Ohio Gov. Mike DeWine COVID-19 Press Conference Transcript December 7

Governor Mike DeWine: (05:42) Good afternoon, everyone. Our flags are flying it half staff throughout the state today, in honor and remembrance of those who died in Pearl Harbor, December 7th, 1941. 2, 403 Americans died, and we remember them today, and we remember all those who sacrificed in World War II. Governor Mike DeWine: (06:10) We'll go now to our data. Today, we're reporting 9,273 new cases in Ohio, that is the sixth highest count we've had to date. We have 336 new hospitalizations, and 40 new ICU admissions reported in the last 24 hours. We passed 7,000 deaths since the beginning of this pandemic, including the 63 deaths reported today. We're seeing somewhat of a flattening out, we hope, of the cases. Too early to tell, particularly with the aftermath of Thanksgiving, but it looks like that, certainly the rate of increase is slowing down as far as the cases. We know hospitalizations, we know ICU are lagging; they will like two to three weeks, sometimes more behind that. And so, we think that the curfew, as well as the masking order and the enforcement where we've seen a great increase in retail establishment across the state, we thank everyone for doing that. We think those two things have slowed this rate of increase, but it is still at a much too high level. I mean, as the heads of hospitals have told me, it's unsustainable at this level. So we've got to not only slow it down from going up, but we got to start taking it down. Governor Mike DeWine: (07:54) Let's look at the 88 County indicators again, you'll see all of these counties are of course in blue, which means that they're all higher than the CDC average, as far as the high incident level. [inaudible 00:08:12] County, as we will see here, is still at a very, very high rate, about 3:1. Eric, let's go to the next slide. Governor Mike DeWine: (08:26) I've asked the Department of Education to keep track of what's going on in our schools, as far as what schools are totally in-person, five days a week? What schools are totally remote? What schools are a combination of the two, or hybrid? As you will recall, this has been a decision that every school district has made at the local level. The community has made that decision, the school board, the superintendent has made that decision. What are seeing in the last few weeks is that because of the spread of the coronavirus, more and more schools are having trouble keeping bus drivers driving buses, having a hard time keeping teachers in a classroom, having a hard time with a number of kids who are quarantined. Governor Mike DeWine: (09:15) So if you look at these numbers, this is where we were as of last Thursday, December 3rd. And if you look over here, I'll start over here: full in-person, this is the percentage of districts, 40% of our districts. If you take it down to population, it's a little under 30%. So about 30%, 29.1% of our students today are in-person. If you go to a hybrid or partial again, 29% of the districts are that way now, and that's about 25% of the students. Full remote, completely remote, 30% of the districts, 44% of the students. So you'll see almost 70% of the students in the state of Ohio are now not full-time in-person. So this is something that has just occurred, district by district as districts are making these decisions. And I've talked to a number of superintendents who have told me why that is taking place. So I just thought that everyone would like to see where we are today, as we get closer to the Christmas break. Governor Mike DeWine: (10:41) Eric, let's go to the map. This map just kind of explains this as well. And again, this is by districts. So again, a five day in-person, usually the ones who are five days is kind of a lightest, vanilla color there, hybrid is the light blue, fully remote is the dark blue. And we have two districts closed all week, and these are the two that are there. So again, it just kind of gives you from a spacial point of view to see what is going on in our districts. At the beginning of the pandemic, we had limited options for testing. We relied on PCR tests, which are considered the gold standard for tests. In the spring, the Centers for Disease Control and Prevention began accepting antigen positive test results, if they included what's called an epidemiologic link. That meant, if you received a positive antigen test, you also had to have a known exposure to someone who was positive, or you must have had symptoms to be considered a probable case. And so, what is done is these calls are made to find that out, case by case. Governor Mike DeWine: (12:03) Since the spring, the Department of Health epidemiologists have been working closely with local health departments to verify links for those antigen tests. Once the links were verified, those tests were included in our probable case counts. After understanding more about antigen tests, the CDC changed their definition in August. As a result, antigen tests, according to the CDC, could be include in case counts without additional verification. However, here at Ohio, we continue to manually verify those exposures and symptoms before counting these tests as positive. Governor Mike DeWine: (12:42) During the past two months, however, a couple of things have happened. Our cases, number one, have skyrocketed. We have many, many, many positive people throughout the state. We have been averaging 12,500 antigen tests per day, with more positive results from those tests averaging about 700 positive per day on average, which means those 700 have to be verified. During the past four weeks, the volume of antigen tests has doubled in the positive results, which need to be reviewed at the state, and the local level, have increased from approximately 332 per day, to an average of 725 per day. Just as our hospitals are feeling the effects of the surge in cases, so are the Department of Health epidemiologists, and the local health departments. These teams alerted us about three weeks ago, that they were simply unable to keep up with the manual verification