Gov. Mike DeWine Ohio COVID-19 Briefing Transcript April 6

Governor Mike DeWine: (00:00) ... is now working to shore up this critical supply chain. They know our manufacturing sector very well, and they know what different companies can bring to the table. And they're taking that expertise and we're utilizing it each and every day. The JobsOhio team provides input as part of this manufacturer's alliance, and assists the state with rapid procurement requirements and identifying viable solutions. I want to thank former Governor Kasich and the state legislature for having the wisdom eight, nine years ago, 10 years ago, to create JobsOhio. It is a tool that we very much are using as we go through this crisis. Governor Mike DeWine: (00:50) Our goal as we try to slow down this virus, and we have made some real progress by the way, and thank you very, very much, each and every one of you, for what you're doing. We're making progress. Thank you for all that. Our goal each day, as we ramp up and get ready for the surge, is to protect our protectors, men and women who are in the front lines, who I hear from, who are in hospitals, who are in nursing homes, who are working in nursing homes, who are first responders, who are out there risking their lives every single day. I want to thank them. Thank you very, very much for what you're doing. What we're trying to do is to protect you. You are the protectors. Thank you for that, and our efforts every single day are aimed at protecting you. Governor Mike DeWine: (01:45) We'll continue to keep you updated on our efforts to secure PPE. We're going to do all that we can to protect Ohioans and those that are working each day to protect us. And I want to quote former Governor Bob Taft, said in his 2005 State of the State address. I thought this was a pretty good quote, Bob. "Ohioans are practical. We are a can-do people. Give us a problem, we'll give you a solution." So salute to everyone who's out there working to do this. Governor Mike DeWine: (02:22) I want to give you an update about what's happening in the only federal prison in Ohio. This is a place called the Elkton Federal Correctional Institution. It is located in Columbiana County. It is a federal prison. It houses federal prisoners. It is not run by the state, and it houses federal prisoners and not state prisoners. We know that seven inmates have tested positive. We also know that dozens more have shown symptoms and some of these very serious. Three inmates have died over the weekend. Friday and Saturday, I started getting calls about what was going on at Elkton, in Columbiana County, from local officials and others who were concerned about that. We started looking into this. I asked the Ohio National Guard State Surgeon to visit the Elkton prison, and the guard came back to me as well as our health department, came back and said, "There is no doubt that this prison needs help." Governor Mike DeWine: (03:36) The head of Ohio National Guard, General Harris, tells me that Elkton's medical staffing right now is at only 50% of what it should be. And for every federal inmate at the hospital, they need two federal guards standing watch. Some of these prisoners are now out in the community at these hospitals. Now, let me again, excuse me, say it: this is not a state facility. It's a federal prison run by the Federal Bureau of Prisons and the United States Department of Justice. It houses federal inmates from all over the country who are sentenced in federal court, but this prison is in Ohio. It is staffed primarily by Ohioans, our fellow citizens. Their families live there, live in the area. When an inmate gets sick, these inmates are of course transferred to local hospitals out in the community. So that is why today I'm announcing I've authorized the Ohio National Guard to go into Elkton prison to assist. Governor Mike DeWine: (04:44) This is very limited. It's limited in duration and it's limited in scope. We have received today a formal request for assistance, and right now, the plan is to go into the prison for seven to 10 days until more federal assistance arrives. We have an advanced team from the Guard there today, and we are prepared to send at least 26 guardsmen and women to the prison to help in the Elkton infirmary. Governor Mike DeWine: (05:16) This is a medical mission only. The Guard members will not be armed, they will not be providing security. They'll be there to assist with non-COVID cases, as well as those who are showing symptoms of this highly contagious, deadly disease. These soldiers, who all work in the medical field, will have N95 respirators for protection while they work to augment the current prison medical staff. They will treat those they can, while triaging others with serious symptoms for hospital care. The Guard also stands ready to help with transporting the seriously ill patients to the hospital in the event of a surge. In addition to the staff, the Guard will be bringing equipment as well as ambulances with them as well. Governor Mike DeWine: (06:12) As I've said, we've all said, we're all in this together, and providing state help for this federal prison is the right thing to do. In the meantime, however, I do feel that the U.S. Department of Justice and the Federal Bureau of Prisons should stop any intake going in to that prison for any reason. And I specifically made that request last night on the telephone, a call about nine o'clock at night with the head of the federal prison system. That's something that we feel very, very strongly about. Governor Mike DeWine: (06:53) Eight. When an outbreak inside the prison takes place, it's certainly not the time to introduce new inmates to that population. Additionally, we've been receiving calls from family members of inmates at Elkton asking us to release the federal prisoners. Let me very, very clear. We do not have that authority. This is a federal prison. I have no authority in that area. Governor Mike DeWine: (07:19) Now let me talk for a moment about the Ohio prison situation and briefly where we are. I'm going to say more about this tomorrow as we move move forward. Director Annette Chambers-Smith will have more information in a release later, but we have five prisoners at the Marion Institute, the Marion Prison, who have tested positive. We have five prisoners at Pickaway County who have tested positive. Of the staff, we have 27 tested positive at four facilities, but most of the staff comes out of Marion. We kept the COVID virus out of the prison for quite some time, but now it is in some of these prisons. Governor Mike DeWine: (08:21) Let me go through what the protocol that's been followed by the director. We have been testing in the prisons whenever appropriate. This testing is not new. When someone had symptoms and a prisoner had symptoms, testing was done. On March 10th, we started screening staff that was coming in. They were screened by asking them questions about travel, asking them questions about their symptoms, asking them if they had a cough, et cetera. Each one was interviewed as they came, every day, every shift. Governor Mike DeWine: (09:10) On March 18th, the prison started actually taking temperatures of the members of the staff who came in. The director