Florida Governor Ron DeSantis July 7 COVID-19 Press Conference Transcript

Ron DeSantis: (00:00)
… [inaudible 00:00:03], and then we have Mary Mayhew is our OCHA secretary. We’re making a few announcements here today related to COVID-19. Today we’re at the site of the old Pan-American Hospital. It’s now the Miami Care Center, and we’re doing that to highlight a new partnership between the Miami Care Center, The Avante Group, Skilled Nursing and Rehabilitation Centers, and the state of Florida to create a 150 bed COVID-19 dedicated nursing home. This is the 12th of its kind throughout the state of Florida. If you look at how this epidemic has affected different groups of people throughout the United States, it’s clear that the most significant impacts have fallen on residents of longterm care facilities, and how you handle that and approach that I think has been probably the most critical thing that you can do on a government level. I think we’ve seen in areas of the country where you had really high fatality rates, part of that stemmed from policies in which longterm care residents who were COVID positive in the hospital, the medically stable, were sent back into nursing facilities, who didn’t have the wherewithal to isolate them.

So as we know what this virus, it spreads, and in those instances, it was spreading amongst the most vulnerable. Here in Florida, we didn’t at the very beginning, we recognized that that would be something that would be very problematic to have a COVID positive nursing home resident be put back into a facility where you couldn’t have proper isolation, would be a recipe for more spread, obviously more hospitalizations and more fatalities. So we prohibited discharging COVID positive patients back into nursing facilities, and that was the right decision to do. It saved a lot of lives by doing that. It’s prevented outbreaks. At the same time, you do have situations where either somebody who’s at a longterm care facility is in the hospital, but is stable and really doesn’t require fortunately additional hospitalization. You also have instances and because we’ve been testing a lot in nursing homes where somebody will be identified as positive, but they’re medically stable.

So if you’re in a longterm care facility where you’re not able to appropriately isolate them, leaving them in that facility runs a risk of having spread throughout the facility, infecting other staff and residents. So we are requiring those facilities and have been for some time to transfer a COVID positive resident to a facility where isolation can be done. That initially was hospitals, and so you have a lot of hospitals boarding or have been boarding a lot of these longterm care residents. We in April said, okay, obviously we need to isolate. There may be ways to do it that make more sense, and so Secretary Mayhew really led the effort to establish skilled nursing facilities specifically for COVID positive longterm care residents. This serves both as a step up from a longterm care facility that may not have the ability to appropriately isolate a COVID positive resident, but also a step down from a hospital setting where you may have somebody who’s COVID positive, but they are medically stable and don’t require that level of medical attention.

So having this is really an important tool as we look at handling what’s going on with COVID-19. If you did an honest accounting, like in Florida, anyone who’s a resident of a longterm care facility, whether they died with Corona in their facility, in hospice, in a hospital, that all counts as a fatality. If you did that uniformly across the states, you’d have a majority of the COVID related fatalities would be amongst longterm care residents. So this is where kind of the tip of the spear where the most danger is from this virus, and this has been something that we’ve been constantly focusing on since March. This is another step in that direction. So right now, or at least it’s been for probably the last couple months, you have anywhere from 250 to 450 medically stable COVID-19 positive longterm care facilities in hospitals.

Now that we have these 12 facilities, you’re starting to see more and more admissions where this could serve as that step down from the hospital, and you’re also seeing admissions work at serve as a step up from a longterm care facility. Exclusively caring for medically stable COVID patients does serve that dual function, both stepping up and stepping down, so The Avante Group began operating this care center at the beginning of July. They’ve already admitted 18 patients and they do have more on the way. They can currently staff up to 70 beds, and we think within the next few weeks they will have staffed 150 beds for COVID positive residents of longterm care facilities. This is very important. So in South Florida, you now have the Miami Care Center, you have a facility in Broward that’s COVID only, and then you have two in Palm Beach County that are COVID only.

So that’s a pretty significant number of beds to be able to care for people who are COVID positive, but care for them in a way that they’re not spreading it to other vulnerable seniors in these longterm care facilities. One trend that we’ve been seeing, and I think that Jackson can validate it is, as we’ve seen more traffic into the hospitals in the past few weeks, we’re seeing a smaller number of residents of longterm care facilities admitted. So we obviously would like this not to be here, not to have anyone admitted, but those residents of the longterm care facilities and when they’re admitted, they have a much, much higher rate of mortality. So to see that decline is something that’s very, very positive. Now we’ve done the testing of the residents and the staff from April through the beginning of June. We now have a rule in place per Secretary Mayhew that all staff members of longterm care facilities need to be tested every two weeks.

That’s 180,000-190,000 people, so those tests are being administered as we speak. They’ve been distributed I think about 10 days ago. You’re going to start getting more and more of those results come in. The first round we did this, the positivity rate for members of the staff of longterm care facilities, about 3%. We anticipated being higher just because these folks are going to be reflections of the community, so if you have a higher positivity rate in Dade or Hillsborough, some of these places, those staff members are probably not going to be immune to that. So we anticipate seeing a higher positivity rate, but by doing the testing allows us to isolate the staff member so that they don’t spread it to the resident. So all in all, I don’t think any other state in the country has done what we’ve done to protect the vulnerable here in the state of Florida.

