California Gov. Gavin Newsom COVID-19 Press Conference Transcript December 21

Gavin Newsom: (00:52)
Well, good afternoon everybody. And forgive a little bit of a delay, we’re trying out some new technology today, I’m back in my home office, back into a 10 day quarantine period.

But I wanted to update all of you on where we are in state and what we are looking at over the course of the next number of days and weeks. We continue to see record breaking ICU capacity, hospitals that are getting filled up, a surge that we are experiencing, not dissimilar to other parts of the country, but putting real challenges on our staffing here in the state.

You can see from this slide, the staff that we have currently deployed, these are state staff specifically to now 75 facilities in 24 counties. You can see the kind of staff that we are utilizing, our Health Corps staff, the California National Guard, as well as contract staff and our Cal MAT teams, very familiar. And if you tuned into these presentations over the course of the last number of months, and working with Health and Human Services at the federal level, these DMAT teams, and I’ll talk more about DMAT and some of the requests we have in with the federal government in just a brief second.

As it relates to the federal request specifically around DOD staffing, as well as that DMAT staffing, one of things we’re trying to do is extend the DMAT staffing that we currently are enjoying down in Imperial County. They’re due to redeploy elsewhere, the middle of this week. I had a very good call with the vice president and I want to thank the vice president for his responsiveness for reaching out, to get those DMAT support, or rather get that DMAT staffing and support extended through January. We’re just waiting for the final determination on that, but it looks very, very favorable.

We also talked more detail about these Department of Defense teams. We have specific asks out for 10 teams of 20. We are currently able to identify 75 personnel that will be deployed. Currently have not, but are about to be deployed to critical sites here in the state. We’re also working with HHS, we talked yesterday with a number of representatives from HHS about this monoclonal antibody strategy. And they’re going to be providing some resources to do some infusions, what they refer to as their infusion teams. And that also will be deployed over the course of the next number of days.

As it relates to what we currently are doing in alternative care sites, the alternative care sites are pre identified. We have 11 of them, all up and down the State of California. I mentioned on Friday, the warm status on a number of sites that are not on this screen, though the four sites that are up on the screen are not only in warm status, they’re now in active status, the others in warm status, these specifically in active status.

We now have 62 patients in these alternative care sites. On Saturday, I was out there at the Sleep Train Arena in Sacramento. They had 17 patients on Saturday. They have 16 COVID positive patients today. Not all of the patients, those 62, are COVID positives. The ones at this rate Sleep Train Arena are, but you get a sense. Imperial Valley College, the Porterville and the Fairview sites, these are sites that are currently have been activated, and we will provide more staffing. As we provide more staffing, we’ll allow for more patients to make their way in to these critical facilities.

37,892 is the last reporting period. Total number of cases, tracking slightly below the 43,901 average number of daily positive cases that we have experienced over the last seven day period.

Now, some have inquired over the course of this weekend, the last number of days suggesting, or at least inquiring as relates to what they perceive based upon the data that’s come in the last four days, that we may be seeing a modest, very modest decrease in the growth rate, total case growth rate. It’s still too early to tell, and I caution people not to read in again to weekend numbers, but we’ll take a close look at this in the next few days, and of course, that data always we make it available, but to give you our assessment, professional assessment. Dr. Ghaly will talk in a moment. He could give you a side of that as well to see if he thinks that is indeed the case. Still too early to tell, but nonetheless, good to see the number the last 24 hours tracking a little bit below that seven day.

Let’s take a look at the seven day testing average. Little over, or rather just shy, I should say, of 330,000 tests. By the way, yesterday, we reported over 395,000 tests. So close to 400,000 tests in the last reporting period. But you take a look over a seven day average, roughly 330,000 tests. Want to still see that test number increase. We’re starting to see those numbers increase, which is encouraging news. You get a sense of, of course, the positivity right now in the state, 12% positivity, that’s over a 14 day band.

Let’s take a look, as we get to this next slide, where we were just 14 days ago, though. That 12%, we were at 8.7%, just 14 days ago. So you see that rate of growth, that trajectory growing rather acutely.

Hospitalizations, not surprisingly, 63% increase over a 14 day period. You’re seeing that same trend line, 17,190 individuals hospitalized that are identified as COVID positive currently in our hospital system. The ICU’s tracking with 3,644 patients now in the ICU, is a 51% increase in admissions as well over a 14 day period.

The death rate is climbing as well. Sober, sober reminder of how deadly this disease is and how tragic the loss of every life is. But particularly those lives that are lost during the holiday seasons with loved ones and family members torn asunder because they don’t have their loved ones at home or even the ability to call. And so I just remind people of this fundamental point, and that is, this disease remains deadly. And just take a look at the lives that have been lost just over a 14 day period, 2,741 people no longer with us. Just over a 14 day period, an average now of 233 lives lost, an average every day over the last seven days. Again, those weekend reporting periods often lag, the 83 though, extraordinarily high. I know it looks to be more modest compared to the average, but that often is misleading on a Monday and the reporting periods, really the average daily rates that we should be very, very mindful, 233 lives lost over that period.

Here’s a chart that more and more people are getting familiar with. And that’s the regions in the state that are in a scarcity frame now in a surge frame, as it relates to ICU capacity. 2.5% is the statewide ICU capacity. That’s in the aggregate. I always say this, forgive me for saying it yet again, none of us live in the aggregate. So that’s nice to see, 2.5% is low numbers that may appear to be, it doesn’t mean much if you don’t live in a region that is also detailed and exampled here. And that’s why we include not just the state number, which could be misleading, but if you’re in the Bay Area at 13.7% ICU capacity, Greater Sacramento region, 16.2, northern part of the state, the northern regions of the state, are higher at 28.7, but you can see the real hotspots right now.

San Joaquin Valley at 0% and in Southern California, the most populous part of our state at 0%, now in the surge phase of the ICU planning. So again, just because it’s at zero, doesn’t mean there’s no ICU available. It means we’re now in the surge plan, 20% plus or minus is the surge capacity pursuant to the plans that we have socialized and are now being utilized and advanced in those critical regions here in our state.