process for antigen tests, because there's such a wide spread of the virus throughout the state of Ohio. As we've noted on our website, since then we have thousands of antigen tests reports pending. Governor Mike DeWine: (13:57) Today, I'm announcing that tomorrow, tomorrow we will align with the CDC's current case definition, we will begin reflecting those tests immediately in our daily reported case counts moving. We currently have 12,600 positive antigen tests in our pending queue. To address these cases in our pending queue, we will apply this updated case definition to positive antigen tests, dating back to November 1, when these tests started increasing, and when these cases began to accumulate. Tomorrow, we will clear those backlog antigen tests, and they will be added to our reported case counts. That will result in a one day spike in reported cases tomorrow, and it obviously will be a very significant spike. These cases will be assigned then to their appropriate onset date, as all cases are. To be clear, all these backlog tests will not translate into new cases, not all of them. There'll be checked, and duplicate records will be removed. In other words, if two people with a similar name turns out not to be the same person, if it's showing up the same names and they verify a birthdate that's not that same person, that is cleared out. Governor Mike DeWine: (15:22) Additionally, we'll also be adding these test results to our positivity calculation in the coming weeks. That will not occur tomorrow, but that will be coming. As I mentioned, we have seen antigen test results become a bigger part of our overall picture of understanding COVID, and certainly a much bigger part of our testing. And it's important to capture that in our positivity calculations as well. Just like we were doing with cases on our website where you're able to look at probable and confirmed cases separately if you want to, we will also be allowing you to toggle between PCR only, antigen only, and combined for positivity. So it will be reported, you'll be- Governor Mike DeWine: (16:03) ... And combined for positivity. So it will be reported, you'll be able to see that positivity, however you want to see it, in any one of those three groupings. We will be reporting the combined rate as our default, and that's what you will see, the number that we'll be talking about, but anyone can still look at the positivity rates by test types if you want to and you want to see a more complete picture. Now, and then significant other Midwestern States, Illinois, Indiana, Michigan, West Virginia, are all combining Antigen and PCR testing into one positivity rate just as Ohio will do. Now I'll go to Lieutenant Governor Husted who's there? Jon, you've got some very good news for us today and I think it's something that I know I'm very, very excited about, something we've been looking forward to and something that the Lieutenant Governor has really focused a lot of his time on. John? Lieutenant Governor Jon Husted: (17:02) Yeah, thanks Governor. If you recall, a few weeks ago, Ohio was recognized and received an A grade as one of five states who had improved or received an A grade for the way we use technology to improve government services. And we were only one of four states to receive that A grade for data transparency. And at the time we got that score, I said I was surprised because we had a lot more to come. And today is part of the a lot more to come, part of this, we're announcing data.ohio.gov, which is really a first of its kind service for access and transparency of information in the state of Ohio. One of the things the pandemic has taught us a lot is that having access to good information helps improve our decision-making, and we want to do that across the board with state government. This collaboration was an InnovateOhio Platform collaboration to create data.ohio.gov, along with DAS, and it's also known as the Data Ohio Portal. This public facing portal will provide more than 200 unique data sets and more than a hundred interactive visualizations, to help you put it in perspective, to inform data-driven decisions for state agencies and their partners. A hundred of the data sets that are available there right now, because this is live, are there for the first time, there's never been access to them before. And frankly, we're just getting started, we hope to have all agencies on here eventually and thousands of data sets that the media, researchers, academics, the public, general assembly members, think tanks from the left and the right, everybody can take a look at it, challenge one another, but ultimately the goal is to have good information so we can make better decisions about the public policies that we're making in the State of Ohio. Lieutenant Governor Jon Husted: (19:09) Part of that new data that's on there, you'll see health data that's clinical, you'll see corrections data, employment data, nutrition data, education data, finance data, and certainly new COVID-19 data that we believe will be of value. And this collaboration also, I want to emphasize, focuses on security of all of that information and privacy of individualized information. The InnovateOhio Platform has four agencies that onboarded their data sets first, I want to thank them, because these agencies stepped up and were really interested in trying to make their information available to the public. That's the Higher Department of Health, the Department of Rehabilitations and Corrections, Department of Youth Services, and the Ohio Department of Higher Education. More to come, but these are the ones that stepped up and were able to get on there first. Lieutenant Governor Jon Husted: (20:06) I want to recognize those agencies for doing that, also the data portal will feature 25 Made in Ohio success stories which highlight the state's data-centric approach, so that's on there right now so you can see examples of how this data is being used to improve things. This is all part, if you all will recall, something Governor DeWine and I promised a long time ago, that we were going to use