Florida Governor Ron DeSantis August 3 Press Conference Transcript

Governor DeSantis: (00:41)
Well good afternoon. I want to thank Broward Health for hosting us. Before I begin, I want to thank the emergency management personnel throughout the state of Florida. They prepared for Isaias and we did not get the major impact that we were prepared for which is a very good thing, but we did get a good trial run for what will likely be a busy hurricane season. In particular we had the opportunity to beta test the new sheltering strategy which we had to evolve in light of the coronavirus. The state of Florida sent PPE kits and thermometers to all shelters in the storm’s path and arranged for non-congregate sheltering options for people who either had or were suspected of having COVID-19, and it all proved to be very helpful. In Palm Beach for example, we had people show up to a shelter that had tested positive recently or who did not pass the temperature screening and those people redirected to a nearby hotel where they had a safe place to stay until the storm passed. I would just tell Floridians there’s been a lot of activity up to this point in the season. We do anticipate more storms developing so make sure that you have a plan. We’ll hope for the best on this but we absolutely need to be prepared for more storms.

I’m really glad to be here with Broward Health. We have Gino Santorio, the president/ CEO, we have Josh Lenchus, doctor/chief medical officer, Cheryl Wild, chief nursing officer and Dave Lacknauth, executive director of pharmacy services for Broward Health. They’re going to talk about some of the things that we’ve been working on in conjunction with them. I think that they’ve done a really good job. I think everyone throughout South Florida has done a fantastic job. Frontline healthcare workers in the hospitals in responding to this crisis. We are looking at … I’m going to make an announcement today about testing which I think will be helpful, but we are encouraged by some of the trends we’re seeing. We continue to see a downward trend in visits to the emergency department with people with COVID-like illnesses. We’ve seen a peak in COVID positive patients that are hospitalized statewide happened the third week in July. We’ve continued to see that census decline and I think that that is consistent with what they’ve seen here at Broward Health. Today we reported one of the lowest numbers of tests that we’ve, positive tests that we’ve reported in a long time and we’ve had two days in a row where the positivity has been 9% which we were 15, 16% there for a while.

These are encouraging trends. Obviously there’s a lot more work to do and one of the reasons why we’re here today is because we want to address the remaining challenges. One is the turnaround time for testing. When we started going to expand testing in May, we thought that if we could get up to 35,000 tests a day that that would really, really be doing well. Remember in March and April, we were doing 7,000, 8,000, 10,000 tests a day. There obviously was a need for more capacity so we worked to do that.

We have done a lot more than just 35,000. We typically will get in roughly 100,000 test results in a given day. You are also seeing more and more testing throughout the country. The result of that has been turnaround times of a lot of the commercial labs have just been moved to the right more and more. You have longer wait times. Obviously if you’re somebody that is symptomatic and if you don’t get your results back for seven days, that is not helpful. For our asymptomatic test takers, if it takes seven days, then the test is basically useless at that time because even if you were infectious at the minute you tested, by the time you get it back, you probably haven’t been isolating anyways and you’re likely to not be infectious on the backend of that.

So increasing the times is something that we’re looking to. I asked Jared Moskowitz to make some changes to try to do that, so starting tomorrow, we’re going to have some real positive changes. We’re actually going to convert two of our sites in Miami-Dade County, the Marlins stadium and Hard Rock stadium, to exclusively 15 minute antigen tests. The tests will be for people that have symptoms or for elderly 65 and older. There will still be a lane for the traditional testing for the other asymptomatic people, but that will be the traditional swab with the traditional lab, but for those folks who are older or who are symptomatic or both, you’re going to be able to go in, get the antigen tests, and in 15 minutes, walk out with a result.

That’s not only good for the test taker and the patient, it’s also good for officials monitoring the trends. When we get tests reported to the state, sometimes those tests were taken 10, 14 days before. Certainly the infections in many cases happened 10 to 14 days before, so if you’re looking at things like the positivity rate or some of these other things, a lot of times that data can be stale. Now we’re going to get every day at these two sites, total of 1,250 tests. We’re going to be able to get realtime data about the percent testing positive, the number of people testing, and so I think it will be really, really good. People want to know and want those results back.