This is another big step in that direction, and I think it’s going to be a really important tool to help protect vulnerable folks, particularly at the time at hand. This is just one thing that we’re doing. We want to do more to be able to help with that, so per Secretary Mayhew, she’s been working with hospitals to ensure that they have the capacity and staffing necessary to be able to handle not just the needs of COVID, but also other needs. We are seeing more traffic in emergency departments for non COVID. That’s not necessarily a bad thing because what happened was in March and April, you saw a decline in people showing up for heart, stroke and some of these key sources of mortality. People didn’t just all of a sudden stop having heart attacks. There are people who were not as comfortable seeking medical care then.

So we’ve been stressing, and I think every hospital that we’ve talked to stresses, “We’re open for business. If you have heart, if you have stroke, come in and get the medical attention you need”, because if you put off the heart than it tends to get worse. We were in the villages yesterday talking to some of the ED docs, and they were saying that some of the patients now that are presenting for things like heart and stroke are presenting more severely because the symptoms started previously and they just didn’t go into the hospital. So we definitely want that to happen, and we view that as is very important. I mean this virus is one part of health; there’s a whole host of other things that we’ve also got to be concerned with. What we’ve done, the second announcement is we have at the state with OCHA approved a temporary increase of 47 beds for Jackson’s Nursing Home license.

So that’ll take them from 180 to 227. That’ll be a force multiplier in terms of their ability to care for COVID positive nursing home residents. So this increase of 47 beds has allowed Jackson to use a former rehab facility adjacent to Jackson Memorial to discharge patients from its hospital to a more appropriate level of care, and obviously ensuring that you have adequate hospital capacity. So we think that that’s something that’s very, very important. The final thing that we’re pleased to announce today is speaking with a lot of folks in these hospitals, if you look at the census, you’ve got I think it’s been about 25% of the beds have been available statewide. That’s been pretty consistent. Dade has a lot of beds available still, but this is the low season typically for hospitals in terms of their staffing.

Usually the higher season is flu season. So they’re looking at ways to utilize staff and particularly at a place like Jackson, where they have folks come in for things totally unrelated to COVID, they get into a car accident, they have heart problems. Everybody who’s coming in is getting swapped and they’re getting tested for COVID. Well I think the rate you guys are seeing 30% to 40% are testing positive, now they’re asymptomatic. They’re kind of incidental COVID positives in the hospital. They would not need to be hospitalized for COVID absent the other conditions, but what happens is if you’re in and yet you broke your leg and you’re an asymptomatic COVID patient, they still have to put protocols in place to be able to isolate and make sure that that doesn’t spread to other parts of the facility, so that requires just more manpower. If it’s not COVID, what’s the difference in the ratio that you would have to have?

Speaker 1: (11:15)
Right now it’s one to four on COVID patients, usually it’s one to six.

Yeah. So that you see kind of there, so there’s beds available, but if you’re having patients come in test positive for broken leg, they still have to do this one to four. So when the vice president was down with [Secretary Azar 00:00:11:39], we were in Tampa on Thursday, some of the hospital folks there were saying, “We have beds. We just want to make sure we have enough folks staffing.” Obviously there’s certain things they do to try to bring in staff as well. So HHS they’re working, we submitted a request for them to be able to folks to Florida, particularly to south Florida. At the same time, the state, we want to do our part. We don’t want to rely just on the federal government. So today after talking with [Carlos Magoya 00:12:14] after talking with other folks down here in Dade County, the state, we are going to be diverting some of our contract personnel to Jackson.

So we’re sending starting tomorrow 100 contract medical personnel, mostly nurses, to be able to augment their operations. I think that that’ll be something that’ll be very useful for them as they continue to deal with not only just COVID patients, but also non COVID patients. So we’re happy to be able to be supportive, and we are standing by to be able to do more as the circumstances warrant. I did speak with the vice president last night. Our request was put in at the end of last week, it is being processed. So we do anticipate seeing some folks as well from there, but in the meantime I think that this will be something that’s very, very helpful for Jackson, and obviously we’re working with other areas of the state. I think Dade is of course seeing the highest positivity and I think the outbreak here is different than some of the other places, but certainly there’s other areas as well that are going to want support and we want to be there to be able to support them.

So I’m excited that this has come to fruition here at this Miami Care Center. I think this is the right thing to do for our seniors in longterm care facilities, and just continue to stress that if you are in those vulnerable groups, if you’re 65 and up, if you have certain underlying significant medical conditions, be very careful about avoiding crowds, avoiding close contact with people who are not in your household. We’re seeing positivity in Miami Dade, some of the other places maybe not as high but higher than they would be. So now’s the time to really continue to be very cautious and continue to limit that close contact so that you can avoid being infected while this virus is out. I know [Mayor Menazor 00:14:06] and I were talking about a lot of this is being driven by younger people and they’re just much less at risk.

