Florida Governor Ron DeSantis July 18 Press Conference Transcript

Governor Ron DeSantis: (00:02) All right, well good afternoon. I appreciate being here in Flagler Hospital. I want to thank Jason Barrett for hosting us. Really appreciate it. We also got a couple physicians here, so I'll be giving an update on kind of the latest that we're seeing with COVID in terms of the COVID response and we'll talk to some of the folks here about the experience in this area and just the ... Not just COVID, but also a lot of the other issues involving healthcare. Because I think that what we've seen was in March and April obviously there was a lot of focus on COVID. There were people who had other conditions who were deterred either by fear or a belief that there wasn't enough services available from seeking care and so now you have hospitals across the state that are dealing with those same patients who are at more acute conditions. So we want to obviously send the message that the virus is an important issue. It's obviously something we're working hard on and I know a lot of people in Florida have taken a lot of appropriate measures and I think it is paying off. I think we'll see that very soon but all these other conditions, these hospitals are here to care for you and if you need the medical attention, you really should go seek it and that. Governor Ron DeSantis: (01:18) As we look at what's going on with the virus, it is an enemy for us for sure, but so too is fear in terms of how we approach this. There's a lot of different things that get put out in the headlines and this and that. Not always with I think the appropriate context and perspective but I think the result is is that a lot of people have a lot of angst and stress that gets built up and I think fear is our enemy here and I think that we approach this with a steady resolve. I think we're going to handle it much, much better and I know that a lot of other folks have been doing just that and I want to thank everybody for doing it. Governor Ron DeSantis: (02:01) We have a lot of things that we're working on day after day. One of the things we were able to do recently ... When this hit in March, it was novel, it's still novel, but it was more novel then and there really weren't any treatments that anyone really knew had to deal with it at the time and so there was a lot of trial and error that was done but there was also by kind of flattening a curve and spreading this out over a longer period of time, it really gave the opportunity for American innovation to take hold. You've seen that in a variety of ways. Some of it is with some of the testing capacity, some of it is other things but one of the things is with therapeutics and so one of the drugs that has been developed since the coronavirus hit in March has been the remdesivir so that had been distributed by HHS probably about ... I don't know, what, a month or two ago maybe started and the Department of Health at that time was sending it out to all the physicians. Governor Ron DeSantis: (03:02) Of course in May and the beginning of June, we had a very low COVID-19 census statewide, but that was done and then as the census increased for COVID, more and more physicians were using the remdesivir and most of the ones I've spoken with have had positive results with the remdesivir and so when we got word that they were running low, we were able to get another shipment expedited that arrived last Saturday, which is very, very significant but then you also had other hospitals saying this is good but we're looking at, we're going to need more before the next shipment is scheduled to arrive. So I worked with the White House, Vice President Pence, White House Chief of Staff and we are getting 30,000 more vials of remdesivir sent to the State of Florida, actually sent directly to the hospitals, from the Gilead distributor and those will be arriving within the next 48 to 72 hours. So there's 30,000 more vials. That's probably about 5,000 to 6,000 additional patients, and so we want to make sure that the physicians have what they need to be able to prescribe for their patients and I think it has shortened hospital stays, I think it has probably taken patients who may have ended up in the ICU but for this and it probably had a positive effect on mortality as well. Governor Ron DeSantis: (04:29) So when there is options to be able to help, we're going to move to do what we can to get the help down to the people here in the state of Florida, but I do want to thank the president, I want to thank the vice president, I want to thank the White House staff for really heeding our calls and they understand and this is something that's important not just in Florida but in other states around the country. Governor Ron DeSantis: (04:51) Another type of treatment that has also proven to have a positive impact is the use of convalescent plasma, so this is people donate blood who have the antibodies for COVID-19 and then that can be used as a treatment for patients who are suffering under the illness. We have an opportunity to really step up our game in the state of Florida in terms of blood donations. Governor Ron DeSantis: (05:15) Yesterday we have antibody testing at a lot of our drive through test sites and for most of May and June, that testing was for healthcare workers and first responders, law enforcement, which is great and appropriate. We recently expanded that to the general public and so if you want to get an antibody test, and I've actually recommended if you're not symptom, you don't have symptoms, but you think you may have had this in the past or been exposed in the past, the antibody test is probably a better test than the diagnostic test because if you have the antibodies that's information that you can take with you. If you test negative for COVID in a diagnostic test, that's just a snapshot in time. You could acquire the virus the next day, so we've really stressed and advocated for antibody. Governor Ron DeSantis: (06:05) Yesterday, the results were 16.1% were positive for antibodies, so that is a significant jump from where we were about a month and a half ago and really that's a snapshot of probably infections that happened at least four to six weeks ago. So there is a bigger pool of people who have the antibodies and so my plea would be is if you are positive for antibodies, if you have cleared the illness, please consider donating the blood because our physicians and medical personnel can use it and it has been something that many