Florida Governor Ron DeSantis July 6 COVID-19 Press Conference Transcript

Governor Ron DeSantis: (00:00) Throughout this whole time, we've worked with UFHealth on doing testing in the villages very early on. We've also worked together on doing some testing in underserved areas, which has been very, very important. I'm going to go through some of the numbers, kind of where we are, some of the things that we're doing to continue in the fight against COVID-19, the coronavirus. Governor Ron DeSantis: (00:23) From very beginning, we've stressed a few main points. One is protecting the vulnerable, those who are elderly, and then those who have significant comorbidities. And we're going to talk about some of the things we're doing to continue that effort, but that's very, very important. The mortality is very, very clear skewing heavily in that direction, so those are folks that need support. I will talk about the expansion of testing, which is very robust now. The social distancing, which is still very important. Support for hospital healthcare workers, and then obviously introduction of the virus into Florida. Governor Ron DeSantis: (01:02) So if you look at where we are and kind of where we've been, particularly, over the last month. When we started this, clearly the testing levels were low at the time. CDC said only test somebody who's 65 and older, has symptoms, if he was in China, maybe some other international places. Part of that was just there was a limited testing capacity. So you look, kind of the March, beginning of April, we were testing at probably similar levels per capita that other states were, except for the Northeast, but much different than what we are now. But the positivity rate was basically about 10% for those first four to six weeks. And so, if you did 10,000 tests, you get a thousand positive is kind of what we were looking at there. Then as we got into April, we started seeing positive movement in the positivity rate. Governor Ron DeSantis: (01:57) The beginning of May through that second week of June was really the best testing that we had had going on in the state of Florida in terms of low positivity. We were expanding the number of tests being conducted, but the amount of people, the percentage of people testing positive was very, very low. So you look at the beginning of May, we were under 5% all the way through June 13th, we were 4.9%. Now the June 13th week, the 7th to the 13th, you started to see, even though 4.9 is still good, we were 3.3% the week before. You started to see a little increase in the positivity. Part of that was driven by discrete outbreaks that we were seeing in different parts of the state. But I think that was kind of the beginning of then the next week we get into... Governor Ron DeSantis: (02:50) And again, we're testing a lot of people, 230,000. But we went to 9.5% positivity. And so you're testing a lot of people, but the percentage testing positive is higher. And then the following week, a huge increase in the number of tests that are done, but also an increase in the positivity from 9.5 to 11.9%. And then this past week, we did almost 400,000 tests, but had just under 15% positivity. And really when you look at the positivity, it's been about 14, 15% pretty consistently now for more than a week. I mean really, probably about eight to ten days. Governor Ron DeSantis: (03:32) So when you're looking at cases, and I'll talk about this a little bit more in a minute, for every case that's documented, there are many more infections that have actually occurred. We only diagnose a small fraction of the total number of infections. So if you are at 5% positivity and you test 50,000 and then you test 100,000, the positivity stays the same. Yeah, you'll have twice as many tests come back positive, but it's not really evidence that it's more prevalent. When you are seeing the positivity increase more people out of whatever amount you're doing, testing positive, that's an indication of the positivity increasing. Governor Ron DeSantis: (04:12) And so some of these things we've seen over the last eight days... I know the media will say, "Oh, this record case." It's basically been the same. I mean, yeah, when we do 85,000 tests, we're going to have more than if we're doing 40,000 tests, we're going to have less positives. But the percentage has been pretty consistent. Now this is, we want to get back down on 3, 4% that we were in May and early June. At the same time, the 15%, that's a far cry from what you were seeing in places like the Northeast, where they were 30, 40, 50% early in the pandemic. And in fact, we are now at the point where we've tested 10% of the state's population. So 2.2 million people we got about, obviously, a little under 22 million Floridians. And so that's a lot of tests, but I think it's something that was significant. We wanted to expand testing and we've done it. Governor Ron DeSantis: (05:07) And then here's the stats for the last week: Almost 400,000 people tested, 14.8% tested positive. So again, if you take the May percentage, we would have probably been 4 or 5%. So that's going to generate a lot more tests, positive tests, when you're testing at 14.8%. And the positivity is not uniform throughout the state of Florida. If you go down to Miami Dade, they've been 20%. You look at Hillsborough, they've been between 15 and 20%. I think Orange County has been over 15%. And then there's other places that have been less. And may not be some places where 1 or 2% in May, now they may be 6 or 7. So you have seen an increase in the positivity, but there are a lot of parts of Florida that are still in the single digits, so obviously want to keep it that way and then be able to do. Governor Ron DeSantis: (05:59) And then the median age is really significant, and I'll talk a little bit more about that in a minute. The median age of everybody testing right now positive for this past week is 36. And as we've seen the cases increase, the median age every single day has been in the thirties sometimes as low as 33. Now, why is that important? Well, because this is a virus that does not affect all age groups equally. It's much more lethal for people who are in their eighties and nineties than it is in your twenties and thirties. And I'll go through some of the numbers, but basically, if you're under 40 and you don't have significant comorbidities, the fatality rate for this is pretty close to zero. So who is testing positive is just as important as how many people are testing positive. This is probably a two decade shift from where we were with the median age at the end of March, beginning of April, we had been in the sixties, then in the fifties. And then as this upswing has really been driven by a lot of people in their twenties and thirties testing positive. Governor Ron DeSantis: (07:05) And so here's a example of kind of the risk profile by age group, which is very, very important. So you look and kind of those, the younger, kind of the 15 to 44, that is where the bulk of these positive tests are now coming from. And particularly that 25 to 34 year old age group, I mean, far and away, it's blowing everybody out in terms of positive tests. You look at the COVID related fatalities, and in those age groups, I mean, the rate is incredibly, incredibly low. Many of the people in their twenties and thirties who are testing positive are asymptomatic, they're being tested because maybe they were exposed, maybe for workplace. And then those who develop symptoms, mostly develop mild symptoms. And so these are the folks who are just simply less at risk than the folks who are 65 and plus. And there's a big difference too, in the risk profile between 85 and plus, 75 to 85 is definitely lower, and then 65 to 75 is definitely lower than that. And then obviously as you go down further, absent comorbidities, it goes down very, very low. Governor Ron DeSantis: (08:17) So the case growth is really being driven primarily in these low risk groups. Now at the same time, just because you're 21 and you may not have significant symptoms that does not mean that you can't infect other people. And I think that's something that we're obviously concerned about, but this is really the picture of where we were since the cases started going up in the last month, has really been driven by those age groups right there. And in fact, if you look, that's the cases by age in the state of Florida. The age that has the most cases in the state of Florida is age 21. And again, without co-morbidities present, you're looking at practically a 0% fatality rate. Obviously, as it gets older, it goes down. That's obviously a good thing. We don't want to see cases in the upper age groups, but really it shows you kind of that real significant increase in those twenties and 30-year olds testing