You look at the statistics, if you’re under 40 and you don’t have a significant underlying condition, the fatality rate is incredibly low, which is a good thing. At the same time, those folks interact with people who may be in vulnerable groups, and so that’s definitely a concern, not only with staff in a nursing home, but just things like multi generational living, visiting parents and grandparents. Now’s the time to exercise that caution. So we’ve at the state have advised from really March that if you are in those vulnerable groups to avoid crowds and limit the contact with people outside your household, and now especially understanding that that 20 to 30 year old cohort, you’re seeing more and more infections in that age group. They probably were already always happening to a certain extent, but I think the transmission rate has increased over the last month. So it’s very-

The transmission rate has increased over the last month. So it’s very important to be careful and to continue to exercise caution. And I think we’ve seen particularly the older folks have done a really good job of being very cautious as this thing has continued to affect folks in the community. So I want to thank everyone for coming. We’re going to pass it along to some of the other folks, and then we’ll probably have a discussion before we take some questions. So mayor, you want to chime in?

Carlos G.: (15:31)
Thank you, Governor. I’m just here to thank you and the Lieutenant Governor, and also a secretary [inaudible 00:00:15:37].

Speaker 2: (15:38)
Can you turn your mic on?

Carlos G.: (15:39)
I don’t know how to turn it on.

Speaker 2: (15:41)
I think there’s a button.

Carlos G.: (15:41)
There’s a button here?

Speaker 2: (15:45)
I think so. On the top maybe, or bottom. There you go.

Carlos G.: (15:49)
Can you hear me now? Can you hear me now?

Speaker 2: (15:51)
Yup.

Carlos G.: (15:52)
Okay, good. All right, thanks. I’m here just to thank you, Governor, Lieutenant Governor, and Secretary Mayhew for the incredible support you’ve given us here in Miami-Dade. This new facility that’s open now is going to be a tremendous help to us here in Miami-Dade. You’ve seen the surge of people that we have in the hospitals, in the ICUs, and also the use of ventilators here. And this is going to be a tremendous help to our capacity here to the residents of Miami-Dade. I also want to congratulate you, thank you for the personnel that you shipped to Jackson, 100 additional nurses. They are critically needed in order to open up even more capacity in our healthcare system here in Miami-Dade and also your continuing efforts to help us with the federal government.

Carlos G.: (16:43)
And so again, I’m here to show gratitude for all the things that you’ve all done. We talk with each other every single day. We are the county with the most cases, unfortunately, and I’m very happy to have your support and the Lieutenant Governors and Secretary Mayhew’s support. So thank you very much again for being here. And I know that I’ll be asking for more as the day goes by, but also the your message that we all have to be careful. It’s our responsibility to keep each other safe.

Carlos G.: (17:20)
It’s our responsibility to follow the rules and we if all follow the rules, we can start to tap down, we can start to drive down the positivity rate that we have here in Miami- Dade County. We continue to have a positivity rate of above 20%. Whereas two weeks ago, we were down at 8%. And so it’s up to every one of us. Including, especially, we need to look at our younger population that we know had a tremendous spike in their positivity rate, which in turn has infected other people in Miami-Dade. So my message is thank you. But also every one of us needs to participate and be good citizens, follow the rules, and we can beat COVID-19. Thank you.

Absolutely. And really over the last month and a half really have increased testing even more in Miami-Dade. I mean you guys obviously have more cases, positivity rates not where we want it to be, but you’re also testing at a very high clip. We have, of course, the main centers that we had had from the beginning Marlins and Hard Rock, but then the Miami beach site. And then we have some of the walkup and then some of the retail pop up at Simon Mall and everything. And so people are taking advantage of that, which is a good thing. We’re happy to support the efforts with the expansion of testing. I had secretary Mayhew…

Carlos G.: (18:39)
I could say it in Spanish, I would like to thank-

Oh yeah, go ahead.

Carlos G.: (18:41)
All right, so [foreign language 00:18:43].

Okay, Mary.

Mary Mayhew: (20:07)
Thank you, Governor. Is this on?

Yes.

Wonderful, thank you so much. First, let me express my appreciation to the Avante group. I think now that we have 12 dedicated isolation facilities, we may have lost sight of what an incredible commitment it is for a facility to come forward and agree to support COVID positive longterm care residents. And to now have 12, and certainly to have this facility here in Miami, 150 beds to support, just as the Governor described, a vision that we’ve had now for several months to both support our other nursing homes and assisted living facilities with the opportunity to transfer a COVID positive individual out if they don’t have the ability to appropriately isolate and to provide the necessary infection control standards. That helps us to prevent one case from becoming ten, five to becoming 20. That has been a critical resource for us around the state.

And now acutely, as hospitals are seeing increased hospitalizations, to be able to support efforts to decompress our hospitals so that individuals who no longer need hospital level of care, but are still COVID positive and in need of a longterm care placement, thanks to the Avante group and their efforts to staff up quickly here, we have an opportunity to transfer these individuals to this setting to get the right level of care until they are negative, and then they can return to their nursing home, to their assisted living facility. So really grateful to you for your leadership, to your commitment and Governor, to your unwavering focus on protecting our elderly. Again, we’ve talked about this throughout the pandemic, but in the early days, in the early weeks, we had hospitals who were very concerned when we said you cannot discharge back an individual to their nursing home, to their assisted living facility, if they are positive.

