Florida Governor Ron DeSantis COVID-19 Press Conference Transcript May 13: Says All Pro Sports are Welcome in FL

Governor Ron DeSantis: (00:00)
Slightly, when we introduce new testing facilities, you’ll see some cases trickle up, the positivity rate goes down in those areas, but you do see that. And so as you look at that, obviously the senior citizens from the beginning we’ve known have been the most vulnerable, so we’ve obviously made this a priority from the beginning, but as we continue to deal with the epidemic, this is going to continue to be an issue, and we want to make sure that not only folks in the State of Florida, but some of our friends in the nursing home community, in longterm care facility community, and our partners at the local level, all understand that this is really the tip of the spear.

So Florida, we have over 4,400 longterm care facilities in the State of Florida, over 150,000 residents, but almost 200,000 staff who work at these various facilities, which is obviously an important vector to worry about in terms of the transmission of the disease. So at the beginning of this, we obviously knew these facts, we understood how the disease impacted different groups. This was a major, major concern from the very beginning. So what did we do at the beginning? So right at the outset, we prohibited outside visitors to longterm care facilities. I think a lot of people know that, I think that that’s been written about.

What people really haven’t said as much about, which I think was probably much more important, is Florida actually prohibited sending COVID positive residents back to longterm care facilities. And the reason why we did that is because if you take a COVID positive resident, put them into a longterm care facility that is not equipped to isolate with negative pressure, according to federal guidelines, you end up creating a major transmission vector that will infect other residents and could lead to a major outbreak, more hospitalizations, and unfortunately more fatalities.

So Florida’s approach was avoid introducing the disease into longterm care facilities. And we drew a very firm red line that was not actually the majority view at the time. If you look at, particularly in the Northeast, they had orders requiring hospital, or requiring nursing homes to accept patients who were COVID positive. And that obviously created a lot of risk at those facilities. I think that they were worried about not having enough hospital beds, but this created a major vector. And so the results, if you look by State in terms of fatalities per 100,000 in longterm care facilities, you see Florida obviously far less than some of the Northeast States, but even States like Colorado, you see in Louisiana much, much less in terms of the fatality rate per 1000, but also in terms of the case rate.

Now, most States or a lot of States don’t actually report the number of cases connected with longterm care facilities, but of the ones that do, you could see Florida per 100,000, just a hair under 15 cases per 100,000. Obviously those other States much, much more. Part of it was those early actions, but then those early actions were supplemented immediately in March, then throughout the crisis as things have developed. So we really have two agencies that have been very key from the beginning, Health Administration with Secretary Mayhew and then the Department of Health under Dr. Rivkees, they have been hands on, thousands of onsite visits, visiting facilities, needs assessments, infection controls, all these things to be proactive, to try to identify where the vulnerabilities would be, and this was probably their top priority from the very beginning, and I think that that was appropriate because that’s really where the list list was.

They have actually done things in conjunction with CDC. We were in Florida doing things in terms of issuing some of our regulations that then CDC would mimic later, but when you’re looking at over these thousands of longterm care facilities, reassessments going training and deploying EMS assessment teams, this was a lot of manpower that went into protecting longterm care facilities.

Now, in terms of the staff, which is obviously very important, there was mandatory screening of the staff very early on in the process, as well as the vendors who go into these facilities. And that involves temperature checks that involves asking questions about where they’ve been, who they’ve been in contact with. And that is a way to prevent somebody who is visibly ill, obviously, from being able to have access to the facility. So that was important. Now a temperature check is obviously, as we know, not foolproof because you have people who are asymptomatic, who can go in, but still very important to have done that.

Also very early, and this was actually when you had people in Federal Government saying don’t wear face masks, the Florida mandated universal face masks be worn by all staffs and visitors in facilities. And visitors, we had banned the visitation, but it was mostly vendors who would come in, would have to wear masks, and then all staff that actually worked with residents needed to wear gloves. And so there were notices put out, requirement’s issued, and I think that that was the appropriate guidance. I think that was based on the best data and science, even though it may have conflicted with what some experts may have recommended at the time.

We also sent or acquired… When you’re acquiring wearing PPE, some of these facilities, they had tough time acquiring PP. There was a worldwide crunch on this stuff, very difficult, and so the State of Florida stepped in and said, we are going to assist with the PPE. So far the Division of Emergency Management has sent 10 million masks just to longterm care facilities, a million gloves, half a million face shields, and 160,000 gowns. And we were going to continue supporting these facilities because it is the tip of the spear. But this right here is a massive logistics operation just for these facilities, and it was important to do because of the vulnerabilities in the facilities.

We are requiring hospital testing prior to discharge to a longterm care facility, even if you’re in the hospital for something unrelated to COVID, we have enough testing available that if you have a resident who’s hospitalized, they should be tested before they’re sent back, that is being very cautious and putting safety first. And then under Secretary Mayhew’s leadership, and I know she’ll talk about the transfer protocol, what we want to do… The reason why you had some of those States forcing the nursing homes to accept COVID positive patients is because even in the older demographic, you still have a number of these patients who if infected may not require hospitalization, or may only require it for a short time, may never get to ICU or ventilator, and so those folks, if they are either never requiring hospitalization or hospitalized, but can be discharged, those folks still need to be isolated if their COVID positive. And so if a facility isn’t capable of doing that, then we need to transfer those residents to places that can, such as hospitals.

I think where Florida has really been innovative, is establishing COVID dedicated nursing come. So these are nursing homes that have the ability to properly isolate with negative pressure rooms, do it safely so that you can take care of a COVID resident without it spreading to other people in the facility. And so Florida contracted with Dolphin Pointe in Jacksonville, this was a new facility coming online, saw an opportunity. Obviously we had to dedicate some State resources for that, but that has been able to accept people who test positive in a nursing home, but may not require hospitalization, or it can be a place when they’re discharged from a hospital, they have a safe place to go that’s going to be safe for them and for other residents.

So we have other sites that are active, one more opening this week. But what you have is hospitals are seeing some of these folks being transferred as cases develop, and a lot of these patients fortunately really don’t need an extended hospitalization. So having these sites is a way to prevent, or at least reduce the likelihood of a major outbreak in one of the facilities. Now, of course you have to test and you got to get there early enough, but I think we’ve seen that that can be effective when you do it.

