution, it's still at 55. That's 46 inmates, 8 staff and 1 contractor. For our state facilities, The Cummins State Prison, The Cummins Unit, we're still at 43 total inmates. We're still testing, we're testing many of the other barracks so that we can make sure we don't have cases that are still asymptomatic there. We've also been testing staff, and so far 10 staff have tested negative. Dr. Nathaniel Smith: (20:33) At the Central Arkansas Community Corrections, we have a total of 44. That's 27 staff, no new staff, but 27, and now we have 17 inmates. We have 35 staff that have tested negative and we have 21 inmates that have tested negative, but our plan is to test all of the inmates at that facility. And we're continuing to work very closely with the Department of Corrections and make appropriate guidance and work with them for any positive cases in any of the units. And lastly, I wanted to talk briefly about contact tracing. As I've mentioned before, we've really been growing our capacity there. Currently we have 78 nurses who are doing case investigations. We have 10 disease intervention specialists who are conducting contact tracing. We have three epidemiologists who are working on software development for contact tracing. And yesterday we went live with a system called Situational Awareness Response Assistant, or SARA, S-A-R-A, which is a system used to monitor contacts and it sends automatic alerts to people during their 14 day quarantine period. Dr. Nathaniel Smith: (21:51) We also have two HAI healthcare associated infections teams that are working with those nursing homes, longterm care facilities and now also the prisons, and there's a total of nine staff associated with those teams as well. So we're currently at 103, and we're training additional staff and additional partners. We hope to be up to at least 150, 160 staff working on that by next week. And with that I'll turn it back over to the governor. Asa Hutchinson: (22:29) Thank you, Dr. Smith. And just let me underscore the importance of what he just talked about. I asked him what we started with in terms of our contact personnel that could go out and do contact investigation. He said we started with three nurses, and now we're looking at 150 to 160 personnel engaged in contact investigations. That's why it is important for now, but I'm also looking six months from now and nine months from now, we need to continue to have this capacity. Because we don't want this to have peaks down the road, we want to be able to make sure we continue to do all we can to reduce the incidences of the virus and it's spread. Asa Hutchinson: (23:16) And with that I wanted to bring up Dexter Payne doing a great job with our Department of Corrections. And I've had a lot of people concerned about our inmates during this incidents of COVID-19 and one of the barracks at Cummins. And that is the Arkansas response and compassion. And these are Arkansans. Even though they're incarcerated now, we have a responsibility to take care of them and provide medical care for them. And Dexter has put that as a high priority. And I want to assure everyone that while they have to be where they are, we want to make sure that we do everything we can to reduce that spread. Asa Hutchinson: (24:02) Dexter. Dexter: (24:07) Good evening. Thank you, governor. I'd like to thank Governor Hutchinson for his leadership and Dr. Smith for his guidance to our division. At this time, the division of corrections has taken many steps to prevent the spread of the coronavirus throughout our facilities. It is our goal to provide the safest environment possible for our staff, inmates, and the citizens of Arkansas. We've put in place our visitation suspension until the date of June 1st at this time. We've also put in place several things to take the place of that visitation. Our video visitation now has been reduced. The cost of it has been reduced drastically as well as the cost of our phone calls. Dexter: (24:55) Our inmate movement inside of our facilities has basically come to a point where we're moving one barracks at a time, and that's for the dining hall facilities, that's for as yard call, our recreation, everything that goes on. That's just to prevent our inmates from cross contaminating each other. So we've put that in place. All inmates at this time in the Division of Corrections, as well as the Arkansas Division of Community Corrections have received face masks like the one I have at this time. Everyone, staff, as well as inmates, have these mass. So that's thanks to our industry program and the hard work of the inmates that participate in that industry program. Like I said, we've taken those steps to prevent this. At the Cummins unit, we're feeding that barracks and we've isolated and we're feeding and doing everything that we can inside of that barracks to help prevent the spread of that disease. That's all I have though. Asa Hutchinson: (25:52) That's good. Stay tuned Dexter. Dexter: (25:56) Yes sir. Asa Hutchinson: (25:59) With that, happy to open to questions. Speaker 2: (26:05) So the only place you're testing is Cummins? You're not expanding to other units. Asa Hutchinson: (26:14) That's correct. We're expanding beyond the simple barracks that are there because we did the 46 in that barracks, but Dr. Smith and his team. [Dr. Patel 00:02:27] has led a further testing as needed within those confines. But we do contact, who's the inmates come in contact with, where's the other risks that we ought to be testing, and so we don't necessarily bring that into a broader parts of the prison system when there's not symptoms or any outbreak. Dr. Smith did you want to add to that? Dr. Nathaniel Smith: (26:56) That's correct. We're working with the Department of Corrections regarding those other units in terms of providing guidance on how to keep COVID-19 out of those facilities. Each