Massachusetts Gov Charlie Baker COVID-19 Briefing April 2

Gov Charlie Baker: (00:00)
Going to tee up the way we think about at this point in time. This is going to play out and our efforts to ramp up our medical capacity as well as a few other announcements that are related to the mitigation associated with that. Over the last several weeks we’ve put into place several measures that have changed in some respects the way we all live our lives and we know that this has been extremely hard for everyone and I want to thank once again the people of the Commonwealth for their patience with respect to all of this. I just want to emphasize that all of the measures that we’ve put in place have all been about flattening the curve. Meaning we’ve been trying to avoid having cases peak all at once here in Massachusetts, which would overwhelm our healthcare system and based on the experiences of other countries, we’ve always expected that there would be a surge here in Massachusetts.

So for the past few weeks we’ve had a talented group of experts working through the command center with academics, healthcare experts and public health folks to plan a coordinated response based on the modeling associated with how the surge might appear, what it might look like and how it would land. And I just want to say that Dr. Facui said something interesting about projecting the surge the other day where he said, “That as every day goes by and you collect more data, not just from your own experience but from the experience that’s going on in other parts of the world, you can rethink and adjust your model accordingly.” And that’s exactly what we’ve been doing. But one of the major points I want to make today is the other guidance that he and others have put forth is that people should plan for the worst and do everything they possibly can to make sure they have the capacity to deal with that and then make adjustments based on changes in experience, changes in data and changes in other countries and other places experience as we go.

And that’s exactly what we plan to do. The medical advisory group that we worked with modeled out with us. When we expect to have the surge, how many cases we can expect and what level of care people will need. We develop these models based on the experience in Wuhan China and adopted that to reflect Massachusetts population and hospital bed capacity. An epidemiologist at Harvard, at the University of Guelph which is in Canada, Northeastern in the command centers medical advisory committee. I’ve been working through and sorting through this data to come up with what we anticipate to be the latest on how this is going to look.

We estimate at this point in time that the number of confirmed cases of COVID-19 in Massachusetts will range somewhere between 47,000 and 172,000 cases during the course of the pandemic. That’s about .7% to 2.5% of the total population of Massachusetts. And at this time the modeling indicates that hospitalizations would potentially peak between April 10th and April 20th and the current fatality rate in Massachusetts is lower than in many other parts of the country in the world currently running at approximately 1.5% of those infected.

It’s important to remember as we said many times that roughly 80% of those who do become infected have flu like symptoms and that many have no symptoms at all. Well, this model is based on Wuhan’s projections. We do anticipate Massachusetts trajectory could differ for several reasons. For example, in Massachusetts we have lower population density. We enacted strict social distancing standards and rules sooner than they did there, and we have a lower smoking rate. Our team also reviewed how COVID-19 impacts other states and other countries around the world and lined our projections and expectations up against those. And based on the projected infection rates our team went to work figuring out what peak medical demand would look like and what it would require to support it. For example, how many people need to be hospitalized, how many will need intensive care or equipment like ventilators and for how long?

Secretary Sudders and our administration had been actively engaging with our hospitals and the Massachusetts health and hospital association on this issue for several weeks so that we all are basically working off a similar playbook with respect to what’s required to meet the projected need. As I’ve said many times, we’re fortunate to be home to some of the best hospitals and best healthcare leaders in the country with extraordinarily talented medical teams. And just as hospitals plan for an increase in patients suffering from the seasonal flu every single year. We’re now planning for COVID-19 with them, but at a much greater scale. We’ve taken steps to provide hospitals with the flexibility that they need to significantly expand their ICU capacity. We’re also asking our academic medical centers and teaching hospitals to expand their ICU capacity. We believe that after hospitals execute on their surge plans, that is what they believe they need to do with their current resources to add beds, staff and equipment.

More beds will still be needed for both intensive care and for acute care, here in Massachusetts. And based on our projections, we believe we need to expand capacity of ICU beds by approximately 500 beds in the coming weeks and based on our projections, we also know we need more ventilators and as we’ve said before, we’ve been chasing supplies from the federal government and through other sources to deliver ventilators that we’ve requested. They will obviously be critical to closing that gap. In addition, we’re also aiming to find or build out an additional 750 to a thousand beds using field hospital technology, which is a proven approach that’s been used around the country and across the world to create additional capacity to deal with fluid situations, just like this one. Along the way, we’ve also been working on developing other alternative care sites to meet the projected need for both acute level beds, step down beds and SNF level of care beds, skilled nursing facility level of care.