of them think has been favorable for their patients. Governor Ron DeSantis: (06:44) Our testing has been very prodigious. We are testing about over the last seven, eight days roughly 100,000 test results are coming in a day here in the state of Florida. To put that in perspective, at the height of the March-April, some of the states that were the most hardest hit, they were testing 20,000, 25,000, 30,000 a day, and it wasn't their fault, there was just a limited ability. So this is a huge number of tests, but I think it's also important to understand who are we testing and how when you see cases and that, what does that really mean? So we have all these drive through sites throughout the state of Florida and other types of sites but we've looked at one of our drive through sites, the Hard Rock Stadium down in Miami-Dade County, and we asked people when they were coming in why they were coming in, what prompted this, all this, and what we found is 80% of the folks who were going through that drive through testing site were not exhibiting any coronavirus symptoms. Some of them just were curious, 25% just said they were just curious about knowing whether they were infected. Some others said that this is employment-related and their company that they worked for wanted them to get tested. Some said I don't have symptoms but I think I may have been exposed to somebody. Governor Ron DeSantis: (08:05) So that's a huge number of people that are testing who have not developed symptoms and have not displayed any illness. Consequently, when we see cases, there's a huge percentage of those cases where the people are either asymptomatic or minimally symptomatic. Those just would not have been detected in March or April with the testing criteria that was in place at the time. Now anyone can get tested and so you have the ability to get tested if you don't have symptoms and the vast, vast majority of people who are taking advantage of that do not have symptoms. Governor Ron DeSantis: (08:43) Statewide, our new case positivity has been relatively stable, probably slight decline from two weeks ago. We had kind of been in that for new cases about 15 to 16%, now we're in that kind of 11 to 13% range. I think that is positive movement. I think you have seen that probably a little more pronounced in some of the individual counties, but even some of the places that have tested more highly in terms of the percent positive like Miami-Dade, you have seen, they've now been 16 to 20, whereas they had been 20 to 24. So I think that that is something where we can say that we've certainly reached a point of stability on the percent positive and I do think you're seeing a slight downward trend. It will take a little time for that to filter out and remember the test results that are being reported, they're from private labs, many of those are reflecting infections that probably happen seven to fourteen days ago. Governor Ron DeSantis: (09:40) Here in St. John's, I think they have had positive movement. You've had in the last nine days the percent of test takers that have tested positive with new cases has been between 5.5 and 10.7%, so that's pretty significantly below the statewide average. We've also seen a downward trend in ED visits for COVID like illness since the week of 6/28 and what we're seeing is kind of the, depending on the place in the state, the end of June through first week of July was kind of where the ED visits were highest and then we have had a decline since July 7 in terms of ED visits for COVID-like illness. Up in Duval, it seems like their percent positive has stabilized, they've been in that 10% range for new cases I think the last three days and they've also seen a decline in ED visits for COVID-like illness since the week of 6/28 and I think they've also seen a stabilization in some of their admissions, COVID admissions. Governor Ron DeSantis: (10:40) We also debuted yesterday a lane specifically for symptomatic individuals at the Regency Mall in Jacksonville with the goal of getting people test results back quicker. I think what's happened is the United States is doing between 700,000 and 800,000 tests a day. Now some of those are being done in hospital labs and in areas where you can potentially have [inaudible 00:11:09] state labs, but that's a limited amount of capacity. Most of the tests are being sent to big private labs and the turnaround on that has gotten progressively worse over the last six weeks. When we went into Phase I at the beginning of May, we set out to have relationships with labs who said they could do 48 hour turnaround. That just has not been the case. I think part of it is the sheer volume and particularly with a lot of asymptomatic test takers. Governor Ron DeSantis: (11:37) Sometimes people will go to a drive through, take a test, then they'll get a result back in like seven to ten days. Well obviously if you're sick that's not helpful because you want to know whether you have corona or something else, and then if you're asymptomatic and the reason you're testing is because we want to identify asymptomatic carriers and we don't want you to spread it to someone else, are you just going to sit there for seven to ten days and twiddle your thumbs until you get the test results if you're not sick? Most people aren't going to do that. They're obviously going to continue to go to work or whatnot and so that really hurts the idea of stopping asymptomatic spread. Governor Ron DeSantis: (12:13) So what we decided to do is a couple things, one, Department of Emergency Management, some of the labs that have had poor records in terms of turnaround, they're diverting business to labs that have pledged to do a better job or demonstrate an ability to do a better job which is good, but then what we did with the symptomatic lanes in some of the key drive through sites around the state is said, "Look, if you have symptoms, go through this lane. We have a self-swab that's done. Send it in to the lab," and so yesterday was the first day that that happened. We think that the results will come in within the next 24 hours. That will be within a 48 hour window, maybe even within a 36 hour window so we're monitoring that, we're following, the labs are going to let us know when they're reporting it to people, but that's a really big deal. Governor Ron DeSantis: (13:02) If you test on a Friday and you can get the results before you go in to work on a Monday, so that's a model that I think potentially has some promise for us going