curtailed programming. The whole goal was to have fewer and fewer people who would be coming in contact with the different prisoners. So people from the outside, religious services, other programming where it might take people from the outside, those were curtailed. Everything that was done to curtail contact from the outside with the prisoner was done. Governor Mike DeWine: (09:43) I will talk tomorrow about some other steps that we're going to take in regard to releasing prisoners. Let me just kind of outline what my criteria is, what the director's criteria is, and what we are weighing. First of all, we're not going to release anyone who is dangerous. We have a long list. I went through the list the other day, the type of prisoners we are not releasing. We're not releasing sex offenders, for example. We're going through the prisoners and taking a look at who might be getting close, who's in for nonviolent offense, and who might be getting close to release anyway. Freeing that space will enable the director and her wardens to better deal with the situation. So these are some of the criteria that we're going to look at. I will have, as I said, more to talk about tomorrow in regard to that. Governor Mike DeWine: (11:04) Let me talk about something that occurs every year about this time, and that is the snowbirds coming back from Florida or Arizona, primarily Florida, I guess, coming back to Ohio. First of all, we welcome you back. We want you to come back. What we would again remind you that you need to quarantine when you come back. You need to quarantine for 14 days. Anyone coming into Ohio, whether a resident or a non resident, needs to quarantine. The population that comes back from Florida is generally older, and again, you are the most susceptible. But whether you're old or young, if you're coming back from Florida, you need to quarantine. Governor Mike DeWine: (11:53) As we look at how we're doing, and this is something that Dr. Acton and I and the Lieutenant Governor talked about, talk about every day, actually, talked about again this morning, we're doing pretty well. We are doing the right thing. Ohioans have done the right thing. We have to continue on that; we cannot let up. And one of the concerns we have is that people coming into Ohio from other states will bring something in with them. And so, that is why our order was issued the other day. But just as a very specific reminder to folks who are coming back from Florida, we want you to come back. We would say to family members who are welcoming their parents back or family members back, help them out. Tell them you'll bring food over, maybe get the food before they come, give them a helping hand so it'll make it easier for them when they come back, and they can enjoy the good Ohio spring that is is here. Governor Mike DeWine: (13:04) Jack Marchbanks, who is our director of the Ohio Department of Transportation, is going to talk a little bit about this, and he's going to give you an update now on the Ohio Department of Transportation's efforts to keep us all safe. Jack? There you are. Director Jack Marchbanks: (13:21) Thank you, Governor. The team here at ODOT and all Ohioans appreciate your strong and steady leadership during this COVID-19 pandemic. I'd like to start by taking a moment to thank some of the behind-the-scenes essential workers, who are keeping our grocery store shelves stocked and delivering needed medical supplies to our healthcare workers, our truckers. The trucking industry is always a vital part of the economy, not only for Ohio, but the entire United States. Their jobs are even more critical now. Every other industry literally relies on them to deliver goods that sustain the livelihood of the country. And we know this is a challenging time for this industry, as it is for all of us. At ODOT, we are working to help make their jobs easier by keeping our rest areas open, clean, and patrolled, even as fewer and fewer people are traveling our interstates. Director Jack Marchbanks: (14:13) We also revised our overweight permit process to allow shippers to get more goods faster to depleted store shelves. We know truckers have fewer options these days, as many restaurants move to drive-through-only operations. So we are working with mobile food vendors to find suitable locations for them to offer hot meals to truckers. ODOT crews are also on the job, making needed emergency repairs and doing needed maintenance to our state highway system, all while practicing safe, physical distancing, of course. We know the most important thing we can do for our truckers and for our state as a whole is to keep our roads safe. Director Jack Marchbanks: (14:52) I want to take this opportunity to remind viewers Governor DeWine and Dr. Acton announced new requirements for travelers coming into Ohio, which will remain in place through the May 1st exploration of the stay-at-home order. As the governor mentioned, all travelers arriving to Ohio must voluntarily self quarantine for 14 days at home or wherever they are staying. Director Jack Marchbanks: (15:13) To be clear, we're not talking about truck drivers coming into the state to deliver goods or medical professionals coming in to help. We are not talking about people coming into the state to provide those essential services we all need right now. We are also not talking about those people who live near our borders and travel across state lines to go to the store or to the doctor's office or to work at an essential job. Director Jack Marchbanks: (15:35) But, if you are coming back to Ohio after being out of the state for a while, this does apply to you. If you took an essential business trip out of state or are one of our many snowbirds returning north after spending a winter in the South, this order does apply to you. It is very important that travelers and residents take this step to help protect their community by staying home for two weeks upon return to Ohio. If you need groceries or essential goods, you can have them delivered. Ask a neighbor or family member. Director Jack Marchbanks: (16:07) As one of the many charitable services that can help you get what you need while you're at home, ODOT has put messages up on our digital message boards on our borders to make sure travelers are aware of this requirement. We are also putting up signs too on our rest areas to make sure travelers who stop there are aware of the requirement for self quarantine. We know this in a lot to ask, but we also know that two weeks can pass very quickly, and doing so will ensure [inaudible 00:16:40]. Governor Mike DeWine: (16:42) Jack, I think we lost your mic there, Jack. Director Jack Marchbanks: (16:44) Thank you for doing your part to keep each other safe. We're in this together [inaudible 00:16:48]. Governor Mike DeWine: (16:51) Director, thank you. Thank you very much. We appreciate it very, very much, and appreciate what you and your team are doing every single day. Thank you. Lieutenant governor? Lieutenant Governor Jon Husted: (17:06) Thank you very much, governor. I do appreciate all the great work that all of the employees across the state, and everybody's part of the essential business services out there, that you're doing to keep things going. As