What every other drive through site throughout the state of Florida, we are going to have symptomatic lanes. This will be people that are experiencing coronavirus symptoms or are 65+ or both and they will be able to self-swab. So they self-swab, we have relationships with certain labs that once we get them the swabs, we usually get a 24-hour turnaround from the time the lab receives it so if we can get it to them as quick as possible, they typically turn it around well. This will be I think very good, so it’s not going to be seven days which is what’s been happening, so hopefully it will be more of a 48 to 72 hour window which I think is a big deal when you’re talking about this and of course there will be a lane for people who are asymptomatic. We’re also going to offer at all these sites antibody testing, and it’s something to think about because think we’ve seen with more of the research and the data that’s come out, particularly over the last few weeks, CDC has now moved to a symptoms based approach for employees going back to work. They’re discouraging needing to get a negative PCR test and I think part of the reason that the antibody test may make sense for people that don’t have symptoms is PCR tests can pick up dead virus CDC says up to 12 weeks but certainly we know people who have tested positive for days and days beyond the 14-day period. That’s not an uncommon thing, so if you’re asymptomatic and you’re testing, we really can’t tell you for sure whether you have live virus once we get those results.

Now some people may still want to do PCR. It’s going to be there, but the antibody tests, we’ll be able to tell you whether you have the antibodies and whether you have been infected and if you have IGM antibodies, then you likely had a more recent infection. If you have IGG antibodies, likely were infected a little bit further back in the past. So that’s very valuable information for people to know whether they have the antibodies and what we’ve seen is since we opened up antibody testing to the general public, we used to do it for the healthcare workers and for the first responders, we’ve opened it up. We’ve seen the antibody rates increase throughout Florida and some days we’ll 15, 16, 17% of the test takers will be positive for antibodies. Now it’s not scientifically representative because it’s just first come first serve, but I think that there’s a surprising amount of antibodies out there so if folks want to do that, we’re going to be able to do it, but it’s all about lab prioritization, understanding that there is a limited lab capacity for a quick turnaround, and if we can focus on those people who really need the test results the quickest, I think we’re going to be able to improve. So you’re going to have two sites with instant tests and then you’re going to have the other drive through sites with the self

It’s with instant tests, and then you’re going to have the other drive through sites with the self swab and quicker turnaround at the lab option, which I’m really excited about. We’re also working very closely with all the hospitals throughout the state of Florida. As we look down with this coronavirus crisis, the two things that I think were just so important to get right were doing everything we could to protect the vulnerable, particularly those in longterm care facilities, but then be there to support our frontline healthcare workers and our hospital systems. Remember, when we did the whole flatten the curve in March and April, that was all just to buy time to be able to make sure that the hospital system could cope with the pandemic. And we’ve worked really hard with all the hospitals, as they’ve had needs, we’ve worked really hard to respond with any assistance we can buy.

So, for example, with this remdesivir which is one of the top therapeutics that doctors are now offering, we’ve gotten 3,500 cases delivered to the state of Florida, which is 143,000 vials. And as hospitals ran low, we had to go to the White House and get the schedule expedited, and be able to get more remdesivir in the hands of our frontline physicians. I think Broward Health, they were going low, and then they got replenished before they ran out and that’s what we were trying to do. We’re also promoting convalescent plasma donations. Hospitals do need this. It’s high demand. It can be an effective treatment. And so we’re going to continue to encourage people throughout the state of Florida to give blood. If you do have the antibodies. If you’ve recovered from an infection to go give the blood.

That’s one of the reasons having the antibody lanes at these test sites are good, because if you do test positive, you can go get blood and you can help potentially save a life. It’s very, very important. We’re also helping hospitals with personnel. When the pandemic really got hot and heavy in March, the fear that was put out was about running out of hospital beds. That never was really a threat in the state of Florida in March, April, May. But then as we got into and started seeing the prevalence increase admissions, we reached out to hospitals and said, “What do you need? How’s your day bed capacity?” And actually, to a man, they all said the bedroom is great, we just need to make sure should we have enough personnel to staff the beds that we have. And sure enough, that’s been the case.