Yesterday the Lieutenant Governor and I visited the field medical station that’s being set up at the DCU center in Worcester. It’s a 200 bed facility which will represent about a quarter of the acute care additional acute care need. Facilities like this will help clinicians relieve the pressure on the healthcare system by treating those patients that do not have to be in a traditional hospital at some point in time in their treatment to be treated. This Worcester site is the first of three medical field stations that we’re working to set up in Massachusetts. The Boston convention and exhibition center has been identified as a possible site for additional capacity as well as a Joint Base Cape Cod and the Mass Mutual building and other smaller locations around Massachusetts. We secured a contractor who can build outside once a healthcare partner has been finalized and we’ll continue to pursue these initiatives over the course of the next week to 10 days.

We’re also securing a thousand beds of step down care options and nursing facilities for stabilized COVID positive patients. Belmont nursing home on Worcester will provide 300 beds for this important function to protect our seniors. And this step down plan will help hospitals make room more quickly for new patients once someone gets stabilized. This is a new model we’re pursuing based on what we’ve learned from other areas that have been hard hit by this virus. I’m going to repeat again that we know all models are not perfect, but obviously you need to plan for the worst and hope at the end of the day. You don’t need to go quite that far, but even with the best planning, we certainly expect our medical system will be stretched. We’re going to continue to work around the clock with our healthcare system and with our provider community to prepare for what will likely be a very difficult period.

I know there’s a lot of information out there for everyone at home. The most important thing I would say is what we said before is that we need to continue to pursue the strategies that we’ve been pursuing to flatten the curve and stretch out and reduce the spread. Stay at home, social distancing, six feet apart, wash your hands, hand sanitizer, take this stuff seriously. It is a powerful weapon and it’s been proven in many cases to be the most powerful weapon of all that we have available to slow the spread of this virus. And if everyone plays their part, we can flatten the curve and reduce the strain on our healthcare system and in our communities. Before I turn the mic over to Secretary Sudders, I just want to comment on some news that broke this morning. I think as many of you know, the Commonwealth receives some welcome news, which was a large shipment of N95 masks that will be arriving at Logan Airport later today.

Thanks to the generous and hard work, generosity and hard work of the Kraft family and many other partners. Massachusetts will receive nearly one million N95 masks for our frontline healthcare workers, emergency professionals, and first responders. Most of that shipment will arrive tonight with more on the way shortly after. I want to extend my sincerest gratitude to our partners in this and there were many. Ambassador Huang Ping, Chinese ambassador out of New York played a major role. Dr. Jason Lee, Jean Hartigan, our partners on the ground in China, Tencent, and our COVID-19 command center. This was a collaboration between US and Chinese governments and private sector folks and required a lot of support for many entities and agencies along the way. We’re grateful that the Patriots plan was able to land in China, load up and return quickly to the US. I also want to thank the People’s Republic of China for going to the lengths they went to, to make this humanitarian aid trip possible.

Later today, Massachusetts will receive this vital shipment at a most critical time. Some of the masks as has been previously reported will be directed to New York and to New York City where everybody knows they’re very much in the throws of dealing with COVID-19 and to Rhode Island as well where the outbreak continues to spread there.

I think as everybody knows, securing personal protective equipment is a challenge from masks to gowns to head covers. Our frontline workers critically need the right gear to keep themselves and the folks that they’re working with safe. The Commonwealth has been chasing these supplies through a variety of supply chains and requesting gear from our strategic national stockpile. We were able to secure this big order of masks from China, which is a great thing and we’re all extremely pleased to have it finally here. But for a variety of reasons we always will need additional gear. The Krafts were terrific. They were a phone call away and immediately went to work on the logistics associated with this and did not stop until they could make it happen. This was a total team effort on every level.

There is still with respect to PPE, much more work to be done, but a momentary success like this along the way and all the community generosity that came with it is something that can help everybody working together and keep people healthy and safe. And for that we are all enormously grateful. And with that I’m going to turn it over to Secretary Sudders.

Secretary Sudders: (12:17)
Good afternoon. In addition to the news that the Governor just shared about the extraordinary effort today in delivering so much N95 to the Commonwealth of Massachusetts and for Rhode Island and New York, I also want to say that MIMA and DPH today will be delivering over a hundred shipments of PPE to hospitals, nursing homes, police, fire, EMS, cities and towns. By the end of today, MIMA and DPH will have coordinated at least 700 deliveries of PPE. And as soon as the shipment arrives at Logan Airport and is taken to the warehouse, we will quickly inventory it as well as get it ready for quick delivery out to our hospitals and others.

