Apr 28, 2020
Gov. Kay Ivey Alabama Press Conference Transcript April 28
Alabama Governor Kay Ivey held an April 28 press conference on coronavirus. Ivey is reopening retail stores and beaches on Thursday.
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Kay Ivey: (03:31)
Well, good morning everyone. As you can see, I’ve got a great team assembled with me here today and I am certainly grateful for each one of their service and their participation in this process. I’m here to speak today about our stay at home order that expires Thursday, April 30th. First, we couldn’t even be here talking about this order that expires if it had not been for the people of Alabama abiding by the regulations and guidelines, for their sacrifices, their patience, and their understanding during the last six weeks. What our citizens have done is working. And I appreciate that so many people have been willing to do the right things to keep themselves healthy as well as to protect others to be well and healthy too. And this has not been an easy process and we are not where in a perfect world that we want to be. Half of the people of Alabama are doing the hard things to ensure that we can get back to our routines just as soon as possible.
Kay Ivey: (04:43)
And today, we’re taking another step in that direction. Before I announce the changes that we’re making, I’d like to first acknowledge a few people that are with me today. Dr. Harris continues to be a great partner in this venture. And I know it’s not been an easy task, but I sure do thank you, Dr. Harris, for your wise counsel and your realistic approach as you have provided great leadership for us during this process. Your measured and balanced approach have given the people of Alabama confidence, the people that you and I both serve. And I know I’m not alone in expressing our gratitude for your leadership during this time. Dr. Harris has worked diligently to ensure that we have more testing capabilities. And as we work to begin reentry into our workplaces and return to daily routines, it is essential that we keep monitoring those infected with the COVID-19.
Kay Ivey: (05:50)
Reopening Alabama’s economy is certainly not as simple as flipping a switch or snapping your fingers. Like any good leader should, I have sought counsel for many avenues and received many, many recommendations. In fact, these are just some of the many reports and suggestions that we received in the last few days from the Small Business Commission to each member of our congressional delegation in Washington. These suggestions are very broad and included many different scenarios, but I truly appreciate every one of them and the hard work and partnership that they represent. The seven members of the executive committee in my coronavirus task force are here with me today. And these folks have been diligently working to help me incorporate these ideas into the plan. This executive committee led by my finance director, Kelly Butler, has recommended to me a thoughtful, well planned timetable on how we can open our economy back up.
Kay Ivey: (06:59)
On April 30th, our current stay at home order will expire. Issuing this order in the first place was not something I did lightly and it was extremely difficult to tell businesses to close their doors, but it was done out of a need to get a handle on the spread of this virus. On March 13th, I originally issued guidelines, strongly urged recommendations, you might say, that if we all just did our part, then hopefully that would have been enough. At that time, I spoke about my reluctance to issue a stay at home order because I’ve always known that if the government kills a business, Washington can’t print enough money to bring it back to life. I offered a solution that was based on the information we had at the time to slow the spread and to mitigate the once predicted hospital surge.
Kay Ivey: (08:02)
Folks, I believe that all business is essential and truly regret any suggestion to the contrary. No matter the size, if you are conducting commerce and providing a paycheck, you have tremendous value to our state. On March 13th, we selected a list of specific businesses to remain open based on their risk of spreading the virus due to specific functions. Our intent was never to pick winners and losers as some have wrongly suggested. We entered a safer at home recommendation on March 27 that we hoped would eliminate the need for a stay at home order. But unfortunately, it did not. For that reason, we enacted a stay at home order on April the fourth due to the continued spread of the virus and the fear of hospital surge.
Kay Ivey: (08:58)
As of this week, we no longer believe our hospitals will see an overwhelming amount of ICU patients who need ventilators as we once believed. And that is sure good news for sure. While we have not seen a decrease in the amount of newly diagnosed COVID-19 patients, we have seen stabilization, a leveling off, if you will, in the amount of cases. Like everyone else, I look forward to easing back into our routines with caution. Just like we eased into this current stay at home order, we will also be thoughtful and careful as we ease back into our social interactions. Today, I am announcing that we will once again enter a safer at home order that will still require social distancing and urge our people to continue taking all health precautions necessary as some people will return to the workplace. And while maintaining focus on our personal health, it’s now time that we also focus on our economic health. And this too will be a thoughtful, methodical process.