forward and again it's interesting. We did 151 of the symptomatic tests at Regency. I think Regency overall did about 900 tests so the bulk of those Regency tests were people who weren't necessarily exhibiting those symptoms and to go to the symptomatic lane. Governor Ron DeSantis: (13:31) We have I think ... When we look at the coronavirus pandemic and kind of where Florida stands, obviously there's a lot of focus on the testing numbers. Some of those may be a little bit more of a lagging indicator at times, but one of the things that I think that is a good barometer is the number of visits to emergency departments for both COVID-like illness and influenza-like illness and what we've seen in Florida over the last several weeks is July 7 Governor Ron DeSantis: (14:02) ... several weeks is July 7th was the peak of these ED visits for COVID-like illnesses at about 2,500 folks statewide. Yesterday we had less than 1,000 individuals visit EDs across the state for COVID-like illness. Our visits for influenza-like illness peaked on 07/07 as well at about 1,000. Yesterday it was a little bit more than 500. And so those are indicators when people actually show up of kind of how the disease is progressing throughout the community. So I think that that's a good sign. I think we have seen admissions slow. We've seen more discharges over the last several days than we had been seeing, and I think there are certainly some parts of the state where you've seen, not just the plateau in hospitalizations, but even potentially a decline. Obviously, you need like a week's worth of data to really know that. Governor Ron DeSantis: (15:02) But I think it's a testament to folks throughout Florida, really just doing the basic things. If you're in that vulnerable group, if you're age 65 or plus, limiting contact outside the home and avoiding crowds. If you have underlying medical conditions, doing similar things. We also are looking around the state and trying to identify different venues or vectors for outbreaks. We have seen a lot of vectors be bigger private gatherings where you have a lot of people together. So we're advising people that in this situation having those big gatherings are something that can absolutely contribute to the spread. And so limiting those contacts as much as you can, certainly for the next couple of weeks, would be a really, really good thing to do. We're very, very focused on providing support to our medical personnel. Governor Ron DeSantis: (15:58) So I spoke about the treatments, which is very significant. We've also deployed a large number of healthcare personnel that the state had been working with or had on contract. And so some of those have been deployed to places like South Florida, the Tampa Bay area. We've also deployed them to some of the COVID-only nursing facilities that the state has been instrumental in standing up. Pretty soon we're going to have about 1700 beds in these COVID-only nursing facilities. And so that's a great thing to have to be able to prevent nursing home outbreaks. If you do have a resident that becomes symptomatic and tests positive, they can be safely transferred to these COVID-only nursing facilities without staying in their current facility and infecting other nursing home residents. So we actually have some of the personnel at those facilities to expand bed capacity in the short term. Governor Ron DeSantis: (16:48) And then we also had an instance up in North Florida, where you had 50 members of a staff of a nursing longterm care facility test positive. I think they were all asymptomatic, but obviously, they've got to be taken out of circulation. And so the state has put about 25 nurses down there. So we hear kind of what hospitals are looking at. The personnel and the medications have kind of been the two things, and so that's been our strong focus to be able to do that and to be able to help them. So it's an honor for me to be here. I'm always glad to be back in St. Johns County. It's a heck of a good place to live, and you guys are doing a great job. So do you want to take it away and offer us some comments? Jason Barrett: (17:32) Yes. Thank you, governor. Let me begin by thanking Governor DeSantis for his leadership and his commitment to the state of Florida and certainly Florida's First Coast. I truly appreciate you being here in St. Augustine, the nation's oldest city. I've been honored to serve on the Children and Youth cabinet. I likewise appreciate the first lady's unwavering commitment to Florida's youth, including supporting our brave program for children's mental health support here in St. Johns County. I also want to acknowledge our courageous caregivers, some of which are here with us today. Our physicians, our nurses, our therapists, day in and day out answer the call of those in need during this pandemic. As others run from the burning building, these are the heroes that run in. These are unprecedented times, and while we at Flagler Health have weathered many challenges in our 131 years of serving our nation's oldest city, we recognize that deep partnership and innovation are critical to overcoming the challenges of this health crisis. We applaud the governor and his team for their steady supportive of this community. Secretary Mayhew and Surgeon General Rivkees have been constant and attendant to the needs of the First Coast. Jason Barrett: (18:48) Our mission at Flagler Health is a community one. Our commitment to improving the health of the communities we serve extends beyond physical treatment. We're equally dedicated to addressing social and economic impacts caused by COVID-19. As part of our community mission, we have established and underwritten a community testing site on our St. Augustine campus, providing free testing to thousands of First Coast residents. This testing has yielded a 9% positive rate with a mortality rate in St. Johns County of 0.66%. With the governor's recent instructions, we were able to safely resume elective procedures, ensuring pervasive testing to ensure a safe environment for our patients and for our valuable team members. We continue to see approximately 30 patients daily requiring hospitalization. This means we have adequate resources to serve our community effectively at this time. Jason Barrett: (19:51) We are experiencing a marked increase in the community spread, based on the most recent transmission index. As stated previously, our mission extends beyond physical health. We are serving the other arms of our mission, working to provide