positive. That's where most of the community transmission is really coming from, particularly in metro areas, like the Orlando and Hillsborough. If you look at their median age, that's dropped dramatically in some of those metro areas. That's fueled by some of those folks in those age groups that we're seeing. Governor Ron DeSantis: (09:37) So when you see the cases, obviously it's something that we're seeing, but it also does matter who's testing positive, in terms of mortality and morbidity. And if you look, and people don't usually talk about this, the case fatality rate by state, Florida is much lower than many of the other major states. So case fatality is just the number of fatalities related to COVID divided by the number of COVID cases. And so we're now, I think, under 2%, and that's been trending downward. And I think that that's a reflection of the fact that a lot of the newer cases over the last month have been driven by people who are at very low risk for fatality. So part of it too, and I think the doctors will talk about some of the things, they also have more tools at their disposal to be able to treat people as they come in. And again, the whole idea of flattening the curve was not that you would not have more infections. I mean, no one said that you can just somehow stop it. The idea was you kind of spread it out so that the healthcare system is in a position to be able to handle what happens. And clearly, we did that in Florida. Governor Ron DeSantis: (10:52) March and April no problem, had very, a relatively low hospital occupancy. We had a lot of availability. And then even as they put the elective surgeries back in, most parts of Florida, now you still have about a 25% availability. And so that's part of it, but it's also the treatments and the other things learning from other countries, other states. And so they've done a really good job about that, but we have probably the most vulnerable population, but then to have a case fatality rate that's now below two, and of course, many more infections and cases. So the actual infection fatality rate is going to be much, much lower than that. Governor Ron DeSantis: (11:32) Here's what we're looking for total tests in Florida, three day rolling average. That little peak in May, I've said this before, but that's artificial. That was about six weeks worth of backlog negatives that got dumped over a two day period. So really it has been a pretty smooth ascent from where we were in March until where we are now at the beginning of July. And we're averaging, I think, over the past a week, I think it's like 60 to 65,000 test results a day coming in. Part of that is because we'll talk about what Florida's done to expand testing. Part of it, the hospitals here, they're testing everyone coming in for procedures. If they're in for childbirth, if they get in a car accident, they're getting swabbed. So you have way more testing being done at the hospitals than you did in March and April. Governor Ron DeSantis: (12:20) One of the things we look at are these syndromic indicators. And again, sometimes their signal in this, sometimes there's noise in this. Clearly, you can see if you would go back in May, this was something that was incredibly stable and low throughout most of late April, all of May, beginning of June. And then as you see, you start to see in the second week of June, a little bit of an increase in the COVID-like-illness. So this is people that go to the ED for COVID or influenza like illnesses that we track. So these are ED visits. So then you look, as we get into the middle of June, you see the increase in the COVID- like-illness visits, and then it goes up even more towards the end of June, and then really at the very end of June, you see, and then you have seen it kind of taper back. Too soon to know whether that's a sustained trend, but obviously those are syndromic indicators that we're looking at. Governor Ron DeSantis: (13:18) When you get positive test results, sometimes these labs will take a week to turn the test around. And so you could be getting a positive test today, and someone may have taken that test seven days ago. They may have been infected seven days before that. So chances are, they've probably already, if they need to, probably already visited by the time some of these tests results come back in. And so unfortunately, you're not in a situation where these are instant, instantaneous test results. But those are things to look at, these COVID and influenza-like-illness indicators. So we're going to continue to monitor that. Governor Ron DeSantis: (13:56) And I said before, I'm just going to stress that cases are simply detected infections. There are, and have been, way more infections than documented cases. And so if you see 5,000 cases, 10,000, just understand that is not the sum total of the people that have been infected. If we were doing 80,000 tests a day in March or April, those numbers would have been dramatically higher in terms of case numbers than what we ended up having. And here's an example of what we mean by that. And this is recently, the end of June, CDC put out they did antibody testing and seroprevalence surveys in different parts of the country. They did one here in Southern Florida in the four counties: Martin, Palm Beach, Broward, and Miami Dade. And if you look, they were testing for the presence of antibodies, IgM IgG. And this was done over a period April 6th to April 10th. At that time, there had been 10,500 cases reported based on the antibodies and the seroprevalence. CDC believes that there were actually 11 times more infections at the time in Southern Florida. So that's 117,400 infections that had actually occurred. Governor Ron DeSantis: (15:12) And if you think about the antibodies, the IgG takes about two weeks to develop. IgM probably about seven days. So if you're testing kind of at the beginning of April, these are infections that may have happened in February, but certainly the first couple weeks of March, probably not that much later by and large. And so that seroprevalence clearly would have increased by the time you get into April. And then, so if you want to know what the seroprevalence was on April 10th, you really need to figure out when those infections occurred, when the antibodies developed. And so I would imagine, and The University of Miami has done this for Miami Dade, they've had infection rate, I think 16 times higher than the number of cases. We do antibody testing throughout the state at our drive-through sites for healthcare workers and for first responders. And what we're finding, places like Miami, 7 to 10% test positive for antibodies. Some of the places like Orlando, Jacksonville, they're more in like the three, three and a half percent. But still that is showing you that the prevalence is not captured by just the detected cases. Governor Ron DeSantis: (16:22) Now that means a couple things, it means that the virus is more widespread than what the cases would say. It also means that the fatalities are less than a simple, raw case fatality rate, because you'd have to include all the infections, doing a seroprevalence. And so that's why CDC now estimates the infection fatality rate for corona to be about 0.26, I think is their best estimate. In Florida, if we do have a 1.9% case fatality rate, if you are going to say something like 10, 11% higher, that would obviously bump that down to about 0.19. Governor Ron DeSantis: (16:56) But I bring this up just because I think it's important that people understand how this has developed. And these were infections that likely occurred before there was any 15 day to stop the spread, before we thought that there was necessarily widespread. So I think it shows that this thing has been circulating for longer in our country than we initially thought, kind of at the beginning of March. I mean, at the beginning of March, we're testing people. It's like, "Oh my gosh, we have a case." Like, "This is it. That's the infection." And in reality, that was a function of the testing criteria. Had you had a broader testing criteria, you would have picked up more cases at that time. Governor Ron DeSantis: (17:38) And I bring that up too, just because as you see cases, just people just should put it into context about what's going on. There's no need to really be fearful about it. I mean, we can talk about the different steps that individuals can take, that we're going to take statewide. But at the end of the day, this is something that's been around for quite some time. I think this is important, and I know some of the physicians here'll- Governor Ron DeSantis: (18:03) I think this is important, and I know some of the physicians here will talk about it, but one of the things that I think did not get as much attention at the time, and only now I