of those facilities have their own medical teams and they're on high alert for any suspected cases and they can test in those facilities. They can collect the specimen, send those out. If we get any positive cases or even get a cluster of suspicious symptoms, then we'll of course work closely with them to do testing. If they don't have COVID-19 in their facility, then since it's a closed facility, then it's extremely low risk. Of course, once it's introduced then the situation changes entirely. Speaker 2: (27:44) Do you have the score card in terms of how many total have been tested? Because you just said you're expanding testing, I don't know if you have any final numbers? Dr. Nathaniel Smith: (27:52) We, Dr. Patel keeps a careful scorecard. I don't have that with me, but at the Cummins unit, I know that we have a plan for testing, sampling, all of the areas within that Cummins unit within the next couple of days. Speaker 2: (28:13) What about the Central Arkansas Community Corrections Facility? Dr. Nathaniel Smith: (28:17) Likewise, we have a plan to test all of those inmates. That's a smaller number and so we're planing on testing all of them. Speaker 2: (28:27) You haven't had testing numbers from the past 24 hours? Dr. Nathaniel Smith: (28:31) I have the ... The short answer is yes, but it's hard to sort out and tease out which of these are from ... I have totals for each of the facilities. I can't tell you exactly right now, which of those are from the last 24 hours and which of those were from before then, and we are using somewhat different cutoff times. The numbers that I present here every day, our cutoff time is 11:00 AM, whatever comes in before that, that's what I present. A little bit different timeline for the team that's going out and doing these contact investigations. Speaker 3: (29:13) Sorry. In terms of the highway signs, what's your particular concern about out-of-state travelers? Like do you think they're contributing to the problem now or why the focus on the out-of-state travel? Asa Hutchinson: (29:29) Well, our attractions have always been a draw for them. So we first saw that at the Buffalo River scenic national park. We've seen it in our state lodges and camp grounds that's attracts visitors. But it's also we had reports that people from out of state were actually trying to get out of the hotspot and just stay at our motels. So we responded closing our lodges. We closed many of our facilities to overnight. Obviously the park, the national park, was closed. Asa Hutchinson: (30:06) So those response to it, we've continued to focus on that because we're doing what we need to do in Arkansas, but our surrounding states, they have a higher incidence. So we're trying to avoid that kind of travel back and forth, but to do it in a way that doesn't impede people from West Memphis going to the hospital in Memphis, or going to work there or vice versa. I mean those are natural interchanges that we have. So you don't want to stop that. So we narrowly defined it to out-of-state recreational travelers and that's something that we can do that's concrete. That has been a historic challenge for us here in this state and certainly could lead to spread. Speaker 4: (30:56) [inaudible 00:30:56] governors from the west coast to northeast have announced passed coalitions with states in their region. Is that something that you consider doing for our region? Asa Hutchinson: (31:06) Actually, I have a call a little bit later today or tomorrow with governors that we'll be talking about whether there is a way to do things regionally, and obviously, there's discussions about what the national approach could be. Despite the president's comments yesterday, which I take as him expressing himself in his normal fashion, that there's a great partnership there and I have full confidence that we do need to have continued national guidance. Asa Hutchinson: (31:43) We don't want to isolate ourselves and do something totally different in Arkansas that impedes our commerce and our interchange with other States. We want to know what the national guidance would be, but they've given us historically state flexibility and we want to continue to have that and continue to have that partnership. Asa Hutchinson: (32:05) We've been on our own in terms of trying to round up our PPE for our hospitals. They've been a backstop for us, but it hasn't been sufficient, and I expect in the future that we'll continue to have dialogue. The states will have a major role obviously when we have these emergency orders in place as to how they are lifted. That's why I have my medical team in place, but we're also going to be talking about other governors and what they're doing so that we can try to come out of this together as a region and as a nation. Speaker 4: (32:41) You mentioned yesterday about organizations needing to rethink summer camps. What do you suggest to parents who are looking towards summer plans for their kids? Asa Hutchinson: (32:55) I'll let Dr. Smith thank just a little bit before he comes up here and he's always got a good answer, but it's a challenge. I mean I hope first of all that we will be in a position in mid summer that we can look at having more access to some of our parks, and some of our recreation facilities in Arkansas you can have vacation, people need vacations, but we have to wait to see where we are. The camps are a unique environment, as Dr. Smith pointed out, and that's the reason we're hesitating about them, but why don't you elaborate Dr. Smith. Dr. Nathaniel Smith: (33:35) Thank you. I understand the concerns and it's difficult to make firm statements about what our situation is going to be later in the summer. As I said yesterday, I think it's likely that we will not be able to have summer camps this summer just based on what we're seeing not just in Arkansas but around