Kay Ivey: (10:20)
My fellow Alabamians, I am pleased to say that because of the efforts during these unprecedented days, we can roll back many of the restrictions that have been placed upon certain social gatherings and businesses. On April 30th at 5:00 PM, our safer at home order will go into effect. All individuals, and especially vulnerable persons, are encouraged to exercise personal responsibility in slowing down the spread of COVID-19 by minimizing travel outside the home. You will be urged to wear face coverings around people from other households when you leave your house. Obviously, no one’s going to arrest you if you don’t, but it’s just good sound medical advice and it’s for your safety as well as for the safety of those with whom you come in contact. You’re also urged to continue proper hand washing and other common sense hygiene. All non work related gatherings of 25 persons or more or non- work gatherings of any size that cannot maintain a consistent six foot distance between persons are prohibited.
Kay Ivey: (11:39)
However, some top level changes in this new order are as follows. Employers should take reasonable steps for employees to avoid gatherings of 25 persons or more, to practice social distancing, and make strong efforts to disinfect their office space. Under this less restrictive order, all retail businesses will be allowed to open with a 50% occupancy rate and not allow customers to congregate within six feet of one another. Our state beaches will be open providing people abide by social distancing and the gatherings guidelines. And the mayors of our coastal towns have assured me they will take the lead and be proactive in enforcing the gathering guidelines. Elective medical procedures can resume if providers take reasonable guidelines from the state regulatory boards or CDC guidance.
Kay Ivey: (12:44)
My fellow Alabamians, let me be abundantly clear. The threat of COVID-19 is not over. We’re still seeing the virus spread and all of our people are susceptible to the infection.
Kay Ivey: (13:03)
The greatest disservice for the people who might be watching me here today is to think that by lifting the comprehensive health restrictions that this must be a sign that there is no longer a threat of COVID-19. Folks, we must continue to be vigilant in our social distancing both today and for the foreseeable future. I encourage everyone to practice productive teleworking if possible and be as innovative as you can as you open your workplaces, ensure you’re taking every precaution while getting back to work. It’s certainly been a challenging month for sure, but better days are ahead of us. I’m sure of that and I just want to thank the people of Alabama for being disciplined and patient as we move into what I hope will be a better season for our state. Now let me call on Dr. Harris to give his update. Dr. Harris?
Dr. Harris: (14:15)
Thank you Governor. Thank you very much. Good morning everyone. Let me just to briefly remind you of where we are right now. We’re around 6,600 confirmed cases. That’s over the last a month and a half with about 242 deaths so far reported here in Alabama. Like we have mentioned to you before we see that our African-American Alabamians are disproportionately represented in those deaths. They represent close to half of those deaths and that is because we believe this disease does have a predilection for people that have chronic health problems, diabetes and heart disease and seniors and so on. So we recognize that these are still vulnerable people that we still need to protect and also I certainly do agree it’s very reasonable for us to begin a gradual opening like this. I really appreciate Governor Ivey and what she has done on this. This has just been really, really difficult decisions and she’s done a terrific job of keeping everyone safe and trying to balance all those factors that are important.
Dr. Harris: (15:22)
We believe there are certain types of activities that is safe for Alabamians to resume. Clearly people certainly do need to return to work and we want to make that as safe as we possibly can do. We feel like we have seen a number of improvements recently as the Governor mentioned to you. Our case numbers are relatively flat. We are somewhere around a couple of 100 cases a day over the past few days. We’ve seen numbers of about 148, 209, 189, 261, and so on. So occasionally are a little higher, a little lower, but tend to stay that baseline of around a couple of 100 cases a day. The deaths that we have seen have been fairly flat as well. We continue to see some of those unfortunately, but they’re certainly not accelerating at those rates like we saw earlier on.