the governor mentioned earlier, the revised or the amended stay-at-home order with the essential business descriptions does go into effect tonight at 11:59. One of the pieces of that is the Dispute Resolution Commission. If you recall, what the Dispute Resolution Commission is designed to do is to essentially mediate and come to a decision when there is a disagreement between two or more health departments about how to treat an essential business. We do know that there are some businesses who operate statewide, that they may experience one set of regulations in one community and a different set of- Lieutenant Governor Jon Husted: (18:03) Regulations in one community and a different set of regulations in another and you're looking to reconcile them. That was the reason for the Dispute Resolution Commission. We heard this from local health departments and local elected officials that they wanted someplace at the state to try to remedy these conflicts. And so the Dispute Resolution Commission has been designed to do that. Lieutenant Governor Jon Husted: (18:23) The details about the Dispute Resolution Commission are at coronavirus.ohio. gov/businesshelp and that is available on there right now. Lieutenant Governor Jon Husted: (18:37) It is important to know that we will make the deliberations for this and all of the information, public information. So this will be done for the media out there and for anybody else who's interested, this will be done in a very public way. And they expect to have a 24 hour turnaround time. So know that that is available, but it is not there to question the descriptions in the order. It's only there when more than one health department has a discrepancy in how they're implementing the order and the dispute commission can resolve that and that's the purpose for that commission. Lieutenant Governor Jon Husted: (19:19) I mentioned last Friday about the SBA payment protection program. This is to help small businesses under 500 people get access to loans and many of these loans, much of the loan can be forgivable for things like payroll to keep your employees on board, mortgage, rent, utilities. Those types of expenses could be forgivable under the terms of the loan. We encourage you to go to your banks. [Audio glitch 00:00:19:55] Lieutenant Governor Jon Husted: (19:53) ...them will probably not be there until mid week, but the applications are available and I know that they're processing those applications as quickly as they can. But I also became aware over the last few days that there are some people, some businesses that for whatever reason they may be small businesses, either don't have a financial institution that can work with them on this or there's something unique about their type of business where they can't get access to the loan. And you may recall that last week I said some of the mayors and I had a conversation with Goldman Sachs as part of their 10,000 businesses program. Well, Goldman Sachs is making $20 million available for Ohio businesses for this type of loan purpose. And so for those of you who work with your bank, and that's the first place you should go, your bank, your credit union, your traditional financial institution, that's your first place. But if that does not work out for you, here's another, $20 million is being brought into Ohio for this purpose. That will be under the bank banking update provision on the coronavirus. ohio.com/businesshelp. A file that is not up yet, but it will be hopefully momentarily as we work through this and I really want to thank development services agency and Jobs Ohio and our Ohio Financial institutions for the way that you're working through this. Lieutenant Governor Jon Husted: (21:21) Also, we talked about the jobs that are out there, a lot of people losing jobs, but a lot of employers who are part of the critical infrastructure of our state, whether that be healthcare or the manufacturers that the governor talked about who are trying to build these PPEs and other products that we need. Maybe you're part of the food supply chain. When we talked about this last week, that the website coronavirus.ohio.gov/jobsearch, there are now over 29,000 jobs. This continues to grow by thousands of jobs a day that these companies need. So if you are in desperately need of an opportunity or maybe you're a younger college student or somebody like that who is not in college, but could even part time work at a place, these are great opportunities to help pitch in to help the team out there. The team of people who are trying to deliver the services we need. You can help them out by going to that website and getting yourself a new job that we all need to be filled. Lieutenant Governor Jon Husted: (22:35) Now finally, you see this big map behind me, which I'm going to turn to in a second. Doctor Acton and I just had a great talk about the map before we came in. I always say that we should celebrate what we value. Celebrating success is the way to get more success. And this map when I get into it, this map is a source of optimism that you have provided us. That you have provided us a reason to be optimistic about where we are in this fight against Coronavirus. Lieutenant Governor Jon Husted: (23:10) I always say that to my kids, if you sacrifice now you'll see the dividends later. I want to turn and point to this map. You see, this is the red indicates that people haven't made any real travel restrictions since the Coronavirus outbreak occurred. And the closer you get to the gray side, the less travel people have done. Essentially the more they have been compliant with the travel restrictions and the social distancing, so to speak that we've asked people to do because we know that it works. Lieutenant Governor Jon Husted: (23:44) We know that it's the biggest thing that we can do to slow the spread and to give us hope that we are going to get through this healthier and in a more timely manner. And as you see Ohioans, you've been great. You really have followed the guidance that the governor has asked and Dr. Acton has asked, we've all asked, of each other. Not in this room, but all of Ohioans, I know all 11.7 million are asking of each other. And most people have done it. Lieutenant Governor Jon Husted: (24:13) And what we hope, this is through the week of March the 23rd, because a lot of the data lag and we hope that these sacrifices that you're making now are going to show up in the modeling that will be coming in the future. And that's why we're optimistic because we're going to get the new data. Dr. Acton will have access to it in the near future, but we're hopeful that our futures will be changed. Our destiny is changed by your actions. And this doesn't mean we should let up a bit. This means if you stick to this and we see this through, we're going to come out the other side stronger. Lieutenant Governor Jon Husted: (24:52) And it's been discussed here before at our two o'clock news conferences that thinking is going into this already. The governor announced the business task force that's beginning to give thought to this. We have staff that's beginning to give thought to this. As business owners, I get this question a lot, what's the future look like? And one of the things