Take a look at the regional stay at home map, 98% now of the population in the state are represented in the update, San Joaquin Valley, Southern California, Greater Sacramento and Bay Area. Again, it’s just the northern part of the state that’s not in that stay at home. You can see, as it relates to the stay at home, that we are likely, I think it’s pretty self-evident, going to need to extend those original dates. You may recall that the expiration in San Joaquin County was on the 28th of this month and Southern California the 30th of this month. Based upon all the data and based upon all these trend lines, it’s very likely, based on those current trends that we’ll need to extend that stay at home order. You recall, it was a three week order when we announced it a few weeks back. Just previewing the likelihood of those stay at homes being extended, certainly in those two regions.

As it relates to preparation, we’ve talked a lot about PPE and the 600 plus million units of procedure masks, surgical masks, as well as N95 masks that have been distributed. We’ve talked a lot about what’s in our inventory, still over half a billion units of PPE specific to just face coverings and masks that are still in our inventory. Just because it’s important to remind folks the critical nature of ventilators as relates to the issues associated with the scarcity of ICUs. We still are in possession of an ample supply of ventilators. You can see here over 20,000, not just in the state inventory, close to 14,000 vents, but also vents still available within our hospital system.

Good news on Moderna. As of this moment, I can report to you, we’ll update you on an hourly basis, or at least over the course of the next few hours, we’ll update you at the end of the day. But as I speak, 21 of the 31 sites that we identified for Moderna to have vaccines delivered, and remember, we’re working with McKesson to do the delivery. They are the intermediary working for Moderna in terms of the distribution of these doses of vaccines. That first phase has arrived in California, 110,000 doses. 672,000 have already arrived. 110,000 of the 672,000 have arrived 21 out of 31 sites as I speak. The reason why is not only did they get emergency authorization from FDA, we also had our Western States Scientific Safety Review Workgroup, a compliment of 17 members, six from Nevada, Washington State, Oregon, 11 from the State of California. Again, similar to what they did with the Pfizer vaccine, they unanimously approved the safety and the efficacy of the Moderna vaccine. They did so over the weekend, formally announced it Sunday morning, put a letter that we received late Saturday night.

So the Moderna vaccine has arrived, and that is indeed good news. 672,600 to be exact, is what we anticipate receiving this week. The 110,000 we already have. As we’ve said many, many times, this is storage for this vaccine is much easier than the ultra cold storage of Pfizer. This is just cold storage, which is the equivalent of freezer storage for the Moderna vaccine. It’s a 28-2 dose regimen. Like the Pfizer vaccine is a two dose regimen, 21 days Pfizer, 28 on the Moderna. And we of course are encouraged by the Moderna vaccine in relationship to the storage needs.

In terms of our distribution, in terms of our logistics, we’re now able to get these shipments into rural parts of the state, into parts of the state that are more remote, and that is indeed encouraging. There’s also some other advantages in terms of the doses in each vial and the total number that you have to order, 975 versus 100 Pfizer orders versus Moderna orders. If I’ve lost you, happy to clarify any of that in the Q and A, but nonetheless, just some advantages, not on safety and efficacy per se, but real advantages on logistics for the moment with the Moderna vaccine, which is indeed a very, very encouraging.

Pfizer, here’s just the update. 560,625 doses have arrived in the State of California. We got the doses all in, 327,600, all that arrived last week in the state. And then 560 anticipates for clarification purposes, the 233,025, the 233,000 that we anticipate arriving this week. They’re already starting to arrive, which is good, and we’ll update you as to the status of all of that remaining 233,000. As you know, it’s 40% below what was originally anticipated. And I appreciate the clarification coming from the federal government, the Department of Defense in terms of their logistics mistake and owning up to that. Again, no reason to have a closed fist in this moment, all of us need to be humble at this moment, everyone’s doing their best.

And I still maintain, this is an extraordinary, extraordinary accomplishment for this country, for our nation, for the world, that these vaccines are even going into people’s arms, that they have arrived, and I want to compliment everybody that was part of Operation Warp Speed. They deserve credit, the administration deserves credit, president and the vice president deserve credit for working hard over the course of the last number of months to get these vaccines out and to get them in these states.

We are so often too quick to be judgemental. And while we were disappointed in not receiving 40% more of the Pfizer vaccine, we are still very pleased. 560,000 doses of vaccine will arrive in the State of California and what we are told very clearly, and I have confidence in this based upon the conversations we’ve had over the weekend and including conversations that my staff had today, we’re going to see a stable of the Pfizer vaccine come on a more consistent basis. We don’t know the exact number yet. And when we do, we’ll let you know right away, but we now have confidence in that cadence.

And so for our planning purposes, that will allow us a little bit more constancy, a little bit more ability to phase in and distribute these vaccines on a protocol that was anticipated based upon the plans of our guidelines work group and our community advisory group. I’ll talk about them in just a moment, but briefly, I want to just update you. The first week, we did vaccinate or at least administer the first dose of the vaccine to 70,258 individuals, 70,258 doses of the vaccine were administered last week. We’ll keep updating you. These numbers lag just a day or two, we want to make sure they’re accurate. So all those doses came in, not all the doses were administered. And that’s why, again, we are, I think again, why we’re being, I think, generous to the nature of this unprecedented distribution all across this country and respectful of how hard everybody across the spectrum, federal, state, and local are working to do justice to really meet this moment head on. As it relates to the upcoming meetings. And I get, I was joking with my staff last night. I said, I feel like a full-time red carpet concierge for everyone that does have access to my direct email and my text messages, asking about their aunt or uncle, about a friend or family member. When are they going to be in the queue? When do they get the opportunity to be vaccinated? And I remind them as I’ll remind you, everybody that’s calling, staff, everybody that calls, that we have a public-

…staff, not everybody that calls that we have public process for vaccinations. We not only had that scientific safety review group, which we talked about, that’s been doing a remarkable job working with the western states.