Dr. Harris: (16:15)
we’re very pleased at how hospitals have been able to preserve their capacity. They have not had ventilator shortages like we had thought or when they have had that short term they’ve been able to share among themselves and manage that. We do have adequate ICU beds and the ability to care for people within the four walls of the hospital and have not needed the alternative care sites that we had prepared for so. So all of these things are very encouraging to us.
Dr. Harris: (16:43)
We’ve mentioned more than once to you about the White House gating criteria for moving to a phase one opening of the economy. We have met two of those three gating criteria. We have not met all of those criteria. We feel good about the criteria related to symptoms, the criteria related to the hospital capacity. We have yet to meet the 14 days sustained decline that is recommended in those guidelines and I would say for that reason we are not proceeding to the full phase one opening consistent with a White House plan.
Dr. Harris: (17:20)
The White House plan suggested opening entertainment venues and gyms and restaurants and a number of other things that we’re not doing at this time. We do think what the Governor mentioned to you earlier is exactly the right approach, it’s a very gradual and reasonable way for us to safely get people back to work and get the economy going again. We will continue to monitor the case numbers that we have and as people get back to work and get back out in public again, we certainly hope that they can maintain the things that they need to do to keep us all safe and healthy. We believe that a gradual reopening makes a lot of sense. But as Governor Ivey mentioned is really is up to the people of Alabama to keep doing the right thing as they have been doing so far.
Dr. Harris: (18:11)
I have appreciated so much the efforts that I’ve seen from people. So many folks have really done their very best to make sure that they’re keeping themselves safe and keeping their family members safe. And we realized that that has been done at great personal cost of for many of them. And so even as we open things back up, we need to continue to ask Alabamians to work with us to continue to do things a little bit differently for the future. As the Governor mentioned, we are going to recommend that people wear face coverings like this or like those so that you can make at home when you’re going to be out in groups of people that you’re not related to or when you can’t maintain a six foot distance between people. For a number of reasons, this was not an order, but this is a very strong recommendation and we think it’s the right thing to do and we want all of you to do that.
Dr. Harris: (19:01)
This is the mask I wore in the car on the way up here and this is what I wear when I go out for takeout and I would encourage all of you to do those sorts of things as well. Most importantly, please remember that we need to protect the most vulnerable people in our society. We have seniors who represent about three quarters of all the deaths that we’ve seen so far, but we have a lot of people with chronic disease in our state, people with diabetes and with heart disease and with lung disease and we know that those people, they’re much more likely to do poorly if they’re exposed, so please keep that in mind. Even if you don’t feel that you yourself are at risk from this disease, please think about your loved ones. Think about those that you care about and try to protect them as well.
Dr. Harris: (19:48)
We know that we have aways to go to get completely back where we were, but I think we’re moving in exactly the right direction and exactly the right speed. We know there’s close contact professions out there that we have not addressed today. Those jobs where people literally putting their hands on their customers are certainly a risk category that’s different from other types of businesses and we hope to be able to address that very soon. We know people continue to have a lot of questions about that. I’ll be glad to mention to you later if you like about what we’re doing around testing and contact tracing. We’ve done some very good things in those areas and believe that we’re moving in the right direction there as well. So again, just a thank you to everyone for what you’ve done so far. We really appreciate all the efforts and thank you Governor Ivey for what you’re doing as well.
Kay Ivey: (20:41)
Thank you Dr. Harris. As I mentioned earlier, Dr. Harris assisting Dr. Harrison and me sifting through all of these recommendations and bringing some perspectives to all of this has been the Executive Committee of my Coronavirus Task Force. These are the folks that are standing behind me today. Leading this group of distinguished men and women has been Alabama’s Finance Director, Kelly Butler. Kelly will make a few words on behalf of the Executive Committee and if each member is interested and would like to introduce themselves and make a brief from all of them, when we get to the questions and answers, you can certainly ask all of the members, they’ll be prepared to take your questions. Director Butler?