that we're doing here, you have to source up. You have to plan for that day when you're going to be able to do, you're going to, you're going to see fewer restrictions, but we're still going to have to practice safe workplaces. Lieutenant Governor Jon Husted: (25:26) So is your business owner out there? Think about this. How are you structuring the inside of your business? Do you have a plan in place? Who's going to be in charge of enforcing that plan? Do you have the resources, the cleaning materials, maybe the face masks, even the cloth ones like the governor was just talking about, all of those things help create a safe workplace, which will make sure that we stay healthy once we come out of this and that we can make sure that you don't have an outbreak in your workplace. Because the last thing we want any business to do in the future is to start the spread again by not practicing these safe workplace measures. Think about those things, source them now, think about planning for that future. That's what we're doing in state government. We're thinking about that day. What do we need to be ready? But there's every reason to be optimistic that if you stick to what you're doing, that there is hope that things will be better as the new data starts to come in. Lieutenant Governor Jon Husted: (26:29) And so I think a lot of people are looking for that source of optimism and you provide it by your actions. And so we're really grateful for the compliance and the great work that people are doing out there. Governor. Governor Mike DeWine: (26:42) Dr. Acton. Dr. Amy Acton: (26:44) Thank you, governor. And good afternoon everyone. We missed you yesterday and I have several things we want to share with you today. We'll start with our data. Dr. Amy Acton: (26:58) So in fact, we do now have 4,450 cases. And unfortunately in Ohio we now know we have 142 deaths to report. We are seeing these cases in over 81 counties now, so almost all of our 88 counties. And our age range remains less than one to 101 years of age, with a median age of 54 years. Dr. Amy Acton: (27:33) Interestingly, our numbers have not changed a lot from hospitalizations. They're still quite high because mostly we're testing still with our limited resources and testing the sickest among us. So hospitalized of our testing and cases is 27%. ICU admissions are 8% of that and the number of ICU cases, of our total cases, I'm sorry, that have been ventilated or requiring mechanical ventilation are at 5%. Dr. Amy Acton: (28:07) I want to talk a little bit about recovery information. That's a question we last left with and it's a frustrating one for all of us. Over 80%, if not more, of folks who have this virus are at home and are not tested. They have mild enough illness that they do not require hospitalization and at this point we can identify those very, very small subset of them and we know that many of them have potentially recovered at this point that the onset of the first illness for our first case was around early February. So we know folks in that category have recovered. But at this point we just have the data of those we knew. Dr. Amy Acton: (28:57) Interestingly, we can take a little bit of a look starting April 1st, we have a new ICD code, which is a code that actually codes for Coronavirus. We have new data coming soon that will give us better insight into the hospitals. We still haven't, it actually just began to be collected today, but we do know that 303 of our cases that have been hospitalized, discharge, 25% of them have now reached that period of recovery. So it's a small number. It's really a shot in the dark. I know folks really want to see those recovery numbers, as do we, because obviously our whole goal is to move all of us to that place of recovery and get us back to life as we want to return. Know that we are working on that. Once we have serologic testing we'll get better and better able to do that once we have widespread testing. We will start to give you some of that recovery information, even though it's asterixis and as imperfect as it is, we will be putting that on our website so anyone can see it who is interested. Dr. Amy Acton: (30:11) I'd like to move to the next slide and again 48,000 tests have been run in Ohio. Next slide please. Dr. Amy Acton: (30:21) A quick note on our death count, again we have 142 folks and it's still very difficult to tell much from this death data. We know the deaths are lagging the cases and the diagnoses by quite a bit. We do have deaths as young as the 30 to 39 year old age range and again still skewing order. Dr. Amy Acton: (30:47) We are seeing our cases are slightly a case lean, slightly more female, not much to call, but we're seeing something that is being seen around the country. We don't know the answers yet on this, but we see that deaths are definitely leaning more toward males and that is something that's currently being investigated. Next slide. Dr. Amy Acton: (31:12) Deaths by race. We have a little bit of data, again such small data sets to be working with, but we just want to share with you what we know. We'll have this on our website. Deaths by race, 61% white, 27% black. There's a huge part of our race data, which I'm going to show you more of now, where we just don't know. We don't have that delineated. Similarly, we have a little bit on ethnicity. Next slide. Dr. Amy Acton: (31:51) Let me tell you a few things about race and ethnicity as we know them today. 25% of the cases that are being recorded in our database do not have race noted. A full 39% do not have ethnicity. Many times this data is collected on intake. It's a patient given, a patient offered information, so unfortunately people are opting out of filling out that part when they're being admitted to the hospital. Dr. Amy Acton: (32:25) So the hospitals are giving us that data that they know, but we really need folks to fill that out as a way of getting some of the data. What we do know by race, again, our cases are 51% white, 18% black, 2% Asian and Pacific Islander, multi-racial 1%. A full 25% we just don't have the data on and that's an issue for us. It's an issue we faced all along in reporting of diseases. Dr. Amy Acton: (32:59) Ethnicity similarly, non-Hispanic non-Latino is 58%, Hispanic Latino is 2%, a full 39% of our cases we just don't know. So we are working very closely to capture this. We're trying to help our hospitals encourage folks to fill out that data. I know some people are uncomfortable filling that out. It's a choice that's made, but it's very, very important. Dr. Amy Acton: (33:27) You're hearing a lot of reports nationwide, a lot of questions about this. Even before Coronavirus, we know that there are huge disparities and health outcomes in this country and some of those very same issues that have faced us before the stress of a pandemic, we know have a chance of being greater exacerbated. This is something that our local health departments on the front lines take very seriously. They're passionate about the social determinants of health and ensuring equity. They're very passionate about health and all policies, so they are working closely with their civic leaders. They are working closely with hospitals, with nonprofits to ensure that