the country. Again, those situations where you have campers coming in from a lot of different areas, staying in close quarters, and then going back after a week, it would be an ideal setting for COVID-19 to spread and disseminate. Dr. Nathaniel Smith: (34:11) But if we can figure out ways to do it safely and the situation looks improved, I don't want to rule it out. I've got two teens at home and I'm at risk of being boycotted for what I said yesterday by my own family. These are very hard decisions, but from where we stand right now, I think that it'd be ... I hope the situation changes, but right now it doesn't look like that would be a safe or wise thing. Asa Hutchinson: (34:42) Do we have anyone remotely that has a question? Craig Cannon: (34:45) Yes governor. Hi, Craig Cannon 40/29 News up here in Northwest Arkansas. Governor, a couple of quick questions. Can you update us on the unemployment office operations and how that's going? We're stills hearing complaints of people having trouble getting through, trouble filing. And second question real quick. We've had some complaints about the [inaudible 00:35:09] Bella Vista Golf Courses, as you're very well aware of, they are still apparently letting people play and is that it against your rules? Other golf courses have closed down in the area. Asa Hutchinson: (35:24) Good. Thank you for the question. In terms of the unemployment claims, we have process over 110,000. So many Arkansans are getting relief, getting their unemployment checks, and have successfully processed their claim. Certainly the volume continues and so everyone needs to be patient to stick with it. Sometimes there's an error in inputting the data. Sometimes there can be an overload of the system that causes a challenge, but we're putting more resources there as well as trying to improve the system. So we are getting processed ... Asa Hutchinson: (36:03) ... tens of thousands are getting processed, so they need to stick with it. And we'll bring a secretary Preston back in a couple of days to give a more full report on exactly where we are. Asa Hutchinson: (36:18) And in the second question on the golf courses, actually we made some inquiry through the county judge and he checked on some of the golf courses there in Benton County. And my understanding is that they are saying one cart per person so they're not doubling up, that they're social distancing in place, and that the restaurants are closed and their bars or whatever are closed as well. And so if they maintain those rules, then there's not any problem them being open. Now if they're not following those rules, that's a problem and they need to change. But from what I've seen, they're doing every effort that they can to comply with the guidance that we've provided. Press Corps: (37:08) When you referred to President Trump's comments, were you referring to his comments about having total authority over the state? Asa Hutchinson: (37:23) Yes. Press Corps: (37:23) How do you interpret what he says? Asa Hutchinson: (37:24) With an understanding of President Trump and how he likes to gig a little bit, how he likes to create a little controversy, and that's part of his leadership style. So as governor, obviously I'm protective of the prerogatives of governor. They've worked very, very well with us. Vice President Pence has been a governor, a colleague. He understands the role of governor. So I don't see an issue going forward in the future; I think there'll be a good partnership. And obviously in terms of the dialogue we value the role that we have, and our Founding Fathers in our country appreciated the role under the 10th Amendment that governors have in the different states. Asa Hutchinson: (38:11) Any other question remotely? Melissa: (38:13) Yeah. [crosstalk 00:38:14]. Press Corps: (38:13) Yeah that's- Melissa: (38:13) This is Melissa [crosstalk 00:38:16]- Press Corps: (38:17) The next question is for Dr. Smith. Asa Hutchinson: (38:19) All right, so I heard the lady first, then we'll go to the gentleman. Asa Hutchinson: (38:24) Who's the lady? Melissa: (38:25) Hi, this is Melissa [inaudible 00:38:27] with Channel 11. This is a question for Dr. Nate Smith. Can you clarify how the numbers are calculated for recovered? For example, all those people at the Briarwood Nursing Home that tested positive several weeks ago, are they among those that have recovered now? Dr. Nate Smith: (38:45) For people who are outside of a healthcare facility, our criteria is the CDC criteria: seven days from the onset of symptoms and at least three days without fever. And we confirm that by actually contacting them, and so it requires that we have that contact with them before we consider them recovered. Dr. Nate Smith: (39:07) For those who are in health care settings, it's a little bit more challenging; there's more opportunities for spread of COVID-19. So the CDC criteria is a test-based criteria. For example, if someone were in the hospital, you would want to see two negative PCR tests. For those who are in a nursing home setting, we tend to be very conservative because those are such high-risk settings and for the most part people remain in an isolation type of setting. There have been at least one individual who has tested negative after they fully recovered. But for the most part if we have a nursing home setting where we've had cases, we're going to continue to act as if anyone in that facility potentially could be infected. Asa Hutchinson: (40:01) I think you have another question online too, remotely. Dr. Nate Smith: (40:03) Yes, there was another question. Press Corps: (40:06) Yes. Thank you, Dr. Smith. This is Neil [inaudible 00:40:09] in Hot Springs. And I want to piggyback on that same question. I think you made reference yesterday to a patient who had been deemed to have been recovered and then tested positive after the