But this drafting guidelines work group and this community advisory group, the drafting guidelines work group is been busily working on plan one B. And this is for the universe above 3 million individuals that we broadly have identified for plan one A. Prioritization, those that are currently getting vaccinated. And those are healthcare workers that have direct interface and interaction with patients and others. As well as those in congregate facilities, skilled nursing facilities, assisted living facilities. That’s the first phase of [inaudible 00:19:54] about 3 million.

The plan one B is the next phase. The guidelines working group has been working on that phase populations as well as subpopulations or prioritization. That includes teachers, includes food workers. It includes vulnerable seniors. CDC put out their version of the guidelines. We will come out more prescriptive versions.

And I just want to update you today. The drafting guidelines working group is meeting again, and then on the 23rd, and this is why I wanted to make you aware of this between two and four 60 member community advisory committee will meet with the 16 member drafting guidelines work group. And they will work through details and nuances answering and asking all the questions that we’re all asking about subpopulation and exactly who within that next categorization priorities or going to get the vaccines. That’s a public meeting two to four this week on December 23rd. And you can watch it. Go to COVID-19. ca.gov, COVID-19 dot.ca.gov. And you can tune in in real time. We want to be as transparent as possible.

And by the way, these are the folks that are contacting me. I’m saying, here’s what you need to tune in on. These are not political decisions we’re making top-down. These are decisions that the experts are making. This is a world-class group, this guidelines work group. 16 remarkable individuals that are putting their reputations on the line and really doing justice on the issue of inclusion and the issue of equity.

And then this advisory committee, truly, we believe he represents the diversity of the state of California. Not just racial and ethnic, but also geographic diversity to really think about those subpopulations that are so often left behind in any vaccine drive, any vaccine distribution plan, and to making sure that we do justice to California for all Californians, true inclusion, true equity. Not just rhetorical inclusion, rhetorical equity that we deliver on this promise.

Please tune in if you’re interested to discuss, or rather listen in on the discussion of plan one B, and we hope to get those guidelines up and formalized very, very shortly. But again, on the 23rd, you’ll hear a lot more about that as it relates to the conversation we’re all having today, and we’re certainly having with my staff.

This is very encouraging news. The federal COVID relief bill. Now adding to the president $900 billion. We can talk about the merits and demerits. Is it enough? Should it have been higher? Let’s just talk about what it is for the purpose of planning.

And so, I put three slides together. I will present to you, and I’ll just walk through very, very brief briefly. And I want to caution, we have initial estimates. And so, anybody watching, I want you please to consider the asterisks that is on these next few slides. These are initial estimates. These are back of the envelope estimates, but I wanted to at least give people a sense of roughly what we anticipate here in California to be the benefits of the federal COVID relief. They are significant. They’ll need to do more in the future, but nonetheless, they are significant.

Most significant, it’s money right directly in your pocket. That’s the $300 a week for the next eleven weeks for unemployment. That’s $20 billion we believe that will come in to the state of California over that 11 week period. $600 direct checks to help lower income Californians. We anticipate an additional $17 billion to be infused into the state.

We got some good language on CARES Act funding. The 15.3 billion that we received from the previous CARES Act. There was some limitations. There was a little bit of lack of flexibility. They addressed that. And that’s very significant in terms of helping us guide the distributions of those remaining CARES Act dollars.

$325 billion in small business relief. This is critical at this moment. Now I’ll remind you of half a billion dollars we put up in grants, the billions of dollars, roughly $3 billion in sales tax float without fees or fines or any associated burdens to small businesses, which we provided a hundred million dollars in hiring tax credits. [inaudible 00:24:27] That’s what the states done.

And my budget, that’s literally at the printer. A budget that we’ll submit to the legislature to become the state’s budget. After we work with legislative leadership we’ll also have some very significant small business support. This is in addition to all of that, but we need to scale the federal government and $325 billion in small business relief coming from this package will be very, very helpful.

$284 billion just in the PPP program, the paycheck protection program. Rental assistance. We were all waiting bated breath about the need to see something big and bold happen on rental assistance. I’m not sure this is as big and bold as we had hoped for, but it is nonetheless significant. Potentially 2 billion of the $25 billion in rental assistance will come to help Californians in need. That is very, very significant and important relief at this critical juncture.

We’re working with the legislature. We’re working to see if we can extend beyond February 1st. It’s a partnership. It’s a collaborative. A lot of work was done to work to get the original moratorium extended to February 1st. If we’re going to extend it, we’re going to continue to have to work in that same spirit of collaboration. We are in that process as we speak that obviously can be complimentary potentially. Any moratorium or eviction or forbearance, foreclosure and mortgages across board spectrum, not just rental, but also commercial. But this direct rental assistance, $2 billion potential infused in California can’t happen too soon.

Testing, tracing, tracking issues related to vaccine distribution, very significant. $69 billion for the country. $1.3 billion that we expect here in the state. That’s going to help with all of our efforts, advertising, marketing, distribution, the planning, logistics, all of those issues.

And we were operating under a scarce mindset. Now we can operate with a more abundant mindset. This is a very, very healthy infusion of support.

$8 billion, 8.5, we anticipate to help us with K-14, also with UC and CSU. I can tell you as former UC [inaudible 00:26:49] sat on the UC Board of Regents, CSU Board of Trustees, spent eight years lieutenant governor in those roles more formally and more actively. This is significant relief for CSU and UC, and very, very timely and helpful relief through our K through 14. That includes community college system.

We’ll be talking a lot more about how that allocation is distributed, but getting plus or minus … These are estimates 8.5 billion will be infused to help those, our educational system here in the state.

Childcare, got four kids, myself. They’re all here if you hear them in the background in the other room. Childcare can’t get people back to work unless we have childcare. We keep our care workers safe, keep them healthy. Keep those cohorts that we’ve allowed in terms of the central workforce going. But this billion dollars we anticipate of the $10 billion nationally will be very, very timely and helpful as well.