think people are starting to realize is when the coronavirus pandemic national emergency was declared in the middle of March, CDC looked at the ED visits across the country for things like heart, stroke, and other serious illnesses. And what you saw was a major, major decline in the number of people visiting the ED for things like heart problems. Governor Ron DeSantis: (18:39) Now, no one believes that those problems all of a sudden just stopped. What happened was people were probably fearful about going into the hospital because they thought maybe they would catch the virus there. Maybe they thought that the hospitals didn't have capacity to deal with them. Who knows. Maybe they thought that they were told to stay at home. Maybe they thought that means, "Don't even get medical." But there are probably a lot of reasons for it, but this definitely happened, and CDC's recent report basically attributes, or it says it may attribute the observed excess mortality not associated with COVID over the last several months to people putting off visiting hospitals for really life threatening situations. Governor Ron DeSantis: (19:25) What happens is, you may not die right then, but the problems worsen, and then by the time you do present in the hospital, you end up you're sicker than what you otherwise would be, and your mortality risk has increased dramatically. So people should just be very, they should understand that the hospitals are safe place to be. This is something that you do not want to put off. There's capacity. They have great safety protocols. You're less likely to get coronavirus here than a lot of private residences or a lot of other things you could be doing. So please come in and don't let those problems fester. That does impact, absolutely will impact mortality if you don't come and get the care that you need when you need it. Governor Ron DeSantis: (20:12) So our number one priority throughout this whole thing is to protect the vulnerable, because of the disproportionate impact the virus has on people who are 65 and up, and people that have significant comorbidities. We've advised really since March, and even as we got into the different phases, the guidance has never changed about people who are 65 and up, we're recommending and advising to avoid crowds and to minimize close contact with people who are not in your household. That is the safest way to make sure that you're not putting yourself in a situation where you could contract the virus. Governor Ron DeSantis: (20:51) And I think by and large, being here in The Villages is important, because they've really, I think, heeded this from very beginning. I remember talking to Gary Lester in early March. I was like, they had a plan. They've done a lot of stuff, and it's really made an impact. And I know one of the physicians was going to talk about some of the other areas in the system where the population's younger, you actually see more cases and even more ED and hospital admissions than you see here at The Villages. And a lot of that is because of people really taking, making the effort to protect themselves. Governor Ron DeSantis: (21:26) So the message for our elderly population is to avoid crowds, and minimize contact outside the home. This virus is circulating and is circulating more widely with people who are in their twenties and thirties, so anyone in multigenerational housing, that's something that should definitely be a concern. And then obviously if you're somebody that has either kids or grandkids in that age group, that's something that you should be cognizant of as well. Governor Ron DeSantis: (21:56) Also, underlying conditions. So if you look, the younger you are, the fatality rate is incredibly low, close to zero. But regardless of age, if you do have some of these significant comorbidities, you are definitely at an increased risk from the coronavirus. And some of the things I think people would understand just instinctively, anything with having to do with the lungs, like a cystic fibrosis. Obviously if you have a serious heart condition, but what they see a lot in the hospital with the patients who may not be in their seventies or eighties, may be in their fifties, that is the difference between maybe having an asymptomatic illness or minimal symptoms, or an illness that requires hospitalization, are some comorbidities like diabetes and obesity. Those are very, very common comorbidities that hospitals really throughout Florida, I think, are seeing over and over again. Governor Ron DeSantis: (22:51) And so the guidance for folks in those situations is the same as for our 65 and up. Be sure to avoid crowds, and minimize close contact outside the home, if you're somebody who's in those categories, because your risk is elevated due to those co-morbidities. Of course our longterm care facilities is kind of where the most at risk population is. We did, early on, I know some of the doctors. I think dr. Luzardo will talk about the impact, but we protected these longterm care facilities. We banned having patients be readmitted if they were COVID positive, because we feared that that would help really spread the outbreak against the most vulnerable. And I think that that was the right policy. But we also understood is, okay, if you have somebody who's COVID positive, who's a resident of a longterm care facility, and they're in the hospital, but they're medically stable, we don't want them back in the nursing home if they can't be isolated, because obviously you're putting the other residents at risk. But if they don't need to be hospitalized, it would be good if they could be isolated appropriately. Governor Ron DeSantis: (23:58) So what we started to do in April was established COVID dedicated nursing facilities. So we now have 12 COVID dedicated nursing facilities throughout the state of Florida that are able to have patients who are COVID positive, but their health does not require hospitalization. And fortunately, even though the mortality rate is much higher for people who are over 75, we are finding a lot of nursing home residents and longterm care residents who do test positive and who have symptoms that are short of what would require hospitalization. So you now have these facilities all across the state of Florida, and that's about 750 beds that can be used for folks who are convalescing and who are isolating. And that's really, this is really worth it, because if you put someone back into a longterm care facility that is still contagious and they cannot be isolated, that is going to end up spreading in those facilities, and you're going to end up seeing more patients come to the hospital. Governor Ron DeSantis: (25:04) So I want to thank Secretary Mayhew for working hard over the last couple months to do this. I think this is going to be really significant. We didn't have this in March and April. The first one was brought in the middle of April. Now that we have this, really puts everyone, I think, in a better situation. It's better for longterm care facilities, better for hospitals, and really better for the residents in all these situations. Governor Ron DeSantis: (25:27) The other thing we're doing, from April through probably the middle of June, we went through and tested the longterm care residents, tested staff, which was important, but what we're also doing going forward is, all staff members at longterm care facilities need to be tested once every two weeks. And so we have a program in place. We're providing the different types of tests for that. Now, I will remind people, you are going to see positive tests with the staff. When we did it the first time, we had about a 3% positivity rate. Now that this is something that is more prevalent in the community, that is likely to be reflected in these staff members. And so I'm hoping that it's lower than the 15%, and it may be, because they have tested lower than the general population throughout the whole time, but we're apt to see that. Governor Ron DeSantis: (26:20) Now, what we will do is, obviously they will be isolated and they won't be interacting with the residents. And so it's important screening mechanism to keep doing, but you've got almost 200,000 people who work in these. We have over 4,000 facilities throughout the state of Florida. So you've over 200,000, almost 200,000 folks who are going to be tested every two weeks, so that's going to be a lot of tests, and it will be some new cases without question. But if you isolate them, then we're protecting, I think, the vulnerable in the way that we really need to. Governor Ron DeSantis: (26:52) And of course, we have almost 85% of the corona-related fatalities have occurred in age group 65 and plus. I think nationally, if you did an honest accounting, any longterm care resident, whether they die in the facility or at