food adequacy, rental and mortgage assistance, as well as expanded mental health services to address the endemic social isolation that has come as a result of this virus. We've been honored to serve thousands of First Coast families through our community health organization CareConnect. And while we honor our past and our community mission, we have developed innovative technology to help businesses reopen safely and worked actively to support the wellbeing of our local employers and their workforce. The bedrock of a healthy community requires a vibrant economy. Jason Barrett: (20:47) As a close, I want to emphasize, we are experiencing community spread here in St. Johns County. We encourage everyone to wear a mask and practice social distancing recommendations. Recently, we have seen some health systems that have had to postpone elective procedures to ensure that they have adequate resources to meet the demands of the virus. Gratefully, we are not at that point in St. Johns County. And as you heard from the governor, we are starting to see we have hit the apex. We are ever vigilant in constant monitoring of this very fluid situation, both at an institutional level as well as the broader community. As we are this community health system, we were made acutely aware of our responsibility to make prudent decisions to ensure we meet the needs of our community. I'd like to thank the governor for empowering us as healthcare providers to make these critical decisions for the communities we serve. Thank you, governor. Governor Ron DeSantis: (21:45) Great. So we want to go Dr. Machado. Dr. Machado: (21:53) Thank you, governor. I want to concentrate on the fact that even though we're taking care of the COVID patients, we're also taking care of the whole community. We are a sole community hospital, and we have the responsibility of taking care of every patient in this county. So I want to make sure that everybody knows out there that we continue to serve every patient that comes to the hospital. Right now we have 32 patients that are positive, but our census is almost 200. So there's 170 patients that are being served for other causes. And our community needs to know that we are ready and able to serve them at this point. A lot has been said about ventilators and how ventilators at the beginning in New York, we used to hear about ventilators all the time. Well, it turns out that of the 32 patients that we have, only seven are on ventilators. So our capacity for ventilators is great. But again, we need to be careful. We need to follow the guidance of the governor. We need to wear masks. We need to self distance. We need to wash our hands. That stays in place. And it's extremely important for all of us and for our community. I want to thank the governor, not only for coming to the hospital, but also for being so informed and having so much information about our county and the people that we serve. Thank you, sir. Governor Ron DeSantis: (23:48) Thank you. We also have Dr. Javier Aduen, critical care specialist here at Flagler Health. Dr. Javier Aduen: (23:54) Thank you, governor. From our standpoint, we are very content. I mean, we need to accept that there have been difficult times, but the way the situation has been handled so far has been satisfactory. We have been, Dr. Machado was saying, able to isolate COVID patients from non-COVID patients. Therefore, we have been able to take care of both populations. Now, from the medical standpoint, we have had the opportunity to provide the patient with the care that we think is good for the patient. Particularly talking about COVID-19 patients, there are three kinds of treatments that are unique and have been shown benefit in the outcome of the patient. That includes the remdesivir, the convalescent plasma and the use of dexamethasone. For those patients that require oxygen, we have been able to provide to the patient. So we have felt the support from administration, and I'm assuming from the government, that nothing has been denied to us to take care of the patients. The result is that our mortality in this hospital is way below the mortality everywhere else. Governor Ron DeSantis: (25:12) No. Thanks. And yeah, I think it should be said. I mean, I think you said the case fatality rate was what? 0.66? Dr. Machado: (25:17) 0.66. Governor Ron DeSantis: (25:18) But when you calculate that, the cases we get only capture a certain number of the infections. There's obviously way more people- Dr. Machado: (25:26) Right. Governor Ron DeSantis: (25:27) That have an infection. So an infection fatality rate would be the fatalities divided by the number of estimated infections, which would mean that is even lower. And I think that that's a testament to the great work that you guys have been doing. Can you just talk about the evolution of how these patient have been handled? I know you guys didn't have as many patients in March and April as you've seen recently, but before people were doing the plasma, before people were doing the remdesivir, if someone came in late March, what was kind of the protocol? And then how has that evolved? Dr. Javier Aduen: (26:05) We have two different waves. At the beginning, we have a high wave, but honestly, we were fortunate that still that mortality was good. But then after that, we have a decrease in the numbers until two weeks ago that we have a new serge. But the important thing for us is that even that we are handling significant number of patients, still the mortality have remained less than 1%. So for us at the beginning, we didn't feel the high mortality because we didn't have it. Now, the other thing that I would like to take opportunity, because you mentioned, that when we're talking about treatment, it's important to understand that the remdesivir and the dexamethasone are something that depends on the laboratory to make them. However, the convalescent plasma depends on the community because those are the patients that the plasma is obtained from patients that have fully recovered from the chronic COVID-19 infection. So therefore, the supply of the plasma is going to depend on the amount or the number of patients that recover from the COVID-19. Governor Ron DeSantis: (27:22) What's your supply looking like right now for convalescent plasma? Dr. Machado: (27:25) Well, so far, we have been acceptable, but sometimes there is a delay, which is a very, very important point because what the study has shown is that the convalescent plasma, the potential beneficial effect