Broadband, we talk a lot about broadband. We’re going to be talking a lot more about it. I love the enthusiasm in the California legislature. I can assure you we share that enthusiasm and it’s going to be a top agenda for our administration in January. It’s reflected in a lot of strategies, legislative, as well as budgetary strategies, also now reflected enthusiastically by the federal government.

$7 billion may seem like a lot of money, federally. Not close to what needs to be, but nonetheless it’s helpful. It includes $3.2 billion for low-income families. It’s additive. It’s complimentary. It will help with our efforts. It will help with all of the things on telework. Everything we’ve been talking about, very encouraging.

Transportation sector, $2 billion potential infusion into the state of California. $45 billion for the nation, and then SNAP issues. The issues related to food scarcity, food security, food assistance, agricultural assistance, nutrition assistance. $26 billion in that space, $13 billion just on the SNAP benefits. Again, that cannot happen sooner now, particularly here in these holidays, we highlight these issues.

We’ve done some supplements in the last number of months. I want to thank the legislative leaders for their insistence on some supplemental supports to our food banks. 90 million recently on top of the money we put in the budget, over a hundred million of additional resources. We’ve been monitoring the availability of those resources. We’re going to be very mindful of what is needed as it relates to food distribution up and down the state. But this is indeed encouraging as well.

That’s it broadly on the COVID relief. Let’s talk a little bit more about two specific issues I want to just bring up before we close out and answer any questions.

We’ve talked a lot I think all of us are talking a lot about this new COVID strain that we’re reading about out of the United Kingdom. And just full disclosure, we’ve been having conversations the last 48 hours with the airlines, having conversations with our stakeholders all up and down the state. We’re looking just preview. Nothing landed yet. They say landed, emphasis landed yet as it relates to new protocols that we are pursuing, potential quarantine protocols or requirement of quarantine protocols for UK visitors.

I hope the federal government takes action in this space. They should. We’ve seen Canada. We’ve seen so many other jurisdictions around the world that have in the absence of that, will be pursuing different strategies on testing and quarantine, and those have been activated in terms of those conversations. And as soon as I have more information, I’ll share that information with you. But I wanted to share this information. It’s just important that folks know this. We have a genomics sequencing effort that exists and persists on a daily basis in the state. We test anywhere from five to 10,000 samples every single day for nutations for modifications in terms of the genomic sequencing.

We do that in partnership just as an example in Northern California with the CCU Biohub, which is in partnership with Chan Zuckerberg and UCSF. Upwards of 10,000 samples, we haven’t seen anything related to a new strain yet. And that’s constant monitoring that is very active, very proactive. [inaudible 00:31:14] genomics space here in the state of California, so no evidence of this strain yet in to the state of California.

We’ve seen reports in other parts of the globe, South Africa. Obviously some European nations, but we are not seeing that here, but it under pins and just underscores the importance of our continued surveillance and these incredible partnerships that we have.

And in a moment, I’m going to ask Dr. Galley to talk more, a little bit more about this space in particular. But first I just wanted to update you on the California Notify app, which is again, just another tool in the tool kit. It doesn’t [inaudible 00:31:58]. It doesn’t substitute. It’s just additive. But 7. 35 million people have activated this new opt in technology. And I remind you if you’re willing, able, desirous to get this notification app completely private opt-in. Don’t have to do it, but almost 7.5 million people have already.

You can go to the Google Android platform and you can just download under Google Play their app. Or you can just go on your iPhone, and it’s simple. Open up the settings and you just go to the exposure notification section in the settings, and you can activate this. I did this right away, one of those 7.35 million Californians to doing this.

The more people that do it, the more effective this notification tool will become, and so, I hope you will considered doing that. Very encouraged by the seven plus million that already have. And I hope you’ll consider the same. California Notify, go to Android, and go to Google play, and you can pull download the app and pull it down, as well on your iPhone and the iOS platform.

With that, let me just turn this platform from over to Dr. Ghaly. And Dr. Ghaly, if you could just briefly, because we’ve been talking a lot over the last … Well over the weekend, you and I are talking the team today about this UK strain and what you’re seeing, what we’re not seeing.

Give us a sense of where you think that’s going. What it means in terms of virulence and what it means to everybody watching and why we should be concerned about it? Why, though you’re not yet alarmed by it, but nonetheless, we are monitoring things very, very closely. Doctor?

Dr. Ghaly: (33:49)
Thank you, Governor and good afternoon. Indeed, as you said, the concern over the past many days is this new strain of COVID.

Dr. Ghaly: (33:59)
Let me be a little bit more specific. We know that viruses, especially new viruses are always prone to mutations, meaning that its genetic code changes a little bit. And sometimes those changes have no impact, and other times the change is material and important.

Dr. Ghaly: (34:20)
And this is a change that was noticed over the past many weeks in the UK, also in South Africa and seen in a few other countries in Europe where essentially the COVID virus that we’re finding in some individuals who test positive, the way I like to think of it as it’s a little bit more sticky than the COVID virus that we’ve been seen to date.

Dr. Ghaly: (34:46)
And what I mean by that is we know that for COVID to enter a human cell, it needs to bind to a receptor that’s sort of front door on a human cell. And the new mutated COVID virus seems to bind a little tighter, a little more easily and enter the cell of the human body easier than our current COVID virus that we have here primarily in California in the United States.

Dr. Ghaly: (35:18)
What does that mean exactly? It means that in exposure to somebody with the new strain may mean you’re more likely to get infected than if you were exposed to the current strain. And that is why we’re worried.

Dr. Ghaly: (35:32)
We haven’t yet seen what we call increased virulence meaning that people necessarily get sicker with this new strain, but the fact that it infects more easily, it seems is what we are worried about. Because of this we’re of course working with our partners across the state, across the nation to do exactly what the governor said, make sure that if we do see it here in California, that we’re able to react to it very quickly. If we see it in the other parts of the nation that were similarly able to react.

Dr. Ghaly: (36:09)
We do on a daily basis over the course of a month, check thousands of specimens to see if the genetic code of the virus is changing at all. We are watching closely for this specific mutation.