We, of course are having DOH in these facilities, infective control and staff testing. The staff obviously is the major vector from bringing this in. And I think if you look over the 4,000 facilities, we’ve probably had just a handful who really just dropped the ball and just didn’t follow anything, letting sick people in, not wearing PPE. The vast majority, some have done outstanding, and others have worked hard and followed everything. The problem is that some staff will come in, they have no symptoms, no fever, but they are infected, and then that can spread, and so before you know it, you have a dozen staff members that may be infected, and no one’s even developed symptoms yet.

Actually, when it’s spread to some of these residents, we found testing even a lot of the elderly residents test positive without symptoms. Now, most of them do eventually develop symptoms, but it’s surprising that there were asymptomatic even with the seniors. We are doing a lot of testing, DOH has a great plan of next steps going forward. One of the things, and I’ll mention a minute though, there is surveillance testing going on, which is a way to identify a trend or a blip. You’re not testing everyone when you’re doing surveillance, you’re trying to do representative samples and try to figure out if we see any flare ups in any of these facilities.

I think Secretary Mayhew has been very, very proactive in working with the hospital CEOs on this particular issue, because this is just a fact of life, when you have a virus like this, that directs most of its fury to the very elderly, we need to be engaged across the hospitals, local communities, obviously the State, in doing this, and she’s done a great job of really working with a lot of those. But we really do think there needs to be a regional approach. So if you’re in Miami-Dade, you have those hospital systems, you have a facility which we think there will be a COVID facility that would be safe. If you’re in Jackson, Northeast, Florida, you have the Dolphin Pointe, you have the hospitals working together. We think that’s the only way that we’re going to be able to get to a sustainable point where we’re minimizing risks to the vulnerable population.

One of the things they also did with Mary and then also with Dr. Rivkees, but AHCA has been very proactive at pushing the envelope on whatever we can do to make this better. So they approved the program to allow personal care attendance to temporarily perform additional duties, because you may have a staff member that test positive, they need to be isolated. And so if you’re short handed, you need to figure out ways to be able to tend to folks. Additional time for nursing facilities and intermediate care facilities to pay quality assessment fees. And then a CMS waiver for hospitals to use swing beds with greater flexibility, expanded Medicaid coverage of telemedicine services and nursing facilities to allow physicians to continue to treat patients remotely, allowing nursing facilities, this is very important, to be reimbursed by Medicaid, even if the recipient is not placed in a Medicaid certified bed.

What happens, I think, and we’ve worked about this, there’s actually a financial incentive to keep a COVID in a nursing home. Yeah, they can lose money if they send them out. So there’s all these financial incentives, and I think Secretary Mayhew has done a really good job. And we went to CMS and said, “We want a waiver to be able to allow hospitals to get greater reimbursements if they have a resident of a longterm care facility.” So that makes it easier on hospitals, it reduces some of the negative incentives, and I think that that’s something that we want to continue to be very proactive on.

So the EMS Sentinel Surveillance, so they’ve done this in 25 facilities so far, they’ll test a sampling of the employees. They’ve done about 300 tests, but this is going to be an ongoing project. We’re going to their surveillance testing that’s going to be done locally, State, Federal. You heard Dr. Redfield talk about it. This is probably the most impactful type of surveillance program because you’re focusing on the areas where the introduction of the disease would be most consequential.

These rest teams have really been a great asset. They’ll have a number of different types of folks like an infection prevention as registered nurses, EMS ambulances. And what they’re trying to do is assure patient safety, they want to make sure longterm care staff can care for COVID positive patients, and obviously want to reduce further spreads. So they’ve actually been on the ground with over 200 longterm care facilities during the pandemic. And look, they focused on some of these areas where some facilities may not have had the best track record, some facilities in Florida have excellent records, and so you go where you think the problems may be.

VA has been helpful. They have 15 teams that are augmenting the State of Florida’s teams, and they’re doing infection control, they’re augmenting staff. Again, small impactful teams, and they’ve done 37 longterm care facilities serving 4,200 patients, and so we really appreciate that. The secretary, I remember, he called me, asked me some of the things that we needed. At that time people were still thinking about a surge to hospitals. We thought we were okay on that, and I said, “Look, the nursing homes, because we’ve got veterans nursing homes, whatever you can do there.” And they responded. So we want to thank the U.S. the Department of Veterans Affairs for that.

Also have, this has been going on for weeks now, 50 mobile testing teams. This is the Florida National Guard, Florida Department of Health, they go in and test residents and staff at facilities throughout Florida. They’ve already tested more than 32,000 residents and staff. They’ve probably been doing it for three or four weeks now. This has been helpful at identifying clusters, and being able to minimize further spread. So we’re going to continue to utilize the National Guard, has been very, very effective.

And then we now are using this mobile testing lab, which is a rapid test, 45 minutes. You go in, you can get the results in the same day, 3,500 tests per week. We introduced it last week, and we’re focusing these rapid tests exclusively on senior citizens and exclusively at longterm care facilities. And if you think about it, you’re sent into a private lab, and we’ve been getting a little bit better turnaround time, but that still is a lag. You get the results that day and say one staff and one resident’s positive, everyone else’s negative, well, then you can isolate those folks, and in that extra day or two could make a huge difference.

So Cepheid was great in helping us outfit this RV. And we think it’s the first of its kind. Cepheid said they’d not seen any of their products used in this way in the United States. They actually have mobile type testing for HIV in Africa that Cepheid uses. This is obviously a much different disease than that, but I think it’s a force multiplier for us. So if we’re looking going forward, we know that we see clusters, when we see cases pop up in Florida, it’s going to be connected, prison, nursing home, maybe a data [inaudible 00:16:28], maybe a new facility where you start to get a few cases to start. But the prison is self contained, there are procedures to isolate people that test positive. It’s obviously a lower risk demographic in terms of the ages than a nursing home. And so we really believe that this is going to be important going on.

So we’ve already done a lot to expand the testing at longterm care facilities, want to continue to do that, but we’re going to have to really partner with, with local folks, local officials, some of the hospital systems there. If you go in and a hospital system responds, they go in, they identify one infection, the rest are negative, and you isolate that person, not doing nothing could lead to 50 infections. And so it really helps to be proactive on this. We will, of course, as mentioned, have additional COVID dedicated facility so that patients can be safely isolated, and then we’re going to continue to maintain the screening of the staff. They report specifically through ESS, the case data, which is very helpful. And of course the hospital and longterm care facilities, infection control really being proactive. I think it’s in everybody’s interest to want to do that.