And frankly, we said, if there’s any risk that they are positive, they cannot go back. We know not only is that population the most vulnerable to fatality, the residential setting is at greatest risk for rapid transmission. We have nursing homes that are 40, 50 years old. They don’t have some of the modernized air systems. And then if you’re at 95% full, it’s awfully difficult to isolate. And then as you’ve described, we have looked comprehensively at the system and government is not often accused of being nimble, but we have done everything possible to respond timely to the needs and the demands around the state. You mentioned Jackson Health and their rehab building and we turned that around as quickly as we possibly could.

We have partnered with the mayor and with his staff, I have their cell phone numbers and they have mine. And we can’t overstate how important that has been to understand regionally, to understand the areas within Miami-Dade, where you’ve had outbreaks and what that has meant for the response and for the collaboration. And so really grateful, not only to be here to celebrate what this asset means to this area of the state, but also the continued partnership so that we are here for each other to continue to respond aggressively in this pandemic and in this crisis. So Mr. Mayor, thank you very much for your leadership and for the collaboration that we have had throughout. Thank you, Governor.

Great, all right. Well appreciate all your hard work. All right Don, you want to make some comments?

Don: (24:34)
Sure, first I’d like to thank Governor DeSantis, Lieutenant Governor Nunez, the mayor, as well as Secretary Mayhew for supporting this project. So Jackson facilities do have capacity at this point. Our biggest challenge is staffing. And with the addition of these 100 nurses, this will help us to continue to grow the census if needed from a safety perspective. And then also what it does is it allows our nurses right now that have been on the front lines since March to have some additional relief and some additional assistance. When you take a look at what we’re doing here is 100 nurses that will be starting over the next few days, 75% of those will be critically care trained. We will be able to start treating patients within a week.

Don: (25:37)
We need to make sure that we orient the nursing staff to Jackson practices and also look at their competency. At the same time, what we’ve been doing is we’ve been doing our own hiring. We’ve hired close to 100 nurses that will start between now and the next month. And those nurses obviously have jobs, they’ll need to give notice, et cetera, and we’ll need to get them into training. So from a capacity perspective, we think this is the right thing to do. This will move us to the next level. I also wanted to make sure that everyone was aware that the most important point I think of today is what the Governor and what the mayor has indicated. Every member of the community needs to go ahead and make sure that they’re wearing a mask, staying six feet apart, and frequently washing their hands. That will prevent hospitalizations and people coming into the emergency rooms throughout the county on that.

Don: (26:42)
I’d like to just share some other statistics. One, I’d like to thank Secretary Mayhew on that effort for our former, we have a hospital being converted over, on any given day, we have 30 to 40 COVID positive patients there that would have been in the hospital that we were able to now use that space for acute care patients. Today at Jackson, we have 345 patients as of 8:00 AM today. 25% of those are in the ICU. About 20% of the current inpatients are under 50, which that number has grown. More than half of the current inpatients are under the age of 65. And to the Governor’s point between 30 and 40% on any given day, these are patients that are coincidentally COVID that have come in for something else, a broken leg, a trauma accident, et cetera, that have tested positive. We do have plenty of vent capacity. That’s not an issue. We’re only using about a third of our ventilators that we have in stock. And so with that, I’d like to thank everyone again. This will be a great additive to our staffing.

Thank you. All right, Kim, from Avante, do you want to talk about some of the things you guys are doing here?

Kim: (28:12)
Sure, thank you, Governor. First, I wanted to say thank you to Governor, the state of Florida, secretary Mayhew, the agency for healthcare administration on behalf of all of us at the Avante group for your ongoing support of longterm care. All of your efforts and your resources have been invaluable to us as an organization and as an industry as a whole. So thank you guys so very much for that. At Avante, our mission statement is simply put our mission is you. And when we opened this facility, that was the forefront of why we opened this facility. Simply put, our mission is you, the community of Miami-Dade, the residents, the families, and getting these folks a place to go that is safe, provide relief to the hospitals, relieve some of that capacity from the hospital to the nursing home setting. We have hired some of the most dedicated and compassionate staff in this facility that are all dedicated to the quality of care and outcomes of these residents that we have that have admitted so far and will continue to admit to the facility in the near future.

Kim: (29:09)
Our goal is to get them better, get them back into their previous discharge setting, and provide them with our values and our standards as a company that we provide quality outcomes and quality care to these residents. We’ve put in place stringent infection control policies and procedures in accordance with CDC, the department of health, and the agency for healthcare administration to ensure that our residents are getting the most up to date, most current care, most current infection control practices provided to them while they’re in this facility in order to have a successful discharge back to the community or their longterm care facility that they came from. So we are honored to take on this project. We are proud to support the hospitals and the community of Miami-Dade, and we look forward to this continued partnership. So thank you guys.