Dr. Ghaly: (36:25)
And there’s a lot of reasons why we’re concerned. A bit I’ve already addressed, but frankly we’re concerned because of the unknowns. We’re concerned that we aren’t sure how this impacts the broad scale efforts to contain and mitigate the virus as it exists now.

Dr. Ghaly: (36:45)
And so, that is why we are looking to make some recommendations at further monitoring people who travel in from these impacted areas, particularly the UK and having those conversations now, because the last thing we want to do is let a new strain of COVID come and spread more rapidly or easily across the state.

Dr. Ghaly: (37:08)
We can. We’ve done it before. We’ve mitigated the virus in the past and we would need to do that and do that early with this new strain. We’re watching this very closely and we’ll be keeping everyone updated as our plans and decisions move forward.

For that update. Of course, happy to answer any additional questions about that in a moment.

By the way, just a moment ago, we just got more information about Pfizer now. 50 locations where the next traunch of that vaccine, 233,000 doses have now arrived in the states.

All of this happening real time, we’ll update you as often as we possibly can in terms of the real time distribution of the vaccines. But encouraging to see now, the Moderna vaccine, not just the Pfizer vaccine available across the state of California. Moderna now getting into parts of…

… across the State of California, Moderna now getting into parts of the state where Pfizer was not yet distributed. Encouraging news coming from Modern and Pfizer as it relates to the expectations over the next number of weeks in terms of doses coming in, in a more consistent basis. With that, of course, we’re now happy to answer any questions.

Moderator: (38:36)
[inaudible 00:38:36]

Speaker 1: (38:36)
[inaudible 00:38:33] Thank you. Early during the pandemic, a lot of the authority making decisions rested with the County Public Health Department. And when it came to testing, there were really spotty… a real patchwork response. If you were [inaudible 00:38:55] you were in. [inaudible 00:38:58] I know you’re coming up with guidelines right now on vaccines, but we’re already seeing some counties making their decisions. Are you worried at all about any kind of fractured authority here on vaccines will replicate some of problems we’ve had with testing when it came to equitable allocation standards statewide [inaudible 00:39:24]?

Yeah. Forgive me and forgive all of us with this new technology and you were breaking up a little bit. And Dr. Ghaly, hopefully you heard a little bit more about that. But I believe that the question was around localism and making sure that we’re monitoring in terms of the safety … not just safety, but the directives that our guidelines working group has put out in terms of our expectation, in terms of the prioritization of subpopulations. And holding folks accountable, providers in our network, of health professionals accountable to making sure that these priorities are being met and those that are being directed from the State.

Dr. Ghaly, that is indeed the case. Maybe you heard more clearly the question? Perhaps you can talk a little bit more, because we’ve exchanged some memos around the issue of enforcing those rules and regulations. Including, dare I say, making sure that doctors are living up to the Hippocratic Oath as it relates to making sure no one’s cutting in the line, particularly well-known individuals or well-resourced individuals in the state as well. Doctor?

Dr. Ghaly: (40:30)
Yes. Governor and just to underscore the fundamental platform that California’s vaccine distribution plan is based on is, prioritization based on risk factors and making sure that it’s an equitable distribution across the state. As you know, our priority group 1A, which we are actively working, all of the doses that the Governor’s mentioning of both Pfizer and Moderna are tracking to be given, provided to, that priority group 1A.

Dr. Ghaly: (41:05)
That includes our frontline healthcare workers and our residents of long-term care facilities. We do, I’ll remind you, that in priority group 1A, we have three tiers. Those tiers are in order, tier one, two and three. And certain healthcare professionals who are on the front lines are in tier one and others are in tier three.

Dr. Ghaly: (41:28)
We expect and are watching closely that our counties and those who are receiving the vaccine stick by those priority groups and that tiering system. It’s all there to make sure that based on risk and prioritization that people do get the vaccine in the order that this state and all of these different groups coming together, have decided makes sense in California.

Dr. Ghaly: (41:56)
We are working to make sure that we’re able to track this part of the effort on understanding not just how many doses are being administered, but where those doses are being administered and tracking that through our various IT systems as part of our strategy. But then also working with the various bodies that work to enforce clinical practice, individual practice, making sure that we are watching closely so that if there are any flagrant ignoring our prioritization, that we can act swiftly. So that those who should be receiving the vaccine now are able to, that the supply is sufficient based on our plans and that those who are just eager to get it and look to either innocently or not so innocently cut a line, that we’re able to monitor that and make some enforcement actions.

Dr. Ghaly: (42:53)
We as the State are working on what those look like, talking through with not just our local county partners, but also the various groups that ensure that whether it’s physicians or hospitals or other clinical settings that are up first to distribute, that we’re able to communicate with them very clearly on not just these prioritizations, but how we expect to monitor and watch that they are indeed adhere to. If there are cases where we are worried about that, somebody is doing this out of order, that we will reach out to those community and county partners that have agreed to follow this prioritization and if follow-up action is necessarily, we will take it swiftly.

I should just note, we have a well established IT backbone [inaudible 00:43:52] system that comes, not surprisingly [inaudible 00:43:58] some time related to the 19 million flu vaccines that we distribute on an annual basis. And that’s typically done over 60, 90, maybe 100 day period each and every year in a concentrated and focused way. So we are able to monitor in a very formal way.

Here’s something that I just in the purposes of maybe over answering the question in the legitimate query. It’s important to note that we have our populations of priority, Plan 1A. And as Dr. Ghaly said, we talk about those three tiers. And within those tiers, there are subpopulations. But when it gets to… For example, I was at UC Davis, when it gets literally to the hospital site, there is some autonomy at that level.

And that autonomy would include, as a specific example, if you’re going to take care of the ICU staff, that staff would include environmental service workers, it would include their support staff, their direct contact staff. Now that may not be obvious when you’re looking at the tiers that a janitor or someone that’s essential to the operations of an ICU is also part of that priority. So we have some flexibility there allowing folks that autonomy to make judgment calls. So we’re not prescribing in total nuanced terms, but we are in terms of broad, equitable, equity terms and terms that are well described by our guidelines working group.