I’m going to let some of the folks here talk about this, but visitation, we’ve now been two months where visitors have not been allowed at these facilities, and my view has been I want to get to yes, on that. I just want to be able to know that we have procedures in place that if someone goes to visit their mother, that two weeks later, we’re not going to have 50 infections, [inaudible 00:18:03] nursing home or a longterm care facility. And I know folks in the industry are working on it, I know Department of Health is working on it.

But as much as it’s great to say that our fatality rate is a lot lower, that we kept the COVID out of the facilities, unlike the other States, which really precipitated way more fatalities in those States, having the isolation does come at a psychological and social costs. And I think one of the frustrating things throughout this whole process has been an inability of people to ever discuss the negative effects of mitigation. You very rarely hear that certainly discussed in any media. But this is an issue, and we can’t just turn a blind eye. Yes, it was right. We had no choice, we had to do it. But we’ve got to figure out a way to get to, yes. We’ve got to figure out a way to give some folks hope, and be able to see their family. And so we’re working on it. I am not going to sign off unless I’m convinced it’s going to be safe, but I don’t think we could just say no. I think we have a responsibility to try.

Now that may be requiring PPE, maybe requires a rapid test. That’ll all be determined, but these are folks who I think really could use a psychological boost, and to be able to see some family again would be a really, really good thing. So we’ve discussed also the peep supply PPE. The hospitals, we hope will be self sufficient on this as the supply chain gets a little bit better. It’s going to still be a struggle for many longterm care facilities, and so I’ve directed the Division of Emergency Management, stay in the fight on this. We want to continue to do it because I think that’s probably, dollar for dollar, the best use of the resources that we can have. So we’re all in on that.

We do though, I think the vision would be to get all the longterm care facilities with the local communities, with the hospital systems in a self sustaining rhythm, as long as we’re dealing with this virus. And if we can do that, then I think we can have good results going forward, but why do we need to do it? Here’s the latest case report, 85 years or older represents 5% of the documented infections in the State of Florida, but 32% of the fatalities in the State of Florida. Indeed, if you look at just 75 and up, 62% of the fatalities in the State of Florida had been age 75 or up, if you do 65 and up it’s even more stark, 84%, 65 or up, but then you look under 25, 0% deaths so far in the State of Florida. Zero deaths in 15 to 24. Zero deaths, 15 to 14. Zero deaths, zero to four.

Now obviously there’ve been isolated cases usually with preexisting conditions, but I think those numbers paint a very clear picture of where we need to be dedicating resources and where we can make the most difference in saving lives and protecting people. And so we’re going to continue to do it. I think it’s an important fight. I really appreciate the leadership that we’ve seen from Secretary Mayhew, and Scott Rivkees our Surgeon General. This was a priority very early, when very few people were talking about it, when very few people were advocating for any of this stuff. But I think it was done in a very surgical and data-based way. And I think it followed the appropriate science, and I think that we’re better for it. I’m going to let some of the folks here say a few things. We’ll start with Secretary Mayhew, then we’ll go with the Surgeon General, and then we’ve got some folks from the nursing home community that I think can say a few things as well.

Secretary Mayhew: (21:52)
Thank you, Governor. And thank you for your leadership. From the very beginning, we’ve known that Florida needed to have a laser beam focus in protecting our elderly, our medically frail. It is absolutely heartbreaking, what we have seen and experienced over the last many weeks. And it extends from the challenges that our nursing homes have faced, their frontline caregivers, the level of commitment and dedication, the isolation, Governor, that you described from family and friends, but all done to aggressively support our most vulnerable.

We have known from the beginning that this aggressive and deadly virus pose the greatest threat to our elderly and that within these residential facilities, that the risk of rapid transmission was greatest. What we also knew early on, even though we saw the CDC guidance changing as data and information came in from around the world.

Changing as data and information came in from around the world and around the country, the standard of infection prevention and control, the use of N95 masks, negative pressure rooms. That’s facility level infection, control and supplies that typically have never been expected within our nursing homes and our assisted living facilities. So all of the precautions that we have taken have stemmed from that understanding, not having false expectations that put our most vulnerable in harm’s way, but also to reinforce with the necessary resources, the deployment of the PPE, the engagement of infection prevention resources to support, to educate our nursing homes and assisted living facilities. The partnership that is reflected with the individuals here. Dr. Rivkees And I have spent days and nights together on calls with thousands of caregivers and facilities around the state. Truly on almost a daily basis, the engagement with the two associations here it may sound like it is a standard engagement. I would suggest that that is not the case around the country. I have answered the call from these two gentlemen night and day to respond directly to concerns, to questions, to recommendations and then direct engagement with facilities. And that direct engagement with facilities has helped to inform all of our actions to date.

Government often is rigid, it doesn’t respond well to the kind of flexibility that was absolutely imperative. And so I am truly grateful for the governor’s leadership that allowed us to have front and center this focus and support for our elderly. To pave the way to demand flexibility from the centers for Medicare and Medicaid services, to acknowledge the role of hospitals in admitting individuals who might not require that hospital level of care from a nursing home, but they needed to be isolated. They needed to have 24/7 clinical monitoring. And so the governor wrote that letter and within days we saw the centers for Medicare and Medicaid services granting us that flexibility. And what we know and what the hospitals know is this is their surge, they do need to be a core partner regionally with our nursing homes and our assisted living facilities so we can continue this commitment to take care of our elderly, to support our medically frail individuals.

So the path and the strong foundation exists today, but we have months ahead of us to continue this level of support and engagement to make sure that as we reopened our state, that our discipline, our vigilance is adhered to as we continue to protect our most vulnerable. I am so proud of the accomplishments in this state. That is a Testament to the strong partnerships reflected here and the engagement. I want to personally thank all of the frontline caregivers around the state. The more than 200,000 individuals here in Florida that have come to work.

And I want to just stress this, these are individuals that are helping people to eat, to bathe, to go to the bathroom. They are there supporting so many of those activities of daily living that we take for granted. And to my staff at the agency for healthcare administration, staff that have been called in the middle of the night, throughout the day, who have been deployed to these facilities to support, to help, to guide, to inform decision making. I am incredibly grateful to all of them for all that they’ve done to help us this far and to continue our efforts. Thank you so much governor.