the hospital, if you count all of that, which Florida does, you'd have a majority of the COVID-related fatalities would be residents of longterm care facilities nationwide. And I think that's true in a lot of these other countries. And so if you want to know where the risk of mortality is from the coronavirus, you've got between 100,000 and 150,000 folks in these facilities in Florida, and they represent over half of the fatalities in the state. And so we're going to continue to put a lot of emphasis on protecting the most vulnerable to this virus. Governor Ron DeSantis: (27:42) Social distancing. Obviously a lot of ... We stress this, and have been. I know as things kind of changed a little bit at the end of May, beginning of June, you saw a lot more large gatherings. You saw different things. I don't know if maybe people thought the social distancing is kind of yesterday's news. It's important to continue doing it. And so we're really pointing out the best way you can protect yourself, but particularly protect our most vulnerable and slow the spread, is to avoid closed spaces, crowded places, and close contact settings. And sometimes that can be all three. I mean, if you're at a private party inside an air conditioned house, and people are shoulder to shoulder, and you're talking over music or something, that is going to be an incredible vector for transmission. When you're in enclosed spaces, particularly with air conditioning, you're going to see more of transmission than you would if you were in ... Even if you're inside, if it's a little more spacious, and certainly obviously if you're outside. But the social distancing is important, because if you do it, you're not going to get infected if you're maintaining the appropriate distance. Governor Ron DeSantis: (28:59) Now, we've also said now since May that if you can't social distance, wearing a facial covering can cut down on the transmission, we believe some, but it's not in lieu of social distancing. If you can social distance, you still want to do that, because that's the best way to prevent infections, whether you infecting somebody else or somebody else infecting you. So those closed spaces, crowded places, and close contact settings really are what makes this thing spread. And we now know, I think, pretty clearly, outdoors, fresh air, sunlight, heat, humidity, it's less risk. It doesn't mean it's no risk. I mean, if you're very close and doing things like ... Definitely, but if you're just outside, the chance of you acquiring this from fleeting contact from somebody is very, very low. The higher risks are those enclosed, crowded spaces with the poor ventilation. Governor Ron DeSantis: (29:57) Florida, I think you're seeing all this happen throughout the Sun Belt, from the Carolinas, to Southern California, places like Arizona, Texas, Florida, that are hot in the summer. People tend to want to retreat inside to the air conditioning, and that's understandable. But if you have groups of people in the air conditioning, that is going to be better for the virus than if you were outside in the sunshine. And that's, I think, been proven over and over again. And so different environments carry different risks, and so as best you can, minimize a lot of contacts in those high risk environments. Governor Ron DeSantis: (30:33) So we talked about back in March, the mantra was, "Flatten the curve." I mean, people don't really talk about that as much anymore, but the theory behind it was if you had infections just spike, you could have patients flooding the hospital. The system may not be able to handle it, so we wanted to slow the spread. We couldn't end the spread, and obviously I've said we're going to have cases going forward, but it's allowed us to be in a position to be able to better handle what's going on. Back at the end of March, we had seven state supported testing sites. By April 1, we had tested 20,000 people in those sites, which at the time wasn't bad. I mean, there weren't tests available everywhere. You kind of had to do what you had to do, but that was what we did. Governor Ron DeSantis: (31:21) To date, right now, we have 47 different testing sites. And just those sites alone have done almost 600,000 tests. And so the sites we have, we have drive through sites. We have walk-up sites. We have pop-up retail sites. We have a mobile RV that will go around in different parts of Florida and test people, so you've seen more and more testing available across the state of Florida. And obviously what the state is doing is just part of it. I mean, the hospitals are doing a lot. You've got other, the locals are doing stuff. Private sector, but we're now in a situation where there's a lot of these test sites in a way that just wasn't the case in March, not only here, but anywhere in the country. Governor Ron DeSantis: (32:08) In May, when our numbers were low, I was begging people to get tested. Some of these places had relatively light traffic. Now, in the past few weeks, that traffic has increased, so the capacity has increased. Some of the, like the Orange County Convention Center, that would do about 500 tests a day. Now they're doing 1,750 a day and they've expanded lanes and done some of the other things. Some of these retail sites would do 25 a day. Now some of them are doing 150 a day. So you've definitely seen more of an interest in getting tested, which is good. Governor Ron DeSantis: (32:41) One thing we are going to do, though, is make available on a wider basis antibody testing. And the reason is, is you've got a lot of people now who are testing, who aren't presenting with symptoms, maybe because of work, maybe because someone they know got infected, and the problem is, if you're negative, it doesn't mean that you can't get it the next day. I mean, it's really a fleeting thing to have a negative test. If you do an antibody test, and you have the antibodies, well, that's something that's very significant in terms of the information. And so for somebody, if you're not symptomatic, those antibody tests really would be good. Governor Ron DeSantis: (33:19) They can detect a recent infection. If you have IgM antibodies, that means that you've likely been infected within a relatively recent time. IgG antibodies would be at least two weeks prior, maybe longer than that. But right now we've been doing it for healthcare workers and for first responders, but I think it's important for folks to be able to have access to that, so we're going to be working on ways that we can get more antibody testing out. The good thing about the antibody test, you get the results in 15 minutes. Bad part is, it's a blood test. It's not a swab, so some people would rather be swabbed than have the blood taken, but it is good information to have. So we're going to be working on that. But the testing is so much better today than it was in March and April, and that includes the hospitals as well as the state of Florida. Governor Ron DeSantis: (34:06) Another major issue that we were concerned about in March and April was personal protective equipment, particularly for first responders and healthcare workers. Our Department of Emergency Management has sent out huge amount of resources to hospitals, but particularly to longterm care facilities. We imposed a PPE mandate on them in March, and then we sent the N95 masks. We've sent face shields. We've sent gowns. We've sent this stuff to them. Obviously we've also helped the hospitals with things that they've needed. Now, most, I have not talked to any hospitals who are having problems with PPE at this point, which is a great thing, but we're in a much better position than we were prior to April. Governor Ron DeSantis: (34:51) You also see, part of the reason I think the fatality rate is lower is because you have better treatments today than you did in March. We brought a lot of hydroxychloroquine to Florida to have that as an option. A lot of physicians have used it the whole time and like it. There was a study that came out in The Lancet that had to be withdrawn that said it was bad. Now Henry Ford Medical in Detroit says this has been very helpful. Bottom line is, we want to provide that for physicians to make those decisions with their patients. The convalescent plasma has had success. The remdesivir, which we work with HHS to get to the hospitals, has had success. And then you've got things like the steroid and these other therapies. So the patient experience is much better today than it would have been in March or the beginning of April, and obviously the physicians have learned a lot about the virus, which is a really, really good thing. Governor Ron DeSantis: (35:47) So flattening the curve, you are pushing infections out longer, means you have to deal with it longer. But I think in terms of outcomes, you'd much