technology to improve the way that we perform government services, that was the InnovateOhio pledge. Governor DeWine signed an executive order a little over a year ago that was going to require all of the agencies to get on the InnovateOhio Platform to prepare this information, and they have, and we hope that this will be a central repository for all data and to give you access to data that you would have never had access to before if you're part of those groups I talked about and the general public. Lieutenant Governor Jon Husted: (21:10) So we encourage everyone to go take a look at it, I know that I took a little peek at some of the things that were on there live this morning. I was excited about it because there are just new insights and information that I had never seen before, so go to the portal at data.ohio.gov. And a reminder, we hope everybody will use it, this is for the media, this is for academics, researchers to identify these problems and solutions, because remember, one of the things that we want to make sure of in this day and age is we have more facts, we have more information, that we have more collaboration, that we give people, through this transparency and access, more confidence in decisions that are being made, that they're being data-driven, and that you will know what we know about these issues and why the decisions are made that they are, and that we can continue to learn, from each other, from this data, to improve the way we serve our customers, which are the people of the State of Ohio. Lieutenant Governor Jon Husted: (22:15) Governor, we got an A grade for the work that we've done so far with this, I hope we'll get an A+ because we're really trying to make access data transparency and use that data to improve people's lives, and I want to thank the InnovateOhio team and all the collaborators out there who got this launched today. A lot more to come, thanks for giving me a few minutes to go through that. Governor Mike DeWine: (22:36) Well, it is very exciting. The more eyes on information, the more you make that information available, you should get better decisions. And it's not just for the legislature, well it is for legislature. It's not just the executive branch, we can use it, the news media can take information, and many times frankly, when they have access to information, they will take that information and drill down it in a different way and it helps all of us make public policy. But it's not just for public policy, it's also for nonprofits. Let's say you're interested in education, let's say you're interested in early childhood development, the more data that is available that we can put out there, the better decisions can be made by everyone and people can decide what the priorities, not just of government should be, but what their individual priorities should be or that particular nonprofit or organization. Governor Mike DeWine: (23:32) So, very, very excited about that. One thing I did not mention, I talked this morning to Senator Brown and to Senator Portman. I had calls with both of them to get an update on what is going on in Congress. I issued a statement this morning calling on Congress to take action. I still feel that there's a deal to be had there and that people can get together. We saw the Bipartisan group come together with a package, whether that's the final package, I don't know. I just hope there is a final package and that's what I'm asking Congress to do, is to not leave town until they come back with a bill. What was done in the spring made all the difference in the world, not only in our ability frankly to fight the virus, but it made a huge difference in individual people's lives. Governor Mike DeWine: (24:27) And it matters a lot, it matters a lot for our economy. We know that the next few months, even though the vaccine is almost here, we know it's going to take a while to get it out and we know the next few months are going to be tough, they just are. So getting a bill out of Congress is very, very, very important. We're going to go now to Youngstown, our first guest today is Lisa Birch. She is a registered nurse, emergency room team lead at Mercy Health — St. Elizabeth in Youngstown. Thanks for joining us, we appreciate it very much. Lisa Birch: (25:07) [crosstalk 00:25:07] Governor. Governor Mike DeWine: (25:09) Take us inside, tell us what you do, tell us what your team does, and what are you seeing every day? Lisa Birch: (25:17) I would say we're definitely in the thick of it here. St. Elizabeth is a Level 1 Trauma Center, as well as a stroke center. We're busy at baseline, and lately we've had an influx of COVID patients so we're dealing with all of our regular patients and then all of the COVID patients on top of that. The hospital has been at capacity, so we're holding critically ill patients here in the ER for sometimes days at a time, so we're just really bogged down. Governor Mike DeWine: (25:51) So tell us a little bit about are you dealing directly yourself with these patients? Are you coming in contact with the COVID patients? Tell me a little bit what you do, what your day is like. Lisa Birch: (26:02) I am. So a lot of times I'm one of the charge nurses in the ER, but I'm registering ambulances, I'm providing one-on-one patient care. A lot of times when patients come in and they're in distress, it's all hands on deck so we're kind of all pitching in, we're all dealing with it here and it's definitely been a tough go. Governor Mike DeWine: (26:30) And so how are you holding up? That's got to be tough day after day after day, and how's everyone else holding up? Lisa Birch: (26:35) It's been extremely stressful. It's definitely been a long 10 months here. Like I said, we're dealing with our regular patients, on top of that we have the COVID patients. The morale is down among staff, we're exhausted, we're exhausted physically and mentally. We're definitely leaning on each other for strength at this time. Governor Mike DeWine: (27:03) What's the toughest part of what you do, just for you maybe personally? Lisa Birch: (27:10) I would say one of the