California Governor Gavin Newsom July 8 Press Conference Transcript

Gov. Gavin Newsom: (02:28) Good afternoon. Today I wanted to take the opportunity to update you on our preparedness plans in the State of California. With the Coronavirus case numbers increasing, with positivity rates increasing in the state, with hospitalization rates and ICU rates increasing in the state of California, I thought it was an opportunity to once again share with you our preparedness plans in this state. Update you on where we've been over the course of the last number of months, where we began and what we're prepared to do to meet the increased number of cases that we are experiencing currently here in the State of California. As many of you recall, when we launched the nation's first stay at home order on March 19th, its purpose was foundational, was to save lives and to better prepare our healthcare delivery system for an inevitable increase in capacity needs. Gov. Gavin Newsom: (03:25) And that increase was not only increase in terms of place, meaning identifying the opportunity to provide conditions where we can find physical assets for individuals' space, but also the appropriate number of people to help support individuals and needs, and of course the appropriate novel personal protective equipment that is foundational and essential to safely providing that care. So as we move forward, on March 19th of this year, we with intention began a process anew to identify those foundational components so that we can meet the needs of those that need to access hospital care and receive high quality care in the State of California. And to look to utilize our existing hospital footprint, the capacity that exists within a hospital setting and within the larger hospital campus setting to build capacity. In addition to that of course, we looked to identify alternative care sites all throughout the State of California. You may recall a few months back, we talked about FMS. These were the federal medical stations that we were able to get from the federal government. We identified locations throughout the State of California to pre-position those FMS sites that provide capacity up to 250 beds to meet the medical needs of the system, to help decompress the hospital system, to provide alternative care sites to meet the needs of patients that either were presymptomatic, asymptomatic or in some instances were not in need of acute care but need of intense medical care that may have been exposed to COVID-19. We identified additional sites throughout the state, including old mothball hospitals, Seton being an example in Northern California. We had identified early on St. Vincent down in LA County. We procured sites that are still under contract in Fairview and Porterville, different parts of the state up here in Sacramento, the old Sleep Train Arena, where now the Sacramento Kings used to play. Gov. Gavin Newsom: (05:42) Those sites, many of those sites still available to us in what we call warm status, all part and parcel of a larger portfolio to meet the needs as we see an increase in the spread and transmission of COVID-19. Speaking of spread, this slide gives you a sense of what our existing hospital footprint looks like in the State of California. We have 416 hospitals in this state, but one thing you'll see from the slide is they're not equally distributed in various parts of the state. Let me give you a specific example. You have roughly plus or minus a few thousand, but roughly 21,000 plus licensed hospital beds in LA as an example. In Sutter County, you have just 14. So depending on where you live, the assets that are available to you are quite distinctive. And you could imagine where you have an increase of just a few patients in your ICUs in Sutter, that can represent a huge percentage of your total capacity. So, so often I make this point in presentations like this, I give you information in the aggregate, but remind you that none of us live in the aggregate. Gov. Gavin Newsom: (06:58) We live in cities and counties throughout the State of California populated with different density in terms of total number of people, but also different density of assets. And so over the course of the last number of months, we've been looking to procure strategies in a very strategic and mindful way of where those deserts of support work, from testing, to tracing and tracking, to addressing the acute care needs as well as meeting the needs more broadly, of communities throughout this remarkably diverse, the nation's largest and most populous state. Gov. Gavin Newsom: (07:34) We had a plan when we started in March that had a surge capacity within our hospital system of roughly 20% of that current capacity that we often identify and I'll give you those numbers in a minute. And those were around the 75,000 hospital capacity number that so often I promoted as a baseline of existing capacity. It's a little less today and we'll get to that in a moment. We had no established alternative care sites, meaning we didn't have the FMS identified, we didn't have these alternative leases and sites already procured and established. We were just in the process in March of identifying if Seton would be interested in engaging a contract with the state, working with the legislature to procure resources beyond just emergency resources, to establish a longer term framework of support. We did not have pre-positioned medical assets of any type and including PPE which I'll get to as well in a subsequent slide. Gov. Gavin Newsom: (08:34) Today in July fast forward, we now have capacity to treat 50,000 COVID-19 patients, well beyond that surge capacity at 20%. We have as I said, built out these alternative care sites, the physical sites, we have secured hospitals like Seton and we have pre-positioned a lot of these medical assets. So it's FMS sites throughout the State of California in areas that were vulnerable to surges and spikes in COVID-19. We also focus not just on the physical, as I said it's place, space, people. This slide represents people. We started something called California Health Corps. It exceeded all expectations. We quite literally had no expectation that if more than a few thousand people may avail themselves with a valid license and provide information about their professional capacity to sort of meet needs based upon a matching criteria and protocol that began to take shape in terms of needs for LVNs and RNs and respiratory specialists and the like over the course of the last number of months. We've been re scrubbing that site, over 96,000 people went to that site, filled out the initial application, but about 35,000 of those applications have valid licenses for professional needs. Gov. Gavin Newsom: (10:03) It's important to note, we haven't updated this in some time. We have been able already to deploy. We haven't needed all these books. We've just identified these folks but we did find the need for 741 professionals that helped us with some of our skilled nursing facilities, our adult daycare facilities. They're actually helping us currently with our corrections facilities and providing staffing and