Great, surgeon general.

Dr. Rivkees: (27:52)
Yeah. Thank you governor, secretary Mayhew and our community partners, as the governor mentioned, this is a virus that directs its fury on the elderly. And it’s always our thoughts are to those who have been stricken by this virus and those who have lost their lives to this virus and their families. From the very beginning this was something that we focused on. In terms of some of the major areas of efforts at educating facilities and workers about this virus, identifying workers when they are ill so we could screen individuals from potentially introducing COVID-19 into facilities, to restriction of visitors played an important role early on was in community. Infection control measures, the proper distribution use of personal protective equipment, evaluating residents when they are ill so we can stop the spread within a facility. How do we separate COVID patients from non-COVID patients in facilities?

And then also if a resident develops COVID-19, where’s the best place where that individual can get their care? This has been a very collaborative and proactive effort right from the very beginning. In January, when we saw this virus coming, we started developing messaging. We started working with long term care facility of organizations to start getting the messaging out. As the governor mentioned in February, we actually started screening of staff and visitors trying to identify individuals who would be ill. Individuals who may have been traveled or were exposed to sites where there was COVID- 19. We started a regular series of calls with longterm care facilities. But as the governor mentioned on March 11th, an executive order was issued limiting visitors to these facilities. Our efforts continued throughout March, in mid March we actually established an emergency call center where any facility could call 24/7 if they had concern about a resident who had a COVID-19.

We developed strike teams early on. So if a facility had a COVID positive patient, we would go in there immediately to make sure that individual had the medical care that they would need and support that facility as needed. We also initiated a series of visits from department of health personnel and emergency medical services to more than 4,000 facilities. 4,000 facilities to talk about important infection control measures. We also started an initial surveillance study in March of workers in longterm care facilities to get an idea as to what the prevalence was. And as the governor mentioned, very important measure that was instituted March 18th, and that is the wearing of masks with a recognition that there could be asymptomatic spread and presymptomatic spread. And this is something which is a very important measure that we continue to follow.

In April we continued our activities, increased distribution of personal protective equipment, increased educational activities. And as the governor mentioned, we’ve also started increased testing of nursing homes, assisted living facilities to the point now where more than 32,000 individuals, which include residents and staff have been tested. And also as the governor mentioned, this mobile testing laboratory where facilities can get test results very early. So we also are continuing these efforts going to models of sustainability, working with the Florida healthcare association in terms of developing a series of webinars for staff, working on developing new plans for sustainable infection control. Again, this remains one of our highest priorities for those of us in the state, as we are fighting COVID-19. Thank you,

Steve Bahmer: (31:57)
Governor thank you very much. I’ll start by introducing myself. I’m Steve Bamher, I’m the president and CEO of Leading Age Florida. We represent about 500 providers around the state across the continuum of care, beginning with low income housing, affordable housing for low income seniors, assisted living nursing homes, continuing care retirement communities. So we represent the entire continuum of care, which has created no small number of challenges, which governor and your team we appreciate your recognition of and your response too. A lot has been said this afternoon already about the number of steps that the governor and his team have taken. I’m going to start by thanking you governor for making seniors of Florida and especially those in longterm care environments a priority from the outset. It’s notable we’ve heard a couple of times this afternoon that in January steps began to occur in Florida to prepare for this, recognizing that these are the locations where the most vulnerable populations in Florida live.

That’s exactly the same time the members of Leading Age Florida began implementing measures too as the governor said, execute on a strategy of keep the virus out of our buildings. And I think the data that you’ve demonstrated governor suggests that that has been a relatively successful strategy. We have partnered with the secretary at AHCA, secretary Mayhew and the surgeon general, Dr. Rivkees. As they’ve mentioned on a daily basis throughout the course of the last several weeks. And I just wanted to express our thanks for a handful of specific steps that the governor and his administration have taken. First, the limitation of visitors as the governor said it was a challenging decision no doubt. It’s a difficult thing to do. Families have been separated for several weeks now, but it was a necessary initial step. And we’ve begun some conversation now about how do we begin to think about allowing families to visit residents in assisted living and nursing home environments.

That step was necessary early. An order requiring testing before folks could be transferred back into longterm care environments was also a necessary step. You won’t be surprised to learn that the people who run longterm care facilities are very interested in knowing whether people who are coming into their buildings are positive for COVID-19 or not. And that order is a significant step. I can tell you governor, our members were very happy to see that order issued in the recent days. The expansion of testing, if you’ve read any of the coverage, you’ve produced most of the coverage in the last several weeks, you’ve heard my colleague and I talk about testing, testing, testing. And governor we appreciate the continued recognition for the need of testing and the expansion of those tests. In particular, the visits from the department of health and from the AHCA teams, standing up the national guard to conduct testing around the state has been a huge benefit.

I made a note as the governor was talking to highlight the assistance from the VA teams as well. We’ve had VA teams on the ground and a few of our member communities. And our only regret is that they haven’t been able to be on the ground in more of our member communities governor they’ve been very helpful. The expansion of testing has been terrific. And then lastly, I couldn’t make remarks today without talking about the work of director Moscowitz at the Division of Emergency Management to procure and distribute PPE across the state. We won’t, as the governor said, stop talking about PPE or focusing on it for the foreseeable future, but director Moscowitz and his team have done an outstanding job. Which is to say we believe that the supply chains are loosening. We’re beginning to see some relief in the private markets, but the state’s support in getting PPE where it was most needed has been absolutely essential. It’s been outstanding.

It will need to continue I’m afraid into the foreseeable future, but we have appreciated that partnership as well. Before I turn a bit to the future, let me just say I wanted to follow up on the governor’s comments with respect to visitation. I mentioned to him in a meeting earlier this morning we’ve heard from members who are watching families be torn apart by their inability to connect with residents in an assisted living or a nursing home environment. Again, a necessary decision, but a very challenging one. Among the many steps our members have been taking since January to get through this crisis and to ensure the safety and health of their residents, we’re creating steps to make sure that families and residents could stay in touch. And so they’ve deployed technology creatively, they’ve used internal television networks, they’ve done hallway and balcony bingo.