no one is left behind in this illness and this is a daunting challenge for us. Dr. Amy Acton: (34:17) Right now it's very hard for us to say much because we're only testing, again the sickest and highest risk individuals. One of the things we're working on is the second way of testing, being able to do widespread testing of the population, the mildly ill, the asymptomatic, and it's crucial that we do that in a way that gives us a very good picture across all populations. Dr. Amy Acton: (34:43) So not only by race and ethnicity, but we have to take special attention for those who are disabled, for the elderly, for folks that are dealing with life threatening illnesses. There are wide variety of ways that we need to ensure as we respond to Coronavirus that we leave no one behind. So this is something I take very seriously. I always have. We've dealt with these disparities and differences in life expectancies and outcome on a number of issues, infant mortality and maternal mortality just to name a couple. So we really want to take this seriously as we try to give out resources in a pandemic and I will continue to share with you what we know, as we know it. These are important, important numbers for us to follow. Dr. Amy Acton: (35:32) I also want to say that another group that we have to think about are the folks in congregate settings. As the governor shared, we had a tremendous discussion in response to outbreaks in our prisons and in a federal prison this weekend. Those on the frontline have been doing an outstanding job. We convened a call and it was really one of our first tests of our zone approach. We have hospitals responding on the front line, Salem Regional, East Liverpool, Trumbull, Mercy, and... Dr. Amy Acton: (36:02) ... Regional East Liverpool, Trumbull, Mercy, and those folks have performed admirably. I had the privilege of listening to the docs on the frontline, to hear from the warden, and we know that we are sending out our Ohio Guard to help in our response. But, one of the new ways we helped, we learned from and did an excellent job is we brought in our regional, so we brought in Summa, Mercy, Cleveland Clinic, Trinity and all of those are working collectively to make sure that we balance patients so that no one hospital is overwhelmed when there is an outbreak in any setting in Ohio. Dr. Amy Acton: (36:45) And so that is fantastic. That's exactly what we want to see to make sure that we're balancing the stress on our healthcare system. So very, very proud and optimistic about how we are responding. And once again here at the state, our job is to help come alongside partners as they face these outbreaks and bring really the full strength of the Governor's Office and the state to bear to help alongside of you. So very, very proud to those in the prison, to all of those affected by this. Our heart goes out to you. We are thinking about you and we will do everything to give you the very best care that we have. Thank you. Mike DeWine: (37:28) Dr. Acton, thank you very much. Who has questions? Tara Morgan: (37:36) Hello, I'm Tara Morgan with ABC 6 News. I have a question if you could expand a little bit more on the sites that you've designated for the surge of patients. Can you talk about the number of beds you're expecting to put in each at one of these? Are these for COVID-19 patients? And will the National Guard be there as well? Mike DeWine: (37:56) Well, I'm going to refer this to Dr. Acton. I don't have the exact numbers. I'm not even sure that exact numbers are available. The first job was to find the location and basically what we're talking about is not standing up a new location. Preferable, and you saw this in the places that I named, these are big locations that have the opportunity to hold a number of people. They can build them out. What you've seen on TV and other locations, it would look similar to that I suspect, but it's the ability to add additional beds, add additional capacity. Doctor, anything to add? Dr. Amy Acton: (38:39) Yes. I just want to add, as I promised on Saturday, we have been working nonstop on the zone and regional plan. You've seen some preliminary information, but the governor and I will be presenting a much more elaborate description of it by mid week. I hesitate to say, because again we are standing up an unprecedented response and I think it's important to give the viewers all the information together. Some general principles. Again, we've known that we need to about double our hospital capacity for a surge. The exciting news, and again this is information that is not finalized yet, but I'll try to give you a little hint on this, is that our social distancing has absolutely had an impact. So I think we're going to be sharing some promising numbers. We are still going to have a surge and I can tell you this is going to be a hard week and we have a couple hard weeks ahead. Dr. Amy Acton: (39:38) So I want people to be optimistic in the sense of we can't let up. The moves we're making are taking so much pressure off our hospital system and we are going to have a complete package of slides and graphs and information for you this week. We're going to be right ahead of that surge and we're going to give you everything you need to know, but we're making a difference, but we cannot let up. The second we let up it unravels and we will need tremendously more hospital capacities. So we are going to show you how that is being stood up. The build outs that are occurring, some have been announced. You've heard of work going on in some of our convention centers, but I want you to know that the highest acuity patients are staying in hospital settings or in preexisting settings. They're not going to be out in tents. We're fortunate because of the time we bought, we're able to use brick and mortar. Dr. Amy Acton: (40:34) And we're able to build in a very thoughtful intentional way. We're so blessed in Ohio by this, we are going to build out some auxiliary spaces and that will be for people that are stepping down out of the hospital, lower acuity folks. So, that's how we'll be using some larger structures. I know you've heard a bit about the Duke Stadium, the convention centers, that sort of thing. So when we give you all that information, that's one thing. For viewers at home, just like in the outbreak we had in Colombiana, all our systems work as normal. You still go to your same doctor, same healthcare provider, or if you don't have one and you don't go to a federally qualified health center, you would go to your local emergency room, calling ahead first. You still go to all your same hospitals and do all the same things. For those of us at home, all the same activities. Dr. Amy Acton: (41:27) So if you're sick now, do exactly what you would normally do, let your provider know and work with them. But then the rest of this, making sure that we spread you that the ambulance goes to the right hospital. That's all up to the hospitals behind the scenes. We have a regional system that does that. We actually do that every day for traumas when they occur or big accidents or maybe a tornado. So those systems are in place, but they're being ramped up extensively. And we saw it work very well to be able to come alongside