expertise and as well, providing alternative care facility personnel support. So that system, the development of this site, California Health Corps site, which by the way if you are a professional, you may have retired recently, you may be interested in being supportive as we've seen these numbers increase. I'd encourage you to go to the covid19.ca.gov website to fill out an application as well. Again, we don't want everybody concentrated filling out applications just in one part of the state. Gov. Gavin Newsom: (10:59) It's really about matching need in different parts of the state based upon different professions within the healthcare system. And so you may have a unique experience, unique perspective, a unique license in part of the state that's significantly underserved. You're exactly the kind of person, we would encourage you to go to that site, fill out the application, provide your license information and we'll make sure over the course of the next number of days and weeks to get back and contact you. That staffing capacity was one part of it. And again, procuring sites, places, beds to put people, staff, those beds was important, but inventory was important, PPE, something that we're all familiar with and needs to do more on getting surgical masks and procedure masks and gloves and gowns and face shields and coveralls in many different areas of need within PPE. The most important though being those masks that we needed. And just look at this slide, you'll see in March of this year when we began we had roughly one million masks in inventory. Wholly inadequate in March to meet the needs of this pandemic. Gov. Gavin Newsom: (12:13) We were fortunate and I've acknowledged this on multiple occasions and I want to just do it again. Governor Schwarzenegger had years prior procured a large cache of N95 masks. Many of them had expired but we worked with the FDA and others, CDC to be able to utilize a lot of those masks so we were fortunate to have 21 million N95 masks. I don't know another state was benefited from that kind of supply. Gov. Gavin Newsom: (12:43) But as we quickly learned, 21 million masks may sound like a lot, but it turned out to be a very modest number. And as a consequence, we had a huge backlog and a need to go bold and to go big in terms of procurement. And it's exactly what we did. It's what we said we were going to do and we're able to deliver. Just one contract, we were able to bring down 189 million new procedure masks, 72 million N95 masks just from one contract that got a lot of attention and I don't think enough attention got to the fact that we were able to deliver on the commitments we made over a two month period to draw down those masks. As a consequence of that, you'll see on this slide, we've been able to, with that contract and others, we were able to put together, distribute 200 additional million procedure mass beyond what we had in inventory. You see that slide 201 million procedure masks we've distributed just in the last four months. 79 million N95 masks we were able to distribute. Gov. Gavin Newsom: (13:48) So today rather than being in a position where we were, one million procedure masks and just 21 million N95 masks, today we have in inventory as of this morning, 232 million additional procedure masks beyond what we've already distributed, the center slide there and 46 million N95 masks. We're still in the process of procuring more masks but we've never been better positioned, so much so, full disclosure that we've been able to distribute masks to four other states to help with their needs. And that's something in partnership with FEMA who has been just extraordinary in helping us with this procurement, is something that we designed with our original contracts, that we would have the kind of agreement once we hit a certain threshold and we're able to make the distributions that we've made, that we can help support other states. They're reimbursing us a hundred percent of those costs but again, we only distribute those when we can meet the needs within state. We recognize that we still have a lot more work to do beyond just the N95 masks and procedure masks. Gov. Gavin Newsom: (14:58) None of us are naive about that and we are sending out millions of masks every single week and I recognize there are still parts of the state that are deserving and in need of additional PPE and we recognize the urgency in terms of the distribution of the same. But I am very pleased with the urgency that has been demonstrable in the development of our protocols, our procedures, and our plans with our partnership that we've created with California Hospital Association in particular. We've had incredible support from the California nurses and other labor organizations like SEIU. I just want to compliment them on their heroic efforts and maintaining their status as our frontline heroes in this pandemic. And let us not forget the nurses and others that are on the front lines every single day. I'm putting up numbers. They're the human face of this pandemic doing everything they can to meet the needs of those that are coming into the hospitals, now at record numbers and meeting the needs of patients that are coming in with symptoms, even some presymptomatic and asymptomatic that have to have their needs met. Gov. Gavin Newsom: (16:13) But the hospital system had a lot of work to do. And that work was led by outstanding leader that is here, the Head of the California Hospital Association, to talk about exactly what the system, the surge capacity looks like and how we've been able to develop an essence of a mutual aid system of sorts, which will explain some of what you've been perhaps reading about. why folks in Imperial County, where we've had to decompress our system by over 500 patients. Why we have protocols and processes of where to send those patients when we move them out of county, that we know that we have agreements in for example, San Diego County, in LA County, including here in Northern California where a few of the patients went up to- Gov. Gavin Newsom: (17:03) Northern California, where a few of the patients went up to UCSF in San Francisco and other parts of the state. So it's a remarkably dynamic system and no person better able to explain that system than the head of that system, Carmela Coyle who's here. And I'm very grateful again for her partnership, her seriousness of purpose, her leadership. And, I just can't thank her enough more publicly than I have in the past, but I need to repeat it yet again, because we're all being put to the test, particularly our hospital system at this moment. And so I want to give her the privilege of this opportunity to engage with all of you and explain a little bit more comprehensively what that surge plan looks like. And while they feel some confidence in the immediate term, in terms of our ability to meet the needs of patients that are coming into our hospital system, Carmela? Carmela Coyle: (17:59) Thank you very much, governor, and it is a pleasure to join you today to talk about our surge capacity and our readiness here in the state of California. California's hospitals have been and