Great. And thank you for what you guys are doing. I think [inaudible 00:29:55]. One thing when you’re talking about discharging these patients, I mean, one of the reasons why you kind of need this is…

Patients. One of the reasons why you need this is we have the rule from the beginning, or from the middle of March, if you’re resident of a longterm care facility in the hospital, can’t be discharged back to your longterm care unless you’ve had two negative tests separated by 24 hours. That was the CDC guidelines. And look, that’s safe. But what happens is, is these PCR tests, they can pick up dead virus. So, there’ll be people who will test positive and then they’ll try to get out of isolation, not just longterm care and they’ll test positive for another two weeks or even three. Some people test positive 21, 28 days out past when they first tested positive. So, it’s a limitation in terms of some of the stuff that we have.

So if you have a step down facility, if they’re still testing positive three weeks after, they’re probably not infectious, but at least you don’t have to run the risk, you put them there. And then when they get the negative, they can go. But it’s a limitation on this PCR testing that if you have RNA, it will pick it up even if you’re not infectious or even if you’re no longer sick. And that does contribute to some of the seniors who continued to test positive even when they’re not showing any symptoms. We have the lieutenant governor here. You want to make a few comments?

Jeanette Núñez: (31:21)
Well, good afternoon. Thank you, governor. And thank you to all who are here with us. Mayor, secretary, and the folks from Jackson and Vontay group. It’s a pleasure to be here and I think today and this facility and everything that you heard the governor announce is in alignment with his pillars from the very beginning of this pandemic.

One of those most important aspects is protecting the elderly. We know that they’re the most vulnerable. We know that not only here in Florida, but throughout the country, those in longterm care facilities, we’re seeing the vast majority of those are what account for the fatality rate. So this facility and facilities like it, you heard the secretary and the governor mention we have 12 throughout the state, these are facilities that are going to protect lives and protect our elderly. The most vulnerable of those that are suffering from COVID-19.

In addition, the governor’s focus on testing. We’ve seen tremendous growth in testing, not just here in Dade County, where we have the most cases, as you heard the mayor mention, but throughout the state. We want to make sure individuals have access to testing. And then also in helping our hospitals and our healthcare facilities prepare for what we’ve seen is an increase in cases. You heard Jackson talk about their numbers. And again, the governor’s announcement today is testament to his focused approach in dealing with this pandemic. It’s a testament to his collaboration and continued cooperation, not just with hospitals and nursing homes and assisted living facilities, but with our county leadership.

And I think that that is something that we’re proud of. I think that’s something we’re going to continue to focus on and make sure that as we battle this pandemic, that we’re going to have a focus on data. We’re going to have a focus on the governor’s pillars that he outlined at the very beginning of this pandemic. So, governor thank you for your leadership. And thank you to all that are here with us today.

Great. Well, thanks everybody.

Speaker 3: (33:11)
Can you say that in Spanish [crosstalk 00:03:06].

[Spanish language 00:03:05].

Oh, go ahead.

[Spanish language 00:03:10]

Great. Well, I want to thank the mayor. I want to thank Jackson, I want to thank the folks here at Miami Care Center. This is really important. The additional personnel for Jackson, I think is going to be very, very important. We obviously want to continue to help and we know that the federal government is going to be helping as well. The fact is, as was mentioned, if you have 30, 40% of people with broken legs and some of these other things that are asymptomatic but testing positive, that increases the manpower because you need to isolate, you need to do the protocols that come with things like when you’re dealing with COVID-19.

And obviously these hospitals are going to continue to do that, but it is more labor intensive, even when you’re dealing with a traditional patient who happens to test positive. So, we’re very sensitive to that and I know that in speaking with the White House, speaking with the vice president and the task force, they’re very sensitive to that as well. So, thank you. We really appreciate all your hard work.

And particularly I want to thank the folks, the healthcare workers, first responders in South Florida in particular. When we went through March, April, we got into May, the other 64 counties had relatively mild cases and hospitalizations. South Florida was a majority of the cases, hospitalizations, and fatalities. And so you guys went through, a lot of that was brought down, I think, from the Northeast to here in ways that other parts of Florida didn’t have to face. And so you had to deal with that. Now I think you’re seeing probably the more natural cycle of this throughout the Sunbelt, which is affecting, of course, other parts of Florida more so, but now again affecting here and that’s required a lot of hard work. Folks, the physicians, the nurses, other personnel done a really, really good job.

We’ve been running these testing sites for months and months. Usually seven days a week. I know they were closed on 4th of July. But the National Guard has been very helpful. They’ve been at this for months and months. And so I just want to say thank you and the people of Florida thank all those folks who’ve been working very hard across the state, but I think particularly here in Southern Florida, where you’ve had to face two humps here. But we’re here for you and we’re going to continue to do what we can. Yes. Ma’am?

Speaker 4: (36:39)
What is the situation with remdesivir? We had a family call us and tell us that their mother could get the drug because it wasn’t available.

So we have … What happened with remdesivir is the federal government bought out a bunch of it and then they sent it to the state departments of health. So, our Health Department has distributed to the hospitals as they’ve needed it. That is no longer what’s happening. So now the next shipment, it’s due in soon, is not involving the state anymore. It’s going directly from, I think, Gilead or whoever the distributor is, directly to the hospitals. I talked to the Vice President, told him that we want to make sure that we don’t have a gap. So, they’re working on it as well. But it’s a change in how it’s being distributed now. It’s no longer coming through the Department of Health. It is going directly to the hospitals.