We’ve had bed capacity the whole time. Certain areas of the state because of the increased admissions, those frontline workers work extremely, extremely hard, particularly in Dade and Broward. And so we were able to send 1900 medical personnel to hospitals. We have more at my direction that can be deployed. 150 of the personnel are working right here at Broward Health. So these are personnel that we didn’t necessarily use in March and April, May, and the beginning of June, but we had the arrangements in place so that if we needed to do it, we could do it. And I think that that’s been a huge, huge source of help. I mean, the amount of just their lives that they’ve had the juggle, if you’re a frontline healthcare worker throughout the whole time has been tough, but particularly once we saw the increase in prevalence at the end of June throughout July, it’s been very, very difficult.

And so to be able to provide some level of support there, I think that that’s a very good use of resources and I’m glad we were able to do it. And finally, I think we’re supporting the hospitals, protecting the vulnerable. We have now established 23 COVID exclusive nursing facilities throughout the state. That’s over 1500 beds. And in Broward, we have three COVID exclusive facilities throughout the state or throughout the county with a total of nearly 175 beds. And what that allows you to do; one, it allows you to limit an outbreak in a nursing home. If someone tests positive, they can be safely transferred to a COVID only physical. It also allows a hospital, if they have a longterm care resident who’s medically stable, they know they can’t discharge a sick patient back to the new nursing home because that would obviously create risk of spread, but they can discharge to a COVID exclusive facility. So it helps prevent outbreaks in nursing homes or limit outbreaks in nursing homes and then it also helps the hospitals be able to manage their beds. And if they have patients in there who don’t require hospitalization, if it is an infected nursing home resident, there’s a safe place to transfer where you’re not going to run the risk of furthering the spread. So we really appreciate the facilities here in Broward stepping up to do this. And the hospitals, I think, have worked really well with our secretary, Mary Mayhew. And I think it’s really been successful. We have 1500 beds, almost. There are over 1500, but we have probably hundreds of more that are going to be online. So I want to thank all the healthcare workers throughout the state that have been working tirelessly to support your fellow Floridians in a very difficult time. We appreciate the sacrifice, we’re going to continue to support.

And remember, there are certain things that all Floridians can do, look out for our vulnerable population, make sure you’re exercising good hygiene, exercising appropriate physical distancing, such as avoiding crowded spaces, closed areas and close contact, and then wearing a facial cover, particularly, if you can’t maintain that six footed difference. Floridians have really stepped up to the plate and done a great job. As I said, got a lot of work to do. Trends are a lot better today than they were a month ago. So we want to build on that success and if we do it with one goal as one Florida, I’m confident we’re going to be able to get that done. So it’s an honor for me to be able to introduce our, CEO Gino Santorio from Broward Health. So, Gino.

Gino Santorio: (15:12)
Thank you, Governor DeSantis for your continued support and not just Broward Health, South Florida, and the state of Florida in general. It has been a challenging summer, but it is very pleasing to report a reduction in the number of hospitalization going on over two weeks here in South Florida, as well as at Broward Health. Today across our health system and our four hospitals, we have 198 COVID positive patients, which is a significant decline from what we’ve seen in the last couple of weeks. Notably, our ICU numbers and vented numbers are also performing better than anticipated in the projections. That’s a very positive indicator with our ability to treat and get these patients better. As we’ve had through this entire surge, we have capacity. The number of ICU beds and ventilator capacity has been adequate. And that’s significantly thanks to our heroic caregivers on the front lines, as well as working with Secretary Mayhew, Director Moskowitz, directly with the governor himself, the surgeon general, have been able to be incredibly responsive to the needs that we have had and asked for.

In addition to the state effectively getting us some of the necessary drugs that have made a significant impact in the survivability such as remdesivir, they’ve also helped us in an area that is a significant need across the state, which was staffing. We currently, in our system, have 131 employees that are a combination of respiratory therapists, nurses, and certified nursing assistants, which have been able to help supplement our own staff to be able to ensure that we can effectuate a surge above and beyond what current numbers are today should we have needed them. We would never, as a safety net hospital, turn away a patient. Safety nets in the state of Florida represent about 12% of the hospitals yet we’ve treated over 50% of the COVID hospitalized patients. And a lot of the resources that enable us to do that have come not just from the state and internally, but have come at a very rapid turnaround.