continue to be ready to deal with the COVID crisis that we have all been working with for the last four months. And we continue to be ready to care for all Californians. And that is for good reason. The governor has been briefing everybody on a daily basis about the numbers. We do have an increase in the number of COVID positive individuals in the state of California and for us in the healthcare delivery system, that translates into more people who are in need of hospital care and more people who are in need of intensive care as well. So we have seen about a 49% increase in the number of people needing hospital care in just the last two weeks about a 38% increase in those in need of ICU care. Carmela Coyle: (19:00) So California's hospitals are really doing three things right now. It's all about planning and preparing and partnering. First of all, in the planning hospitals have on an ongoing basis, an emergency operations plan, that plan and teams that are dedicated within each and every one of those 416 hospitals to being ready and prepared for any kind of emergency. We have learned quite a bit in the last four months. So we are adjusting those plans to take into account how we have prepared, how we have to prepare differently. As we're seeing numbers begin to climb again. In terms of preparing and being ready really logistically, the governor has just talked about a number of things. Hospitals are being prepared and logistically prepared as well. We are building up our inventory, whether that is of personal protective equipment masks and gowns and others. Attempting to build up our capabilities and our inventory of testing supplies. Carmela Coyle: (20:02) We are working to be prepared to make certain that we're cross training staff. So nurses who may typically serve at a bedside in a medical or surgical unit, how can we train them up in case we need them in an intensive care unit. So many things going on right now in terms of being prepared, including looking at every nook and cranny within California's hospitals, to see if there is more space we can dedicate to caring for COVID positive individuals. And finally partnering the governor just mentioned the important partners we have in our nurses and in our doctors, we cannot do it without those frontline caregivers. That partnership has to be solid and we continue to work to make that happen. Hospitals are also partnering together so that we can balance the load of COVID positive patients as we're doing right now in Imperial County, also in the Bay area, as we are dealing with outbreaks there in the prison system. Carmela Coyle: (21:02) If hospitals work as teams, we can move patients and ensure that they are transported to the right place where we've got that additional capacity. We can work as a team. We're partnering with our counties and our local health officials, because we've got to be able to do that regionally as well. And of course, our partnership with the state and that is in terms of the stockpiles of masks and other kinds of equipment that's out there and available and needed. As we take a look at being ready for even higher numbers. So, we're preparing to surge, we're going to surge differently this time. We have learned a lot in the last four months. We know that we have different tools available to care for COVID positive patients. We've got therapeutics like Remdesivir, and others that are actually shortening the stay of those patients. We are putting fewer of those patients on ventilators. Carmela Coyle: (21:58) Our doctors, our nurses have learned quite a bit in the last four months about how to care for COVID positive patients and all of that, working as a team rowing in the same direction means that we can do that even more efficiently and create even more capacity in the system to care for more COVID positive patients. So, the surge is about finding a balance between caring for COVID positive patients and continuing to care for everyone in the state of California. And so the last point, and it's the point you've been hearing. Carmela Coyle: (22:31) But I really want to thank each and every one of you, the best way that we can expand and have as much capacity as we need to treat COVID positive and co-patients with COVID-19 disease is to make certain that we're stopping the spread of the infection in the first place. And that is all about masks, and social distancing, and hand hygiene. Every time you do that in your home, in your neighborhood and in your community, you are helping a nurse, you're helping a doctor, you're helping a hospital and you're saving a life. So thank you for your continued focus on those practices, help us expand the capacity that we have to care for those in need. Thank you. Gov. Gavin Newsom: (23:20) Thank you. And as you can see, we have an outstanding partner and developed incredible partnerships at a regional level local level, but statewide. And the partnership is a dynamic and it's demonstrable, not only in terms of the planning documents, but the actualization of our efforts that have been tested in certain parts of the state over the course of the last number of weeks. I want to just note, in addition to what we have, as it relates to our hospital capacity. I mentioned these alternative care sites. We were fortunate, I had a conversation with the vice president just a few days ago, to be able to draw down even more support than we had in the past for these field medical teams, we're going to get 190 individuals that are coming from HHS from our federal partners to come in and help to relieve some of the stress for some of our caregivers and Carmela was saying, appropriately, not just the nurses, but also our doctors. Gov. Gavin Newsom: (24:19) I want to acknowledge by the way, the California Medical Association, they had sent doctors, they had sent a team of folks to New York during the peak of the pandemic and the challenges they were experience, and not only to provide support and assistance, but they also got valuable experience that we're able to take back from that time in the state, and being able to share that information with other caregivers and providers, all of these are reasons in addition to what you just heard as it relates to therapeutics that are coming in, Remdesivir, in the fact that we got received our first inventory of Remdesivir, one of the more promising therapeutics, but also began the process of distributing that to our local providers. All of these, again, are additional points that allow us more confidence in our capacity to meet need and to address our surge. Gov. Gavin Newsom: (25:08) So 1,929 warm beds, only a handful of those beds are currently being utilized in our alternative care sites, distributed throughout the state of California. And we'll continue to keep those within a 72 hour prism of being made operational, which is a guideline for what it's worth, we have established to allow us to move. If indeed, we see some additional stresses outside of our surge plans, and our capacity that we have built within our hospital system. Again, we're doing this because we're seeing hospitalization rates grow as, well, I just said