is better when given in the early stage of the disease. So although we have it, sometimes there is delay in few days that can affect the outcome of the patient. Governor Ron DeSantis: (27:49) Now, if somebody wants to give, can they come to this hospital to give? Or is it all through blood banks? Dr. Machado: (27:54) No. The way for the donation? Governor Ron DeSantis: (27:58) Yes. Dr. Machado: (27:58) There's a link that Flagler has a blood bank... Dr. Javier Aduen: (28:02) Flagler has the blood bank, [crosstalk 00:00:04]. Governor Ron DeSantis: (28:03) Oh, so right. So I guess people, because I know people know that there are different entities that do the blood donations, but if they go to your website, there'll be something where they can- Dr. Javier Aduen: (28:14) Correct. Governor Ron DeSantis: (28:16) And then the steroid, do you use all three? The convalescent plasma, the dexamethasone and then ... Dr. Javier Aduen: (28:23) The convalescent plasma and remdesivir are for every patient that come to the hospitals. The dexamethasone is only for those patients that need oxygen, either on the vent or oxygen supplementation. Dozen studies show that the mortality improve when we use that. Governor Ron DeSantis: (28:40) And you were not using that in March at that time? Dr. Javier Aduen: (28:45) Was kind of hit or miss, because there had been an evolving and dynamic process. At the beginning, all the authority was saying that was not a good idea, then next week, it was a good idea, until finally the studies came, and particularly the study that came from Europe, from England. That was the biggest study showing that [inaudible 00:29:07]. That one made the change. Governor Ron DeSantis: (29:09) Dr. Machado, can you just talk about ... I had mentioned it, and I know we had talked earlier. Did you guys see a decline in visits for heart and stroke and in March and April like we saw throughout the rest of the state, and then if so or even if not, are some of the patients you're seeing now for things other than COVID more critical because of not seeking the care that could have potentially helped? Dr. Machado: (29:36) Absolutely. What happened was all of the sudden we were looking at each other and say, "So what's happening? Where are the stroke patients? Where are the cardiac patients? How come we're not seeing them in the emergency room?" Well, a lot of people were having symptoms. They were just scared to come to the hospital. So all of the sudden we open the elective surgeries, elective procedures, and then we see an influx of patients coming in to be tested and to be treated. At this point, we're back to normal, but yeah, we did see an influx of patients coming back I suppose you can say. Dr. Machado: (30:23) Right now, we are full throttle with all our cardiac procedures, all our interventional radiology. We are doing approximately 70 cases of elective surgery between our surgery department and our surgery center, so we're pretty much back to normal. The only thing that is not back to normal at this point is the visits to the emergency room. We're still seeing people scared of coming to the emergency room, which should not happen. I mean, we have a system that has now proven itself with the past five months that we are able to keep patients separate, and we can treat safely the patients that need it. Governor Ron DeSantis: (31:15) Yeah. I would just reiterate, the fear factor is a really, really, I think, negative influence on just the community, not just dealing with the virus, but just thriving as a community, having society function well. But when you have folks that still are fearful of coming to the hospital for chest pains or something, look, this is one of the safest places you can be. I mean, of course they're taking all types of efforts to make sure that corona patients are appropriately isolated. They understand that, probably better than ever, and these conditions aren't going to get better if you don't seek the care. I don't think we're going to know immediately, but eventually we will be able to figure out the mortality increase linked to people being fearful for getting care. Governor Ron DeSantis: (32:10) As important as the coronavirus is, if you look at the number of people that die from heart every year, it's very, very significant. So by not getting care, the mortality will unfortunately likely increase there, and that's a big, big problem. So I think what Flagler's showing is they're dealing with the corona patients as they come in. It's an important part of what they do, but as Dr. Machado said, most of the people in the hospital are not in the hospital because of coronavirus. They're dealing with all types of things, and the mission continues with all those patients. I'm glad. These elective procedures, we put those back at the beginning of March. It was recommended that they be delayed, and I don't think that was a terribly effective policy. That was, I think, recommended by the CDC. The fact of the matter is they know how to manage their operations, and so to say you can't do this procedure, well, when that happened, by mid-April, the hospitals were half empty. So just because it's elective, it may mean you can schedule it different times, but these are things that do need to be done as well, so they're continuing to do it. They have the PPE that they need. If they see a change in the COVID census, then they can make appropriate changes here on the ground level, but that's a much better approach than a ham-fisted prohibition that was really what had been put in place nationwide, I think, effectively that last time. Governor Ron DeSantis: (33:40) You do see other areas, some other parts of the state that have had more traffic in terms of COVID patients in the hospitals. They've made the different decisions, and so even some of the bigger systems in South Florida, you have increased COVID patients, but their overall census is basically the same in the last 30 days. That's how you manage these things, but it's really important, I think, that the hospitals have the ability to meet the needs of the community, and I think you guys are doing a good job here. Governor Ron DeSantis: (34:08) Now, do you have, because I remember in March it was like just getting an N95 mask was a huge thing. The testing kits and everything, I was literally on the phone the third week of March, I remember, with my emergency manager, and I would talk to the CEOs of hospitals. I'd say, "Orlando Health needs a hundred swabs. They need