rather be in a situation now than have to have done this at higher levels in March and April, in terms of positive outcomes. Governor Ron DeSantis: (36:02) The levels in March and April in terms of positive outcomes. So support the healthcare system, one of our main pillars. There's a couple of things that I think some of the folks have asked for. One, is I was with the vice president on Thursday. They obviously want to be helpful in any way they can. One of the things that we see a need for, is some personnel support for some of our hospital systems. And the reason is, is we have 15,000 plus beds available, the sense is, 25% are available. Obviously, hospitals you'd want to run probably at 90% capacity normally. So the beds are there. The issue is, is how the personnel can be used. So for example, in Miami-Dade, their largest hospital system, Jackson, they have almost 40% of the people that come in for non COVID things like car accident, childbirth, are testing positive. Governor Ron DeSantis: (36:56) Now, they're asymptomatic. They don't need to be hospitalized for COVID, but once somebody tests positive, there's a whole set of procedures that then get put in place. It requires manpower so that those folks are isolated and the COVID doesn't spread to other people. And so, what they're finding is, is okay, someone gets in a car accident, they get swabbed, they're positive, they don't need to be hospitalized for COVID, but they do need care for other things. That still requires the COVID procedures to be put in place. So having a little bit of relief on that element, and there's different things that they can do, would be good. So we've put in that request. We think it'll be favorably granted, and we hope to have some folks down. They're fine now, but just looking at, particularly as you see certain communities where there's a higher positivity rate, well, that's going to be reflected in the general patient population who come in, too, apart from COVID-19. Governor Ron DeSantis: (37:55) So they're at the higher end with the 40%, but even some of the ones in Central Florida like Orlando Health, I think they said they're about 20% of the people coming in for other things that get swabbed, do test positive. And again, these are people, I think 99% are asymptomatic, or most of them are asymptomatic, and they don't require hospitalization for coronavirus. But nevertheless, those procedures need to be put in place. And that just requires a lot of care and a lot of manpower. And they've had a lot of people working very hard for months. And in the summertime is the lower season for Florida typically in terms of staff. And so, this is an important request. Governor Ron DeSantis: (38:32) The Remdesivir, we want to make sure that that continues flowing, that HHS had been sending it directly to the Department of Health and then Florida was distributing it to all the hospitals based upon need. It's worked very well, but now what they're doing is, they're going from the manufacturer directly to the hospitals, which is fine. But we just want to make sure that there's no gap there. So we're working with the White House on that. Governor Ron DeSantis: (38:56) And then finally, just some of the chemicals for the labs, they're doing a lot of testing in these hospitals. And so, they're running out of some of this stuff. I know this stuff's available throughout the country. And so, we hope to be able to get it. When we had lower numbers, we wouldn't get anything because they were sending it to places that were higher. So the fact that we have these cases, we're running a lot of tests. People get that the hospitals need to be able to turn around these tests very quickly, so that's something that we're going to be working on really significantly. Governor Ron DeSantis: (39:24) So we're better prepared now. And I think that the steps to protect our most vulnerable is clearly the most important thing that we can do to minimize the impact of the coronavirus. And I know we're working very hard, not just at the state level, all our localities and the federal government are working side-by-side with us. Governor Ron DeSantis: (39:45) We're going to hear from some of the physicians and then we'll have a little discussion. And then we can open up the floor for some questions. And so, Dr. Nelson, I want to thank you for having us. You want to just kick it off and make some comments? Dr. Dave Nelson: (39:58) Thank you, Governor. Better. My name is Dave Nelson. I'm the president of UF Health, which means I oversee the Gainesville Jacksonville campus, as well as, the two beautiful hospitals here in The Villages. I'd like to get maybe a little reflection at a system level for what we're dealing with in terms of COVID-19. And then, I'll let my colleagues give you more specifics. Dr. Dave Nelson: (40:23) So other than overseeing the health systems, we're also responsible for bringing back the University of Florida and the professional schools at the different universities for UF Health. And so just to give you an idea, we currently have done well over 40,000 tests. And so, we have been testing a lot throughout this current pandemic. We use a technique called pooling, which is we don't do a single test, 10 people in the audience. We take 10 of your samples, put in a single test and if it's negative, all 10 are negative. If anyone's positive, you go back and have to test each one. Dr. Dave Nelson: (41:01) It's a resource that allows you to save those precious reagents that the governor just talked about, and it allows us to turn 1,000 tests a day into 10,000 tests a day. It's just an example. So we have probably over tested, I think if many people had asked, but we're very interested in ensuring a safe healthcare system and a safe university for the students to come back to. In the last week or two, we've seen, I think what everyone has been talking about, we have seen a dramatic increase in the number of asymptomatic employees and students, which we just tested, 20,000 in the last few weeks. But to put things in perspective, we went from 0.1%, 0.1 to 1%. So if you're walking in off the streets of Alachua County, it's coming [inaudible 00:41:47] to work. The likelihood of having asymptomatic infection is much lower than much of the rest of the State. So we've been very fortunate. Dr. Dave Nelson: (41:54) However, in our three healthcare systems, we have last week, saw a spike in diagnoses, cases as the Governor referred to them, and we had a little over 500 positives. If you look at the median age and where they distribute, Gainesville, Jacksonville, Central Florida Health, were kind of one, two and three. But an interesting median age of around 25 was occurring outside of the hospitals, which are all around 58. So we're seeing young people coming to the emergency room or coming to the healthcare system to get tested. And we're seeing, I think the age pushback in terms of who's getting hospitalized, is probably in that mid to late fifties, which is a change, I think, from our early experience that was dominated, unfortunately, by the nursing home patients and those with very heavy comorbidities. Dr. Dave Nelson: (42:44) And so overall, if you look at healthcare capacity, so we test a lot, we're seeing a fair amount of disease. It's in the young. So how are our three big healthcare systems stacked up to take a second or third peak? Right now, all three of our healthcare systems have very good capacity. I think there's a lot of misconception in the general public. When you hear that, let's just say our Gainesville Campus is 90% full, that's a good thing because we're usually closer to a 100% full, because we need to run fully to serve our community. Dr. Dave Nelson: (43:18) We have triggers that we can turn. The Governor turned one before which helped us decompress, which is elective surgeries. And we can continue to evaluate, but at least so far in the Central Florida health hospitals and our Gainesville and Jacksonville community, we have significant capacity and don't see that being a problem. But we probably could go tenfold higher than we saw in what you would see as the first wave because we never got into the mitigation strategies. Because we didn't see what South Florida hit. Dr. Dave Nelson: (43:50) There's no doubt. Miami will have a little less capacity than the UF Health system because we had never got the positive rates of 15 or 20%. So anyway, overall, I think we're definitely seeing a common younger persons spread. Hospitals are getting more active, and we will continue to watch those numbers, but have many triggers to pull, to open up the system more if we need to. Governor Ron DeSantis: (44:15) Great. Dr. Spry, why don't you talk a little bit about the ED and some of the stuff that you've been seeing throughout these many