toughest things is having the fear every day that we're going to take something home to our own families. It's just a very scary feeling. Governor Mike DeWine: (27:23) Yeah, that's got to be a constant thought, huh? Lisa Birch: (27:26) Yeah, definitely. Governor Mike DeWine: (27:29) Constantly thinking about, wow. Yeah, I can only imagine. Tell me about the patients when they come in, what condition are they usually in when they come in, the COVID patients? Lisa Birch: (27:46) Well, we see COVID patients with all degrees of symptoms. Some of them are mild and we're able to treat them accordingly. Other patients come in in respiratory distress, they require immediate attention. A lot of times we intubate those patients right on arrival and, or we utilize BiPAP as well, but those patients need immediate intervention. So like I said earlier, it's just all hands on deck. Governor Mike DeWine: (28:21) So I was talking this morning to all the health commissioners around the state of Ohio, and one things that they said that they were seeing, and it was being reported to them, is emergency response team come and get somebody at their home and they're already in pretty significant distress. And so they thought that maybe they were seeing more and more people waiting too long to call to go to the hospital. So what could you recommend? When should somebody, they're at home, at what point should they think about going to the hospital? Let's assume they have not reached out to a doctor and let's assume they have not had a test, but now they're starting to have have some symptoms. At what point should you get nervous about that do you think? Lisa Birch: (29:18) I would say that any time that there is significant shortness of breath involved or any type of respiratory distress, by all means call 911. You definitely need to be here. Mercy Health has done a great job of establishing flu clinics in the area, so we really encourage people to utilize those clinics for mild symptoms. It will definitely help us here in the ER to be able to treat the more serious patients in a timely manner. We just really need people to utilize the appropriate level of care right now. Governor Mike DeWine: (29:55) Okay. Well, please thank everyone, thank you for what you do every day. And anything else you want to say to the people of Ohio, and we'll let you get back to work? Think they'll still appreciate it. Lisa Birch: (30:09) I just want to say this is our plea for help, we need everybody to do their part. It's not only to protect yourself and your family, but it's to help keep us healthcare workers healthy so we can continue providing care. So by all means, wear your mask, wash your hands, stay socially distanced, just be responsible. Governor Mike DeWine: (30:34) We appreciate it, thank you for the message, thanks for what you do. Lisa Birch: (30:38) Thank you. Governor Mike DeWine: (30:38) We appreciate it very much, thank you. Our next guest is CJ Adams, a nurse manager at TriHealth Bethesda North Hospital, Southwest Ohio, serving Hamilton, Warren, Butler Counties, and parts of Indiana. CJ worked to help set up the COVID unit, she is also a captain in the Air Force Reserves. Thank you for joining us. We appreciate it very, very much. CJ Adams: (31:02) Oh, thank you for having me. Governor Mike DeWine: (31:05) Tell me what your day is like, what's going on there? CJ Adams: (31:10) Well, it's pretty busy. I'm the nurse manager over 2300 critical care at Bethesda North Hospital, so currently that encompasses two of our different COVID units. I have a Telemetry COVID unit which has 14 beds, and I also have a ICU COVID unit which has nine beds, so we are very busy and very full right now. Governor Mike DeWine: (31:29) Wow, wow, and being full, what does that mean? Are you reaching capacity and I guess the other question I'd like to know is how are you doing? You've been doing this for a long time and all your team, how are they holding up? CJ Adams: (31:49) So we're reaching capacity as well as staffing challenges. So being that we've been doing this for 10 months, I've had several team members who have been out themselves sick, as well as myself, I'm just coming back from a two week quarantine so... CJ Adams: (32:03) ... as well as myself, I'm just coming back from a two week quarantine. So we are full, bed capacity wise, as well as staffing wise. Right now my assistant nurse manager is actually working and the charge nurse role, and I will be doing so when I go in this afternoon. So very busy and very tired. The team is just exhausted. As the other nurse spoke, we've been doing this for a while and just burnt out tired, scared. There's still fear of when this is going to end, or how it's going to end and what that means for the face of nursing. So I think just fear is probably the biggest concern right now, and burnout in general, with just general health concerns that all the nurses are having for their own personal health/safety reasons. Governor Mike DeWine: (32:43) Yeah. Your experience in the military, how has that helped prepare you? CJ Adams: (32:46) It's actually done a great service for me right now. I think resiliency is probably one of the biggest things I've carried with me. Being a flight nurse in the Air Force, I have to be prepared to handle situations on my own, in an aircraft at 30,000 feet. So kind of like leading during a pandemic if you've never done it before, just being prepared for the unknown. So the lessons I've learned is resiliency and leadership, and being able to lead the team. Not just leading in front of them, but alongside of them, whether that's working shifts with them, whether that's buying pizza, because no one has a chance to eat. Whether that's making the phone calls for families to have that difficult conversation, if a patient codes. So really just doing whatever I can to be part of the team and help ease some of their stress and anxiety that they're having as well, I think are the biggest opportunities that the military has helped me during this time. Governor Mike DeWine: (33:37) Sure. Makes sense. So tell me, when