this, they need that," because they were in such short supply. "We need masks here. We need this." It seems like, from everyone I've talked to, the whole PPE situation is much better, that those supply lines are really fluid now. Are you guys in a good spot with both the testing and the PPE? Jason Barrett: (34:48) We are. Testing and the PPE. The issue continues to be in the access to remdesivir and the staffing, as you mentioned earlier. But from the standpoint of PPE resources, we have more than an adequate supply. Dr. Machado: (35:01) On a daily basis, we have incident command at 8:00 in the morning, and that's one of the things that we look at constantly, basically on an hour by hour basis. But our staff has been incredible and ordering and making sure that we have everything we need. It's been now five months of being on top of it, and we plan to stay that way for a while longer, but so far we've been able to take care of our patients. Governor Ron DeSantis: (35:39) Yeah. No, I know it's really, really important. I'd also just like to say, earlier this week, the First Lady and I were down in Tampa talking about mental health, because when you have a situation like this, obviously I've said, talked about the yanks and the fear that so many people have felt, and part of that is concerned about what the virus may do. But quite frankly, what we found is for a lot of people, it's concerned about some of the fallout that's happened with some of the changes that have happened to our country since March. People concerned about making ends meet, putting food on the table. What's going to happen with their kids, what's going to happen with school, all of these very pressing things that really do weigh on a lot of people, and we can't forget that that is a huge part of what we're dealing with right now. Governor Ron DeSantis: (36:32) One of the things that I think has been tough, and I don't know what your policy is, but I know for a while, most of the hospitals were not allowing visitors. Where are you guys on that? Are you still not doing that? Jason Barrett: (36:46) We're still restricting visitation at this point. The challenge to COVID is for those that are acutely ill, this a very isolating virus, and we have made concerted efforts to make sure that we engage the family members through technology. Now, of course, for extenuating circumstances like a delivery or if someone is terminal, we certainly make exceptions for folks because ... But I'd say one of the greatest casualties to this virus is the isolation. That is, from the standpoint of what we've seen in terms of incidents, in terms of increased use through our telehealth tele mental health services, we've seen double digit increases dealing with the concerns around social isolation. Governor Ron DeSantis: (37:38) Yeah. I think it's been hard on a lot of families to have one of their loved ones in hospitals, and not just for corona but for other things, and then not be able to be there under certain circumstances. Those are really critical moments in life, and that's been a huge, huge, negative effect of this. Another thing that we've seen is very early on in the process, I think it was the middle of March, in the state of Florida, we restricted visitation to our longterm care facilities. The reason we did that was because we saw that this virus had a disproportionate impact on folks who are elderly, particularly those who add one or more comorbidities. We were concerned about traffic in and out of there bringing the virus in, and that that would lead to major outbreaks. Governor Ron DeSantis: (38:33) Of course, we also instituted mandatory screening of all the staff. We required the staff to wear PPE, and then the state shipped huge amounts of PPE to all our longterm care facilities, and then we've tested the residents and the staff. Now we do periodic testing of the staff to try to identify infections before they can bring it in there, so there's been a lot done to try to protect those most vulnerable from having the virus go in, but we have to acknowledge, and I've certainly done it, that that is a that's coming at a huge price, because when you don't allow visitation ... And obviously the reason is because you can't be sure if someone's going to come in, and they may spread it, but when you're not allowing visitation, that takes a huge, huge toll. Governor Ron DeSantis: (39:20) And, yes, the state has done stuff. The facilities have done stuff to connect with technology and to do the best you can, but that's not a substitute for that in-person interaction. We had a story here in Northeast Florida that was recently in the newspaper about Mary Daniel. Her husband is at a memory care center, and obviously the visitation is limited, and she was understandably very, very interested and very insistent on figuring out a way to able to see her husband. So what she did was decided to take a job as a dishwasher at that memory care center, so she screened just like every other staff member is, but then she's able to see her husband again. Governor Ron DeSantis: (40:06) So that's an example of resilience in the face of a very difficult situation, and I just want people to know that I'm sensitive to those. When we do a policy like the visitation limit, ban on visitation, trust me, I know that that's not cost-free, and if I could lift that tomorrow without fearing negative consequences, we would do that. We look forward to a day when we can do that, but in the meantime, I think people like Mary are finding ways to connect with their loved ones, and that's a really, really great thing. Yes, ma'am? Speaker 1: (40:44) Governor, do you have a timetable on when you see could see bars allowed to open up again? Governor Ron DeSantis: (40:48) No timetable. I think we're focusing on what we're trying to do right here. Like I said, I think people have responded very positively over the last couple of weeks, and I think that that hopefully will be apparent in some of the numbers that we see as we're going forward, but this was always a fluid process. There's a lot of different issues at stake, and so we've got a task at hand, and that's what we're going to keep doing. Yes, ma'am? Liz Landers: (41:15) Hi, governor. Liz Landers with Vice News. You were talking about some preventative measures that Floridians can take. I didn't think I heard you say anything about wearing a mask. Is there anything that would change your mind about a mask mandate in Florida? Are you taking your cues right now from