months? Dr. Jeremy Spry: (44:24) Sure. Is this on? All right. I'm Jeremy Spry. I'd like to, first of all, thank Governor DeSantis for coming here and speaking with us. It's important that he gets a lot of information from the physicians that are in this every day, and it shows in your control of the data, which is very important. And I'm the medical director of the emergency department here at The Villages and also, the vice chief of staff for the medical staff. Dr. Jeremy Spry: (44:47) One of the slides that he put up, there was one that reflected what the CDC reported about severity of other illnesses. And we're not just seeing an increase in the severity, but also in the mortality associated with it, too. So heart attack, stroke, other infectious illnesses aside from COVID, patients are waiting, and they're not coming in. That's getting a little bit better, but still to this day, we're seeing patients that should have been here earlier. That has a direct effect on their overall health. There's going to be issues with delays in cancer diagnoses for not just reaching out and coming to the ER, but also to even their primary care physician. Dr. Jeremy Spry: (45:25) So my job today, is to let the public know and reassure them that our policies that we have and procedures in screening patients and visitors and staff on a daily basis, the hospitals are very, very safe. And we're here and ready. And and if you've got anything that you're concerned about, come in. Don't delay. Governor Ron DeSantis: (45:50) Great. Dr. Lauzardo, can you talk about some of the stuff you're seeing? You have mentioned some of the nursing home components, so can you speak about that as well? Dr. Lauzardo: (45:59) Absolutely. Once again, thank you, Governor, very much for having us here and for coming to be with us here at UF Health. COVID presents some unprecedented challenges, things that none of us have seen during our careers. And probably one of the biggest challenges, is the wide range of outcomes related to age. So in other words, in one group, you see very little bad outcomes. In another group, you see devastating outcomes. But yet, I remain optimistic. It's a bounded optimism, so it's got its limits. But I'm still very optimistic. Dr. Lauzardo: (46:29) And why is that? The reason being, the Governor said it himself, is that probably the single most important intervention that we've done has been to on the nursing homes. And I couldn't agree more. When you look at that idea of testing repeatedly and going in every two weeks to ensure that that's where you watch that population the most, not only the workers, but also the residents in longterm care facilities, that has been a huge breakthrough, and that's a very important step to take. So that moves and makes a big change, and effects probably the single most important risk group, in terms of mortality and really the outcome that matters the most. Dr. Lauzardo: (47:05) But secondly, I said a bounded optimism. The bounded optimism is that what's been driving, what's been going on here lately, and it's been behavior. As the father of a 21-year-old and a 15-year-old, I get it. I understand what some of the challenges are. But much of what we've seen lately, is behavior driven. And again, yes, we want to see that stay in the age groups. But again, that fear is that unmitigated behaviors, in other words, just thinking of now and not thinking of tomorrow or thinking of others, that spills over into other age groups. And then we've got another problem. Dr. Lauzardo: (47:37) So again, I think that we have the tools. We have a lot of steps so that we can move forward, but again, we need everybody to work with us on that. So follow the rules, follow the guidelines, try to think about others as well. I know so many people are doing it, and this is a long haul. There's some challenges here, but there's a lot of reason to be optimistic. And I think that those steps will make a big difference. And especially with those younger age groups, thinking about others, trying to put off some of those things, think about the ones you love. Those are going to be the steps that are really going to help all of us continue to get this under control and continue to have reasons for optimism moving forward. Governor Ron DeSantis: (48:08) Great, thanks. All right. Dr. Lowenkron, do you want to weigh in on some of the stuff we talked about? Dr. Jeff Lowenkron: (48:13) Sure. Jeff Lowenkron, chief medical officer for The Villages Health, probably the only representative in an outpatient system here. A lot of what we have, as a patient-centered, primary care driven, community based healthcare model, is the ability to talk to folks before they're sick. And part of what we need to be able to do, is assure they have a confidence to be able to speak with us, either in person, which we'll welcome them into the care centers, or in whatever way they want to reach out to us. The real key is that we, as the healthcare delivery system, have to make sure they're safe when they come in. So we're making sure, and we've been doing this for months now, we screen people on the way in. We keep our own folks who are working there safe, and we keep the people that they're coming in contact with safe. By doing that, we assure that they can get the care they need. Dr. Jeff Lowenkron: (49:04) The real key is this. Most people, as they get older, don't need a hospital stay every year, but they all need a primary care visit every year. So we've seen demand for services come down for inpatient, for in person, but our ability to still make sure we deliver on the high quality service that we can, is key. And what we know is, if they need to come to the hospital, they're going to get outstanding and safe care here as well. So with that, we've been pretty comfortable sending our patients here when they need to, but we do start out by making sure they need to come. Thank you. Governor Ron DeSantis: (49:38) And I mean, just for the course of this pandemic, particularly the residents at The Villages, I mean, it seems like they've really taken some of the guidelines to heart and they still do things, obviously, because they're a very active bunch. But they've done it in a way that's minimized risk. Has that been your experience? Dr. Jeff Lowenkron: (49:55) It has been. And I think one of the things that really doesn't get the credit that it deserves, so the leadership here at the hospital and our leadership and the Department of Health in the counties here, have gotten together to assure we're giving a clear, consistent message as to what's been expected. And that clarity and that communication plan has been in place since March. So we've had ongoing, almost initially daily, sometimes two or three times daily, conversations. Now, it's probably just twice a week. Governor Ron DeSantis: (50:25) Yeah, and I know that there were certain things, some of the big indoor gatherings, whatever, they stopped in March. And they've continued to monitor. And I think that they had planned on maybe doing something sometime this month, but I think they were just waiting on that. And so, that's very much, focusing on the facts and making those decisions. And so, I think from the very beginning, I remember when I called Gary at the beginning of March. They had a plan and they've executed, and that's really what you need to do. And that's part of the reasons that you've had the very low numbers here, even though you have a more elderly population. Dr. Nelson, across your system we've heard throughout different parts of Florida that March and April patients that were presenting, they tend to be older, very sick. Now, maybe a notch younger, maybe a notch milder. Is that what you guys are seeing in terms of your COVID positive patients? Dr. Dave Nelson: (51:19) Yeah, I would say that's accurate. Also, we're so much smarter, right? We know how to put people down on prone position, and we know probably not everyone needs a ventilator. We have Remdesvir and steroids that have a role in hospitalization. So not only do I think we have a little bit either different virus or patient who's getting exposed, but we've just got so much more knowledge that we learned from the New York's and the Connecticut's and the rest of the world that kind of taught us things that would have saved probably lives back then. So I think we're all getting better. And hopefully, we'll get some new therapeutics or a vaccine down the road and make it a little easier. Governor Ron DeSantis: (51:54) Absolutely. Dr. Spry, in terms of the EED visits, you guys saw decline. How much of a decline did you see and how long did that decline and where are you now? Are you back to normal for things like heart and stroke symptoms? Dr. Jeremy Spry: (52:08) Yeah, we had about a 40 to 50% decrease in overall daily