you talk to patients, what do they tell you? Where do they tell you where they think they got it, the virus? Or what do they generally say? CJ Adams: (33:49) Some don't know. Others believe it has to do with family gatherings, church events, just getting together, going out to restaurants. People, sometimes they can pinpoint exactly where they were, or at least where they had their biggest chance of getting sick. But other times, people aren't sure. I've had some people who did all the right things and wore masks and socially distance. So their concerns are, "Did I pick it up on my groceries, or was it on a surface that I touched?" So it's a little bit of everything, especially as time has gone on. I think people either have a good general understanding of where they may have gotten sick, and others just aren't sure, and baffled as to why they were the ones who got sick, but they still followed all the rules. Governor Mike DeWine: (34:31) Sure, sure. And what about you seeing different ages in the hospital? How's that work? What are you seeing? CJ Adams: (34:40) We are. At first we were definitely seeing your typical older population. Definitely had comorbidities, or other illnesses that made them at high-risk categories. Right now we're seeing definitely more of your younger crowd. So when I say younger, I would say the forties, fifties, sixties, healthy. We consider them walkie talkie adults generally. So I think that's been the change more recently. When you're used to seeing the people who are more dependent, and now we're seeing those that are seemingly usually healthy. It adds to that fear that it really can and is affecting any and everybody, even your typical 40 year old that's completely healthy is now dependent on us to provide just the basic care for them. Governor Mike DeWine: (35:22) Wow. Wow. yeah, that's got to get everyone's attention, I would think. Anything else you'd like to tell us, we really appreciate your time and thank you so much for what you do. And if you can tell your team, we appreciate it very, very much. And we can only imagine what you guys are going through, but thank you for giving us a little insight into what you're seeing every day. CJ Adams: (35:50) Thank you. If there's anything else I think I would say it's just, this is very serious. It's definitely different than the first wave. We're seeing more people. We're seeing capacity issues. We're seeing staffing challenges and it's not just affecting COVID patients. If there's no beds in the hospital, it doesn't matter whether you have COVID, or you're having a heart attack. Everyone's being affected, because of the capacities that we're seeing. So please wear masks, socially distance, especially during the times for holiday seasons. I know everyone's tired and wants to be able to gather and get past this, but if we don't do what needs to happen, then we're just going to see this elongated further into 2021. So please do what's appropriate and what you can do, so we're no longer the last line of defense in the hospital. Governor Mike DeWine: (36:38) Thanks for what you do. We appreciate it very much. CJ Adams: (36:38) Thank you very much. Governor Mike DeWine: (36:38) We'll go to questions now. Speaker 1: (36:43) First question today, governor is from Laura Bischoff at the Dayton Daily News. Laura Bischoff: (36:47) Governor, can you tell us if vaccine data is going to be displayed on the dashboard, like the number of doses administered by category? And can you also give us some more detail on how the December doses will be prioritized within the 1A group? Governor Mike DeWine: (37:03) Sure. It's our intent to have it displayed. The technical team has not told me they can't do it. So I believe that they can do it. I told them that we wanted to see those numbers every single day. Now, how to those numbers will be, Laura, don't know. I don't know. A lot of this is what information is coming in to us. And while we want more information, we also want people to be able to get the shots out fast. So we'll be announcing exactly what that will be, but we hope to be able to give you a running count every day of how many people have received shots. Governor Mike DeWine: (37:47) As far as the scheduling within 1A, let me just kind of go through it a little bit and our team continues to work on it. But you're going to have, initially, a certain amount that's going to go to the 10 hospitals. We're writing for them, the priorities, but it's pretty easy priorities, in other words, what the mission statement is for priority, but it's pretty simple. It is, people who are most in danger, people who are in contact with people who have COVID, and this would not be limited to nurses or doctors, it would be anybody who, because of their job, is in contact with someone who has COVID. So that instructions will be given to the hospitals and then they will work off of that internally for those people who are most at risk. Governor Mike DeWine: (38:50) When we're dealing with the health departments, there will be some go to the health departments and the health departments again, there are certain groups they will be told to target, so EMS for example. And they will target that within their county. Another group, of course, a huge group is people in nursing homes, residents of nursing homes and people who work there. And again, that's going to be through Walgreen. That's going to be through CVS, and those shipments will go directly to them. We will work with them on a daily basis in regard to the priorities, but that is a scheduling issue at that point. Governor Mike DeWine: (39:43) In other words, you got a whole large group and then that's a scheduling where CVS will be reaching out to let's say a nursing home, or nursing homes and scheduling when they will be in there. And what we're requesting nursing homes do, and any other congregant care that's falling under that category, is for them to have everybody there. Bring people in if they're not working that day, because to get this out quickly and safely, one-stop there is what's needed. Now they'll have to go