Speaker 5: (37:28)
[crosstalk 00:37:28] contact tracing. So we’ve been learning a lot from some of the communities that have been able to get ahead and manage some of these cases like New York. When they started their reopening plans, they had a pretty robust contact tracing and program that dovetailed without reopening strategy. Infectious disease experts this morning, again, reiterating to me that there are not enough contact tracers on the ground. As we are now experiencing this rollback, this economic toggle back triggered by the percentage case increase, my question to you is why didn’t you invest in more contact tracers in a hot spot like Miami Dade and Broward County? And now that Miami Dade is in this rollback, do you plan to invest [crosstalk 00:08:09]?

I’ve already greenlighted 138 million for the department of health to support, not just contact tracing, but other personnel. All the counties have gotten huge amounts of money from the Cares Act. The contact tracing is something that can be done. It’s a component, but understand when you’re talking about an asymptomatic virus that largely doesn’t create symptoms in people who are healthy and under, say 50, the contact tracing is not going to be enough. You have to have some of the things we’re doing with the nursing home, some of the other things that you’re doing with social distancing. But we’ve put in a lot of money for it. The counties have a lot of money to be able to do it.

But New York, they went through the boom and bust. It wasn’t because of contact tracing. That’s the way it was. They had massive infections. We’ve had a flatter curve so those infections get spread out over a longer period of time. That was what everyone said we wanted back in March. But we’ve put 138 million from the state. These guys have money. I know you’ve invested in contact tracing, I believe as well.

But at the end of the day, this is not a disease in which you get visibly sick, then you’re contagious, so that if you isolate contact, trace, you do. Most of the people walking around with this either don’t know they have it or have very mild symptoms and will never come in contact with the health.

Another problem that you’ve seen is, particularly the younger folks, aren’t cooperating with contact tracers. And so when they’re trying to call, they’re just not getting a lot of support. You do have some informal contact tracing that’s gone on with younger people where someone will have a party at somebody’s house and someone at that party later tests positive, then they tell everyone, “Hey, I tested positive.” Then those people go and get tested. So, you do see some of that. But yeah, no, we’ve put in a lot of money for it. But I think it’s important. But it doesn’t do the whole thing when you talk about an asymptomatic. So, it’s not as simple as saying you could just contact trace everything. Not when you have a largely asymptomatic illness.

Speaker 3: (40:15)
[crosstalk 00:40:15] Follow up on contract tracing?

Speaker 6: (40:16)
Two prong question for me [crosstalk 00:40:19] Please let me ask a question. But it’s a two pronged question. Restaurants, beleaguered. They’re saying, “Oh my gosh. We felt we’ve done everything we’ve done.” And then I want to ask you about gyms. What can you say to restaurant owners? I know you’ve expanded it to allow outdoor dining. But what do you say to these beleaguered restaurants in Dade County, say, “We’ve done so much and oh my gosh, you’ve got to back a step.” What can you say to them, mayor?

Carlos G.: (40:46)
It’s unfortunate that the way they do business means that the people have to take off their masks. And taking off your mask in an interior space, according to our experts, it’s dangerous because the virus spreads as people talk. And so the nature of the business, it’s not that they did anything wrong, it’s just the nature of the business and the number of people and the percentage of positives that we have in Miami Dade. And so the percentages are that in that restaurant, somebody one, two, three, four, people may have COVID-19 and maybe spreading it. That’s why it’s okay to do it outside. They can have outdoor dining. So, that will be allowed.

Carlos G.: (41:23)
In terms of the gym. We came up with a, a, a compromise. Now people, when they go in the gym, they must wear their mask, they must wear their mask all the time. If they have to do something strenuous, then they have to do it outdoors. And so the gyms are going to remain open, but under a new set of rules, which they’re okay with and so we reached a pretty good compromise.

Speaker 6: (41:42)
[crosstalk 00:41:42] Follow up in English, please. How long do you think, mayor, that will last for the restaurants?

Carlos G.: (41:48)
It’ll last for the restaurants until we get a positivity rate somewhere around 5% because that’s what the CDC guidelines call for. And so we right now are running out of positivity rate of over 20%. One of the reasons that I’ve asked please keep your mask on is so that we can start to reduce the positivity rate. And once we get that down to about 5%, then we can start to, again, open up the restaurants and the interior spaces of the other restaurants. But until then, we’re going to have to go with what we got right now.

Speaker 7: (42:17)
[crosstalk 00:42:17] Governor, Miami Dade has said that only Florida can contact trace and the Miami Dade County can not. Can you please explain why Miami Dade County can not contract trace?

He has hired contract trace. He’s-

Speaker 7: (42:35)
He announced on May 14 that he was going to hire 801,000 contact tracers, and he has not been able to hire them. And we asked them, and they gave us a statement saying that in Florida, only the Florida Department of Health can contract trace. Can you explain why during a pandemic?

Well, I’m not sure that’s correct. We want the County health departments to be involved in this, working with their local leadership. That’s how they’ve been doing it the whole time. As I said, we do have $138 million with Cares Act money that I approved weeks ago for this and for other things that are significant. But I think that they should be able to do it and help do that.