Moderator: (45:33)
Stephanie [inaudible 00:45:34] AP.

Speaker 2: (45:35)
Hi governor, this is a multi-part question, so just bear with me. The growth model that you referenced last week now is protecting 99,000 hospitalizations by mid January, which is nearly six times the current level. Do you think that’s a real possibility? And how can the State system support that many patients? And then beyond that, is the State going to establish protocols for rationing of care, or will that happen county by county, and you think we’re close to instituting such drastic measures?

I appreciate the questions and I can assure you we’ve been answering those questions including over the weekend. And I should note, one of the things that was missing from the federal requests slide that I put up was a request for another field medical station, a full medical station that is inclusive of staff as well. So look, we are anticipating a substantial increase in the hospital surge. You’re correct. Some of the modeling suggests in that 90 plus thousand range. We are working with the hospitals, the hospital system, working with their representatives on a very granular level, not just at the State level. And we are looking to support the staffing in these alternative care sites and looking to potentially stand up more alternative care sites up and down the state. But let me turn this over now to Dr. Ghaly, can talk more specifically about when we do anticipate not just the ICU going into the surge, which as you know, two of our counties already have… Or regions that is. But now hospitals moving into their surge plans and their surge capacity.

Dr. Ghaly: (47:21)
Yeah. Governor and thank you for the question. Indeed, this has been certainly part of the reason even before we see the hospitals have such an extreme number of patients, that we’ve been signaling to all of you really working, not just with our County leaders, but the individual hospitals on what we see coming based on our projections.

Dr. Ghaly: (47:46)
Simply put and to remind people, we believe that 12% of today’s cases will be hospitalized 12 days from now. And then 12% of those hospitalized patients will be admitted to the ICU for critical care needs. And with that in mind, looking at the cases day over day, and the trajection that we are on, we are worried that certain regions do exceed their existing capacity and even may go beyond the existing surge capacity that they currently have planned.

Dr. Ghaly: (48:25)
That is why, in part, we work closely with those hospitals to talk about not just the theoretical, but boots on the ground, what’s actually happening. Meetings frequently throughout the day to make sure that we’re able to do as much as we can to support each facility as we sort of day over day, increase that need for that level of care.

Dr. Ghaly: (48:50)
It is true that some counties or some regions may begin to exceed their existing stated hospital capacity, not just ICU capacity, by the end of the month and early in January. We don’t see that across the entire state quite at that time, but we’re watching it very closely. Remember we have a well exercised mutual aid system between counties, between regions that we will always invoke and work to make sure people who are in one facility or one part of the state and they’re not able to get the level of care that we need them to get in a timely way, that we work across the entirety of California’s health care system. And we will continue to do that.

Dr. Ghaly: (49:37)
With regards to your question about care-rationing. California, from the beginning of this pandemic, worked with stakeholders not just in the healthcare delivery system but throughout with groups of advocates for seniors, those with disabilities, a number of different groups across the state to create what we call our Crisis Standards of Care Guidelines.

Dr. Ghaly: (50:03)
These are guidelines that are posted on the CDPH website that explain exactly the process by which facilities, happens locally at the hospital level, happens regionally between healthcare delivery systems in a certain geography and every hospital should be prepared. I know some have, in an abundance of caution and to be well-prepared, begun to have conversations about how they stand up their crisis care teams, those who are in a hospital that are able to help support the bedside clinical team to make what are challenging decisions.

Dr. Ghaly: (50:48)
But we continue to build up our capacity so that even though hospital systems may be preparing along those lines, that we do everything we can to make sure Californians receive the care that they want. So our goal is to make sure those plans are in place, but work hard to make sure no one has to put them into place anywhere in California.

And I should just note on the Crisis Standards of Care, that was a process that unfolded over at the beginning of this pandemic and anticipation of a moment like this. So we worked through, there were some bumps in the road in terms of just people’s reaction when the draft was originally submitted. We listened to those concerns, we incorporated and amended those standards. And we now have them distributed.

That said, the last many, many months have been preparing for a significant surge as it relates to looking at footprints and existing hospital sites, looking at the capacity to expand those existing footprints. Not just alternative care sites, but looking at expanding the healthcare delivery system within the system itself. Clearly that’s already taking shape and place in many parts of the state.

But I remind you the issue at hand for us, the primary issue today and likely for the upcoming future, at least in the immediate future, I should say, is staffing. And that’s why we’re being particularly aggressive in terms of the federal asks, aggressive in terms of our promotion of the Health Corps Program. And I’ll remind folks that know someone or maybe they themselves have recently retired or have a particular expertise they can offer to go to the COVID-19.ca.gov website to learn about whether or not they are needed to help support fellow Californians at this remarkable time of need. That program has been effective. We just need to scale it back up and we need to remind people of its purpose and its potency.

Final point, because it’s relevant. And it’s a question I’ve received often, and that is, “Are we pursuing the USNS Mercy again?” As you recall, we were the beneficiary of one of the large medical ships, East coast and West coast. Currently we are not. What we however are looking for is personnel folks that are those that often are deployed on the USNS would be identified as a top priority staffing our need. Not the physical structure, yet as it relates to our immediate needs.

Moderator: (53:37)
Dustin Gardiner SF Chronicle.

Dustin Gardiner: (53:42)
Thank you, Governor. With respect to the regions at 0% ICU capacity are those regions still transferring patients to other areas of the state that have more capacity. We’ve heard from some Bay Area counties that they are no longer accepting transfers because they’re concerned they might need their beds for their own counties. What can you provide on that update?

No, it’s a great question. Of course, we’ve seen that in the past. You saw from Imperial folks coming up to the Bay Area to decompress that system a number of months back. But as it relates to how we’ve organized these broader regions, we’ve done so intentionally. And with that, let me ask the person that architected that strategy to answer the question with more nuance and specificity Doctor?