In addition to trying to chase down every supply chain. We’re also trying to determine what we can do to ensure we have sufficient supplies of N95 in the Commonwealth of Massachusetts. So working with partners in the Mass Hospital Association, Partners Healthcare has been able to secure the Battelle 90 N95 decontamination system that is, some of you know, is received national press attention. It’s scheduled to be operational in the Boston area by Monday, April six and I really want to give a shout out to Partners Healthcare. The Battelle system uses FDA approved N95 decontamination technology. It is the fourth site operational in the United States. We moved very quickly to secure Massachusetts as the fourth location. The Battelle owned and operated system is hosted by Partners Healthcare at the current.

… operated system is hosted by Partners HealthCare at the currently vacant Somerville Kmart site that’s adjacent to I-93. The system can contaminate up to 80,000-

Decontaminate.

Did I say contaminate?

Yes.

Okay, so the system can decontaminate up to 80,000 masks per day, which should cover all demand in Massachusetts over time. The current pricing is $3.25 per mask. [Bitel 00:14:30] has indicated it will reduce the price when it reaches national quantity levels. Each N95 can be decontaminated, disinfected, five to 10 times before it has to be disposed.

The principle benefit of this turnkey system is that it is fully staffed, industry grade, and brings a level of quality assurance that will allow hospital teams to concentrate on other priorities. Bitel is a defense contractor and runs chemical and biological defense for Homeland Security. That’s a significant win for Massachusetts.

Some additional updates. As I believe I’ve announced here before, the Commonwealth implemented a pilot project that allows for safe onsite testing of residents of nursing and rest homes with a quick turnaround. Actually, I’m not calling it a pilot anymore. I’m just calling it a program, is operating under the auspices of the Massachusetts National Guard in partnership with the Department of Public Health and the Broad Institute. Samples are collected by trained personnel from the Massachusetts National Guard.

The nursing home project that we launched on Tuesday is now ramping up to full force. We have 16 members of the Massachusetts National Guard deployed. An additional 45 will be added to the team in the next couple of days. We have a single point of contact for nursing and rest homes seeking help with testing. So far, the program has tested 280 individuals, and we plan to reach more people in the coming days. In fact, 14 facilities today are having onsite testing.

We are focused on homes with known clusters of cases, as well as facilities that are transitioning into COVID-19s nursing homes. We have issued guidance instructing facilities with onsite medical staff. So if facilities have onsite medical staff, we’ve issued guidance to them that they can swab their own residents, and we will provide the sampling kits. This will help our National Guard testing team reach as many nursing homes as possible.

Massachusetts has a total of 700 longterm care facilities, including 380 nursing homes, 255 assisted living residences, and 62 rest homes. We’ve identified COVID clusters in about 78 facilities; and as you know, as COVID-19 continues to evolve, that number will change across nursing homes, rest homes, soldiers’ homes, and assisted living residence. We will be publishing the data about this in the coming days.

We know that older residents, particularly living in longterm care facilities, are at high risk. We know from the experience of other states that there would be clusters; but frankly, if we hadn’t put the restrictions in place that we had, the situation probably would be worse. We are working hard to mitigate these clusters and keep residents and staff safe.

Update on Chelsea and Holyoke Soldiers’ Homes. The Chelsea Soldiers’ Home implemented a continuity of operations plan in early March, preparing for COVID-19, establishing an incident command structure in order to proactively prepare the home’s response. The Chelsea Soldiers’ Home has and continues to implement the guidance issued by the Department of Public Health, the Centers for Medicare and Medicaid guidance, and the Department of Veterans Affairs, including they had implemented cleaning measures per the current Centers for Disease Control and Prevention guidelines, including isolation rooms and quarantine zones for COVID-19 positive residents. They increased the use of PPE, they restricted visitors, and increased personal hygiene measures and increased disinfection protocols.

On Wednesday, the Boston VA Healthcare System deployed a medical team to test residents at the Chelsea facility. This was another proactive step by Chelsea to identify the risk in the facility and get residents appropriate care, as well as reduce the potential spreading through the facility. The test results included nine veterans who are now newly-tested positive. Upon notification of these new positive results, the Soldiers’ Home worked with our partners at the VA Boston Healthcare who quickly assisted in finding appropriate care and placement for veterans.