If you can think of it, they’ve done it to try to make sure that residents were as mobile as they could be. And that families were able to be in touch with them because we are acutely aware of the profound effects of social isolation, especially with potential mental health results as well. So appreciate your focus on that governor and the opportunity to work with you. I would just say as we look to the future, we do have months of work still ahead of us. We are not there yet. We will continue to focus on PPE with I think a bit more specific granular focus on particular items that are necessary. Again, with appreciation for the expansion of testing we’ll continue to push for and I’m sure received the governor’s assistance with expanded testing, both in terms of the kinds of snapshot testing we’re doing now for all residents and staff in longterm care facilities, but for repeated testing as necessary as well.

We’ve all been hearing that testing gives us a snapshot and that’s correct. And so we’ll continue to work with the governor and his administration on repeated testing when necessary to make sure that there aren’t positive cases in these buildings. The focus on regional partnerships with hospitals has come up a couple of times this morning. I would only reiterate that those partnerships have been and are developing in our regions across the state. Those relationships with hospitals have been essential in terms of transfers as we’ve heard about this morning, but also in terms of PPE, there’s a particular area with the N95 mask requires fit testing. The kits to test for the appropriate fit have been difficult to find, but our partners in the hospitals around the state have been helpful in that way just one small example.

Lastly, I’ll close governor and thank you again for the opportunity to join you and your team this morning by thanking you, secretary Mayhew and the surgeon general for your expression of support for the caregivers in these communities around the state. We have watched as folks have walked into the fire day after day after day for weeks to care for the most vulnerable population under extraordinarily challenging circumstances. And so we appreciate very much your recognition of the people who are doing this work every day, the support they continue to need from us as an association, from you as the public and from your governor and your administration. Thank you very much for the opportunity to be here.

Great. And then on testing, we obviously have devoted a lot of resources for it. There’s also we have a lot of tests available beyond the capacity of maybe the national guard to administer. So if there are nursing, particularly skilled nursing facilities, where they would have the wherewithal to actually take the samples, we absolutely could get a lot of tests out very quickly. And then we have contracts with labs, just put it in FedEx, we’ll get the results back. So I would say any of those facilities out there that do have the wherewithal to be able to actually conduct them, let us know we will send you the supplies, we have the lab contract all taken care of, because that really is a force multiplier. I mean as much as great as the guard is with these 50 different teams, we got to stay to 22 million people.

It’s pretty doggone big. We got over 4,000 facilities, just realistically having some type of assistance in that respect would be a huge, huge thing. And I would also say for all staff at these facilities, Florida’s got 13 different drive-through test sites throughout the state. We’ve got three in Miami Dade County, we’ve got two in Brower, two in Palm Beach and then Orlando, Jacksonville, Fort Myers, Naples, Sarasota, Bradenton, Panhandle. And then that’s just some of the thing, Jacksonville, those are just some of the ones we’re running. We’ve got walkup sites, there’s other healthcare providers that have set up different things. And I would just say if you’re a worker in one of these avail yourself of that testing, we have at our 13 drive-through, we get about half capacity of what we could do. So don’t feel shy about it. If you’re a healthcare professional, you go right in line, get tested, no problem.

And I think facilities should be having them do that once every couple of weeks. Because if we can identify an infection from a staff early, that could make the difference between completely obviating an outbreak in one of these facilities. And so those resources are there. Now, obviously the guard will show up, the mobile lab will show up. There’s going to be other things for it. And of course they can avail themselves of oral health resources, which we certainly encourage the hospitals to be proactive. But at a minimum use the drive through sites. The guard does a very good job on it, but I mean we’re at four or five, 6,000 tests a day on all those sites where we could do usually twice that many. And I think that that would be something good. So especially if you’re in some of those very delicate positions, it’s important to get tested in those situations even if you’re not symptomatic. Because we know there’s asymptomatic and presymptomatic spread and getting those test results just make it.

And we’re also actively engaging in the private market with some of the new things that are coming online. They have the antigen point of care tests, they just got emergency use authorization from the FDA. So we’re looking to bring that online. It’s a good test for if you’re positive, there’s a little bit of a specificity drop if you’re negative. So there are some false negatives, not a lot, but there are, but this is important stuff. Certainly a positive test and that’d be very good. There’s also home tests where you can do it yourself and then send it in. So we’re looking into that and I’d imagine that you’re going to continue to see more innovation in this space so that hopefully as we go on this testing could be something that every facility would have really easy access to without having to send a major team in there or do a big site or anything.

I think the technology and the innovation is moving in that direction, but that would be really good to just be able to periodically do that. And some of these tests, the antigen test I think is relatively inexpensive compared to the RNA test. So that’s another good thing to be able to have those options, but yes, any worker please use these resources. We have it, we would love for you to be tested and then any facility that wants us to send them tasks where they would administer, we can make that happen very quickly. All right, sorry about that.

Emmett Reed: (42:54)
No, that’s okay. Thank you. Thank you governor DeSantis. My name is Emmett Reed, I’m the executive director of the Florida Healthcare Association and on behalf of our over 550 nursing homes and 200,000 caregivers, I want to thank you for your leadership and everyone at this table. Thank you so much governor DeSantis. I’m going to try not to be too repetitive of my colleague’s comments, but I do think I can shed some light, some different takes on some things that are going on. First of all, I would be remiss if I didn’t thank the heroic caregivers in longterm care facilities. They’re often overlooked yet they’re at what’s described as ground zero for this pandemic. So I do want to recognize their incredible work. And we appreciate the governor for leading the way, always seeming to be a step ahead or in front in helping us contain the spread of this virus.

He’s made some really tough decisions that along the way have proven to be right. From restricting visitors to holding COVID positive patients in the hospital and sending them to nursing homes. Governor, I believe that saved thousands of lives in Florida. That one action alone. And you got a lot of heat for that, but it was the right decision. So thank you for doing that. We were talking about testing, obviously that plays a huge role in that and the governor’s offering more testing. He’s allowed secretary Moscowitz to help nursing homes with the PPE. That’s been huge. I can tell you that I’ve been on the phone with secretary Moscowitz, secretary Mayhew, the surgeon general all weekend on Sunday mornings doesn’t matter, they answer the phone. And so that strong partnership is huge. So I appreciate that secretary Mayhew and your leadership.