Dr. Ghaly: (54:28)
Yes. We continue to work to ensure that patients who do need to be transferred… We do our best to make sure that those transfers happen in a timely way. As the Governor appropriately pointed out, the number one strategy is to work to increase the staff, the supplies and the space in the existing hospitals where patients are now. Because we know that over time as not just one or two areas of the state get deeply impacted with COVID those regions see their own ICU capacity go down quite a bit, that we will not be able to as easily move patients from one region to another.

Dr. Ghaly: (55:11)
You’ll recall, as the governor reminded us that in the summer we did move patients from Imperial County throughout the state. Today, that is more challenging because those hospitals that had room to accept those patients from Imperial, today have their own surge challenges.

Dr. Ghaly: (55:31)
So again, number one strategy is to support hospitals where the patients are today to make sure either through expansions on the hospital footprints themselves, or through alternative care sites, or transferring not across the entire state but maybe to nearby counties where they have some of those alternative care sites set up as well. So we are seeking to do that. Even if a county said one day that they’re not able to take a transfer, we constantly check in because we try, as every hospital does, every county does, every region does, to make sure we do all we can for every single patient within the state.

Dr. Ghaly: (56:15)
And I would be negligent to not point out that in the prior question, when we looked forward to the forecasts of quite a few patients in our hospitals down the road in January, towards the end of January, that we should remind you that that is not a story that is already written. Some of it is, some of it is about cases that have already happened. But our actions today can make a difference on what happens down the road. Every bit of our ability to not mix, keep our face covering on, reduce the likelihood that we either transmit COVID, or ourselves are infected by someone else transmitting it to us. That becomes a victory for the state. That becomes a role in protecting our healthcare delivery-

Dr. Ghaly: (57:03)
That becomes a role in protecting our healthcare delivery system, so that the points we’re talking about today, whether it’s about transferring patients across the state or moving into crisis care standards, that all of those things can be avoided, if we together, work to follow those simple acts and do what we can. Especially, as we enter into the next couple of weeks with important holidays for our state and nation, that we can still make a contribution, a gift if you will, to the entire state, by avoiding mixing and avoiding extra transmission, that does protect our hospital systems.

I appreciate Dr. Ghaly reminding all of us that we have agency, that we’re not victims of fate. I say this often, and I’ll repeat it. The future is not just something to experience, something to manifest. Decisions, at the end of the day, our decisions, individual decisions, the sum total of the collective decision-making of 40 million Californians strong, will determine that fate and future. It is really important to take heed this moment we’re in. In so many ways reflective of the surge that we’re experiencing coming from that Thanksgiving holiday. Now, as we move into this week and Christmas and New Year’s, it is incumbent upon all of us to just consider in contemporary terms, they experience that we are reflecting today and how that experience was manifested a few weeks back by decisions where we were seeing activity and movement, that ultimately inured, to putting this kind of pressure on ICUs and hospitals.

We can avoid that in the next week, the next days. We could substantially impact those projections, bend that curve and work quickly, get this third wave behind us and get out of this in some, in a way that I think this state is uniquely capable of.

Speaker 3: (59:04)
Ryan Carter, LA Daily News.

Ryan Carter: (59:08)
Thank you. Thank you, Governor and Dr. Ghaly for the update today. Maybe a slight tangent here from such a sobering … I’m calling from inured where obviously, The Rose Bowl, obviously a huge deal. Can you elaborate a bit more on the state’s position, as it relates to the 2021 Rose Bowl Game? Perhaps, talking a bit on why it was important to push back against these efforts to make an exemption for player guests and perhaps elaborating a bit on just your general reaction to the game relocating to Texas this year or next year?

We love the Rose Bowl. It’s part of … I don’t know how best to describe it. As a fifth-generation Californian, I feel like there was a gold rush and there was a Rose Bowl. It’s been a big part of our lives, the Rose Bowl parade, the game itself. I’m an avid sports fan, so I am eager to watch the Rose Bowl. That said, look, I think the question in so many respects, and I appreciate the tone and tenor the way you even asked it answers itself, right? I mean, when you’re in Southern California, you’re 0% ICU capacity. We can’t make exceptions. We have to be stringent in terms of our rules and our regulations. We’ve got to do everything in our power to mitigate spread and to mitigate mixing. What they asked for was contrary to that determination into our medium and long-term goals.

Gavin Newsom: (01:00:44)
Obviously, I’m disappointed. We’re disappointed that we had to make that call, but boy, hear me loudly. Our reverence, our respect, our admiration, our pride that comes from the Rose Bowl, and obviously the impact that’s had on Pasadena and the entire region, the international identity that we receive, every year from it, economic vibrancy that comes out of it, the brand, I mean everything about it. Just know that. None of this is what we want to do. It’s what we have to do in order to mitigate the spread and be responsible at this moment, at peril of regretting the decision and putting people’s lives, 233 people dying on average every single day, putting people’s lives at risk.

Speaker 3: (01:01:41)
John Myers, LA Times.

John Myers: (01:01:45)
Thank you, Governor. You earlier in this event, hinted that the stay at home orders will probably be extended beyond the current time in the various regions. How’s that going to roll out in terms of how people are going to know when that happened and how [inaudible 01:02:03]related that is. That may be something you want Dr. Ghaly to talk about and then quickly, just because you referenced it at the top, but I don’t think the rest of the public understands you are in quarantine right now. Can you talk about what exposure you have to staff and the rules that you have around staff? Do they all wear masks around you and what that procedure is, given that you are back in quarantine.

Everybody wears masks. We have very strict guidelines, rules, procedures, temperature checks. People are being tested all the time. Most folks are teleworking. This seems deeply anomalous, just shows the virulence of this disease, how easily transmittable this disease is. Very few people in the staff environment, we were, the only contact we’ve had was in preparation for some of the events that we’re doing right now, in terms of just trying to communicate with you, trying to be accessible to you, trying to be transparent to you. In some cases, there are a few extra people in the room, but everybody wearing masks up until literally, when you see us take them off to communicate with you and others. It’s unfortunate and we wish speedy recovery for the individual that tested positive, that was proximate to me a number of days ago.