that first local hospital in Salem. So, we'll give you lots more. Sorry it's not today, but I'm going to give it to you complete. Thank you. Kevin Landers: (42:11) Kevin Landers, WBNS 10 TV. My question also is for Dr. Acton. Dr. Amy Acton: (42:18) Hi, Kevin. Kevin Landers: (42:19) Hello. How are you? Dr. Amy Acton: (42:20) Good. Kevin Landers: (42:21) Today, the Institute of Mental Health statistics out of University of Washington put out new modeling today and it's being shared a lot on social media. So I wanted to bring it to your attention. It says that we're two days away from the peak, that we have enough beds and ICU beds and ventilators and we're six days away from the peak of deaths. Do you support this model and what can you tell us about this hopeful outlook that this modeling is presenting? Thank you. Dr. Amy Acton: (42:48) Well, I will be going over the modeling extensively this week with folks. We'll actually show you a bunch of new graphics on this, but once again we're finalizing it. So it is the Institute of Health metrics, that you might've said mental health. Kevin Landers: (43:03) I'm sorry. Dr. Amy Acton: (43:05) It's easy. And that model has been discussed in detail. We've worked with them closely as well, but I'll be giving you a lot of detail about how our statistics are actually based on the facts of our cases and our state, versus a statistical modeling that's based on deaths. And as we know in Ohio, especially because of our limited testing, especially because we've done so well with social distancing, our data on deaths is far behind that. So we know that we are making a dent in the hospital surge. So I think we'll be able to celebrate some things that it is not the worst case scenario that had been raised in some of the early Cleveland Clinic data modeling, but I think it will not be as optimistic as that data. Dr. Amy Acton: (44:01) It will be somewhere in between. And really the issue for us is the stacking of patients. I'll be talking more about that this week and I'll break it all down for everyone. So it's a lot easier to understand, but it is about how long people stay in the hospital. So I feel, and I'm excited about sharing with you this week, the data that we're using. I feel that the modeling is staying right. It's actually, we go back and see if it predicted what we experienced and we're spot on. So I think we're going to have some great numbers that are the most accurate for Ohio to share. Again, probably midweek as soon as I can get them to you. Kevin Landers: (44:37) Thank you. Molly Martinez: (44:40) Hi, this is Molly Martinez with Spectrum News. My question is for the governor. We've gotten a lot of viewer feedback from essential workers that say that they don't feel safe at their work. And specifically, letter carriers. They say they go into the post office in the morning, none of the mail is sorted and they're all sort of cramped in there. They don't have any PPE. They're touching all of our mail and they're going from house to house to house. Is there any plan, I know that's a federal job, but is there any plan to keep them safe? Mike DeWine: (45:10) Well, that's a very good question. It's something that I will take up with the post office. I've not myself received any specific complaints, but that doesn't really mean anything. I get anecdotal reports from around. And of course, the average citizen is not in in the back room where they're sorting the mail or where that is that is taking place. So I certainly will check into that and I'll see if we can get some improvement in in regard to that. Molly Martinez: (45:42) Thanks so much. Mike DeWine: (45:44) Yep. Jim Province: (45:48) Jim province with the Toledo Blade. And this question is for Dr. Acton, I think first, and then possibly the governor. That because Michigan is going to peak a week or so before we are, that the beds in Northwest Ohio could be taken up by people from Michigan and that they won't be available when our surge comes. Could you respond to that and tell us whether a doubling of capacity is going to be enough? Dr. Amy Acton: (46:16) Absolutely. I'll bring you more details on that because I haven't in the last couple of days spoken with them, but it is something we're taking into account in all our building. We know that we share borders, workers and hospital systems containment areas across states. It's true even in Colombiana in the prison I was talking about often care is received over in Pittsburgh right across the border where I grew up, it's a little closer even than say going to Akron. Similarly, we have that across the border in Toledo area and we have that in Kentucky. And all of our zones, our CEO's who are taking a look at that, have actually been working closely across the borders to assure that that capacity is there. So they're taking across the borders into account. And I'll give you some more details on that when we roll out that zone plan. Jim Province: (47:12) And do we fully expect people from out of state to be in our hospitals in Ohio? Dr. Amy Acton: (47:18) I think some do seek their regular care there. So I think there will be some of that. I know, I've spoken with the Health Commissioner in Michigan and they have a similar triage plan that they're looking in, in their state. So they're aware of this. They're aware that we're going to spike not long after them. We're fortunate to be behind them a bit, but those are all things that we're having conversations about and taking into consideration. Jim Province: (47:45) Thank you. Jeremy Pelzer: (47:50) Hi, this is Jeremy Pelzer with cleveland.com. Dr. Amy Acton: (47:52) Hi, Jeremy. Jeremy Pelzer: (47:54) Hi. This question is for Dr. Acton and Governor DeWine. Following up on the question about modeling. Last Friday, the CEO of the Cleveland Clinic said on MSNBC that the Clinic's modeling shows that coronavirus will peak in Ohio between mid May and mid June as a best case scenario. Now, this is later what you and the governor have been saying, citing among others, of course, as you said, the Cleveland Clinic. So why is there this discrepancy? And do you believe that this is going to last into summer? And is this why you and the governor decided to close swimming pools and other summer related activities? Thank you. Dr. Amy Acton: (48:35) Thank you. So the battle of models continues and there's a lot said about this, but I am promising you all if the governor will give me a good chunk of time about midweek, I'm going to do modeling 101 for everyone and sort of help us all get to the bottom of this. But, I feel that in my estimates the peak will be late this month to that May 5th time. But, the Cleveland Clinic's modeling took into account a different peak on the social distancing. People at home, you are moving mountains, you are saving lives. Again, I get emotional talking about this because this is no small thing that we are doing together. It is so incredibly hard to shut down our lives the way we have. I am absolutely certain you will look back and know that you helped save each other in this state. Dr. Amy Acton: (49:43) The impact is profound. More than I'd even hoped for was possible. We've never been here before. We've never fully executed these kinds of