Speaker 8: (43:16)
You’re kind of sitting right next to each other. We have the county mayor who as of last Thursday said contact tracing is in the state purview. You’re sitting here, the governor of the state, now saying the county can do it. Can you guys just took look at each other right now and decide who’s hiring contact tracers?

Well no, he announced that he was going to do it, and he told me, he gave us a head ups that they were going to be investing in some of it. We obviously have done it at the state level. As I said, it’s a lot of Cares Act money. That was what the state Department of Health requested of me, they created a plan, they had different levels, they had some that were a little bit less, but I approved the more robust plan. And so that’s what they’re going to be doing at the state level.

But I just also want to stress on this. Look, we understand now how this thing is transmitted. We understand the things. Especially when it’s hot out, you pack a bunch of people in a private residence, have a party, loud music, lot of hooting and hollering, that is going to be a strong venue for transmission.

They understand that if you maintain physical distance, the chances of you infecting somebody or being infected drops dramatically. We understand that doing things outdoors, fresh air, heat and humidity, virus doesn’t transmit as readily in those circumstances. And so those things I think are really the significant behaviors. And then obviously, for the vulnerable populations, to be limiting your close contact outside your home, to avoid crowds as much as you can to be able to protect yourself. That is really where we’re going to be needing to do this. So, we’re doing that. It’s part of it. But it’s really the behavior that I think that the mayor’s been talking about, that we’ve been talking about, protecting the vulnerable, by-

…talking about that we’ve been talking about protecting the vulnerable. By far the most important clinical consequences in the vulnerable group, way higher than clinical consequences in the younger groups, but the younger groups are able to spread it to other folks. And so that is the message, protect our vulnerable population. And then just follow the guidelines that have been put out. Whether it’s a state guidelines on social distancing, whether it’s some of the things that the mayor has done here in Miami-Dade.

We’ve really not had a lot of problems in Florida when folks have been following the guidelines. And I can tell you that throughout all, if you go from the beginning of May, through the beginning of the second week of June our statewide positivity rate was under 5% and it’s six weeks. Sometimes it got as low as 3% statewide. Miami’s was down in the single digits. And that was part of our phase one, you had businesses open, but you had people by and large following the guidelines. And I think when that happens, we’re able to have a lower positivity rate and to move it in a better direction. [crosstalk 00:46:10]

Speaker 9: (46:11)
… county on the ground. Do you know? That are working right now how many contact tracing [crosstalk 00:46:15]

You’ll have to ask the Department of Health for the exact number [crosstalk 00:46:21].

Speaker 10: (46:17)
One at a time please. One at a time. Samantha.

Samantha: (46:23)
Miami-Dade County has published hospitalization data. How many people are being admitted to the hospital every day, but the state has not published that data on a county by county basis. The state has promised that that data would be made available, I think last Tuesday you guys announced that. And I want to know…

If you look, this report is something that you get. I get it every day from Department of Health, but they have so much raw data on there. People can pull out all this information. It’s really incredible, people do the charts and the graphs and everything. And so that’s all available for folks and they’re able to do it. Now, obviously not everything is presented in this report, but just an unbelievable amount of data that’s available for folks. [crosstalk 00:47:08]

Speaker 11: (47:07)
… she’s asking about is not being released. She’s asking specifically about the number of patients.

All the data that goes into this is all available. [crosstalk 00:47:19]

Speaker 11: (47:18)
… spreadsheet from that data, governor, it is not available. It is not available as a data that’s available that shows the total number of hospitalizations, is a number that if you analyze it, it really does not give us any information. The only way for us to be able to inform the public in a better way is to know the number. Just like Miami-Dade does it Mayor [inaudible 00:47:40] releases that data every single day. And we’re able to look. Here in Miami-Dade, the hospitalizations in the last 13 days have increased by 90%. We’re able to see that because the County releases that data, but the state is not, and we’re wondering [crosstalk 00:48:00].

Yeah, so I think a couple things to think about here is [crosstalk 00:48:03], so obviously, you are seeing, as the mayor has mentioned, we’re seeing more traffic, particularly in Dade, in Southern Florida. Now, part of that is, when he’s reporting, that includes these 30, 40% of people who are incidental. You obviously have had increases for the COVID treatable, but you’ve also had increases that supplement that.

I think when you look at, in March and April, when they were doing this, you didn’t have testing of people coming in for other reasons at the time. If you’re an expectant mother, you wouldn’t be tested. If you’re in a car accident, you wouldn’t be tested. Now, all those people are being tested. And so they’re capturing a certain percentage of people in the community who are largely asymptomatic, would not require hospitalization for this, but are doing it.

And so, I think by them talking about their rate and I think Jackson’s probably the highest that we’ve seen in that 30, 40%. But I think others like Orlando Health and some of those, they’re 20, 25%, maybe a little less than in the Tampa Bay area, but it’s definitely a phenomenon that we’ve seen. But I think that the message is, the census, I think that there were, I don’t know, 13, 14,000, 25% of the beds statewide are available. That’s pretty consistent with where we’ve been. We’ve been, I think between 20 and 30%, since the elective procedures were put back in May. And then people started to become more comfortable about going back to the hospital.