We’ve been working with the Florida Hospital Association, Florida Healthcare Association has on a partnership between hospitals and nursing homes. How do we communicate better? How do we share resources on infection control? How do we help with continuing education? And we’re urging conversation between local nursing homes and their local hospitals, and it’s working, it’s starting to work. We began this week with mother’s day and this week actually continues as national nursing home care week. Normally our care centers would be filled with visitors, family members, volunteers and big celebrations, but that’s just impossible right now. But we do share your concerns and we can share your desire to get things back to normal in a safe manner.

And so we’re working on that because we want family members to be able to hug their grandmother, their grandfather, their aunt, their uncle, their brother, their sister. We know the residents want things to return back to normal too. They want to be able to play bingo. They want to have meals with their friends, but we have to do it safely. And the governor has always focused on safety of the residents first, and we believe that’s the right way to do this, resident’s safety first. So after conversations with the surgeon general and with secretary Mayhew, the Florida Healthcare Association put-

… and with Secretary Mayhew, the Florida Healthcare Association put together a task force of infection control experts, clinicians, nursing home administrators, assisted living administrators, representatives from the Florida Hospital Association to find out what would it look like and what does it need to look like to safely open up our long-term care centers. Our recommendations are going to be focused on strong screening procedures, testing, proper infection controls and PPE, designated areas with appropriate social distancing, along with a process that is facility and community specific based on the impact of COVID-19. The Florida Healthcare Association looks forward to our continued work with the strong leadership of Governor DeSantis, Secretary Mayhew, the Surgeon General and Secretary Moskowitz. We thank you for your support of the long-term care community, and we look forward to moving forward together. Thank you.

Well, thank you very much. Just a couple other updates. We do now have this new FDA approved drug, remdesevir. So, that’s just being made available to folks. I think we have enough doses right now. What, about 200 patients, would you say? Do you know how much? Something around that line?

Speaker 3: (47:19)
It’ll be 100 to 200.

100 to 200. So, we have about 250 people on ventilators statewide. So, that’ll take probably most of those. But that’s another interesting thing. If you look at the number of people hospitalized in the ICU in Florida, our peak was at probably what, 850 to 900, something in that line? We’re now down in the 450 range, probably over the last four or five weeks. The hospitalization trends have all been, in terms of just a run-of-the-mill citizen getting COVID going to the hospital, it’s been a real noticeable decline. Where we’re seeing hospitalizations is because of the transfers.

So these are a lot of folks who really don’t require hospitalization. They need isolation, but they’re being go, and all these other things. And I think Secretary Mayhew’s right. Look, the hospitals were half empty throughout this whole thing. They were never overrun. And so now you may have some situations as we continue to get different facilities COVID compliant so that they can actually do it in a place like Dolphin Point, you may be seeing transfers. But you know what? Getting the COVID positive out of the nursing home will potentially save lives.

If it spreads, you will have more infections and more fatalities. And so we appreciate the hospitals that have worked on this. Obviously, we’re going to continue. We’re going to hopefully have some announcements very soon, some different parts of the state. But we just have to remember that putting somebody who’s COVID positive back into a nursing facility that is not equipped to isolate with negative pressure is a major, major hazard to the health, safety, and wellness of those residents.

All you have to do is look. You saw the Northeast’s approach where they forced them back in. You saw Florida’s approach where we forbid COVID positive from going back in. Those states have more fatalities in nursing homes than Florida has total. Those states, many of them are half our size, and they have more nursing home deaths than Florida has had in total with 22 million. When you do it by population, it’s not even in the same ballpark. So these decisions have consequences. And I was talking to someone at HHS that said, “Yeah, Florida doing per 100,000, obviously controlling for population, but that doesn’t even really do it justice because we have such an older population that if you even factored that in it would be even more stark.”

So taking the extra step to protect our seniors and to support long-term care facilities has been worth it in the state of Florida. All you have to do is look at other places that did not follow the way we did it. So I want to thank the folks in the industry. I do want to thank everybody who’s working at these facilities. I mean, this is a very, very stressful time. You’re dealing with residents that you know are at high risk. If they were to acquire this virus and you may be doing everything right, pass every screening, people have this and don’t even know they have it. It’s been a very, very difficult high pressure time. I think you look at the facilities, for the number of cases that we have as a percentage, we have so many facilities who’ve never had a single infection documented.

I mean, thousands of facilities with not even one. And then we have a number of facilities that have had between one and five. Where they found it, they isolated it, and they prevented a major outbreak. So I think that they’ve played a huge role in this. But, I think the messages going forward is this will continue to be the tip of the sphere. You look around the country as the virus has receded from where it was in the middle and end of March and beginning of April, you still see the cases in the meatpacking plants. You still see outbreaks in prisons. And unfortunately, you do see outbreaks in the long-term care facilities.

And so the virus is not going away. You’re not seeing as many outbreaks throughout the country, I think as people feared. But all it takes is one introduction into a long-term care facility, and you could have 50 people infected within a week or two. This is a very high risk environment for this. And this virus has shown that there’s certain environments it really thrives on. Any of these really close contact environments, enclosed environments. That’s why you keep seeing cases popping up in all these other areas. And so Florida’s in it for the long haul on this.

We believe that this has been important to do. We’re glad we did it. We understood where the risk was, but we also understand that as we do phase one and all these other things, look, you can have a strong economy and still protect long-term care. Just like some states totally shut down everything and didn’t protect long-term care. So they’re not really like a you can do one, you can’t do the other. You can easily do both. Well, it’s not easy to do. It takes a lot of hard work, but certainly you can pursue both. And that’s what we’re going to be doing here in the state of Florida.

So we’ll be having hopefully some more good announcements. I know Secretary Mayhew’s working on a lot of things. And we do want to get the families back together with their loved ones. It’s very, very important. We obviously got to put safety first. But I think this separation, human beings are not meant to be separated, particularly family members. And especially with some of our residents as they get older, these are important moments and we want to get them back together. And we’ll work hard to do that very soon. Questions.

Speaker 4: (53:08)
I thought I heard Secretary Mayhew say it would be a couple of months before you get those families back together. Is that a fair assessment of the timetable?