Kelly Butler: (21:34)
Thank you, Governor. Pleasure to be here this morning. I wanted to first thank you Governor and Dr. Harris for establishing this committee of very distinguished members of Alabama’s community. We have two members who are medical doctors, accomplished medical doctors. Dr. [Vickers 00:21:54] is the current Dean of the UAB School of Medicine and Dr. Nancy Dunlap-John’s is the retired Dean of the University of Virginia School of Medicine. We have business leaders that were part of this committee. Clearly Mr. Tim Vines, President and CEO of Blue Cross, Secretary of Commerce, Greg Canfield, Speaker [Protem 00:22:16] … I’m sorry, President Protem Marsh and the speaker [McCutcheon 00:09:25]. All very accomplished people and as I like to joke, we had one accountant, which is me.
Kelly Butler: (22:28)
I really believe that the makeup of the committee contributed to the debate that we had. The conversation that we had, the committee was able to draw on the expertise of these members, draw on the medical doctors for expertise when it came to those issues, draw on the business leaders when it came to those issues. Draw on the two highly elected state officials for all that leadership. I believe that led to a careful approach in the committees work based as much as it could be on data and the expertise of the members. As the Governor mentioned, we looked at volumes of information including the Small Business Commission Report, recommendations from the congressional district members, recommendations from legislators, business people, individuals.
Kelly Butler: (23:18)
Our task was to review all that information along with the data on the fight against COVID-19 and make recommendations to the Governor and Dr. Harris so that they could make the decisions they needed to make. The committee did produce a report and delivered that to them. I believe that the process was helpful and useful and I want to personally thank all the members of the committee for their time and effort that they put into this. And lastly, Governor, I want to thank you and Dr. Harris for your leadership throughout this and for your wisdom in seeking out guidance from as many people as you could. Thank you.
Kay Ivey: (24:05)
Certainly we do thank the members of this committee for working so hard. Y’all poured through pages and pages and pages of documents and recommendations. Folks here in Alabama, one out of two adults in Alabama attend some type of church or religious worship service. Faith is clearly a part of the thread of the people of Alabama and getting back to worship services is essential as we maintain our spiritual and mental health during this coronavirus pandemic. Like so many others who call on a pastor or a priest or rabbi in good times or bad, I often turn to my pastor and friend, Dr. Jay Wolf. However, getting back to these services be done with very much concern. Last week as we were discussing this effort to reopen Alabama safety, I asked Jay if he would reach out to his network of friends across the state from all different denominations, from all parts of the state. I want to ask Dr. Wolf to come forward now to share the consensus of what many of our religious leaders from throughout Alabama are feeling at this time. Dr. Wolf?
Jay Wolf: (25:28)
Thank you so much, Governor Ivey, we thank God for you and for allowing us the privilege of contributing to your decision making process regarding reopening houses of worship in Alabama. Like you, Governor Ivey, we simply want to honor the Lord, help and protect God’s people and do what is right and responsible. Our task force was asked to provide for Governor Ivey some helpful and common sense considerations for reopening houses of worship across-
Jay Wolf: (26:03)
… Alabama in accordance with the White House and CDC recommendations. These guidelines were compiled by a team of ministers, lay leaders, and medical personnel, and in particular, Dr. Don Williamson, who was the head of the Alabama Public Health Department for many years was our primary guide. The process for reopening churches for large in person gatherings must proceed gradually and in a measured fashion because Covid-19 has proven to be a highly contagious and very dangerous enemy. We must reopen in a way that will not inadvertently facilitate an outbreak of this virus. Many sad stories from other states have emerged where Covid-19 has spread through a congregation and even taken the lives of pastors and created community outbreaks. The CDC is recommending a three phased approach to reopening houses of worship. It is our opinion that the CDC guidelines should be followed. Please visit www.whitehouse.gov opening America and they will give you current information.