When we needed something, be it drugs, be it staffing, we’ve had a turnaround in less than 72 hours. And that is a true testament. I would be remiss if I did not mention that despite the fact that Florida has the fifth oldest median population, our survivability of this virus has significantly outpaced what the expectations were. And that’s a true testament to the fact that we’ve been able to protect the most vulnerable population, via testing, staffing, drugs, and being able to ensure that our longterm and post acute care facilities such as our skilled nursing facilities have had testing of both the residents and the-

[inaudible 00:18:00] nursing facilities have had testing of both the residents and the caregivers on a consistent basis. You heard the governor speak about our COVID only facilities that have been stood up. That has been an absolute, huge success factor in survivability of COVID, and maintaining a low mortality rate. So, very pleased to report that. I do want to encourage, and we’ve joined our hospital partners as well as additional healthcare partners in South Florida to come together. We launched a campaign called caringforsouthflorida.org that encourages, and really follows suit with the One Florida campaign from the governor’s office to really encourage, and maintain the diligence around social responsibility, social distancing, masking, et cetera.

We need to be diligent in maintaining this, so that we can continue the decline, and beat this. You’ll hear from some of our expert clinicians on some additional items, but I thank you for being here today, and certainly can look forward to any questions. Thank you.

[inaudible 00:01:08].

Dave Lacknauth: (19:13)
Hey, good afternoon, everyone. Dave Lacknauth, executive director of pharmacy service [inaudible 00:19:16] for Broward Health. A pleasure to speak on behalf of Broward Health today, and the state of Florida. The items that I wanted to cover today are just our clinical response to COVID, and with our clinical teams, what we’ve been able to assemble. We’ve worked really hard upon initiation of hearing about COVID. We are a very close knit group of physicians and pharmacies from a therapeutic management standpoint here at Broward Health. We brought together the key physician groups that really kind of, I say, drive the clinical bus when it comes to treating our COVID patients. That’s our intensivists. I want to give them a ton of credit.

They are on call for us night, day, weekends, anytime they are there for us. Our infectious disease physicians as well, same thing. They are on call, they’re on board, they’re working with us to drive what I call that clinical bus in making sure we have the right therapies for supportive care around COVID. The care that we provide for COVID for our patients that are hospitalized is critical, and important. In this day and age, what we find out is the one thing we understand is everything changes every day. Data comes out tomorrow that we didn’t see today, data is going to come out in two weeks that we don’t know from tomorrow.

Our job with our clinical team is that we quickly pull the data in, review the data, validate the information that’s in the data, and then, come out with what we’re going to do moving forward around treatment, and treatment of our patients. I just want to again, give credit to the infectious disease doctors, and our intensivists, and our medical staff leadership for being available, and being available to interpret this information for the most effective treatment for our patients today. I want to thank the state. I’m the guy on the phone. [inaudible 00:21:09] my phone call too, and our governor, and our state really supported us when we were running low on some critical medications.

They were able to ensure we got what we needed, when we needed it to ensure our patients had the supplies and medication portfolio that they would need for our clinicians to then administer care. Again, I just want to keep it brief with an overview of what we’re doing clinically to support our patients that come into Broward Health. If you do come into Broward Health for COVID or non-COVID issues, our clinical teams are here to support you, and you will receive the best care that we can possibly give to you with the most up to date information. I’m going to hand over now to [Dr. Lunches 00:00:21:55]. He’s our chief medical officer for Broward Health Medical Center to expand on a little bit more.

Dr. Lunches: (22:04)
Thank you as Mr. [Inaudible 00:22:06] and the governor had mentioned, it’s been a few difficult weeks. Obviously, this wave has presented more than a few challenges, which I’m proud to say our caregivers have been incredibly resilient, and have risen to the challenge as we expected them to do. Now, the state’s provision of staffing and pharmaceuticals has enabled our caregivers to continue to provide that quality of care that the community has come to expect from us. You heard the governor say, unlike the first wave, the patients that we’re seeing this time around are a little bit younger, and their conditions are a little less severe. That has helped us with facilitating their throughput through the hospitalization, which is obviously the most important part of their care.