We have abundant capacity, but I think that having some of the personnel support will be very, very important. I know some of the hospital systems have done a little bit on how they’re handling elective procedures. I don’t think you guys have gone to any type of second level yet. And so they have a lot of levers that they can pull. And then obviously I think providing this support for the personnel, the hundred for Jackson, obviously working with HHS to be able to provide more, is something that’s very, very significant and will allow the hospitals to be able to handle folks as they’re coming in. Not just for obviously the people are hospitalized because of COVID, but be able to have the appropriate isolation procedures for folks who may be giving birth, who may have a broken leg who may be coming in for something else, but are also found to be carrying the virus. [crosstalk 00:50:29]

Speaker 12: (50:30)
… county that’s going to be hiring. Let us [crosstalk 00:05:34].

I’ve told you, I approved the plan $138 million for the Department of Health. They can provide, the details of that plan, if you want to. That’s already been agreed to and approved. And that may be enough to what we would need. It’s a lot of people, it’s a lot of stuff. But I think it’s also important to point out, when you have a lot of these asymptomatic 20-year-olds, there’s not a lot of contact tracing that’s being effective with them, because they haven’t been as cooperative with doing it.

And so, there’s limits to how much, if people aren’t going to cooperate, how much that could be done. But that 138 million, that’s probably the biggest commitment that you’ve ever seen before in terms of doing that. That’s what the state has done. [crosstalk 00:51:25]

Speaker 13: (51:24)
Where are these 100 nurses? [crosstalk 00:51:33]

We have had contracts in place at the state this whole time, just basic preparation, in case there was a need to have folks. We’ve used some of those contract nurses at places like test centers, some of these other things, in addition to National Guard. And so we have capacity to be able to bring some more folks on. Some of that may be shifted from things that they’re doing, that they may not need to be doing as much. So that’s all just things that the state, we plan for contingencies and have the ability to execute accordingly.

Speaker 13: (52:06)
From other states, or just Florida. Where are they going?

Well, I think it’s a mix. There’s places you can contract with for personnel, how they choose to deliver that. We’ve obviously waived any out of state limitation, so if people are coming from Georgia or from other states, there’ll be allowed to do that. But that’s really a function of what’s going on, how the companies are doing it. But those have been in place since March. We didn’t really need to do much of it beyond helping with the test centers in March and April. Obviously, May, beginning of June was light for us. But then as we’ve gotten into now, we hear the demand signal, that stuff’s ready, so you flip the switch. And then you need to flip another switch, you flip the other switch. That’s just basic planning to be able to meet whatever contingencies.

And I would stress, I mentioned this yesterday. When we were in March, obviously people didn’t necessarily know what’s going on, the idea was flatten the curve, have a flatter curve, which meant that you’d push this out over a longer period of time. The places that went boom and bust that have the highest death rates, that’s what people said you didn’t want to do. Now, by spreading this out, you now have the ability to have way more robust testing. They’re testing everyone that comes in the door. No one could do that in March. It just wasn’t being done. There wasn’t enough of an infrastructure. You have that, you had PPE shortages in March. Not that PPE’s never an issue, but the PPE lines are much better now. We have the protective equipment.

The state has sent out huge amounts to hospitals and to longterm care facilities. So they’re in a much better position. Of course, we mandated PPE in the longterm care facilities third week of March, and we’ve been supplying them ever since. So you have that, which is very significant. You also have some of the different treatments that have been used. The steroid, you have, the remdesivir, you have some of the other techniques which are much better in delivering better patient outcomes. The fact of the matter is, the mortality rate for people who are hospitalized now is lower than it was in March. And I think that’s true worldwide, probably, but certainly true in the United States and here in the state of Florida. You have that, which is something that is, that is really, really significant.

And then of course now with having longterm care facilities that are COVID only, you’re in a situation where obviously we don’t want to discharge a COVID positive patient back into a facility. We’ve never done that, but you also have the ability where these facilities can be stepped down from hospitals, so you don’t have hundreds of people dwelling in a hospital who don’t necessarily need to be there. But then can still be appropriately isolated. And so all these things that we now have in place, is much different than what was in March. And remember, the whole point of the curve, flattening the curve, was to make sure we had enough healthcare capacity. People understood that, you have a virus, people will get infected. You want to shield the vulnerable, of course, but you want to be able to deal with what ends up happening.

And so we’re in a way better position today to be able to do that. And I think that that’s something that has taken a lot of work. It wasn’t obviously all just the state. We were involved in some of it. A lot of the hospitals, the physicians, have gotten much better at this. That really is the nature of what we were trying to do. We obviously want to get over this wave as soon as possible, but we have the tools in place to be able to deal with it in ways that not only Florida didn’t, but really no state in the country had it. When we’re talking about the beginning, or middle of March. It just something that wasn’t there. Now it’s there and we’re much better off to be able to handle it. All right. Thanks everybody.

Florida Governor Ron DeSantis July 7 COVID-19 Press Conference Transcript

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