I think it was on Friday, to be exact. I was tested yesterday, tested negative, but you got to walk your talk in terms of protocols that we put out, established, as it relates to quarantine, which we did, and that 14-day quarantine, a few weeks back. Now, with the 10.day quarantine look, as it relates to the issue of next statements, rather when we will be making announcements based upon trends, based upon these guidances that we put out, that expire on the 28th of this month and the 30th of this month. I appreciate John, you were referencing Dr. Ghaly in the context of being able to more specifically answer that, and I’ll turn it over to Dr. Ghaly, who will do just that in a moment.

Dr. Ghaly: (01:04:03)
Yeah. John, thanks for the question. Indeed, we are preparing over this week, to really roll out exactly how those determinations will happen. We expect to run this, whether it’s at the end of this upcoming weekend or early next week, indeed for that first region, so that we can anticipate, and I’ll remind you what we said. We’ll be looking at ICU capacity projections four weeks after we have the first day, when that regional stay at home order could be lifted. If you’re looking at the 28th of December, you’re looking somewhere around what our ICU projections are about the 25th of January. We have tools, as we have in so many areas to make these projections. What will we be looking at? We’ll be looking at current ICU capacity. We’ll be looking at the number of new cases on average, over a seven-day period. We’ll be looking at that transmission rate factor, not just what the transmission rate is, but how fast is it either accelerating or decelerating?

Dr. Ghaly: (01:05:15)
Those different aspects will come together to help us make that projection. It’s not just, well, what is my ICU number in my region today? It’s actually a lot about the various individual decisions and behaviors that have manifested in the case number, and that R-affected value, that some of you’ve been tracking with us since the beginning. We’ll be looking at all of that, bringing it together, socializing it with many, so that they can track it on a very regular basis, starting early next week, sharing that about the San Joaquin Valley, and then quickly after that, the Southern California region. As the Governor said, given where we are today, and we of course, only will reveal this when we are done with the calculations at the time that they need to be done. But at the moment, our projections don’t show that any of the regions that could first exit the regional stay-at-home order will likely do that. But as they say, we will only make that call when we actually do the calculations when the time is right.

Speaker 3: (01:06:29)
Final question, Brittany Johnson, KCRA.

Brittany Johnson: (01:06:35)
Thank you for the question. Two questions here. One, Governor, what would be your takeaway to businesses and everyone now that you’ve been quarantined twice within a month and never change your outlook on any future decisions surrounding COVID? The second question here, are quarantining with your family or are you separate from your family? How is this going to affect your holiday? Are you guys going to have to stay in California? Are you going on vacation to quarantine?

No, Yeah. No vacations. That ended in mid-February? No weekends either, but that’s an aside. No, I’m separate from the family. We have a separate little small room that they put me in. I’ll be here for the next number of days, and hopefully will keep getting tested negative, and that should calm the nerves of my wife and my four kids. But, we hope to be doing our best, like everybody else to safely stay at home and enjoy what we can have of the holidays. I’ll be working, but my family will try to create conditions where this can be as normal as it possibly can for your family, for my family, for all our families. Look, these quarantines aren’t easy on anybody, and we’re mindful of that.

That’s why we did a lot of things over the course last number of months on providing people presumption so that they’re eligible for resources, if indeed, they have come into contact with someone that tested positive, they can do so safely and can afford to do so as well. That They have economic supports and they have the ability to be isolated and get the opportunity to be separated for a period of time, if they must from their family and have the resource. There’ve been a lot of tenets of support in that space, but I cannot impress upon you more, the importance of doing a lot more in scaling those efforts. That’s why I was very encouraged to see what is coming from the new stimulus and while it’s a lower number than we had hoped for, it is nonetheless significant. Let me just say this because I didn’t say this. Thank you, Nancy Pelosi. Thank you, Speaker Pelosi for not taking, not only your eye off the ball, but not taking foot off the pedal in terms of accelerating a responsible conclusion to these very, very exhausting negotiations, of course, of many, many months.

I just don’t want to make the case, not just for what was accomplished, but for what she in particular accomplished with this new stimulus and how impactful it’s going to be to people directly all up and down the state. Let me just close by reminding people that what comes from the federal government does not end the story. It’s the beginning of the support, including the small-business supports and the medium size business supports, rental assistance, eviction assistance, all of that, which we are responsible for as well as a nation state, at least a state as large as ours. You’ll be hearing a lot more about that in the coming week., We have outstanding legislative leadership that is very focused on this, very committed to this.

We are working overtime to see if we can advance some early decisions and make some pointed movement, so we’re not waiting months and months and months, for the traditional legislative cycle, meaning we have to take some early action. Long-winded way of saying some early action on all of these fronts. We’ll update you in the next hours and days on issues related to the UK. We’ll continue to update you on vaccination plans. We’ll update you as well, on any news we hear from the federal government, in terms of additional supportive staff from the Department of Defense, from HHS. I want to thank HSS for providing additional supports for the monoclonal trials and the infusions, which we’ll be doing very shortly when those resources arrive. I want to thank the team at Department of Public Health and all of those in the Scientific Safety Review Committee, the Vaccine Distribution Planning and work groups for their diligence. I encourage people to tune in on the 23rd, in a couple of days, to see where that progress is on the plan, 1B.

I thank again, all of those that were responsible for Operation Warp Speed. I just, it’s just wrong that we don’t say this enough. It’s an extraordinary accomplishment that we’re even in this position, to have the ability to get doses of vaccines in people’s arms. I cannot impress upon people enough, our gratitude, my gratitude, on behalf of the State, for the millions of people that will benefit because of the urgency and the deliberative speed that was advanced, that has been advanced through Operation Warp Speed. With that, look forward to updating you tomorrow, updating you Wednesday, and hopefully doing the same. I may spare you on Christmas Friday, as well. Take care, everybody.

California Gov. Gavin Newsom COVID-19 Press Conference Transcript December 21

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