The patient’s outcomes of course are predicated on our knowledge of the ever evolving landscape of COVID-19, as you heard Dave Lacknauth talk about. We do use things like remdesivir, convalescent plasma is used so long as we can get it, and you’ve heard really what we need the most though, is for the community to help us help them, and the way that they could do that is by adhering to the pivotal components of the governor’s platform where we protect the vulnerable, where you wear your mask, where you do hand hygiene, and where you physically distance.

That means that a closed, prolonged contact is not something that we should be doing. This is something that we’ve advocated from the very beginning, washing your hands, wearing a mask, a little bit of that as has changed, but that’s really the best advice that we could give to the community to help us help them. Thank you.

Cheryl Wilde: (23:50)
I am Cheryl Wilde. I represent nursing for the facilities in Broward Health. I would just like to say that I very much support what my clinical partners have just said. The care that we’re giving the patients is amazing. The caregivers, I cannot stand here without thanking them. The caregivers, the nursing teams, the respiratory therapists, everyone who’s come out to really give everything that they have this last five months or so has been very challenging for them. I cannot thank the governor, and the state enough for the support that they’ve given us, the staffing, and the nursing who have really just come out, and help to support our system. The care that we’re giving our patients, again, is top rate. Our outcomes have been very, very good, and I’m just very, very thankful for all the support that we have received from the state at this point.

Well, thanks so much. We really appreciate all the hard work. I think the average member of the public understands that people in health care often have to work hard, and I think that they assume that in a situation like that, that’s even doubly, but dealing with an infectious disease like this really is labor intensive, because even if you guys have someone in a car accident, they swab positive, you’ve got to do all kinds of procedures to isolate, to make sure that you’re keeping it from spreading throughout your facility. It requires a lot of folks to work a lot of hours, work very hard. Obviously, you have PPE and everything, but none of that is foolproof, so people are potentially exposing themselves as patients come in.

Although, I think the track record has been really good with our healthcare workers in terms of using that equipment. It’s been a real challenge, and I think that the folks really have stepped up, done a great job. We are happy to be able to provide some support, and we’re going to continue to keep that support going for as long as you need it. I’m encouraged about your trends. I think that, that’s a really good sign. We look at all these different things. This number of tests, or that, but some of that is based on how many people you’re testing? What’s your testing criteria? When are the labs reporting all this?

But, the people showing up at the emergency department, or the people that are being admitted or discharged here, that’s just the reality of what the disease is doing, and I think the fact that they’re either discharging people, they’re generating a lot of positive outcomes compared to what you would have seen in February and March, either in the United States, or in other parts of the world. That’s really, really encouraging, and we’re obviously excited to be able to provide remdesivir, work with the White House to do that, and as other things come down the pike, we want to continue to be helpful.

But, we are here to help South Florida. We really appreciate. It’s been a challenge for the whole state, don’t get me wrong. The first kind of time we had South Florida, and then, the rest of the state was relatively modest in terms of the prevalence. This time, I think everyone saw more prevalence, but of course, here in Broward and Miami-Dade, you’ve seen the most, and so, I really appreciate how great everyone’s responded.

… you’ve seen the most. And so I really appreciate how great everyone’s responded with that. I’m happy to take a question or two. Yes, ma’am?

I got tested like two days ago, so I’m not sure when that would have happened or whatnot. So I’m tested regularly, and I don’t have, or have not had any symptoms. So the number of times I’ve been tested has been pretty significant, and I’ve had my temperature checked probably a hundred times just in the last few months. Yes ma’am?

Is that Glenna? Oh, hi.

Glenna: (27:52)
[inaudible 00:27:47].

This is for the longterm care isolation centers? Okay.

Glenna: (28:12)
So remember [inaudible 00:01:02]. I’m wondering if you can speak to [inaudible 00:28:29].

Yep. Well, a couple of things. One is the family should be notified if a family member is transferred to an isolation center. I thought that that was being done, but I’m going to look to see, because they need to. Obviously, if there’s a positive case, the nursing homes are required to notify the families with that, but they should also do that.