Deep cleaning has been and continues to be conducted through the facility per CDC guidelines. As of Thursday at the Chelsea Soldiers’ Home, since March 1st, two veteran residents have died, nine veteran residents have tested positive, and seven staff have tested. Two positive, two negative, and three pending.

At Holyoke, testing has now been completed for all residents, and the results are coming in. The total number at the Holyoke Soldiers’ Home as of Thursday, this would be this morning, eight veteran resident deaths, 23 veteran residents have tested positive to date, and seven staff have tested positive. Based on these results, isolation and quarantine zones are being established to contain the virus outbreak. The National Guard continues to be on site supporting staffing needs, to conduct staff testing, and support the clinical command structure that we announced on Monday. The testing and screening of all employees continues as they arrive for work. Staff are screened now multiple times a day and are asked to leave work if they have elevated temperatures.

The clinical command structure has focused on implementing immediate controls, staffing and protocols, increased PPE to protect the health and safety of the residents and staff. This has included clinically assessing and triaging all residents and determining their care needs, establishing clear protocols for and implementing transfers of patients to hospital level of care where needed subject to the advanced directives of residents, identifying and implementing infection control measures, and an infection control nurse started there this morning for clinical staff and care as well as for housekeeping, nutrition, and other supports. We are updating the staffing protocols and measures, including as I said, the deployment of National Guard clinical resources.

Despite the clinical command structure establishing order and medical protocols, COVID-19 is a highly-contagious virus that has a much more severe impact on older adults and those with underlying conditions. The majority of the residents at the home and the numbers of infected residents and death will unfortunately continue to increase over the next coming days.

Families have been able to reach out to the Soldiers’ Home in Holyoke using a family-dedicated hotline and an email inbox to check in on their relatives and loved ones. It’s available six days a week. Obviously, the email is seven days a week.

Thank you, Governor.

Questions?

Speaker 2: (21:48)
Governor, if the state gets the thousand-plus new ventilators-

Say again.

Speaker 2: (21:52)
If the state gets the thousand-plus new ventilators it’s looking for, how would they be allocated among the hospitals? Who would decide? By what criteria?

So we asked the command center’s medical advisory committee, and in particular it was Dr. Paul [inaudible 00:22:11] to put together a process to determine the fair and equitable distribution of ventilators, and it will be determined by a group of medical experts from the hospitals, including academic medical centers and community hospitals. So when the requests come in, it will be this panel of experts, like a Eureka panel to serve and make the allocations.

Speaker 3: (22:32)
Secretary [inaudible 00:22:36] ventilators that may be faulty. There have been some reports that some ventilators that have gone out to the federal government ended up not working and needed to be repaired.

We have repeatedly requested for ventilators from the federal government, and we’ve actually increased our ask today. So we have not yet received any ventilators. And of course, any ventilators that come in will immediately go to hospitals to be tested before that they would be utilized.

Speaker 3: (23:04)
How many [inaudible 00:23:04] or request?

1400, was the first one.

Speaker 3: (23:04)
Yeah, we requested 1400.

Speaker 4: (23:04)
Do we have enough people to operate them [crosstalk 00:23:13]

Speaker 5: (23:13)
[inaudible 00:09:13].

Speaker 6: (23:13)
One at a time please.

Yeah, it’s hard to answer. Are you looking for me or for the Secretary?

Speaker 4: (23:19)
Probably the Secretary. Do we have qualified-

And we’re not social distancing.


Speaker 4: (23:24)
Do we have qualified people to operate all of these [inaudible 00:23:28].

In fact, in the guidelines, ones of the things important to the guidelines is also if you had the equipment, do you have the capacity to operate, to use it? So obviously respiratory therapists is a sort of a new profession, and we all know there are not lots of respiratory therapists. Also, nurses who are anesthesiologists. I cannot get the words out today. My apologies. Anesthesiology nurses can also use ventilators. We are hoping that between respiratory therapists and nurse anesthesiologists that you’d have the capacity to use them. Honestly, I want to get the ventilators in Massachusetts and then figure out what we need for staffing in order to use them.

Speaker 7: (24:17)
Governor?

Speaker 8: (24:17)
[inaudible 00:24:17] share a little bit about the back story about how Kraft got involved versus the federal government going over to get the masks for us?