volume. That just wasn't here in Central Florida, that's all throughout the entire country. Even my friends where I trained in Detroit, the COVID capital, their volumes were down as well. Now, volumes have picked up. We're still down about 10%, but we're not where we were typically, even in this seasonal area right here. Governor Ron DeSantis: (52:30) So because there was a decline and I think most people don't think that all of a sudden people stopped having heart attacks or strokes. The people that eventually would come, who probably should have come, are they coming in worse condition? Dr. Jeremy Spry: (52:43) Yeah, absolutely. And we said the same thing. What happened to appendicitis? What happened to heart attacks? Where did they all go? It just doesn't disappear. So, they're waiting. And when they come in, they're having issues with more significant congestive heart failure, because they rode out their heart attack at the house, or they're laying on the floor for three days, not wanting to come in and get help. We've seen several falls at home that typically just tried to make it themselves. So it is very important that you don't ignore these things just because we're in the middle of a pandemic, and you're concerned about the state of the hospital. Governor Ron DeSantis: (53:17) Great. All right. Well, I want to thank you guys having us here. Thanks for all the good work you're doing. Thanks to The Villages for really going about it in a really, really smart way and protecting their residents. And of course, we want to continue to do that. As we've seen this positivity rise, as we see 15% in communities, maybe not quite 15% here but in a lot of parts of Florida as you start to see that, it's very, very important that we continue protecting the vulnerable. Governor Ron DeSantis: (53:49) Obviously, we've got a big apparatus in place with the longterm care facilities. Very important. But also, our 65 and up population, that they're minimizing large crowds and close contact with people outside their homes and folks- Governor Ron DeSantis: (54:03) I was in contact, close contact with people outside their homes and folks who aren't in that age group or don't necessarily have comorbidities to understand that particularly in the twenties and thirties, you're seeing this thing circulate more widely. And look, this was probably circulating amongst that age group in March or April, we just weren't testing for it. But I do think it's circulating at a higher rate now or certainly has in the last few weeks than it would have been detected even if we were testing a little bit more aggressively. So that's out there and so what you want to do is just be cognizant of that. Particularly in those twenties and thirties, you do see more infections there than anywhere else, any other age cohort and so grandmother, parent, please keep that in mind over these next couple of weeks. With that, we're happy to take some questions. Yes ma'am. Speaker 1: (54:56) Hi Governor. You talked about how [inaudible 00:54:54]- Governor Ron DeSantis: (55:04) No, no, no. The theme parks have been doing great. I mean, Universal, if you look at what they're doing, and that's what I think the lesson is. We have to have society function. You can have society function in a way that keeps people safe. And when you have all the different procedures that they have in place, people are going to be, it's a safe environment. Disney, I have no doubt it's going to be a safe environment. I think that where you start to see the spread, it's just in social situations where people let their guard down, usually like a private party or something like that. That's kind of what we've seen. But I think that the folks who put a premium on safety, that's showing you that we're able to handle this, have society function, we still want people going to work, but do it in a way that you take some basic precautions. And so, really impressed with what Universal's done and I've looked at Disney's plan. I mean, it was very, very thorough. Governor Ron DeSantis: (56:03) They've been doing a good job. Here's the thing. You see where the virus is spreading and the age groups it's spreading in. We need to protect the vulnerable. We need to protect the folks who are in the at risk age groups, people with comorbidities. But the broader part of society doing the moderate social distancing, doing the basic things, will go a long way and so that's what we need to do. We need to keep people working, keep society functioning, and combat it that way, and I think we will. Speaker 2: (56:37) Governor, [inaudible 00:02:38], a lot of people [inaudible 00:56:38] are singling out- Governor Ron DeSantis: (56:43) What else is new? They were doing that in March, too. Remember that? Speaker 2: (56:47) And it seems picking on Florida. You know, Chicago, the latest city to implement a travel restriction for Floridians on top of New York and New Jersey, Connecticut. Europe will not allow Americans in. As of July 1st they said they were going to. But the talking about positivity rates, not so much cases, I know you're focusing a lot on positivity rates. Some of their requirements are until the positivity rate drops below 10%, they won't allow Floridians, and specifically pointing Floridians, the Disney's Actor's Union has said, "We don't think that Disney can reopen safely." They seem concerned. Are you not as concerned as they are? Governor Ron DeSantis: (57:23) Obviously, I mean, we were doing so much in terms of combating this from the beginning. I mean, if you look, just look at what we've done with these COVID-only nursing homes. I mean, like that's saving lives, so we're doing all that we can do on that. So obviously, I went through the numbers. I want us to be in May. I want us to be in early June where we're at three, four percent. I mean, there were times in Central Florida, I mean, Orange County, sometimes they'd have days they'd be one and a half, two percent would be positive. And really, if you're at one and half, two percent, that's basically false positive rate. There may have been nobody that actually was infected at one and a half. So we want to get back to that for sure. I think we've stabilized it where we're at, and other states can do what they want, but you go back and look at March, the positivity rates in some of those areas, it wasn't 15%. I mean, it was 40, 50, 60% daily in some of those areas. Governor Ron DeSantis: (58:17) So it's a little bit different. And I would also say Florida is very diverse as many of you know. We have one major metro area in South Florida that has the highest numbers, both in terms of positivity and in terms of ED visits and hospital usage. And then we have others, if you look at Central Florida, no doubt. You've seen way more cases in Orange County. But the median age sometimes is in the twenties on a daily basis, never above I think the mid thirties. And so the clinical consequences of that has been relatively mild. I mean, Orange County has one of the lowest case, fatality rates for the amount of people that you have. Governor Ron DeSantis: (58:58) So, it's not an even epidemic throughout the state. There's a lot of diversity here. Obviously I think the solutions are going to be tailored differently based on the facts at hand. But I think that we're much better off today than we were in March. And we're much better off to weather compared to what some of those other areas are. So yeah, look, they can do what they want on Florida. I would not do that if I were them. When I took the action against the northeast, it was factually the case that tens of thousands were coming to Miami right at the height. I didn't necessarily want to do it. Hell, I got a lot of private blow back because I know people that travel back and forth, and they told me, they're like, "Look, we're fine," and I just did it because I thought that that was the safe thing to do. Governor Ron DeSantis: (59:40) And I think in hindsight, you look back, South Florida had it worse than largely because I think of that being seeded, you didn't see the seeding as much in Central or North Florida. And so it was milder in March, and April, and May here. Now I think this part is starting to see more cases or whatever. So, I mean, it's a team effort here in Florida. We've got all hands on deck and I think the people of Florida are responding positively, and I think they're responding in ways, like look, there's no need to be fearful. Let's just focus on the facts. We understand what we've got to do as a state, and let's get it done. And I think if we do that, we're going to be in good shape. Governor Ron DeSantis: (01:00:20) And I do think to listen to some of the things that you hear from some of the folks in the hospital systems, they understand. They prepare for this. I mean, this