So these isolation centers are following all the CDC guidelines. They have negative pressure, they have to be able to do that in order to get approved by AHCA. So as long as they’re following those rules, it’s going to be safe, and if somebody is COVID-positive and is put there, they are not allowed to be mixed, if you do have a situation like that, with the general population, of course not. That would defeat the whole purpose of doing the transfer in the first place. Because if we’re going to do that, we could have just left them in the nursing facilities. The nursing facilities, we do have many just regular nursing facilities that have the ability to isolate. We have 4,000 plus, most of them don’t have that ability. Some do. So if you have the ability to isolate, and you have a positive test or two, you can isolate the residents appropriately. And obviously not allow that to get into the general public. But for those, which are the majority, who do not have the capability of isolating, they’re required to be transferred to a place that can be safely isolated. Sometimes that’s hospitals. And when we were in April and May, we would see a lot of transfers, but when the patient is not requiring hospitalization to have a COVID-only nursing facility where they can safely isolate, convalesce, and then be discharged safely back is a really good tool.

But I think the families, they need to be kept apprised on that. So I’m going to talk to Secretary Mayhew and make sure that that’s the case. Believe me, there’d be no reason to transfer anyone unless it was necessary for safety. But I think as we found, that when you have these outbreaks that run unchecked in a nursing facility you are going to see major clinical consequences for that in terms of hospitalizations, and unfortunately in terms of a longterm care facility resident deaths. Yes sir?

Speaker 2: (30:55)
Governor [inaudible 00:30:59], wearing a mask be [inaudible 00:31:05]. I’m curious if you’ve had any [inaudible 00:31:09]?

So I haven’t talked to the White House. But I’ve tried to say from the beginning, well certainly over the last few months when it became apparent, the number one source of outbreaks is in the home. And so that becomes a specific challenge… My house, my wife and I, I got young kids, we’re not in the risk categories, but you’ve got a lot of families in Florida where you’ll have multi generational living, or even if they’re not under the same roof, particularly you look like a county like Miami-Dade, you just have a lot of family that live in the area, and they’re getting together. They’re doing what normal families do. The risk, and either if you’re under the same roof the whole time or if you’re in close contact, is that those more vulnerable relatives, whether it’s a parent, a grandparent, an uncle, they then can be exposed by younger people who may not be visibly demonstrating symptoms.

And so I think it’s something that people should absolutely look at, whether it’s the mask, whether it’s isolation. I think there’s a lot of different ways, but just to understand protecting our vulnerable, part of that is if you’re in those vulnerable groups you need to do what you can do to avoid crowds, to protect yourself. But everyone else also has a responsibility to govern themselves accordingly where they’re not providing any type of a danger to them.

But I would also say though, the physical distancing, avoiding the close contact in an enclosed environment, that should not be put aside. So you’re going to do the mask in addition to that, but just understand if you’re in very close sustained contact, particularly with some of those cloth masks, you don’t have a hundred percent protection of the droplets. You’re talking about it will intercept hopefully some, hopefully most, but certainly not all. So people shouldn’t have a false sense of security on that. You still got to do the sanitation. You still got to do the physical distancing.

Speaker 3: (33:14)
[inaudible 00:33:14] so they can return to school safely?

So in terms of the education, our primary policy is that parents should have a choice if they want to do distance learning because they don’t want in-person instruction right now, they should have the ability to do that.

But then for the many parents who really do believe that their kids need to be in the classroom, we want that choice as well. The Department of Education is working in conjunction with the Department of Health, with districts on a district-by-district basis, and they are also working with their local county health departments to be able to devise the best safety plans.

I think that there’s a number of things that they may have in common. But I also think that a plan in Miami-Dade may look a little bit different than some of the other counties, which may be more rural, and may have less prevalence. But I’d also say that we are happy to see single-digit positivity statewide for two days in a row. We had been mired in 15, 16%. We did have it go down to 11, 12, and then to see this decline, I hope that that trend continues. I think people have really been doing their part to make sure that it does.

Thanks everybody.

Florida Governor Ron DeSantis August 3 Press Conference Transcript

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