I’m going to start by saying I will get none of the details on dates correct, because I feel like March 6th to today has been one day. I can’t keep track of it anymore. So what I do know is that sometime around the time that we had our 3 million masks that we had ordered through BJ’s confiscated in the Port in New York, that at that point it became pretty clear to us that using what I would describe as sort of a traditional approach to this wasn’t going to work and just started calling everybody I could think of who might have the ability to help us access N95 masks, which were clearly viewed at that point … That was the loss. It was 3,000,095 masks that we lost in the Port in New York. So that was clearly goal number one. It wasn’t just about calling people who had connections to or relationships in Asia. We were also calling people who had relationships in Europe, people who had relationships in Canada, people who had relationships in Mexico. I mean, one of the best parts about being in Massachusetts is you have a lot of organizations and individuals who have global networks. Our colleges and universities have global networks. A lot of our businesses have global networks. A lot of our cultural institutions have global networks. So if you start calling these people, you may eventually land on someone who has the ability to help you figure out how to actually put something like this together somewhere. We eventually landed on some folks who could help us navigate some of the issues associated with how you would do this if you were trying to make a big purchase in China. Then the question became, okay, we have somebody who we think can help us actually execute on a purchase. But then the question becomes, how do you actually get it back? I didn’t want to go through the same exercise we’d gone through previously with the Port of New York. So we concluded that the best way to make this happen would be if we could find a private trip that we could treat as a humanitarian mission.

That was when I called Jonathan Kraft and said, “I think we have a way to access a procurement in China, but I don’t know how to get it back here. We think pursuing this as a private humanitarian mission is a far better way to make this happen than trying to do it through sort of traditional, commercial means.” Along the way, as I said, Ambassador [Wong 00:27:29] was incredibly important to making this happen out of New York. The Minister of Foreign Affairs in China was extremely helpful and a whole bunch of other people, both on this side and on their side, understood the nature of what we were trying to achieve. And Tencent, which is the company that in China that actually had the gear, was the sort of connection point to make it happen once the plane landed there. I think in-

The plane landed there, and I think in many ways I’m really grateful for everybody who is involved in this, because you combine that shipment with the machine that Secretary Sutter’s talked about, and while we will never have enough gear, we are always going to be seeking gear, we have a huge pipeline of additional asks and potential orders and all the rest that’s going to play out over the course of the next couple of months, this gives us the thing we have heard time and time again from first responders and emergency medical personnel and nurses and docs and everybody else on the healthcare side, which is N95 gear. And the fact that we’ll be able to decontaminate it and use it on an extended basis using an FDA approved machine that will be located right here in Massachusetts creates a shelf life for that equipment that wouldn’t have been possible otherwise.

Speaker 11: (29:09)
… the unemployment rate today, people that are watching this afternoon are obviously concerned. I know you’re concerned. What do you say to these people that are sitting at home following your guidelines and the numbers are escalating off the chart?

So I’m pretty sure that at some point in the past few weeks, I think it was when we were still upstairs, I talked about the fact that we knew that these initiatives around gatherings and restaurants and businesses and social distancing were going to have a profound impact on our economy. And we knew it, and we said it, and it has. And I think from our point of view, the public health issues, which are in fact public safety issues, that were associated with using the proven mechanisms that had actually slowed the spread and bent the curve in other parts of the world had to be priority number one. And if you just looked at the data that came, especially out of Italy, it was pretty clear that if we didn’t do that, we would be overwhelmed in a relatively short period of time. We wouldn’t have time to plan, our healthcare system, and we wouldn’t be able to deal with it. And once you get to that point, getting out of it gets much harder. And I think the fact that so many people in Massachusetts have taken seriously these social distancing and stay at home advisories and no gatherings and all the rest, has in fact helped with respect to our ability to plan for the surge and to create the capacity we’re ultimately going to need to deal with it. But I think we all understood that was going to come with a pretty signi… When you start talking about what’s an essential business and you start telling people to stay at home and you start going through a lot of what we’ve been doing here to keep people safe, we knew that was going to have consequences.

And economically, and the feds know that too, which is why they created two new programs that didn’t exist previously to deal with unemployment, why we took a 50 person call center and made it a 500 person remote call center, and are going to continue to work our way through while the folks who are applying for this to make sure people get the resources they need to stay in place while we go through this very difficult period.

Speaker 12: (31:39)
Governor, [inaudible 00:31:40] some layoffs in the private sector, I wondering, has the executive branch made any layoffs and if so, how many?

If we’ve had layoffs, they’ve been targeted and particular and specific. But generally speaking, when you get into an environment like this, a lot of the stuff that goes on in government becomes more important, not less important. So the UI program being probably the best example of all. Three weeks ago they had a 50 person call center that was operating out of the Early Building. Now they have a 500 person plus call center that’s operating remotely to deal with the incredible surge associated with unemployment.