Well, I don’t think any of us really know. I mean, I think we’re going to solicit some input from the long-term care facilities and I’m going to look at it. And look, if it’s a situation where we’re running a risk of having an outbreak, we just have to err on the side of caution. And we’ll also see how this evolves over the next coming weeks. So I wouldn’t want to put a firm timetable on it, but I also don’t want to give people false hope and say, “Oh yeah, you’ll be in there in two weeks,” because I can’t guarantee that. We have thought about with the rapid tests could we go and maybe test visitors and then 45 minutes later, they could go in if they’re negative. The problem with that is it wouldn’t be fair. Which facilities are you going to do that for? We have so many facilities to just go to one. So I’m not sure that that ultimately is the best solution. Yes, sir.

Speaker 5: (54:01)
[crosstalk 00:08:04]. And whether or not you’ve considered it?

What’s that?

Speaker 5: (54:07)
Have you considered universal testing for all the residents and staff for all of the facilities?

So we want to do that. Yeah. We obviously want everyone tested. Now, some residents don’t want to be tested. So when the National Guard goes in, some of them say no. And we’ve respected that. But yes, we want every resident who wants a test to be able to do it. We have the tests available. It’s how you administer them. So we think that that would be a good thing. And then for the staff, for sure. I mean, from the very beginning of this, when all the test facilities that we stood up, the drive through sites, they always had a dedicated thing for first responders and healthcare workers, because we understood they were on the front line.

And so this is something where the numbers were showing for a National Guard going in and testing. That doesn’t mean that’s the only, because you’ve had had these workers that have gone through and been able to get a lot of tests. And so that’s been a good thing. We want to continue to do it. But I do want to just stress, the tests are available in the drive-thru. So please, if you want it, do it. We want each facility to have a testing regimen for their employees. Now, we have had some who’ve expressed concern because if someone tests positive, they got to be isolated. You could end up shorthanded very quickly. And I understand that. But I think we’ve got to err on the side of getting the information and getting the testing.

Speaker 6: (55:25)
[crosstalk 00:55:28]. Long-term care facility have all their staff tested in the next two weeks? The White House, on Monday, made that recommendation. Why is Florida not pursuing that same recommendation?

First of all, Florida has done more than any other state. So we’ve led the way on testing. We want to test as many people as we can. But we have 4,400 facilities. So I don’t want to give false hope to say, “Oh yeah, everyone will just show up.” We can distribute tests. So if people want to do it, do it. We can, I think accommodate every worker, if they want to go to the drive-thru. But it’s going to take a nuanced approach to be able to logistically do it. And of course, we’ve already tested a lot of folks throughout this whole time, they’ve always had a dedicated lane. They’ve always been able to go regardless of symptoms and get tested. So a lot of them have already been tested, which is obviously a very good thing. And of course, they’ve all been screened for illness every day, or required to be screened for illness every single day, since mid March, which is very, very important.

So we’re going to continue to lead on this and we’re going to continue to expand testing. The surveillance testing is something that’s important too, because if you’re doing surveillance testing and continue to get negative, negative, negative, that’s a pretty good indication that the virus isn’t permeating those facilities. And so I think that was a good innovation and we’re going to continue to do it. But we want every staff member to get tested and we’re happy to work with them to get that done. Now, the residents, we want to get tested too. But there have been some that just don’t want it. And so I don’t know that we’re going to force that, but I think for any resident that wants it, we want them to get tested as well. Yes, sir.

Speaker 7: (57:18)
[crosstalk 00:00:57:14]. Are you planning on extending the moratorium on evictions?

I think we’ve done that. Or I think we probably do it to the end of the month. I got to look to see whether we’ve [crosstalk 00:57:27]. What’s that?

Speaker 7: (57:26)
It expires the 17th.

Yeah. I think we’re going to do it through the end of the month, but we’ll have an announcement on that I think pretty soon. Yes, sir. Behind you.

Speaker 8: (57:39)
Are you prepared to let Broward County move to phase one of their reopening? And what should the County do about its beaches?

So as you know, on the beaches, I’ve let locals make that decision from the beginning. I never understood the outrage. I think that was more based on partisanship than based on anything. But, I also understood dealing with the Mayor of Fort Lauderdale, Miami Beach. I mean, they had situations where those are just a little bit different than like St. Augustine, or the panhandle or whatever. So I thought that making those local decisions made sense. So we’re going to let them make those decisions, how they see fit.

There’ve been a lot of ink spilled saying how Jacksonville or all these places. And the fact is we’ve not seen outbreaks from it. And it’s because this virus prefers indoor and closed, close contact transmission. It doesn’t mean you can’t do it outdoors, but if you’re maintaining social distance and you’re kind of just with your family, I think it’s very low risk. But I also understand in some of the more populated areas like Miami and Broward, kind of maintaining that social distance may be a little more challenging than it would be in like a Bravard County, which has had the beaches open the whole time. Has one of the lowest fatality rates in the state, 600,000 people. And have generally done a good job. In terms of phase one, I know they’re going to be presenting me kind of with their plan. I will say this, Broward has definitely trended well. If you look at their infections, their cases are down.

And Miami has too. I mean, they were 500 cases a day at the beginning of April, and now they’ve trended down. I think they’d been between 100 and 200. And that is including Homestead Prison. I mean, those are those cases. And so I think that they’re both proceeding very thoughtfully. So we’ll have a decision on that very soon. It’s also important to note when we moved the other 64 counties to phase one, I didn’t really do full phase one. If you look at what was provided by the White House, in terms of what you could do, phase one. You could do the restaurants with half. I did 25%. You could do movie theaters. We didn’t do that. You could do the churches, but we never closed that.

You could do gyms. We didn’t do gyms. And so we really did kind of a … it’s almost a phase 0.5. It certainly wasn’t a full phase one. So we have those other 64 counties that obviously we’re going to look to see, okay, can we do full phase one on that? Because I know a lot of people have asked about some of these things. And then the Southeast Florida counties, Palm Beach wanted to go to kind of that modified phase one. So they did that on Monday. They haven’t had as severe as Broward or Dade, but I mean, they certainly were more severe than anywhere else in Florida outside of that. But I think they had a good plan. I’ve talked to Mayor Jimenez, he’s got a really good plan. We’re in contact with the Mayor of Broward, the administrators.