strategies on a scale that we're doing in modern society and it's working. So I feel very comfortable that the data I'll share with you this week will show that. But, please at home don't stop. We are picking these dates like May and we're letting you know that we know we have to slowly come out of this, but if we do it right and we keep doing it right, we can get out of this a lot sooner and a lot healthier and get ourselves back to our lives a lot sooner. So, thank you. Mike DeWine: (50:29) Let me just kind of state the obvious. In each modeling, no matter who's doing the modeling, there are assumptions. And one of the biggest variables is where social distancing is on that date and then into the future. So the biggest variable is what is the social distancing. So if you build in and you assume we continue to do what we do, you end up with one result. And I'm not saying that's the difference between the different modeling. Dr. Acton will go into much more detail there. Mike DeWine: (51:06) But, we're kind of like a ... I love baseball, so I'll make the baseball analogy, everything I make the baseball analogy too. It's like a baseball team. 162 game season and you're winning, but then the next day you start all over again. The next day you start all over again. And so this depends on what we do every day. We're on a streak, we've done well, but we have to just keep repeating it. We have to continue to do it. And if we don't do it, all that modeling goes out the window and you fundamentally change what is going on. Jeremy Pelzer: (51:46) Thank you. Laura Bischoff: (51:51) Good afternoon. Laura Bischoff, Dayton Daily News. I guess my question is for Governor DeWine. I've heard a lot from people who have loved ones in the state prison systems and they're very worried about the coronavirus. And obviously you're going to give us more information tomorrow and maybe even later today. But what assurances can you offer to inmates and their families during this crisis on steps you're taking to prevent? Mike DeWine: (52:22) First of all, I want to assure everyone who works in a prison, everyone who has a loved one in a prison, everyone in a prison, that we will do everything that we can every single day. Our Director has a background in these issues in prison. She's been preparing for this. She's been doing the testing. As I indicated earlier on when we started, the testing didn't just start yesterday. She's been doing testing for some time. She has been checking the temperature of guards when they come in and of prison personnel when they come in. She's been following every single protocol there is to follow. And what has happened is, in most of the prisons, it's been slow getting into, it's been out in the general population. It's been slow getting into the prison. Mike DeWine: (53:13) Once it gets into a prison, it is like every other group, small group of people that, and it just, it takes off. And so this is something that we're going to have to continue to battle, but the Director is doing a lot of different things. She is doing everything she can to reduce the contact among prisoners, from prison-to-prison, prisoner-to-prisoner, but also certainly anybody that is coming into that prison. And even in the serving of meals, she has changed how they are serving those meals to make less contact and to do everything that we can to keep this from spreading. We are going through with the Director a very tough analysis, frankly, of- Governor Mike DeWine: (54:03) Tough analysis, frankly, of who we can release on different conditions. On Friday I announced that we were recommending to judges, and I don't have the power to do this, I don't have the power to do this quickly. And so these cases go through a judge, a local judge, the judge who knows more about that case than really anybody because he or she was the judge who sentenced that person. We have tried to pick in that first batch of people, people who we thought were not dangerous, people who might have been closer to their time to getting out and people we just thought might be likely to be able to be released with whatever conditions that judge wants to place on that individual. And that's entirely up to the judge. The first batch went out over the weekend to the judges. They will hold their hearings, they will contact victims, they will contact prosecutors, they will get and make the decision that they think is best. Governor Mike DeWine: (55:07) But we want to tee this up for them and basically say, these are some potential ones. We will be announcing some more tomorrow. And in the vast majority of the cases tomorrow, with a few exceptions, I don't have the ability to move quickly. Again, we set them up, we send them back to the judge, we send a letter to the judge, and then the judge is the one who can in fact move quickly and set whatever criteria, if the judge decides to release them, then set whatever is the proper criteria. Another thing that is happening in our prisons is that the number of prisoners coming in every week is going down. That in and of itself is starting to take our population down and we anticipate that that is going to continue. Governor Mike DeWine: (55:56) We're picking up significant numbers and the whole idea, for those of you watching at home, the whole idea is a couple of things. One is to give our prison officials more flexibility to be able to move people around, to put them in a more secure setting, a better setting to reduce the chances of someone getting the COVID virus. And so all of that is goes into the mix. And that's what we're thinking about and we'll have more tomorrow. Speaker 2: (56:32) You said you don't have the ability to act quickly on this. You can't use your powers of commutation? Governor Mike DeWine: (56:35) No. I got a good constitutional lesson in this and this goes back a number of years. The constitution was changed. There's criteria, certain things have to happen. There has to be, for example, the parole board has to take a look at, you have to have notification to victims. It is a process that generally takes at least 60 days. Ultimately, I could make that decision, but I can't make that decision right now. That pushes out. There's a couple cases. If a case is already to me and has gone through all that procedure, then I can make a decision and I'll have some of those tomorrow. But in the majority of these cases, it's a 60 day waiting period at the minimum. That's if everything goes right. Obviously we don't have 60 days to try to deal with this. And our concern is the safety of the guards, safety of all prison personnel, the safety of the prisoners and the safety of the public. We're balancing all of those things and trying to make these decisions. Speaker 2: (57:37) Thank you. Jessie Balmert: (57:40) Hi, this is Jessie Balmert with the Cincinnati Inquirer. Got a question about convention centers, so really either of you. At what point should Ohioans expect to see patients at convention centers? Are there certain circumstances that would trigger that? And then would it be COVID 19 patients or other types of patients? Dr. Amy Acton: (58:00) Hi Jesse. And everybody's wearing, you can't see this at home but everybody is wearing a mask. With each