Mass. Health, Medicaid program, the DTA program, all the work that’s done by child welfare folks. It’s in times like this when these become more important, not less important. And I think for the most part, I think about 40% of our executive branch workforce, I can’t speak for the courts or higher ed because I don’t know. But I think about 40% of our executive branch workforce is working remotely. And about 60% of it is working what we would describe as on the job. Although many of them don’t spend a lot of time in the office because a lot of their work’s in the field. For example, the people who work at the parks, a lot of the folks who work at DCR, who work for Fish and Wildlife, those folks spend most of their time in the field anyway.

Speaker 13: (33:15)
Governor, [inaudible 00:33:15] to the supply of masks, how long do you expect that to last even with the ability to clean them? And how quickly will the masks be distributed and how are you going to go about allocating that to hospitals?

So the first part of the question’s just a hard one to answer. What I can say is that we believe the combination of the mask plus the ability to clean them buys us a buffer here where we believe we should be able to service those folks in healthcare and public safety who need these, for some extended period of time, while some of the other stuff we’re working on on the supply chain side has a chance to come to fruition. But I said in my remarks that I don’t believe we’ll ever have enough masks. And I continue to believe that. Do you want to speak, the second part of the question was about the process for distribution. Do you want to talk about that?

So first the supplies have to arrive. They’ll be taken to the warehouse where there will obviously be unpacked and inventoried. In order to ensure that we optimize and have a fair prioritization of the PPE distribution, it is sort of, who needs N95s? So in terms of high likelihood of COVID-19 to lower likelihood of COVID-19 is sort of the first tranche if you would. So it’s hospitals, nursing homes, EMS, fire, police, schools and then other agencies. That’s just sort of the hierarchy of how we will distribute it from who needs N95s in terms of the highest likelihood of COVID-19 exposure to the lower likelihood.

There’s a team of MEMA and DPH staff. They will literally go through the requests and prioritize. It is the goal is to adjudicate the request to keep all organizations stocked with a seven day supply of PPE for those facilities in need. And we define facilities in need or entities in need who have less than five days of remaining stock. So that’s sort of the general how we’re going to distribute it. And honestly we’re going to get it out as fast as we can inventory it, go through the requests, and get it out the door.

Talk about the posting of the data.

Yes. In our commitment to be as transparent as possible, we will actually put out publicly, we’ll post who gets what once we get the inventory and get the stuff out, because that’s obviously people have been sort of interested in who’s getting the product. So we will actually start to post that.

Speaker 15: (35:51)
Governor, what do you [inaudible 00:35:51] jails and prisons [inaudible 00:07:57]?

They’re part of the community that will benefit from this, although we’ve also been using surgical masks in many of our state prisons. But the biggest thing they’ve been doing is acting on some of the same guidelines we talk about for others. There is no visitation but there’s added phone call time for inmates, but they’re doing all the same things with regard to disinfecting surfaces. Both those that are used frequently, they disinfect frequently as well as the rest of the facilities on a pretty regular basis. Everybody on their way in in the morning has their temperature check to determine if they have any kind of symptoms at all. If they do have symptoms, they are at that point told to leave and get tested. And I think many of the most important things they’ve been doing have to do with the same kinds of guidelines that had been given to a lot of the other folks who look after populations in a contained setting, which have to do with keeping the place as clean as you possibly can, using high standards and best practices with respect to hygiene, limiting visitation and making sure that folks who come in are not symptomatic in any way.

Speaker 16: (37:15)
Last question.

Speaker 17: (37:17)
… guidelines and procedures are taking place correction in the sheriff’s houses of correction as well?

They’re supposed to be playing by the same rules that the DOC plays by as well. Yeah.

Speaker 18: (37:27)
Governor, [inaudible 00:37:31].

Can I let… Bruce hasn’t asked a question.

Bruce: (37:33)
Yeah, I was just-

Karen hasn’t asked one either.

Bruce: (37:33)
Can you go back to your projections for a minute?

Yeah.

Bruce: (37:43)
You said 47,000 to 170,000 confirmed cases. I was little puzzled about over what time period, and is the low end with social distancing and the high end is bad social. What is that?