the White House? I know you're [crosstalk 00:41:30]. Governor Ron DeSantis: (41:31) No, I'm not involved with at all. So we put out at the end of April when we did our phase one, we advised that folks were facial covering, particularly when they can't physically distance. We've also advised senior citizens to limit contact outside the home and to avoid crowds, and then we've also advised limiting large groups. Those are advisory. Those are not punitive, and I think if you look, we have in most of the places that have most of the cases like Miami-Dade ... Governor Ron DeSantis: (42:03) Have, in most of the places that have most of the cases, like Miami-Dade and Broward, they've had compulsory mandates in place since April. So that's actually been in place, but we're doing advisory and we're not going to be prosecuting people. Yes, sir. Liz Landers: (42:16) Sir. Just another question for you about St. Augustine, here. We saw last night Congressman John Lewis pass away. He's a Civil Rights icon and a hero. This is happening amidst a big conversation in this country about race, monuments, flags. There's one that's happening here in St. Augustine about a monument downtown, in St. Augustine, that's been voted to be removed from the plaza downtown. It was a memorial to Confederate soldiers- Governor Ron DeSantis: (42:41) All right. Yeah, I appreciate the question, but let's, we're trying to focus on the coronavirus. Liz Landers: (42:44) [inaudible 00:42:44]. Governor Ron DeSantis: (42:45) I appreciate it, but I'm going to let someone ask about, do you have a question about the topic at hand? Speaker 2: (42:50) I did, yes. You mentioned early on about some information that is floating around that's not in the proper context. Can you expound a little bit on what context- Governor Ron DeSantis: (42:58) Well, I just think... Yeah, yeah. I mean, look, I think... So for example, I think it was a week ago where it was like Florida has record shattering cases, which was true. That was the most cases.,I think it was 15,000, but I don't think the headline said that that was out of 144,000 test results. So that's a percentage that's a little higher than where we were in May and early June. Obviously, we'd like to be 5% or less, but had some of the states that were having massive outbreaks tested at 144,000 at the height of theirs, they would have had 50, 60, 70,000. Governor Ron DeSantis: (43:33) And so I think it's important to put that in context, because I think a lot of people see cases and I think they get really, really scared. And my message is the fear is our enemy. Let's understand, I mean, there's obviously things that Floridians are doing and that we're doing, whether it's working with hospitals, whether it's doing some of the other stuff, but there is that. And I think the other thing that gets missed with the cases is the sheer number of people who are testing who aren't sick. Because I think most people see cases and they're like, they think that that many people are in the hospital or are going to go. And the way this disease is, is it's largely, particularly for people who are under 60, either minimally or asymptomatic. We're now capturing a lot of those folks. Governor Ron DeSantis: (44:15) When we were doing this in March, I mean, I don't know what you guys had for criteria, but at any of our sites, you had to be symptomatic and you had to be 65 or older when we first rolled out our drive through testing sites. And so in late March, I mean, we were getting 1,000, 1,300 cases a day out of maybe 7,000 tests that were administered. Part of the reason we did it that way is because we were concerned, or we just were limited, in that there was not a lot of testing in the country compared to what we have now. So I think just with the cases, people should just put it in the context, you look and see, it seems like the US has more cases now than it did in March or April. Not just including Florida, the whole country. But if they were testing like we are now in March and April, it would have been way, way more throughout the country. So that's just something that I think people should understand, put it in the proper context. But the idea that when we're testing 100,000 people a day and the majority of the positive tests are people who are either asymptomatic or minimally symptomatic, that's something that's important for people to know. Speaker 2: (45:25) A lot of people are wondering about recovery, the recovery numbers. Can you speak at all as to why the State via Department of Health isn't releasing numbers? Governor Ron DeSantis: (45:35) I don't think it's that they're not releasing it. I think it's just, not all States have done that and they just haven't been doing that. I mean, I think that they're, the view is basically you look at the cases, you have the case fatality rate. So in Florida, I think ours is about 1.5%. Nationwide, I think it's about 4%. And so you do the deduction that the folks, once they get a certain part, they kind of clear the illness, but they're not going back and saying there. I know Texas is, I know some other one was. I kind of wish we would do that, but that's just not something that they've done from the very beginning. Governor Ron DeSantis: (46:08) But I do think that that's important to just point out to people. I mean, if you guys have someone in the hospital and you give them treatment and you discharge them, they're likely have recovered at that point, or they certainly will. Most of the people who probably test positive at your walkup site here, you just send home and tell them to isolate and then they recover. And so that's a good thing for people to know, that people do clear the illness and obviously have the ability to donate convalescent plasma, to be able to help folks who may be suffering more. Governor Ron DeSantis: (46:43) That's another issue with just kind of our, what we've seen since our testing really started to go up in terms of the numbers of positives, the positivity rate, is the huge numbers of cases between the ages of 20 and 44. And that's obviously a very low risk group. If you look at the case fatality rate there, it's incredibly small. And if you take out co-morbidities, it'd probably be close to zero. But they test positive at a higher rate, particularly the 20 to 30, their positivity rate, I think for the whole pandemic is close to 16 or 17%, whereas the senior citizens they're in single digits with that. Well, that really matters. And I've said, long before we had