recovery. Could you talk about the length of time? And is that a one off or are you starting to see that other places? Dr. Nate Smith: (40:27) The issue of testing after recovery ... And there have certainly been well-documented cases where someone has recovered and continues to test positive, or has tested negative and then tests positive again later. The PCR test that we're doing is a polymerase chain reaction. It's an amplification test, so it can detect really very small amounts of viral RNA. And so it's a very sensitive test. But whether those people actually are at risk of transmitting COVID-19 to someone else, we don't have all the information but they don't seem to be an important part of the transmission that we're seeing. Almost all the cases that we have seen of COVID-19 seem to be directly related to contact with someone who is either symptomatic or presymptomatic, they were a few days before the onset of symptoms. Asa Hutchinson: (41:21) Is there a final question? Press Corps: (41:22) If they test positive a second time, are they symptomatic at that time? Dr. Nate Smith: (41:27) No, generally not. These are just tests that there's some viral shedding, or at least shedding a viral RNA. Asa Hutchinson: (41:35) Other table? Press Corps: (41:39) Within the prison system, is there any plan to ... Are we just going to keep all of those guys within that barracks together throughout the whole process? Or if some recover, do they kind of break off from those that might still be symptomatic? Dr. Nate Smith: (41:55) For practical terms we'll probably keep them cohorted. There would be no reason to bring them out of that setting unless there were other practical reasons to do so. Joe: (42:11) One more question from remote here. This is Joe Flaherty [inaudible 00:42:12] in Little Rock, and this question is for Dr. Smith regarding the Forrest City outbreak. Dr. Smith, on April 5th you emailed two colleagues at the Department of Health and asked if they were getting full cooperation now from the federal prison. Dr. Patel replied and said, "Yes, sort of," and added that they seem to be coming around to the seriousness of the situation. Can you elaborate on this exchange? And additionally, do you believe that Forrest City officials should have acted differently at the outset to contain or mitigate the outbreak? Press Corps: (42:49) All right. Joe, Dr. Smith will answer that shortly, but I wanted a Dexter Payne to finish up with the first one. Dexter Payne: (42:57) Yes. Our plan is to keep those inmates in the same barracks until the quarantine is over. Our partner, Will Path, is guiding us on what we should do; they're out medical provider and I'd like to thank them today. They've done a great job, as well as our staff. But our plan is to keep them there. Press Corps: (43:15) [inaudible 00:43:15] Just forgive my ignorance here but inmates, are they issued their own toiletries and stuff like that? Or is it some ... Do they share supplies and stuff like that? Joe: (43:29) They are issued their own soap towels, clothing, things of that nature. I mean, it's our goal to take care of these individuals. I mean, even though they're incarcerated inside of our facilities, our goal is to take care of them. They're people too and we're going to treat them the same. Asa Hutchinson: (43:43) All right. Dr. Smith, can you handle that question from Joe from the Democrat-Gazette? Dr. Nate Smith: (43:49) Certainly, thank you. Dr. Nate Smith: (43:52) Warden Hendrix at the Federal Correctional Institute in Forrest City has been an excellent partner. He contacted us for assistance. We gave that assistance. We had the CDC team come in and he also has support from the medical staff, medical director from the Bureau of Prisons. Dr. Nate Smith: (44:15) In terms of challenges, there are some challenges in working as a state department of health with a federal facility in that they have their own chain of command and issues of who's in charge here. If it's a state prison, we know how to work well with Secretary Kelly and her team; in a federal institute they've got the Bureau of Prisons, their own medical staff, who are working closely with CDC. Attorney General Bar told us that their medical staff had been consulting with CDC through this process. Dr. Nate Smith: (44:59) So some of those issues have to do with determining who actually is calling the shots on the contact investigation. I think we've had some clarity at this point on that, but we'll continue to support as needed in that. Asa Hutchinson: (45:17) I think that ... Is there one final question? We got it, here at the table. Press Corps: (45:23) A few weeks ago you said you expected us to keep at 1,000 hospitalizations and that, that would be in early May. Based on our hospitalizations right now, is it safe to assume you're not expecting that anymore? Or how does that stand? Asa Hutchinson: (45:37) That is correct. Because of the people of Arkansas being disciplined, taking the measures that they need to and social distancing, our numbers are not anywhere close to the projections that they made two weeks ago, one week ago. And in fact they continue to modify them down. So I was presented with an option as to having to build field hospitals in preparation for a very high level of peak of hospitalizations. We're not going to do that based upon where we see the peak going. And even though we're not to the peak yet, we are confident that we're not going to reach those high level of numbers at this point. Press Corps: (46:25) So you think our hospital capacity is going to be sufficient [crosstalk 00:46:30]? Asa Hutchinson: (46:32) Well unless something just turns totally haywire, our current hospital capacity is sufficient to handle the current COVID virus challenge that we have. Asa Hutchinson: (46:44) Thank you all very much today. Speaker 9: (46:46) Goodbye.