is what they have to deal with. So we're in constant contact with all those folks. As I mentioned, the personnel that we're going to bring down is largely because of non-COVID related illnesses, that people are in for other reasons, they test positive for COVID, and all the procedures that then go in, that then takes away some of the manpower. So we want to be able to help supplement that, the Remdesivir, all these things, we're going to continue to do that, and I think do it very well. So, we're going to be okay. [crosstalk 01:01:00] Speaker 3: (01:01:00) Governor, how do you respond to the President's message that 99% of people with COVID-19 are going to be totally okay? Governor Ron DeSantis: (01:01:10) Well, I think if you look, so you saw, I'm not sure exactly what he meant. In Florida, the case fatality rate is under two percent now, which is much lower than a lot of these other states. Now, obviously, if you don't die, some people have nasty illnesses and hospital stays and we shouldn't minimize that. I mean, obviously we're focused number one on the fatalities, the care homes in those areas, so you do that. But I do think if you look at the infections on top of just the cases, which may be 10 times as many, the rate of lethality is much lower in an infection fatality rate than a case fatality rate. Governor Ron DeSantis: (01:01:49) And it's something, I mean, even the CDC has said is 0.26%. I will say though, for the people that are testing positive at the highest rates in Florida, those 20 year olds and the 30, by in large, they're presenting very mild or asymptomatically, and that's obviously a good thing. It's a good thing in terms of the health outcomes. Now, it makes it harder to contain the spread because if this was SARS-1, I don't even think you were contagious until you were really ill. And so you'd get ill, you could isolate, and you really could stop it. Here, most of the people who have it under 50 are not exhibiting symptoms or very, very minor symptoms, not enough where they would want to go seek medical attention. Speaker 3: (01:02:33) It sounds like the President is trying to minimize- Governor Ron DeSantis: (01:02:35) No, no, no. Well, I'm not minimizing it, but I think we should also have proper perspective. When we went into this, there were people saying that 20 year old was just as at risk as a 90 year old, and that's just not factually true. We know where the risk is. We know who the comorbidities that are impacted. We've got data on this now. We know who the folks who are more vulnerable who need to be protected. So it's a very serious thing. And I don't think he was trying to minimize it, but I mean, clearly we viewed as serious from the beginning in January when we were monitoring it. Governor Ron DeSantis: (01:03:08) But at the same time, when you hear news about cases, I just think that should be put in the proper context and perspective that the number one age for cases in Florida is 21, and if you're 21 and you don't have significant comorbidities, your fatality rate is pretty much zero with that. And so to me, that's comforting to know when you see the cases, that it's affecting folks who are less likely to see clinical consequences than some folks. And I've said this before, even before we started to see more cases. From a clinical perspective, a thousand cases under the age of 30 is going to be less significant than 50 cases in a long-term care facility. That's just the way this virus works. It's very much dependent on age and on the comorbidities. [crosstalk 01:03:58] Speaker 4: (01:03:57) This month, the Federal PUC $600 payments that people are getting is going to expire, and a lot of people have been depending on that because if they're unemployed. Do you support the idea of extending that unemployment for as long as people want to go through the end of the year? Do you support that? Governor Ron DeSantis: (01:04:15) Well, what I would want to see, I think, and they're discussing it in the Congress in this next round, if they do do a next round, is providing people if they do go back to work and take their old jobs, maybe a financial premium to do that. Because right now there is a disincentive, depending on where your wage is, if you had some type of premium, then there's more of an incentive to want to go back. And so I think that they should structure it differently, but I would support them doing something to be able to get people, to keep them on their feet, get them back into the workforce and do. I mean, we've seen a lot of people get back in their jobs after the kind of the March April shutdown. The problem is that I see is, you know some of those jobs are definitely going to come back. But the question is, is there going to be 50%, 90%? Governor Ron DeSantis: (01:05:05) I mean, if it's 50%, you're going to have some problems. If it's 90%, we're going to be able to kind of deal with it. So here in Florida, we obviously haven't had the job numbers yet for our state in particular. But if you look at the national numbers, we're obviously anticipating a positive increase here in Florida to be reflected from June. And then obviously we want to continue to do that as we move forward in a very safe way. Governor Ron DeSantis: (01:05:32) Well, I want to thank the folks here again for all their hard work, I want to thank Dr. Nelson for partnering with the state on a number of very neat projects. You know, we did a surveillance project at the villages, I think it was probably March or April, pretty early on. And we wanted to try to figure out what percentage of people are asymptomatic. Because at that you wouldn't even get a test unless you had symptoms, which a lot of the people testing positive now probably would not have met the criteria. Governor Ron DeSantis: (01:06:00) But at that time there was an age component and there was a symptomatic component. And we said, okay, that makes sense, because we had limited resources, but what about asymptomatic seniors? So they tested, I think, what did you do, 2200 or 1400? Speaker 5: (01:06:14) 4,000. Governor Ron DeSantis: (01:06:15) 4,000. They did 4,000 asymptomatic seniors and not a single infection, right? Speaker 5: (01:06:21) There was one percent. Less than one percent. Governor Ron DeSantis: (01:06:23) Less than one percent. I mean, I think the first round they got zero. Then they did more. They got a few, but I mean very, very low prevalence. Now part of that is they were doing a good job here at the villages. Part of it, I think, as we now know is you didn't see this really come through Florida outside of South Florida until we got into June. So I bet you if we did it, it'd probably be higher now, hopefully still pretty low because they've done a really good job here, but that's just something that. Governor Ron DeSantis: (01:06:49) And then, UF Health, they started doing the testing in low income neighborhoods, public housing, and that really provided the inspiration for us to do all of our walk-up sites. So we have all these walk-up sites in underserved or low income neighborhoods in different parts of the state now where people could go. Had a tough time getting a lot of people to test in May, and then all of a sudden in June. Now we got a lot of people going through those sites as well, but that's what they're there for, for people to be able to do that. And so what they did in Jacksonville really informed us to say, okay, it's one thing to have a big drive through site. It's one thing for the hospitals or a doctor's office to do it, but we really need to bring testing to the people and get it in areas which are very convenient for folks. Governor Ron DeSantis: (01:07:35) And quite frankly, not everyone has access to a vehicle all the time. So we wanted to do that, and it's been very, very successful. So we look forward to working with you. One thing I would like to see is I think we need a statewide, scientifically valid statewide seroprevalence study. So if you guys are interested in helping with that, we have one University of Miami, Miami-Dade. We have this dated one from the CDC now for Southern Florida. Governor Ron DeSantis: (01:08:04) But that is really, really important to know the seroprevalence throughout the state, because the higher the seroprevalence, the less the ability the virus is going to have the spread. So some of these areas that have hit 15, 20%, the virus doesn't expand as much. So if you have a very low seroprevalence, then it's got more potential targets to reach. So I think it's very important, not only as we get through this period, but not knowing what may happen, in the fall and as we get into flu season. To have that source of information, I think, is going to be very, very important. So we want to work to get that done. All right. Thanks everybody. [crosstalk 01:08:42]