person who steps up, it's interesting to see. Governor Mike DeWine: (58:13) Some of them are real fashion statements, too. Dr. Amy Acton: (58:13) Yeah, they're pretty elaborate. The convention centers will be a later stage use. We still have, thanks to all the steps we've taken and the policy moves, capacity, a good capacity in our hospitals, which is exactly what we wanted. Hospitals have built out their capacity on site. They're using different parts of their hospitals differently. I would anticipate that it would, even though we're going to start work on convention centers because we know that will take time, we are a ways away from needing to use them. Again, we're going to go on the cautious side as we do with everything we do in Ohio and prepare for the worst and work our way back. And again, I anticipate that we would be seeing more mildly ill, convalescing, potentially isolating or quarantining people, our sickest folks will be probably more in a traditional bricks and mortar and that's sort of a strategy we've adopted as a state because we've had the luxury to be able to do it that way. Thank you. Jessie Balmert: (59:16) Thank you. Adrian Robbins: (59:21) Adrian Robbins, NBC Four and my question's for Dr. Acton. This week the surgeon general said that this week for America would be the hardest and the saddest of most American lives. Do you feel that urgency here in Ohio? And do you think that this week could be our tough week? Dr. Amy Acton: (59:41) Well, I have to tell you, he's speaking truth. I think I feel it. I feel such a tremendous urgency. And it's something I can hardly put words to. We are going to see in places like New York, Louisiana, we're seeing it in Detroit, in Chicago, it's going to other ... Indiana is getting hit hard right now. They're ahead of us a bit. But I think for all of us, anyone who's watching the news, you're going to see the devastating impact of what is just this terrible, terrible disease we're fighting. We're seeing it here in Ohio. You're not seeing it as much, but I certainly am hearing the stories. I was listening to the doctors and the prison warden and folks talking about what they're going through. I think in Ohio we will be seeing more and more stories. I don't think this is our peak week. Dr. Amy Acton: (01:00:41) I think our peak is farther out. I think everything that we are doing is to lessen that impact, to lessen those kinds of scenes that we see here, to really be able to control our surge and control that response. That is everything the Governor and Lieutenant Governor have been fighting for. And again, at home don't give up our ability to control this storm and this threat, it's in our hands. Everything we're doing, all the healthcare things we can do. We are building that out. We are doing all the moving of mountains. But a huge part of it is what we're doing collectively. Dr. Amy Acton: (01:01:23) When we see some of the things that are hurting us so much to see, and there's plenty of Ohioans here who ... How many desks today? 142. That's everyone in their sphere and their lives and their friends. There's all the folks who are home sick, who've never even been tested. We all know somebody, it's going to impact all of us. And as those things impact us, and as we see those things double down. Double down on your commitment, Ohio. Double down. And I'm a competitive person. If that's what it takes, if it's a baseball game, then doubled down and let's fight this together. We do not want to be passive and let this virus own us. We have got to own everything that's in our control. Adrian Robbins: (01:02:13) Thank you. Andrew Welsh Huggins: (01:02:18) Hello. It's Andrew Welsh Huggins with the Associated Press. Once again, thank you for taking our questions and I guess today I am the last question. This is for Dr. Acton. We're getting obviously piecemeal reports about how things are going in nursing homes and skilled nursing facilities. I think just because of the way we're divided with our health boards, but could you briefly give an overview of how things are going in facility by facility? Is it good, bad? What are your concerns? Dr. Amy Acton: (01:02:48) Well, everyone knows during this pandemic, and we saw it very early on in Washington state, that any time we have what's called a congregate setting, when people, whether it is a prison or a nursing home or other institutions, that that is a place where we can be particularly vulnerable. I have to say folks in our teams, we've doubled down. We have strike teams who's only focus, whenever we hear of even one case in a nursing home, that local health department is surrounding that, doing the contact tracing. And then they work with us at the state and we have a whole team of experts. We get on the phone literally with every one of these hot spots, we'll call them hotspots moving on. I've been calling them spinning plates because we'll have more and more of them as the days go on and, and we go uphill here. But we come alongside with the best epidemiologists, our best medical providers, and we work on solving that alongside the locals. Dr. Amy Acton: (01:03:49) All of this happens at the local level, but we work alongside of you. We are seeing that, I know in Cuyahoga and they can tell you a lot better about the names of the institutions, but they have more than 20 institutions that have cases in them now. And that's to be expected in this epidemic. It's to be expected. We will be sharing with you some guidelines we've created as a state. It's really important. Something we're learning from this pandemic is that the more we can be consistent and have guidelines that we all share, the better. We are actually, Maureen Corcoran who's our director of Medicaid, has been working very closely with the team along with director Ursel McElroy, who you know from aging. And they've been working tirelessly on sort of best practice standards. They've been sharing that across the industry all along. Dr. Amy Acton: (01:04:44) But we'll try to share some more of that with the public so they can have an understanding. But then we're taking what we've been doing all along, what are best practices say in a prison, our director of prisons, one of the best renowned health experts in prisons who's helping many other states, by the way. We take those best standards and we make sure we're implementing them across the state. And then those are being wrapped up into our hospital's own plants because all of these folks, ultimately might need that hospital system and might need to go be discharged back to where they came from. All of that is being coordinated together and that's sort of how we're approaching it as a state using the best guidance we can find. Andrew Welsh Huggins: (01:05:27) Thank you. Dr. Amy Acton: (01:05:29) Thank you. Governor Mike DeWine: (01:05:31) Well, we'll close with a video that we've made for our #stayathomeOhio. And this features students from Gahanna Lincoln High School, Marion L. Steel High School, and [inaudible 01:05:43] Orange High School. Governor Mike DeWine: (01:05:58) I guess we have no volume here. We may have to see this tomorrow. We look forward to seeing you all tomorrow at 2:00. Thank you very much and we'll see this video tomorrow