it's because people are not wearing their masks. People are not for many different reasons, and many different circumstances practicing the physical distancing that they should. And they must in order to mitigate the spread of this virus, we're seeing increased mixing within households. We've said that on many different occasions, you're hearing that at the local level, you're hearing that across this country as well, governors in other states making the same point, so often is the case, you have members, your extended family of neighbors from outside your household. Gov. Gavin Newsom: (26:18) We take our guard down a little bit and we're seeing at least based upon the feedback we're getting from our county health experts that is one dominant area of concern. Obviously a consistent area of concern from day one, outside our skilled nursing facilities, our veterans facilities, and our congregate homeless facilities is around our jail system and our state system. So prisons, and jails, we are monitoring. Good news is we saw a modest about 400 less identified positive COVID positive patients in our CDCR state federal system than we had even on Monday. But there are parts of the system, San Quentin, substantively, but still others in Chino that we are monitoring up in, up in Lassen County, and some others that we are monitoring where we're seeing intense outbreaks, and obviously that's impacting some of the hospitalization rates in those communities and around those communities. Gov. Gavin Newsom: (27:18) And as always, and I neglected this, there was, I thought a wonderful question was asked of me on Monday about why we're seeing an increase in hospitalizations. I talked about the young, and the invincibles, and you are seeing this across the United States, younger people that just feel like they are invincible, and that they're not going to, even if they get COVID-19 that the symptoms will be so modest that it won't typically impact them. Well, we're seeing the hospitalization rates that we're seeing some younger patients, but we're also mindful that it's not just the young invincibles, it's not just those that are increasing mixing outside of households. And those that are not practicing physical distancing as they should wearing masks as they must, but we're also seeing our essential workforce. And I just want to acknowledge that there's a little bit of mythology about reopening the economy. Gov. Gavin Newsom: (28:10) It's important to note 60 plus percent of the economy never shut down in California. So we talked about the stay at home order on March 19th, 60 plus percent of the economy was still fully operational, at least operationalized in a modified sense, meaning was moving forward. And a lot of those essential workers put their lives, their health, quite literally on the line. These are the food workers, these are farm workers. These are the folks in the grocery stores, and others. And a lot of these are young, tend to be some cases, younger individuals, a lot of them that truly represent the diversity in the state of California that became very vulnerable to the spread of this virus and continue to be vulnerable to the spread of this virus. So I just want to acknowledge that essential workforce overrepresented in the black and brown community for being there when we needed them the most. Gov. Gavin Newsom: (29:05) And it's incumbent upon us as we meet the needs of this surge and the broader community in the state, and our nation, the world, we're trying to collectively build that we are mindful of these essential workers and have their best interests at heart as we move forward. As we do move forward, and we've said the hospitalizations are increasing. You heard a statistic that represented from yesterday. Interestingly, the new number we just got in a few hours ago, which Carmela didn't even have the privilege of having, which we're just putting out publicly shows a 44% increase in hospitalizations over the last two week period. So you're seeing the total number of hospitalized increasing to 6,100, again, that represents a 44% increase over a two week period, total capacity, and this is a side, you become familiar with our system still around 8% COVID-19 identified positive patients in terms of the total number of licensed hospital beds in the system. Gov. Gavin Newsom: (30:03) So it gives again a relative sense of total healthcare, licensed bed capacity, and percentage of those that we have identified as COVID positive. ICU admissions, again, you see the hospital rates go up, you're going to see the ICU admissions likely to increase all as lagging indicators. We're seeing ICU admissions increase over the course of a two week period in this new data set that's coming out today at 34%, 44% increase in the hospitalizations over two week period, 34% represented in the number, 1,753, that are currently admitted into our ICUs. Our ICU capacity with that cohort of 1,753 COVID positive patients represents in terms of the total number of ICU and NICU beds in our state, roughly 15% of the population, we still have maintained, and by the way, this is demonstrably of because of the work the hospital association's done, not the state, mostly the hospital association, they've been active in securing PPP, active in securing more ventilators. Gov. Gavin Newsom: (31:17) We are as well, as a state, but because of their outstanding work, we have still 11,300 ventilators available just within their capacity within their system that are currently not being utilized. And so that gives you a sense of the numbers. Speaking of numbers, this number should draw some attention, and that is one of the largest single day cohort number of positive cases that we've reported since the beginning of this pandemic. So, I want to caution you for purposes of full disclosure before the press respectfully runs with that number. I hope you responsibly will condition a recognition of the note that we put on this slide, that the number includes a backlog of reported numbers that we're still working through with LA County. We had mentioned that on Monday, there was a bit of a backlog. There is a cohort that would actually bring this number below 10,000. Gov. Gavin Newsom: (32:17) That's represented in the number we're presenting here today. And so I hope as we run with that number, we're cautious and are being fully informative to the public. That that number does include a backlog of some LA County numbers. So, I think a way to really start to express this, and we began to do this on terms of total number of cases, to talk about positivity rates, what I really want to emphasize, and I think this is important for all of us as individuals and as members that are responsible, and all of us accountable for distributing information to the public. To really focus on the seven day average, and you can see the seven day average. And this number is reflective of that backlog reflective of a contemporary assessment of our daily numbers that we collect 8,116 individuals have tested positive over a seven day period. Gov. Gavin Newsom: (33:17) The last cohort that I provided a rather seven day average that I provided was 7,867. 