Jay Wolf: (27:23)
Now, at this time, Alabama does not meet the criteria proposed by the CDC for reopening houses of worship for large in person gatherings. Reopening our places of worship will be a process, not an event. According to the CDC, as the number of infections go down, then the number of people who can safely gather will go up. Consequently, at this time, we are recommending that Alabama follow the guidelines of the White House and the CDC and affirm that in person, corporate gatherings and in person, small groups are not currently advisable. However, churches are encouraged to continue doing God’s vital work of connecting with people by using creative online services for worship, meetings, and ministries. Let’s keep connected to people through technology tools. Let’s use innovative serving projects. Let’s also use the highly effective drive-up worship services, but it is not yet safe and wise to gather in person.
Jay Wolf: (28:35)
Now when the number of new Covid-19 patients and infections decline, then in accordance with the CDC guidelines and timelines, larger in-person groups can safely meet, but to reopen at this juncture could facilitate outbreaks of infections that could tragically harm our neighbors and set Alabama’s progress back. As we prepare to reopened places of worship in the future, which will be based on the standards specified by Alabama’s public health officials, you are encouraged to consider and following the guidelines that are a helpful game plan designed to assist your congregation prepare for a safe reopening in the coming days.
Kay Ivey: (29:28)
Thank you so much Jay. Now before we open up for questions, let me go ahead and answer one question that I know is on y’all’s minds today and that is what about restaurants and barber shops and others like that that have been closed? When will they be able to open?
Kay Ivey: (29:49)
Well, first of all, when we started talking about what to reopen and what to close, I want to go on the record that I said to Dr. Harris that in my opinion hairstylists or at least mine are essential to the function in the state government. I look forward to getting back to my hair salon.
Kay Ivey: (30:09)
On a serious note, we will be working proactively with the state cosmetology board, the Alabama Restaurant Association and other boards and associations to address every business that is currently on our list of higher risk businesses that are still closed. Some of these are regulated by the health department such as tattoo parlors and restaurants, but we know there’s still more questions than we’ve got answers for today like summer camps and gyms and bowling alleys. Y’all, today is the or the beginning of our new stay safer at home order will be the first phase of what we hope and expect will be a multi-phase reopening of our state. And as I’ve said repeatedly, we know that what we are announcing today will please some and will make others frustrated that we’re not going further at this time. But our job must be always to find the right balance. Keeping our people safe and healthy as well as focused on the economic health of the state. Now I’m happy to take your questions.
Kay Ivey: (31:26)
Governor, what role did our surrounding states play when you announced this order?
Kay Ivey: (31:33)
I hadn’t talked to any of my fellow governors from the other states about this particular order. This has been developed with input from our small business commission, our congressional delegation and constituents from their districts as well as our executive committee behind me pouring through and [inaudible 00:05:53], so this is an Alabama developed, an Alabama prepared step we’ve taken today. Yes sir?
Dr. Harris, can you address, as you said before, the testing situation in particular, some of the disparities we’ve seen particularly in rural areas like the black belt and the Wiregrass. What is the state of testing right now in Alabama?
Kay Ivey: (32:13)
The question is what is the state of the testing, especially in the black belt area?
And the Wiregrasses, ma’am.
Kay Ivey: (32:17)
And the Wiregrass.
Dr. Harris: (32:20)
Thank you, governor. We believe we continued to increase capacity quite a bit. Our county health department teams are doing clinics in all of these counties. Not every county every day, but they’re traveling to do those in every County, certain days of the week at least. We have been in discussions recently with our federally qualified health center community health centers. You may be aware that nationally they were awarded about $400 million last week by Congress for Covid activities and much of that we think can be used to work with testing and possibly with some other activities as well, for example, contact tracing as well, but we know that our FQHCs are located in most counties in the state. They’re where a lot of people go to get their healthcare and we think that they’ll be excellent partners in helping us to do that.
Dr. Harris: (33:10)
There’ve been some other initiatives that governor’s office has actually been working with Walmart as you know, to do some mobile testing sites and they’ve been doing that in Jefferson and Montgomery counties, but are also going to Dallas County to Clark County to Marino County I believe, and so there’ll be prevent some availability there.