increases in cases here, I would say from a clinical perspective, the number of cases isn't as important as where those cases are falling on the spectrum. In other words, if you had 1,000 cases for people in their 20s, that's probably going to have less clinical impact than if you have 100 cases at a longterm care facility. Speaker 3: (47:48) [inaudible 00:47:48] last question [crosstalk 00:47:48]. Speaker 2: (47:48) I just have one more quick thing. And I'm Joe McLean with News4Jax in Jacksonville, by the way. I wanted to ask, could you quickly comment on the letter your office received from the Florida chapter of the American Academy of Pediatrics? I believe the letter was sent Thursday and it speaks about school re-openings and some recommendations from the state chapter of the AAP. Are you, were are you able to- Governor Ron DeSantis: (48:13) I haven't had a chance to review it yet. But I know that the general view of pediatricians that kids should be in school. Obviously, there's a lot that goes along with that. But particularly, I would say the primary school kids, if you look at that, the evidence in terms of, well, you obviously know low risk for the illness, but they're transmissibility. There's very little transmissibility from the primary school to adults. Which, because when we talk about kids' safety, that's kind of paramount, but then you have adults. You have teachers, you have people that work in the cafeteria, all this other stuff. What risk would they be in? And I think it's pretty clear from all the studies that have been done, particularly in Europe, that if you're somebody who's an adult and in like a primary school, the chance of you getting infected is almost entirely from another adult rather than from one of the younger kids. Governor Ron DeSantis: (49:03) And so I think that that's something that we're going to do. But I'm going to be doing a lot more personally, getting involved to just help some of the school districts. I mean, I think that we have different parts of the state that are dealing with a different type of epidemic. And so you look at like a Miami-Dade versus a St. John's County. Now that's a big difference in terms of what you're seeing. I think the one thing I think is really important is parents should be able to make the decision that's best for their kid. And so if they believe their child would be better off doing distance learning, if they're not comfortable with their kid going back to a school setting, I think they should have the right to make that choice. But I also think that there's a lot of parents who've seen regression in academics and seeing their kids miss some of the great things about being in school, who want to have that ability to get them back. Governor Ron DeSantis: (49:56) And I know, I think the vast majority of folks really want to see kids prosper. And we just have to look at this honestly, in terms of their best interest. If the distance learning was just as good. I mean, I would acknowledge that. We take pride in our distance learning in Florida. We've put a lot of effort into it. A lot of the States, when we went to distance in March, were calling my Education Commissioner saying, "Hey, how'd you do this? How'd you do this?" So in spite of that, though, there is just, they fall behind. I mean, that's just the reality of the situation. And so we've got to be cognizant of some of the harm. I mean, I've seen stories across the country in some major areas, where you have a third to 40% of the kids didn't even log on or haven't logged on. And I'm just thinking, wow, that is going to be something that society is going to be dealing with for a long time. Governor Ron DeSantis: (50:52) And so I think just approaching it by saying, okay, are the bonafide risks of having the kids in school? Fortunately, the risks from the virus to their health is minimal, more minimal than seasonal influenza. What role do they play in transmission? I think certainly the younger kids play almost zero role in transmission. I know you've seen maybe some high school. I think that that would be something that you would look at, but that I think is pretty clear. How would you have an environment that protects adults? And from our very beginning, from when we announced phase one in April, every employer has to make accommodations for folks who may be at risk from corona. So whether that's age, whether that's for health status, and that would apply obviously in a school setting as well. Of course you do that. Governor Ron DeSantis: (51:40) The fact of the matter is the statistics we see every day, show us 65 and up is the, 80 plus percent of the COVID related fatalities in Florida, and I think throughout the country, and then when you're in that 40, 50, under 65, in that 40 and 50, it's usually linked to one or more significant comorbidities. And so this, taking that into account, of course, is something that you should do. So I just think it's a really important issue, but I'm a huge believer in just giving parents the choice. Governor Ron DeSantis: (52:13) But I do think that they should be reassured on this. Because when a novel virus comes, people, look, it's a fear of the unknown. It's a natural human response. But I can tell you, having dealt with this every day since February, and looked at the data in the US, Florida, across the world, and as a father of three young kids, I do not fear this virus's effect on my kids. I think the risk is incredibly low. I fear way more things in terms of their health and safety. But I would not have any problem having them in school if they were, they're not school age. But if they were, I would absolutely do that. And I think it would be safe for them. And that's just as somebody who's looked at this and looked at this and looked at this. Governor Ron DeSantis: (53:00) And the one thing, I mean, the Spanish flu, you would have kids, you'd have soldiers who were very healthy, it could just, it could just knock people out. Hell, H1N1, if you look at that compared to corona, much more. Kids really bore the brunt of it. So for whatever reason, it's tended not to have the most significant impacts on our kids. And I think that that's something, in spite of it being a very difficult situation, a very harmful virus, particularly to the most at-risk groups, that is something that I think a lot of parents should have some sigh of relief on, because I think that some of the other pathogens that we've seen have targeted kids much more acutely. All right, thank you.