back, obviously for that second shot and that will take place. So, that's the best I can do to tell you how this is going to go. We've already set the priorities. Within that priority now, is a scheduling job. Speaker 1: (40:33) Next question is from Shane Stegmiller at Hannah News Service. Shane Stegmiller: (40:40) Thanks governor. When you talked to Senator Brown and Portman today, what were the things that you said you want to see in any kind of stimulus package that comes out of Congress? And what do you think of the bi-partisan proposal that's been circulating around for about a week or so now? Governor Mike DeWine: (40:59) Yeah, I have not looked at everything in the bipartisan proposal, but what I've seen, it looks good. Look, I spent 20 years in Congress. Everything is the art of the possible, art of the compromise, how you put something together. And so I don't expect this to be perfect, I don't... Governor Mike DeWine: (41:43) ... unemployment, some money there, money for small business, money in regard to so many other different, different things. So the priorities that you've heard talked about certainly are our priorities. I put a statement out, and listed some of those priorities. But doesn't have to be Mike DeWine's priorities. There's a general consensus out there of what is needed. And I was talking with both Senator Portman and Senator Brown today, as I said, in both about this, that I think sometimes it's been underestimated, the huge impact that the CARES Act dollars had, particularly in the spring, when they came out. It kept some businesses going, kept people able to continue to draw a paycheck, help with unemployment, help with the overall economy. Without those dollars coming in early on, it would've been just devastating, from an economic point of view, and from a human point of view. Governor Mike DeWine: (42:55) We are now in a very dangerous stage, again. December, January, February. There's no reason for any of us to think these are not going to be very tough months. Now the vaccine this year is coming and hope and help is on the way. And we're very happy about that, but we know it's going to take a while to work our way through that. And so December, January, February look very tough. We really desperately need a bill out of Congress. Speaker 1: (43:23) Next question is from Marty Schladen, at the Ohio Capital Journal. Governor Mike DeWine: (43:28) Marty. Marty Schladen: (43:28) Governor. I don't know if Lisa's still on, but you mentioned that critically ill patients are being held in the emergency room at her hospital. And I wanted to know if that's happening elsewhere in the state. And also, if we assume that new cases levels off at 9,000 a day, what does this look like in a couple of weeks in terms of being able to provide care for people who don't have COVID? Governor Mike DeWine: (43:56) Yeah. I'm going to let Bruce answer both of those questions. Dr. Bruce Vanderhoff: (44:01) Thank you, governor. First, in terms of the issue of patients in the emergency room prior to having a hospital bed, that's called boarding, and it is not at all uncommon during very busy times for there to be a period of time where they're preparing a bed, where a bed may not be immediately available and the care has to be delivered in the emergency room. Dr. Bruce Vanderhoff: (44:25) That's a process that hospitals are familiar with it. We don't like it, in the hospital environment. The best place for them is to get up to that bed, but it is a safe way to provide that care. It's an indication when it occurs of just how busy things are. And I think part of what you're hearing is that while those busy periods happen in hospitals, of late, what they're experiencing is a continuously busy hospital census. So there's no letup in what they are seeing. And I'm sorry, Marty, could you repeat the second part of your question? Marty Schladen: (45:10) Yeah. I just wanted to know, if we stay at where we are now, about 9,000 new cases a day, what's that look like in a couple of weeks? Can we sustain that? Dr. Bruce Vanderhoff: (45:19) Well, some of that is already evident in our hospitals. I think one of the first things that we'll begin to see is that the postponing of services like surgeries and diagnostic tests, will begin to happen much more frequently, much more widely. We're seeing some of that in our hospitals today, but I describe it almost like rolling electrical outages. It happens for a period of time, but then the hospitals are able to get those services back on track. As we get busier, that'll be one of the first things that we begin to see in our hospitals. Dr. Bruce Vanderhoff: (45:56) As things get even busier than that, then we begin to look at services in our hospitals becoming much more focused on just caring for the very sickest people, doing what we have to do to prevent immediate deaths. And that may require us to provide care in settings where you know what, we have to move to much more limited privacy in the hospitals. Going to double occupancy rooms, and even pulling providers from other parts of the health system. For example, providers who may be today focused on helping with outpatient care and keeping our primary care services open, we may have to redirect some of that. So these are very, very serious next steps that we would be looking at. Governor Mike DeWine: (46:55) Yeah, I would just add to that is, we're always two, three weeks away. And so continuing sustaining at this level, we hope that we've plateaued out. We don't know that we don't know how Thanksgiving is totally going to impact this. But the idea, even if we're plateaued out, this is not sustainable for a very long period of time. And it's going to have some very dire consequence. Speaker 1: (47:25) Next question from Luis Gill at Ohio Latino TV. Luis Gill: (47:30) Hello, governor. Governor Mike DeWine: (47:32) Afternoon, Luis. How are you? Luis Gill: (47:34) Yes, sir. Thank you for doing this. Governor, I'm going to give you a break, perhaps this question could be to Dr. Vanderhoff. As we get ready to receive the first shipment of