7,876, forgive me, my dyslexia is coming through. 7,876. That was on Monday was a seven day average, you see, it's increasing just two days later, 8,116. Let's take a closer look at some of these numbers as we do on a daily basis. We are now averaging over 106,000 tests per day. Over the last seven days, just shy of 100,000 yesterday, we got up to as high as 127,000 tests on Saturday. So, we're making good on our promise to in- Gov. Gavin Newsom: (34:03) On Saturday. So, we're making good on our promise to increase testing. Remember where we were just, I think it was 90 or so days ago. In fact, in April, we were testing about 2000 people a day. I'll repeat that. We were testing 2000 people a day. We decided to do a reset, put together a task force led by Dr. Charity Dean and by Paul Markovich of Blue Shield. They delivered on what we had promoted and what they promised, and we have now exceeded the goals that we had established. I will say, these all are goals and goals have to be re-imagined, and I think we have to realign some of our goals and we'll be talking more about that I think maybe as early as Friday, as late as Monday. I'll talk about our next iteration on testing and how we're going to be much more strategic, much more dynamic in our testing. Much smarter, dare I say, peril in terms of who we're targeting in terms of testing and how deep we're going in testing people on a more consistent basis. Gov. Gavin Newsom: (35:06) So, it's not just about the numbers. We can get caught up in just the aggregate, the numbers, but it's how we're testing, where we're testing, and we're all recognizing a current stress. You're seeing some articles about this, some attention, which is good, and it's certainly consistent with our experience over the last few weeks. As you've seen an increase, even at a greater rate, we're looking at a 7.1% positivity rate reflected in this slide over the 14-day period. You're seeing a doubling, sometimes tripling, of a positivity rate in some other states compared to California. By the way, I'm not pleased with a 7.1% positivity rate. That has gone up and I'm going to show you a slide in a moment that underscores the concern, but in other states, that positivity rate is substantially even higher. Gov. Gavin Newsom: (35:52) As a consequence, testing is increasing. Testing supply constraints are starting to present themselves again. And some concerns about accessing the golden oldies of reagents and some of the transport media and swabs and the like. So, we're working through all of those issues, and we'll be announcing a reconstituted taskforce with new goals, new specific strategies to address our needs as we move forward. But again, I cannot impress upon you more how impressed I have been of that task force delivering on that goal, which stretch goal was 80,000. 60,000 was a baseline, 80,000 on a daily basis. They've exceeded that over 100,000 now averaged over a seven-day period. Gov. Gavin Newsom: (36:41) Positivity rate continues to climb. Let me give you this slide as you've seen it often. This positivity rate shows you a cohort of positivity rates that we put together over a 14-day period. This represents an increase of roughly 39% over a two-week period and total positivity rates. So, that's a concern. I've made this point before. I'll make it today. Every decimal point is a point of concern, and I cannot emphasize more a point of consideration for all of us, that we have the capacity to move that number down by our individual behavior, by wearing masks, by practicing the hand washing and physical distancing and social distancing that's required of all of us at this moment. Gov. Gavin Newsom: (37:26) At peril, that 7% can spike and quickly into the double digits and you've seen in other states even into the 20 plus percent range. So, we're monitoring this very closely and all of us should monitor on behavior accordingly, even more closely in order to mitigate the spread and the transmission of this disease. Speaking of spread and transmission, we have been transparent in terms of providing a list to you on a consistent basis of counties that we're monitoring on a list. Some refer to it as a watch list. More formally, we refer to it as a monitoring list. These are counties that put out attestations that attested to containment plans and procurement plans in terms of their own strategies to procure assets and resources, human resources, physical assets, to meet the needs of their communities, their particular counties, and their particular and unique circumstances. Gov. Gavin Newsom: (38:25) Today, we're adding three new counties to the monitoring list for a total of 26. A week or so ago, we had 19 counties on the list. 23 counties when I was with you on Saturday. 26 now with Napa, San Benito, and Yolo County on the list. Remember, the monitoring list then requires some modifications to the stay-at-home orders, the modifications and sectors that require a lot of indoor activities to be brought outdoors, and I want to just acknowledge that a number of these counties didn't come kicking and screaming. In fact, reached out to us in anticipation that were likely to enter onto the list, and we are very proactively working with them, have been, and engaging them on making sure that we're all working together on the technical assistance and helping them support and prepare for the modifications in their counties. Accordingly, just to reinforce that, you'll see that we've had 18 counties already move forward with their own locally issued orders. Four have just submitted to the state orders and four are awaiting action. Three of them we're just announcing today, Colusa that I anticipate will move very quickly. So, I just want to thank again, these counties. The partnership is really demonstrably. I know there was some flare up and some consternation a few months ago, and people had their own ideas about pacing and their own considerations, but the overwhelming majority now of counties are just conducting themselves as we would all hope. Gov. Gavin Newsom: (40:01) I'm very, very pleased and proud of that and very thankful. I just would be remiss if I did not acknowledge their local health officers, their city administrators, their County board of supervisors, for their patience and their assertiveness, as we move into this new phase and try to mitigate and tame the spread and transmission of this disease. As always, the best way to do that is to wear that mask. As I said, physically distance where you must or you can, socially distance as always from cohorts that are outside your household and strangers, and do, as [Carmella 00:40:39] said, the basics. Wash your hands, simple hand hygiene, and making sure that all of us are taking very, very seriously this moment. I cannot impress upon people before I open up to questions, the potency of your individual decision making. I just want to underscore the potency of that because we had 111 lives lost in the last reporting period. Gov. Gavin Newsom: (41:01) 111 lives lost. Again, sort of breaking a little of the mythology, why we're seeing mortality rates that have declined. That masks, forgive the pun, the reality still of hundreds of people across this country dying on a daily basis of this disease. 