Dr. Harris: (33:29)
Th the real issue with testing is not the total amount of tests we have out there available in the state. If you add up all the capacity of all the labs, we probably have enough people to run tests, but it’s really about access. It’s about having the testing in the right place.
Dr. Harris: (33:46)
In the past week, those of us in public health have reached out to every person who has submitted lab results to us. Every lab that’s [inaudible 00:33:55] submits test results and sort of ask them about their capacity and how many labs they can run and what barriers do they have for increasing their testing.
Dr. Harris: (34:02)
And really the problem is just an uneven distribution of tests. It’s definitely a barrier for people in rural areas to have to go see your provider and get a test ordered, but then maybe you have to travel somewhere else in another part of the town or even another part of the county to get tested. So we’re working on ways to make it so that testing can be done in accordance with where people get their care. And that’s really going to be the solution to the problem.
Governor. We just received or that at least one business in the Birmingham area to decide that we’re going to open tomorrow, a salon. What is the state response going to be to businesses that decide to defy your state? This new order that you’re planning to [inaudible 00:34:43].
Kay Ivey: (34:44)
I didn’t hear all of your question.
We received word that there was a business in the Birmingham area that’s planning to open Friday. It’s a salon. Even though they’re listed, must remain closed. They plan to reopen anyway. What’s the state’s response going to be to those that decide to defy this order?
Kay Ivey: (35:01)
These are orders, and if there are violations, they’re subject to a $500 fine et cetera, so I would encourage them to rethink their strategy.
Kay Ivey: (35:08)
Governor, where are the funeral services fit into these orders? Funeral services.
Kay Ivey: (35:19)
Oh, the funeral services are still limited to no more than 10 people, six feet apart.
Governor, there have been some states that have reported they’ve had issues with acquiring some of those supply chain items such as swabs and materials needed to transport the tests. Has Alabama seen that issue or anything that [inaudible 00:35:41]?
Dr. Harris: (35:43)
The question has to do with acquiring testing materials. I think that’s been an issue for all states for as long as we’ve been involved in this response. We continue to have some supply chain issues and we try to source those materials everywhere that we can. We wish we had better access to testing materials. We’re doing the most with what we have. We are sort of working through our own channels and the governor’s office has a team that’s been terrific in helping us find those products in places that we don’t even know where to look in public health. So right now we’re stable with that. We do feel like a lot of time we have sort of just in time inventory like where we’re not sure if we can test tomorrow, but then at the last minute we manage a way to do that. So we’ve not had any complete interruptions but it’s still a bit of a issue every single day to make sure we have what we need.
Kay Ivey: (36:38)
Governor and Dr. Harris, when will you reassess the issue of restaurants and barber shops and [inaudible 00:36:45]. Will that be on [inaudible 00:36:47]?
Kay Ivey: (36:51)
The measurements of several criteria, not just one category of measure. So you look at vacancies of hospital beds, how many folks on ventilators or not on ventilators, ICU beds, et cetera. And so we look at a cluster of factors to measure things. We’ve already started making inroads to the restaurant association. They going to be getting with us this week or first of next to provide some recommendations. So we’ll be addressing beauty shops and restaurants fairly soon.
Governor, how can the state ensure that employers are doing everything that they can and following the guidelines to keep employees safe and prevent them from getting sick as they return back to work.
Kay Ivey: (37:40)
Well, we trust the business of the state to be good citizens and I believe that most of them are trying to do that and do what’s right. And so I just, I have not heard of anybody really personally complaining, not doing it. So I think our business owners are responsible and they want to be healthy too. And they want their employees to be healthy.
Kay Ivey: (38:03)
[inaudible 00:38:06] personal protective equipment available a factor in whether or not you’re going to allow close contact services and restaurants to reopen?
Kay Ivey: (38:14)
Will the availability of PPEs?
Yeah. Is that a factor in whether or not you’re going to allow those businesses to open?
Kay Ivey: (38:23)
Well, I hadn’t had my meetings with the restaurant folks yet, so we’ll certainly consider all factors, but we just haven’t addressed that particular aspect of it yet.