vaccines, and we start doing the massive vaccinations on the health personnel. Are you... of the side effects on this personnel that perhaps five, 10, 15% of... Luis Gill: (48:03) Personnel that perhaps five, 10, 15% of them will we get the side effects at the same time, would that be a secondary problem? And a followup with that is fever, headaches, etc., how about if you get vaccinated with the Pfizer vaccine and then two, three weeks later, you get vaccinated with [inaudible 00:48:27] or Johnson and Johnson vaccine, are they chemically compatible? Dr. Bruce Vanderhoff: (48:31) Well, thank you for the question, Luis, and there are really two questions there. They're both very, very good questions. So the first question is, well, what about the side effects of the vaccine? And it's very important to draw a distinction between side effects, which we expect, and adverse effects, serious adverse effects, which we really don't expect. When a vaccine is really working, when it's had the kind of impact you want it to have on generating a robust, good immune response, you would expect that there are going to be some transient side effects. Dr. Bruce Vanderhoff: (49:09) You might have some headache. You might have soreness at the injection site. You might feel tired for a day or two after you get that a vaccine. That's actually a good sign. That's an indication that your immune system has recognized this, it's reacted, and you're probably mounting a very good, very robust immune response. On the other hand, very serious adverse effects, much more dangerous things, we're just not seeing with these vaccines. And notably usually within six to eight weeks after the administration of a vaccine, you'll see those very worrisome, adverse effects that have not been seen. Dr. Bruce Vanderhoff: (49:53) So that's the first part of your question. In terms of administering one brand of vaccine and then following it up, the current expectation is that a person will receive two doses of the same brand of vaccine. And that's how our planning is going. That's the early guidance that we've received. And by the way, that is very typical when we are looking at vaccines that come from differing manufacturers. So currently, that's the view. Speaker 2: (50:28) Next question is from Dan DeRoos of WOIO in Cleveland. Dan DeRoos: (50:33) Good afternoon, gentlemen. First question for the governor and possibly for Dr. Vanderhoff. Governor, you sent out a pretty ominous tweet on Friday saying we need to do more. Can you explain what you mean by more? Is it just more of the distancing, social distancing, mask? Second, has there been any discussion when it comes to the vaccine of not vaccinating people have tested positive, had symptoms, recovered? Because aren't those people producing their own antibodies and couldn't we stretch the vaccine further if we're not giving it to people who have already had it? Governor Mike DeWine: (51:12) I'll let the doctor answer the second one. I'll do the first one. Simply meaning, we've made real progress with masking in retail. I think people have pulled that back some. We just have to do more of that. We have to reduce the number of our contacts with other people. So that's all I meant. But, we need to do it. We need to pull back even more because the more contacts there are, the more potential there is for the spread. So masking at all times. Look what the CDC just said. If you're in a house with somebody else, you're inside with somebody else, that's not in your household, you need to have a mask on. Governor Mike DeWine: (51:56) And even if you've got someone in your household and you're going back and forth, you got to be careful with that. You might have someone that has a high risk in your household. So just pulling back more is really what I was talking about. Doctor, you want to take the other question? Dr. Bruce Vanderhoff: (52:11) Yes, Governor, thank you. The Advisory Committee on Immunization Practices, that's the ACIP, they will be providing very specific guidance regarding who should receive the vaccine, who should not receive the vaccine. And your question about vaccination after having had COVID-19 will be addressed by them. But, I fully anticipate that they are going to advise that everyone who is otherwise eligible consider receiving the vaccine, even people who have had COVID-19. Because the immunity that is generated by these vaccines has every indication of being a more robust immunity, the kind of immunity that we would hope or anticipate would be longer lasting. Speaker 2: (53:10) Next question is from Geoff Redick at WSYX in Columbus. Geoff Redick: (53:16) Good afternoon, Governor. You talked earlier about the curfew having helped to create a slowdown. That curfew is set to expire later this week, in fact on the same day you usually hold your next briefing. Do you have any indication before then whether that curfew order will be extended or some other measure might be taken? Governor Mike DeWine: (53:36) Well, no. It will need to be extended. We'll talk more about that Thursday, but it'll need to be extended. Speaker 2: (53:44) Next question is from John London at WLWT in Cincinnati. Governor Mike DeWine: (53:48) Hey, John. John London: (53:49) Governor, I'm wondering what you see there because there's so many businesses, bars, restaurants, and just regular citizens, really on pins and needles about the next few weeks as we come into the Christmas holiday with travel and everything else. And I wonder what you see numbers wise for the rest of this week, next week and the week after, and maybe Dr. Vanderhoff as well, to avoid any further limits? Where do those numbers have to be? Because both of you are saying that right now at the current level, that's not sustainable. Governor Mike DeWine: (54:29) Yeah. We're at a very ... I'll start and then get the doctor on. But, these numbers are just not sustainable. No one thinks they are. If we keep, even if we're flat, we're in just be filling up our hospitals. And we've got to try and take this down. I think we know what we know what works. High ones, if you