111 here just in the state of California alone. Lives lost, families destroyed, torn asunder, loved ones that will never return. So, I hope all of us are sober about that and cognizant of the moment we're in and the vulnerability that everybody has at this moment. This moment will pass. We will get through this. We will become more resilient as a state, as a nation. I would argue, globally as a world. We will. There's no question in my mind about that. The question is when, and that determines the basis on the determination of how we conduct ourselves, how we behave, goes to the question of how do we safely reopen our schools and when do we reopen. Gov. Gavin Newsom: (42:05) In many respects, that's determined on our behavior and what we do over the course of the next few weeks to mitigate growth and spread and the transmission of this disease. Data makes those determinations. Data and science make those decisions. Fundamentally, that's what's guided us into that March 19th stay at home to making the first subsets of modifications on May 8th, as it relates to the modifications of the stay at home, and now working with these 26 counties to monitor and put that dimmer switch, as we've referred to it, back in play to address and mitigate some of the sectoral guidelines that we've put out and address the concerns around these spreads, mitigate the growth of the spread of this disease in counties and communities, large and small. Gov. Gavin Newsom: (42:53) So, forgive the long-windedness of today's presentation, but I wanted to give you an assurance that the last four months have been meaningful and intentional, and we have done an enormous amount to prepare and presenting you today, I hope you feel a sense of that preparedness to meet your needs, to meet your neighbors' needs, your community's needs, the state needs, and to do so head on. But again, we need your compliance. We need your support on wearing these masks. If you're a senior, if you have these preexisting conditions, if you are vulnerable to this virus and in that category, we cannot impress upon you more to take very, very seriously this moment and do what you can to stay home except for essential purposes and essential needs. So, with that, of course, now happy to answer any questions. Speaker 1: (43:52) Sophia Bollag, Sac Bee. Sophia Bollag: (43:57) Hi, governor. You mentioned that the state is sending masks to other states. Can you clarify how many masks you guys have sent and exactly what threshold in terms of mask capacity that we have as a state that led you to the decision to send more to other states? Gov. Gavin Newsom: (44:19) Hundreds that you saw on that slide. You'll see the threshold in numerical terms, quite detailed terms, of the detailed list capacity. The state has hundreds and hundreds of millions of masks. When we made the agreement for a large procurement, which many of you have written about, I hope you'll consider the fact that that procurement prevailed in 72,000,095 masks. Just one contract. Wasn't the only contract over 189 million of our procedure masks. We were able to do that in a very short period of time, a concentrated period, just over a 60-day or so period plus or minus. We were able to procure that. I don't know another state in the country was able to procure at that scale. Part of the agreement in partnership with our federal partners, particularly FEMA, was a consideration of need to those most in need. Gov. Gavin Newsom: (45:13) We did that with ventilators. We're part of the human condition. We are one of many states. We feel very connected to the American spirit that must meet this moment and the needs of our brothers in sisters and other states. So, I mentioned a few weeks back the number of 17 million. That's more specific to your question. I mentioned that on a number of occasions, including one state where we had sent, and I think everybody would understand why, and that's Arizona masks. We've also done it in Alaska, Oregon, Washington, and we're looking to do more as necessary, but we must always in the threshold in terms of the question, we must also as a primer, as a foundational principle, meet the needs within the state. That is precisely what we've been doing over the last number of weeks as these new supplies have come in. You saw that in the amount of masks that we have distributed, including, by the way, two months' supply into our public-school system. Gov. Gavin Newsom: (46:20) We mentioned this last Friday. 35 million masks to the California Grocers Association, the Restaurant Association, working in partnership with CMTA, which is the California Manufacturing Trade Association that also is helping sectorally reopen the economy safely and how we're partnering with them on the distribution of masks. Our first priority, of course, are our frontline men and women in the hospital system. By the way, hospital systems procuring, as I mentioned a moment ago, their own PPE in addition to what the state's doing. So, we're trying to supplement that, find gaps, farm workers and the like and seasonal farm workers coming in. So, we feel at the moment we are meeting the needs, but as I said a moment ago, we're getting these out in real time. So, the orders are coming in and we can't get these masks out quickly enough. So, we're putting together a spreadsheet where we think we need to be, and all I can assure you is we're continuing to procure even more masks. We're not going to sit back statically and allow that stockpile to deplete so we're back to where we were in March. Speaker 1: (47:33) Renee Santos, CBS 13. Renee Santos: (47:38) Hi, governor. Thank you for taking my question. We are seeing more cases, cases are increasing, but many of those people are testing positive and some are asymptomatic. There are concerns about these so-called super spreaders. Can the recent increase in cases be attributed to the super spreaders and should people who essentially aren't showing symptoms, should they be getting tested? Gov. Gavin Newsom: (48:04) Well, we've tried to encourage testing, particularly in our diverse communities. We've been able to put up a site, and this is my opportunity to remind you and allow you to avail yourself to accessing the site COVID-19. Ca.gov, COVID-19.ca.gov. You can type in your zip code, and we will provide information about the availability of testing sites that are approximate to where you live, and also the reimbursement or costs associated. A vast majority of these, there is no cost associated with getting a test. As I said, either on Friday or as late as Monday, I'll be putting out a different frame of engagement on the testing that will go more substantively and specifically to your question, because we are now looking to really target and modify our testing criteria in a much more strategic way. Gov. Gavin Newsom: (49:02) We actually put a little guidance out on Sunday. I don't know that you had a chance to take a look at that. I encourage you to take a look at it. It's on that same site. That