Governor, [inaudible 00:38:37] wanted to go further than this and do something like Georgia… Is the reason that we’re not going further because we haven’t met all of the White House criteria [inaudible 00:12:47]?
Kay Ivey: (38:46)
Well, we need to make more of the criteria than we have thus far, and this is a beginning of a reopening effort. Once we reopen this, we’re outlining with all retails-
Kay Ivey: (39:03)
… being able to have 50 percent open and to have 50 percent occupancy and limited access to our beaches and press on with elective medical procedures. We’ll see how this trend lasts, but we’re moving forward. Let’s see, gentleman back there in the white shirt?
Speaker 1: (39:23)
Governor, will there be a high school football season in 2020 and if so, will our high school athletic facility be open for training in June?
Kay Ivey: (39:23)
Will high school facility-
Speaker 1: (39:44)
They have off season training in late June. Running, and passing, and throwing all through the summer to get ready for the [inaudible 00:39:49] kick off. Will there be a high school football season and if so will we be able to open up those athletic facilities for the athletes?
Kay Ivey: (39:57)
Well this is the end of April and so we’ve got some time to track progress as we begin this limited reopening, so we’re hopeful, but I can’t speak with specifics on that issue yet. Yes sir?
Speaker 2: (40:15)
This question for Dr. Harris. Part of what a lot of experts are talking about in terms of getting ahead of the disease tracing aspect, how things are going, can you speak to that because we really haven’t talked about that much.
Dr. Harris: (40:24)
Sure. The question has to do with contact tracing. I think most of you are aware of how that works, but contact tracing is simply what we’ve always done in public health for a lot of diseases when we locate certain diseases of public health significance, particularly ones that spread person to person, then we get in touch with all of the people who are around that case and let them know that they may have been exposed and give them advice about what they can do or should do, or to look out for. And so that’s a really important part of what we do with COVID-19 because it is spread person to person. With the 6,500 or so people that have been diagnosed so far, we have contacted all of them and we attempt to learn from them who lives at home with them, and what type of workplace they’re in, and in many cases we have to contact the workplace in case there are other exposures.
Dr. Harris: (41:14)
You can imagine that this is an enormous task, because every person may have dozens or scores of contacts that need to be traced. What all states have identified is that the way really to get ahead of this is to make sure you’re doing that on the scale that you need to do. You may have seen where Massachusetts for example just hired a thousand people to do this sort of work for a state of that size. We are going to use a number of different strategies to do that. We have already moved a lot of our staff internally, I believe I’ve spoken to you all about it before maybe last week, but we normally have less than 10 people who are doing a lot of this outbreak work for us. We’ve moved a lot of staff internally and now have between 50 and 60 people who are doing that work. But we have also got volunteers who are helping us from medical students for example, or school of public health students as well, who can do that at least for a while.
Dr. Harris: (42:12)
We clearly will need to find some additional resources and I mentioned a moment ago, we’ve had discussions with our community health centers about their ability to help us with that as well.
Dr. Harris: (42:22)
There are phone banks that we use for a lot of survey work that have HIPAA trained operators who are used to calling people and asking them questions and asking them about medical things, that we can use kind of as we need to. And there are also some kind of really interesting electronic means that have been designed by some of our big tech companies in the U.S. and in the world. There a product from Microsoft that I know Dr. [Bickers 00:42:51] knows a lot about. Google and Apple have a product that they’ve been working on. There are some others that we have looked at specifically and that involves tracking people based on their cell phone and allowing them to put information in and who their contacts are so that they can be reached in a real efficient way.
Dr. Harris: (43:09)
Ultimately, I think we’ll probably use some of all of those strategies, until we have a vaccine or at least and effective treatment, we’ll have to scale that up quite a bit for a while.
Speaker 3: (43:20)
I have a follow up question to that. I think, ADPH said about two weeks ago there were 120 people who were doing the contact tracing. [inaudible 00:43:31] about 6,000 cases, obviously simple math shows that that’s just not enough. How confident are you that ADPH will be able to identify and isolate those infected so that we don’t see another surge in the Coronavirus once we start phasing in these business?