look at ODAT travel, for example, and Thanksgiving, you saw that this Thanksgiving versus last, the number of miles driven went down significantly. You saw the cell phone data showing activity that weekend. So we still may have a big bump from that. I'm not saying we won't, but it certainly Ohioans, we're doing better and understanding what the problem is. Governor Mike DeWine: (55:21) And I just think more and more Ohioans understand that this was a crucial, crucial period of time. But Bruce, you want to make any? Dr. Bruce Vanderhoff: (55:29) Yes, Governor. I think what I'd add to that is the national picture isn't very good. The White House Coronavirus Task Force has indicated that the country's in a very dangerous spot because of the very high COVID baseline activity and its impact on hospital capacity. But I would go further and note that if that's the case, there are a number of indications that Ohio is worse. The rate of new cases in Ohio, according to the White House Coronavirus Task Force, is in the neighborhood of 160% of the national average. Dr. Bruce Vanderhoff: (56:10) When we look at that national map that shows that the rate of positivity on our testing, all of our neighboring states, except Pennsylvania, have lower rates of test positivity. Meaning, we're now the state that the other states are advising people to avoid travel to. You put all of that together, and you have a picture of us having had some degree of success in slowing the rate of increase. That's good. But I think that as the governor indicated, we're going to need to go further if we're going to even get to a flattening. Speaker 2: (56:57) Next question is from Jessie Balmert at The Cincinnati Enquirer. Jessie Balmert: (57:01) Hello, Governor. Governor Mike DeWine: (57:02) Jessie. Jessie Balmert: (57:02) There've been two to three state lawmakers who have tested positive for COVID in the past week after being at the State House. So I guess my question is, is the State House a safe place for citizens to visit right now? Or do you have any recommendations to fellow public officials about this disease? Governor Mike DeWine: (57:22) Well, her recommendation has always been the same, that is everyone wear a mask. If people are inside, they need to wear a mask. If you're not with your family, any public place, you certainly need to wear a mask. And that guidance is certainly not changed. Speaking of the members of the General Assembly, we had a good call, I think, this weekend with the leadership, some of the leadership, giving them a briefing on where we are with the virus. And we're going to continue to give members of General Assembly briefings on the virus. Governor Mike DeWine: (58:03) I think it's good for them to get directly from the doctors who are dealing with this and let them know exactly what's going on. Speaker 2: (58:12) Next question is from Justin Dennis at mahoningmatters.com. Justin Dennis: (58:18) Hello, Governor. How are you doing this afternoon? Governor Mike DeWine: (58:20) Justin. Justin Dennis: (58:22) Mahoning County has one of the highest COVID-19 death rates in the state, far worse than other similar sized counties. County also has a comparably high prevalence in mortality rates for diseases and medical conditions considered to be COVID-19 comorbidities like obesity, diabetes, heart disease. What are medical experts learning about the correlation between a community's overall health outcomes and the threat COVID-19 poses in that community? Governor Mike DeWine: (58:49) I'm not doctor. I'll turn it over to the doctor. But what everyone in the medical community has told me is obviously that creates more problems. The higher rates of the comorbidity that you have, the more dangerous it is. Doctor. Dr. Bruce Vanderhoff: (59:08) Governor, you said it very, very well. I don't think I could add much to that, but we know that there are risk factors for COVID-19 and they include obesity and respiratory illnesses, etc. Those comorbidities that exist inside the community impact the community's ability to weather the COVID storm. Speaker 2: (59:38) Governor, next question will be the last question for today, and it belongs to Farnoush Amiri at the Associated Press. CJ Adams: (59:43) Hi, Governor. The question I wanted to ask is what pressure, if any, are you getting from grocery and restaurant industries to move their employees up on the priority list for the vaccine, given that they provide essential services? I know many people in the state, the grocery store is the only place that they go to these days. And if you've been receiving pressure from them, what is your response? Governor Mike DeWine: (01:00:10) Well, I've really not received any pressure. I don't know whether I've received any emails. I have not read any, at least in the last few days. I think it's when you look at the 1A group, there's kind of a consensus of the most vulnerable people and the consensus that we need to take care of the people who are taking care of us and who are taking care of the people who have COVID. When you get to the next group, the next group is where I think a lot more, it's going to be more difficult. You're going to have more difficult discussions. Governor Mike DeWine: (01:00:46) Who do you prioritize next? And I think looking at who, because of their age, because of their occupation, because of any other reasons, because of their medical condition, who are the most at risk, it's going to be we're going to have to look at that and look to see who is most at risk. And one things that you talked about is see someone in the grocery store who is seeing hundreds and hundreds of people every single day. I'll leave this up to the doctors to tell me, but one would assume, I would assume as a lay person, that that person is subject to significant risk. Governor Mike DeWine: (01:01:31) So that's the type of analysis that we're going to have to have. So I appreciate the questions. Good to see everybody. We appreciate two guests today, and unless there is some emergency, we look forward to seeing you back here on Thursday at 2:00. Thank you very much.