gives you a sense of a preview of where we're going with our new testing protocols in terms of really targeting most vulnerable members of our community, most diverse parts of the state, and still addressing some main existing testing deserts that we have to address in the state, and obviously, the supply concerns that I mentioned a moment ago. Gov. Gavin Newsom: (49:32) Look, as it relates to why we think the hospitalization rates are up, you saw that slide. Those are the four areas that our experts, the health officials that we're engaging, our own health officials, our hospital partners, those are the areas where they suggest most of the activity is occurring in terms of the cause and effect of why people are ending up in the hospitals. Gov. Gavin Newsom: (49:57) Those vectors or super spreaders, spreaders, however, you may want to define them, we've defined those four categories as areas of most concern. I will say, full disclosure, if you look more granularly and I've brought this up on many previous occasions, so I didn't feel the need to do it again today, you'll see regional considerations. Imperial, we've talked about a lot of people, dual-citizenship, cross border activity down in Imperial. That's also an issue, so there are many other micro factors, but in the macro, those are the four carat areas where we think are the most contributory in terms of the increases that we're experiencing. Speaker 1: (50:37) David Baker. Bloomberg News. David Baker: (50:40) Governor, I want to ask you two related things about San Quentin Prison. One, are you going to be transferring more prisoners out of there into other facilities, especially since we've had outbreaks in some other facilities now? And two, are you going to go to the prison yourself and speak with the staff there or some of the family members of the prisoners inside? Gov. Gavin Newsom: (51:01) Yeah. I've visited San Quentin on many, many occasions. Speaker 3: (51:03) It's nursed inside. Gov. Gavin Newsom: (51:03) Yeah. I've visited San Quentin on many, many occasions on a daily basis, including right after this press conference we'll be reviewing additional releases. So the answer to your question is an affirmative. We've been able to decompress that, it feels like at the hospital now, but that prison from that number, which I've mentioned on Monday, mentioned previous week, 4,051 prisoners on March 1st, the goal is to get it down to 3000. It looks like as of today, this morning, we think we have a plan in the next few weeks to bring the population down to 3076. So from 131% capacity where we were just a few months ago and now getting it down below that 100% capacity threshold. We still want to do more than that so that we could provide more co-horting, more isolation of inmates. Course, we have staff concerns as well. We're using the chapel and the gyms differently. We have now our FMS, mentioned FMS as relates to alternative care sites. We actually moved one of our FMS sites to San Quentin proper. I visited Vacaville Prison yesterday where we're doing the same there in a very proactive way, and had the privilege of being with the federal receiver or the judge, or other rather, not the federal receiver, but federal judge that has been doing a wonderful job trying to address the needs of our entire system. And so I am very, very grateful to his leadership. We were there with the acting warden, for his leadership, Vacaville, and was there with many of the leaders within CDCR to get a first hand sense of what's going on. But I've not been just visiting the prisons recently. I've been doing that on a consistent basis. Been a cause if you've been following me for decades, a big cause of the why, when one answer is why do you want to do certain things in life? Criminal justice reform has been a big part of that. So this weighs very heavily on all of us and me. And as I said, there has not been a day in the last few weeks where we're not working individual by individual to try to address the needs at San Quentin, and more broadly Chino and other parts of the system that we have responsibility to address as well. Speaker 2: (53:27) Jeremy White, Politico. David Baker: (53:30) Hey Governor, thanks for taking our question. The President has been talking a lot about reopening schools. He suggested today that he could withhold funding from states that don't do enough and pressure governors. The Vice President on the other hand said that they could reward states that reopened with funding. So my question for you is, as California tries to figure out how to reopen those schools, obviously a huge issue for parents and teachers and kids alike, what do you need from the federal government to ensure that happens? And do you feel repercussions if, for example, there aren't enough teachers willing to go to schools to reopen them, and then there could be some federal penalties? Gov. Gavin Newsom: (54:06) Yeah. I'm not worried about the latest tweets, and I could give you ad nauseum examples of why I've concluded that that's not the issue that we need to address. What we need to address is safely reopening the schools, and we need to make that a foundational principle. That to me is non-negotiable. We have to safely reopen our schools and we also have to reconcile what is also non-negotiable, and that is we must insist upon learning the beginning of the school year. We provided, as I mentioned a moment ago, two months of PPE. We are procuring more PPE to provide even more support for our educational system, not just K through 12, but our preschools and obviously our system of higher education as well to help support their efforts. That's why we have to continue to do more on face shields, masks, gloves, and gowns, and the like, deep sanitation and other procurement, which is foundational in terms of safely reopening the schools. Gov. Gavin Newsom: (55:10) Number two, we put together statutory language in our budget that incentivizes the kind of learning that we think is more advantageous, which is in-person learning. But we also provided flexibility in our statutory language in the approved budget. By the way, that includes $5 billion for learning loss and safely reopening the school system support that we were able to draw down from the federal government already. So I think that's an important point to note. And we are providing the flexibility based upon local conditions. I know it sounds almost like a mantra, but it's foundational. In a state, again, as large as California. 