I think there’s three ways to think about this and the reason there’s a big spread is because this is unprecedented and we’re playing a game that… Usually when you play one of these games, the more you know about it, once you’re in it, the spread between the top and the bottom starts to come down. There are three big issues we don’t know the answer to, which is why the spread is big. The first is we don’t know how long it’s going to last, right? So that almost by definition creates what I would describe as the upper end. The second is part of this depends on our ability to continue to be able to test and ramp up our testing capability to identify people who are in fact infected, recognizing that some portion of those who are infected are never going to show symptoms, which is a pretty significant issue. And at some point it’s going to have to change the way we think about how we come out of this, which we’re already starting to talk to the medical advisory group about a bit.

And the third issue is recognizing and understanding that as time goes by and as we collect more data, we will get smarter about where we are between that 0.7 and the 2.5. But the last thing you want to do here is start with a range that’s too low. You want to make sure the range is pretty generous so that you have the ability to make sure you’re preparing for it in anticipation that it might be bigger and longer than you might’ve thought at the beginning.

Bruce: (39:24)
Keep a range over time.

I think of it is a range over time.

Bruce: (39:25)
And over any particular time?

It’s hard to tell where the end is, right, because, yeah. I think of it as weeks and months and it will get narrower farther into it we get. Just one thing you should all know, with the work we’ve done to ramp up our testing capacity, we’re now the third largest tester in the country. We are certainly not the third largest state by any means, but the only two states that are issuing more tests at this point than we are are New York, which is obviously much bigger than us and Washington, which got into this in a big way about two weeks before we did. Testing is ultimately, we’ll talk more about this tomorrow when we talk about contact tracing. Testing in the long run, as we continually build out and build out and build out our testing capacity, it’s going to be a big part about how we ultimately get our arms around this and create strategies to help us play a little bit of offense and not so much defense with respect to the way we deal with this. But we’ve gone from being sort of not on the board at all to being one of the largest and most expansive testers in the country. And I’m proud of the work that people have done on that, but we have a ton more to do.

Speaker 19: (40:49)
Governor, do you-

Karen hasn’t asked a question yet.

Karen: (40:54)
Thank you, Governor. [inaudible 00:40:58] promo. Governor, MBTA workers are very concerned. The bus drivers are especially hit hard. One inspector apparently, well I know his died. At least 12 have been affected. South Hampton Street is the… What would you say to T workers who have to go to work, who have to get these health workers to work and really don’t have much of a barrier between themselves and the public?

Well, the first thing I say is that, and I’ve said this before, I get the fact there are a lot of numbers in this conversation and there always will be, because people need to figure out what the scoreboard they’re going to use to keep track of what going on looks like. But every single person who’s affected by this has friends and family. And so when we talk about the T for example, I don’t want to talk about the person who lost his life is just a number, right? By all accounts, he’s a hardworking guy and-

By all accounts, he’s a hardworking guy, and his loss is being felt as badly as every other loss is being felt by people who are close to the folks who are unfortunate enough to come down with this and not survive it. The T is pursuing many of the same protocols that other essential businesses are with respect to distancing and hygiene and testing every day on temperature and symptoms and all the rest. I do believe that the essential order had a big impact on the number of people who were traveling on the entire public transportation system.

It’s pretty much down at this point to people who are in fact essential, which I think has made all the issues around distancing for folks who were on the trains, the rapid transit system and the bus much easier to live up to. If we ever do get to the point where we start getting to the other side of this, one of the things we’re going to have to make sure we do is ensure that all of our transportation assets continue to maintain what I would describe as appropriate distancing policies to prevent the spread of the infection again.

Speaker 21: (43:15)
Governor, do you still expect to receive the thousand ventilators from the feds by the end of this week?

I don’t think we’re going to get them by the end of the week. We submitted… the secretary mentioned that we submitted some supplemental information to them. The big thing the feds are trying to figure out at this point, and I’m mildly sympathetic to them on this one, is where they think the next big opportunity or the next big surge is going to be so that they make sure they deliver just in time. They don’t want to be putting them out to people long before they’re actually going to be necessary or put into use.

Speaker 21: (43:56)
[inaudible 00:00:43:56]?

Well, we’re somewhere, as I said in my remarks, between April 10 and April 20 for what we think is going to be the peak of the surge here.

Speaker 21: (44:06)
Governor, did the crass relationship with the President or with the White House in general have anything to do with the slow cadence?

I don’t know. I don’t believe so. It never came up in any of the conversations I had with anybody. It was designated as a humanitarian aid mission, and that helped us in a number of ways. It helped us on the Asia side, but it also helped us with respect to the hopscotch that was played through the state of Alaska, where the governor of Alaska was terrific about recognizing the humanitarian nature of the mission and made some modest accommodations there to make it possible for us to hopscotch through there to China and back, rest there and then come home.