Dr. Harris: (43:47)
I think we have a lot of concerns about that. It’s very important that we’re able to do that and one of the distinctions we made when we get a new case is do we have a new case that’s linked epidemiologically to another case, that is if you have an infected person is it because we know they live in a house with someone who’s infected, because that’s the case we can explain. Or is it a case that just acquired it without any known exposure, we want say a non epi-linked case. Those are the ones that concern us because those are the ones that tell us that there’s community transmission going on. That people got infected without having any known exposure or just going about their normal every day lives so in addition to seeing those numbers improve, we really want to make sure that those non epi-link cases are the ones that are going down. And they actually have been, although they’re just not at the level that we’d like to see.
Speaker 4: (44:36)
Dr. Harris, how many people do you need doing contact testing?
Dr. Harris: (44:42)
There’s a lot of ways to calculate that. We need a certain amount of FTE’s which may not be a certain amount of people and that certainly doesn’t mean public health employees, but we need hundreds of FTE’s to do it and there are certainly some turnkey solutions out there. There are companies that are just professional contact tracing companies, that you can contract as you need to and I think what we anticipate in the future is that we will probably be able to manage our workload with a certain amount of capacity but we may see an occasional outbreak. If you have a nursing home infection for example, or you have a workplace infection like we’ve seen recently, and then you may need to add additional capacity like on a contract.
Dr. Harris: (45:25)
Dr. Harris: (45:25)
To ensure that-
Dr. Harris: (45:25)
Dr. Harris: (46:42)
… who are in the hospital, so those are all the reasons behind the elective procedures health order. Now that we are allowing all those again to go forward like normal, we would just want people to remember that we still might have episodes where a community suddenly has an outbreak and where that local hospital may be suddenly overwhelmed and be sort of temporarily short of resources. We just wanted to communicate that; that even though it’s business as usual for all those providers, there’s certainly a reason to think about what’s going on in the community, sort of in the context of the whole situation.
Speaker 5: (47:22)
Dr. Harris, how does this state define recovery?
Dr. Harris: (47:22)
Recovery doesn’t have a set definition anywhere in the world. There are a lot of ways of calculating that and so with a disease that’s only been around three or four months, four, five months, we’re not quite sure what recovery is. No one knows what a longterm recovery COVID-19 patient looks like. But generally speaking, we would think recovery would be continuing to follow a patient after they’re seemingly well and free of symptoms and ideally test negative as well. And there aren’t a lot of places that are able to do that yet just because of the epi-capacity that it requires.
Dr. Harris: (47:56)
If we had enough epi staff to do that work, then certainly we would continue to follow those people, but generally now we’re doing initial contact and investigation, contact tracing, and we’re just not able at this time to go back and follow up with those patients several times over the next couple of weeks which would be required to define recovery.
Dr. Harris: (48:14)
I would say we think just from what we’ve seen in the world, 80 percent of people never have really serious disease and of the ones that are hospitalized, there’s a mortality rate of… we’re not sure, one percent or somewhere give or take, but most of the others even of hospitalized seem to recover. We expect most people will recover.
Speaker 6: (48:35)
And this is the last final question.
Speaker 7: (48:37)
Governor you talked about the beaches reopening on a limited basis, but the social distancing requirements will be in place, how will that be enforced on Alabama’s beaches? The social distancing now they’re going to be open starting Friday.
Kay Ivey: (48:53)
Well the order that goes in effective April 30th at 5:00 PM will be enforced by the local officials down there, the mayors of each of the coastal towns and the Baldwin County Commissioner for Fort Morgan, et cetera. They have assured us, we talked to them yesterday, and they’ve assured us that yes they will enforce the procedures, because they want the folks to be able to come back to the beaches too. It’s in their best interest to keep them safe, so I think we’ve got a good deal there. Thank you all so much.
Speaker 6: (49:49)
Thank you guys.
Speaker 8: (49:50)
Businesses can go back to work as long as social distancing and good hygiene is practiced-