1000 plus school districts, conditions are unique and distinctive classrooms, physical classrooms are such where you can't have the physical distancing that you can in other classroom environments in different parts of the state. All of these things need to be managed the local level with the foundational framework of keeping our kids, and as you suggest, Jeremy, our teachers healthy and safe. Gov. Gavin Newsom: (56:17) And yes, I fear that more than I fear a tweet. I fear that as a foundational principle of responsibility to protect our caregivers, our teachers, to protect their support staff, janitors, the bus drivers and our children, and obviously we have a lot of work to do as a society to mitigate the spread of this disease. That will be foundational in terms of making a data informed decision on how to safely reopen our schools. But foundationally, we need to acquire learning and that has to occur, and so we are working very closely with our partners. We put out guidelines on June 5th laying out our specific strategies. We've been modifying that and working with our partners, Superintendent of Public Education, many others, and we'll be seeing a lot more on this topic over the course of the next days and weeks. Speaker 2: (57:18) Adam Beam, AP. Adam Beam: (57:22) Hi Governor. Following up on that question. The Los Angeles Times is reporting that the LA County Public Health Director has told local school officials that they should be prepared for a possible delay in the August 18th schedule start to school, and the resumption of distance only learning. Given the case numbers, do you think it's likely schools will be able to open in as little as five or six weeks and that some form of classroom instruction will be possible? Gov. Gavin Newsom: (57:47) Yeah. So I sort of repeat a little bit of what I'm saying. I said a moment ago, in terms of the decision will be based on the data based upon where we are in a number of weeks. We're not bystanders in that respect. We are agents of our own lives and our own decisions. So foundationally that answer can be affirmative, meaning we can just roll over and accept the spread and transmission, continue with the behaviors that have led to this transmission and this increase, or we can do more to practice the kind of personal responsibility as it relates to wearing face coverings and masks and physically distance from others that will mitigate the spread, will shift that trend line, and avail ourselves to more flexibility and more opportunity. I would like to think that we have the capacity to make better decisions the next few weeks so we don't have to make the decision to delay a school year. Gov. Gavin Newsom: (58:49) But we have, and this is why I referenced the previous response, the question, provided flexibility, statutoral language, provided local flexibility on distance learning, hybrid learning and looking at a prioritization always of in-person learning, which goes to issues of social, emotional development, not just intellectual academic development, which we place a great deal of emphasis on. So again, this is work in progress, all to be determined, and we are working very, very collaboratively with our partners all across the state in this dynamic. Speaker 2: (59:29) Final question. Anna Ibarra, CalMatters. Anna Ibarra: (59:35) Hey Governor. So earlier you said you'd be giving a more detailed response on testing at some point, but for now as testing centers are closing and you mentioned backlogged, this means in some cases people are having to wait more than a week to get tested, and then more than a week for results. And with such a lag, some people are asking what is the point of testing? Is there still much value it? And I have a followup on schools as well. I'm wondering if the state has any projections on how many students, teachers and staff are expected to be infected from in-person classes to when and if they resume in the fall? Gov. Gavin Newsom: (01:00:07) No. We don't have any data on that basis because we're looking to bend and we're looking to mitigate the spread and transmission of this virus to be in a very different place before the schools begin to reopen. And so we're hoping that we have real impact in the next few weeks so that we can mitigate these trend lines and not just accept those trend lines to be then factored in just some numerical expectation in terms of spread within the school system. Gov. Gavin Newsom: (01:00:35) That said, this relates to testing and we agree with you, and that's exactly why I've been previewing, on Monday I previewed, it's why I'm previewing again, the work that is ongoing that various certively is ongoing. We were able to do what we said we were able to do and actually exceed expectations including the last seven days, over a hundred plus thousand tests. Gov. Gavin Newsom: (01:00:56) So it's an interesting moment. You're right. There's some supply chain concerns, at the same time, we're doing record number of tests. But again, that masks some of the nuance of where there are supply challenges, and as well, the challenge we are all having now with the time to getting that testing information back. We were within a couple of days. We started, remember it was six, seven days, and some people, 11, 14 days. We again got it down a few days and we were really making progress as a nation, not just as a state, and now you're starting to see because the backlogs with Quest and others, that we're experiencing multi-day delays. Gov. Gavin Newsom: (01:01:41) That said, and you're going to forgive me. I don't' want to get too far ahead of our announcement, but let me give you a little more of a preview of it. We're working to match some of our testing capacity with local labs, with many of our hospitals and not just doing these national labs where you're seeing a lot of the delays occurring. Gov. Gavin Newsom: (01:02:05) We're also, and it goes to the previous question, around San Quentin just as an example, where we're using Quest at San Quentin. We had a lot of delays. We're now working increasingly specifically with Biohub, partnership with UCSF, CG's foundation, and we're doing more dynamic testing with much quicker results. So that gives you an indication of sort of the specificity to which we'll begin to answer that question with much more dynamic strategies for testing to get that response time diminished substantially. Gov. Gavin Newsom: (01:02:39) Look, if you have symptoms, if you're in a high risk category, you're in a congregate setting and the like, we want to encourage you to get tested, not be discouraged in some cases by some of these delays. We think that's foundational and fundamental. And so please don't be dissuaded by that. Know that we have a team working overtime on this, and we'll, like we did last time when we went from 2000 tests over 100,000 tests, we'll work our way through this final point. Gov. Gavin Newsom: (01:03:09) We have also been very engaged with FEMA in terms of the supply question and are getting a kind of response we were hopeful for, including from the Vice President himself who recognizes the opportunity and responsibility to help support states like ours with some of those supply constraints and some of these backlogs as well. Gov. Gavin Newsom: (01:03:29) So thank you all for the opportunity as always, privilege of your time. Thank you for giving me the opportunity to update you. Look forward to making subsequent updates. We'll be back tomorrow and look forward to answering more questions. And moreover, just encourage you to do the kinds of things that are foundational and fundamental at this moment, and that begins with wearing these masks, and physically distancing, and washing your hands as often as you possibly can. Take care, everybody. We'll see you tomorrow.