Speaker 21: (44:53)
How much did they pay for those, for the masks, and where did the money come from?

I don’t know what the price of the mask was. Do you?

Speaker 21: (45:03)

We’ll get it. [crosstalk 00:45:10] Say again?

Speaker 21: (45:12)
[inaudible 00:45:12] legislative appropriation or where did it come from?

Remember, we’re spending money on a whole variety of things. We’ll be spending money on the Battelle machine. We spent money on public health programs, we spent money on a lot of stuff, and we’re going to continue to spend money on the things we believe we need to spend money on to deal with this.

Okay, so the masks range in price from… [Crosstalk 00:45:45] Yeah, you should probably speak to that one.

So if you remember… So first of all, masks are generally around $5-$6 a piece. And the legislature initially appropriated $15 million for us to just start to deal with the COVID-19 epidemic. And we used that money primarily to get money out to the local boards of health to start doing contact tracing for individuals. That was one piece of it. We also used it to increase… We used it to buy some swabs and others. But in terms of specifically as the governor said, that we are using various state appropriations that we have and expect to get reimbursed by NEMA through MIMA to FEMA from the federal government, from the national disaster relief, as well as money coming in from the CARES Act. That starts coming into Massachusetts next week. We also had some other CDC funding that came into the Department of Public Health that we’ve used to pay for supplies and the like.

So basically we’re using federal state dollars that we have available to us. We’re obviously keeping a very long ledger sheet of where we are committing to funds with secretary of ANF. And in part, we need to keep that so that when we go back to the federal government for reimbursement through FEMA, that we will have very good documentation. So, it’s literally using every source of funding that we have available to us of federal and state dollars, the $15 million, which was a deposit as I like to say from our colleagues in the legislature. And then being able to document it so that we can get reimbursed from the federal government.

By the way, the reason I didn’t give you a number on masks is because it’s all over the place. And that is a clear indicator of the nature of the demand and the nature of the supply.

Yes, we have 50 million in orders. Yeah. But that would all run through the disaster relief declaration that we made.

We do not have any guidance yet from the feds on that. Every morning it’s one of the first things we ask, and we’re hoping that we’ll get it at some point in the not too distant future because we know the clock’s ticking on that one.

Speaker 21: (48:19)
[inaudible 00:48:19] the parking lots at the beaches and the state parks happening today. I know people aren’t going to those places today, but what’s your message to people? Again, just all part of that collapsing down of where people should be moving about publicly.

I can’t stress how important it is for people to understand that the next three or four weeks are going to be very difficult ones. And people have done great work for the most part in dealing with the stay at home advisories and the essential business stuff and the small gathering orders and all the rest, okay? The message, whatever the details are is pretty clear, which is we’re supposed to do everything we possibly can to limit our exposure to other people. This virus can’t survive if it can’t jump from one person to the next, period. The reason for the order with respect to the beaches, which is basically, at least for the state operated beaches, a parking ban from this point forward is we heard from a lot of our colleagues at DCR and from many of our colleagues in local law enforcement and in local communities that people were not abiding by the rules and the guidelines associated with gatherings, distance, pretty much everything at the beaches last weekend.

And I heard from several mayors about it, I heard from folks at DCR and we just simply… Most of the time along this, we’ve tried to respect people’s willingness to play by the rules, okay? In this particular click case, we got a lot of input from a lot of places that people were not treating any of the distancing rules at the beaches the way they should have been. And our solution to that is if people can’t play by the rules, if it’s too big a temptation, then we’re just going to get rid of the parking. And if you can walk to the beach, okay. But you better be sure you abide by the rules associated with social distancing and recognize and understand that parking yourself at a beach on a blanket with a barbecue with 15 other people is just an incredibly bad idea at this point in time, given where we are and what’s going on. Thanks everybody.

Speaker 21: (50:44)

Do you have an update on Middleton?

Speaker 21: (50:57)
[inaudible 00:50:57] after a staff member and one of the residents both tested positive. Do you have any update on that?

So, we have a state epidemiologist and a nurse in constant contact with the Nashoba Valley Continuing Care Center, I believe is the name of it, in terms of ensuring that their protocols are in place. So, I don’t have a specific to what you’re asking, so I’ll just need to follow up with you. But we have daily contact with the assisted living facility in Nashoba Valley about what protocols are using and it’s a state epidemiologist and a nurse in constant contact with them.

Massachusetts Gov Charlie Baker COVID-19 Briefing April 2

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