Governor Ron DeSantis: (01:00:34)
And we’ve worked with them from the beginning. And that’s really how this has been done, because we have a big diverse state. This is a radically different outbreak in different parts of the state. And we knew what Mayor Jimenez needed to do in Miami Dade was going to be different that what needed to be done in Duvall, or Okaloosa, or some of the other places. And as we go into this phase one, 0.5, however we term it, it’s going to be the same thing. And so these are going to be local solutions working collaboratively with the state. But my view has tended to be, if the commission has a plan, or the mayor has a plan, and it’s sensible, and the health folks sign off on it, my view is to want to work with them on all those different things.

The one thing I am going to do probably this week is all professional sports are welcome here for practicing and for playing. Now, we’re not going to necessarily have fans. But there’s been reports that Major League Soccer may want to have their season in Orlando. Do it. We want to have you here. We want to have the basketball practicing again. We would love to have the Major League Baseball. And I think the message is that our people are starved to have some of this back in their lives. It’s an important part of people’s lives. So we want to be able to do that. I think we can certainly do it in a way that’s been safe. And we have had events, UFC, these other things. We’re having a charity. There’s a charity golf tournament in Juno Beach on Sunday. It’s going to be on NBC at Seminole Golf Club. The next week Tiger Woods, Phil Mickelson, going to be at Medalists and Hope Sound.

So we want all that. But all these professional sports are going to be welcome in Florida. That may not be the case in every other state in this country as we’ve seen. And so what I would tell commissioners of leagues is if you have a team in an area where they just won’t let them operate, we’ll find a place for you here in the state of Florida, because we think it’s important. And we know that it can be done safely. We’re also going to be looking at some of the stuff with our youth sports as well. It’s very important. And we need to figure out a way forward there. So, we’ll hopefully have some announcements on that very soon. Mike.

Speaker 9: (01:02:47)
[crosstalk 00:16:47]. Can you talk about prisons and what you’re doing to mitigate the huge spread that we’re seeing in cases there? What kind of resources?

Well, let me just generally correct you on huge spread. I mean, we obviously are having cases. But if you compare that to some of these other states, there’s some states where they’ll have like five, six, 700 prisoners, 1,000 prisoners test positive. We had yesterday, I think 100 prisoners in what, Hamilton County or one of the rural counties. And so you have had it and the percent positive has been higher than the percent positive in the state as a whole. I think that they’re between 10 and 15% in the prisons. But, understand there’s some other prisons throughout this country where 75% of them are testing positive. And so I think that’s a testament. Now, we are going to continue to expand the testing in the prisons. But I think it’s a testament that with General Lynch, they are isolating people.

They’ve transferred prisoners. They’ve done things to able to mitigate the spread. But you will continue to see some cases coming out of prisons, because the testing is ramping up. We’re going to continue to test in the prisons. So it’s important when people see there’s X number of cases that Florida reports. Okay, where are those cases coming from? They’re coming from prisons. It’s not that that doesn’t matter, but that’s obviously a discrete issue that’s not really indicative of a community outbreak.

Same, I would argue with the nursing homes. Very important issue, a super important issue, but probably a discrete issue and not necessarily indicative of what’s going on in the community. So you’re going to continue to see those cases. We obviously would like to see fewer cases in longterm care facilities, get that as low as we can. But, you’re going to continue to see that. But there’s been a lot of isolation. There’ve been transfers.

Speaker 4: (01:04:40)
Can you comment on where you’re transferring them, because if they get transferred to a hospital that requires law enforcement at the hospital?

Well, most of them, very few of them have needed that type of treatment. I mean, that’s the thing with the prisoners. And I don’t know with these more recent numbers, so I don’t want to speak out of turn about Florida, but if you look at some of these others states, you’ll have massive outbreaks in prisons. And they’re almost all asymptomatic, because a lot of this is their age, and everything, and they tend to be a little bit younger. So, that’s just the reality. So you have not seen a huge amount of hospital resources have to be expended. I know there’ve been some on ventilators, I think probably now, but relatively few so.

And I don’t want to say, because there’s different things, and General Lynch i handling that. But just suffice it to say, they’ve taken a lot of steps to be able to mitigate the virus spreading. And I think if you look, even as you will see more cases in prison, the percentage of people testing negative between, and actually the staff, it’s amazing. There haven’t been a huge number of staff that are testing positive. You would think in the longterm care, we’ll have staff outbreaks. Prison, it’s been very small. One or two here, one or two there. I was expecting you to see a lot of staff members testing positive, but you just haven’t seen it. And that’s something that’s very, very important.

Speaker 10: (01:06:01)
One more question.

Speaker 11: (01:06:01)
[crosstalk 01:06:04]. Have you had a chance to look at it yet and do you support what you see so far?

I just heard that that’s basically an extremely partisan bill with all kinds of very partisan things in it. So I would imagine that that has probably a 0% chance of passing. So it’s not going to be something I’m going to thumb through. It was probably thousands of pages. Nobody probably read it. And that’s just the way Congress operates. It’s really, really frustrating to watch some of this. And look, I am a recovering Congressman. Six years. My colleagues there say, “We miss you so much, man.” I don’t miss you guys at all. I don’t want to go back. So no, I haven’t looked at it. I’ve spoken with the President about different things for states. And my view has been, look, whatever you do, you should look to see where all the states were positioned in February of 2020.

And if whatever you do comes out and states like Florida and Texas lose their competitive advantage, that’s not going to be fair for us. And so just make sure that what you’re doing is not rewarding states who didn’t do a good job managing their finances. It’s one thing to say COVID has hurt the economy. You have revenue, okay, we want to help you. But it’s quite another thing to say, “We’re going to use COVID as a pretext to be able to bail out pensions or to be able to do things that really were a result of mismanagement, not a result of COVID.” And part of the problem I’ve seen with some of the stuff, like you look at the PPP. You have companies that are getting this money, who are doing it more because of mismanagement, not necessarily because of COVID.

You have some companies that have been operating. And then they’re using it to paper over flawed practices in the past. I think it’s the same thing with states. Don’t do things to bail out bad decisions. It’s one thing to give support, particularly for some of the local folks because of this. And so we’ll see how it’s done. I haven’t looked, calculated to see how Florida would come up or not come up in all of that, but by all means, however we come out of this, the relative fiscal positions of the state should reflect those positions prior to COVID-19. Thank you.

Speaker 10: (01:08:26)
Thank you, everyone.

Speaker 13: (01:08:26)

Florida Governor Ron DeSantis COVID-19 Press Conference Transcript May 13: Says All Pro Sports are Welcome in FL

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