Ohio Gov. Mike DeWine COVID-19 Toledo Press Conference Transcript November 18

Governor DeWine: (00:00) Can you guys hear me okay? Not the most ideal, is it? Governor DeWine: (00:05) All right. So I have with me today Dr. Brian Kaminski, who is the medical director of ProMedica [inaudible 00:00:11] Hospital. So I'm going to talk for a couple of minutes and turn it over to the doctor. He sees COVID patients every day. He's going to talk about what he's seeing, and what they're seeing in the hospital. I wanted to be here in Northwest Ohio today to really give you a report of what we are seeing. The fire is burning strong throughout NorthWest Ohio. If you look at every county, every county has a very high incidence of cases. This is a list, the different counties, and what you can see, you can't see it, what we have here is every single county in Northwest Ohio is at least five times as high as what the CDC says is a high incident level. Governor DeWine: (01:07) We've never seen anything like this. In the spring, we didn't have this. In the summer we did not have it. What we're now seeing is this virus permeating every part of the state. So early on, if you were in a rural county in the spring, you probably didn't see much of COVID. You might not have known anyone who had COVID. Today, you can't escape it. In fact, our small rural counties are hotter, they have more cases many times than even our urban counties. Governor DeWine: (01:45) So what do we do about this? Let me just start by saying what this threatens. This threatens keeping our schools open, our kids in school. When you have widespread community spread, it threatens the nursing homes and our loved ones in nursing homes. And it threatens our hospitals, and the ability of hospitals to carry out their function every single day. What are we doing about it? The curfew that we put in place will start tomorrow night at 10 o'clock. We hope that that will help. We believe it will help. But we're also asking everyone to pull back a little bit, pull back from your personal contacts with other people. The curfew in and of itself off will be helpful, but it's frankly just as important, could be more important, what people do in their individual lives. Governor DeWine: (02:44) So we're kind of back to basics. Wear a mask, keep some distance, but every day, I'm asking every Ohioan to find ways to pull back a little bit. Do some of the things that we did in the spring, when we said, look, we're only going to the grocery store once a week. We're only going to make this trip once. If you have the opportunity and you want to do carry out, do something kind, do carry out for your neighbor, take it over to their door. These are all things we can do during this time of crisis. And I think we have to look at this as a time of crisis. Governor DeWine: (03:25) There is great news, and the great news in the last few days, we have seen two pharmaceutical companies that are telling us they're almost to roll. We expect us to be getting some of the vaccine we hope in December. We're going to get that first out to our most vulnerable, that is the people in the nursing homes, we're going to try to really build a wall around our nursing homes, by getting people who work in nursing homes inoculated, getting them the vaccine, and really protecting our most vulnerable. From there, we're going to move directly into our medical teams that are out there in the forefront every single day, trying to protect us. Governor DeWine: (04:09) So let me just stop at this point and we'll wait until that plane takes off. Governor DeWine: (04:13) (silence) Dr. Brian Kaminski: (05:20) All right. Well, that was quite a welcome from the governor, I would say. Thank you, Governor DeWine. Thank you for your support, for your focus, and for all you've done as it relates to Ohio's response to the pandemic. We're very grateful for everything that we've received from the state. We're also grateful for our local health department, who served as a guiding beacon during the response to this pandemic, and we're grateful for our other healthcare systems that work in Northwest Ohio in a collaborative fashion in fighting the response to the pandemic. Dr. Brian Kaminski: (05:51) The impact has been wide [inaudible 00:05:53], as many of us know. We see people with no symptoms, we see people with very minimal symptoms, and we see people with severe illness, hospitalized, hospitalized sometimes in the ICU. And in the worst cases, we're seeing people actually succumb to the illness. We also see this group of patients that many people don't hear about, but we're going to be hearing about them more often. It's a group we call the long haulers. So people who get the illness, they survive, but they go on to have significant symptoms. We don't know the long-term impacts of COVID. What we're seeing is we're seeing people who contracted the illness even in the spring and are still having symptoms from this. That's a separate group of people that we're going to learn more about over time. Dr. Brian Kaminski: (06:34) COVID cases in Lucas County and the surrounding areas are trending upward at an alarming rate. The number of hospitalized patients in our system has increased dramatically. When I actually first wrote these talking points just two days ago, I was set to say that our rate of hospitalized patients has doubled. But unfortunately, I have to say now that our rate of hospitalized patients in the last three weeks has tripled. So you can see the increase and the concern that we have over the progression of the disease. We expect that number to grow, unfortunately. The number of patients being admitted to the hospital keeps going upwards. I just want to be very clear. There's no doubt that our hospital systems, our healthcare systems, will become overwhelmed. Dr. Brian Kaminski: (07:12) One of the reasons we're seeing such an uptick is the weather change. You can tell it's a cool day now. The humidity is down. We know that the disease transmits more easily in low levels of humidity. We fear that we're at the beginning of some of our darkest days yet, just because of this trend that we see. We don't know how bad things will get, but we know that how bad they get is generally up to the public and measures that we take to prevent the virus. More than ever, we need our community to come together, to take actions, to do those things that we know reduce transmission. Dr. Brian Kaminski: (07:45) There's a reason that you keep hearing us repeat the three Ws. We sound like a broken record, but washing your hands, watching distance, and wearing a mask really do make a difference. The science is out there. It's a minor inconvenience, but it actually saves lives. When a vaccine becomes available, it's going to be a great relief. Governor DeWine referred to a vaccine, and that is great news, but we're not there yet. We know that it's going to take up until mid to late summer to vaccinate all of our population. So we really need to buckle down now more than ever. Dr. Brian Kaminski: (08:19) You're also hearing a need to limit gatherings. I know we have the holiday season coming up, Thanksgiving and Christmas when people like to get together, but we want to strongly advise everybody to reconsider that. Reconsider spending time with people outside of your own household. We know that that takes a huge emotional toll, and we'd never ask it if we didn't think it was going to save lives. Dr. Brian Kaminski: (08:41) We also want to reassure you that our healthcare providers and our healthcare systems are doing absolutely everything they can across Toledo to work together to prevent the impact of this pandemic. We're sharing resources, we're sharing knowledge, we're sharing data. We work collaboratively. Even though we live in a competitive healthcare environment, there is no competition when it comes to this pandemic. We work closely and collaboratively, and it's a great relationship up here in Northwest Ohio. Dr. Brian Kaminski: (09:08) We also have surge plans in place. So all of our hospitals in our hospital system have surge plans in place to help increase capacity and to help us train our staff members so that we can maximize the use of our existing resources. That has its limits, as well. So it does not go on infinitely, and as the volume increases, we are concerned that we could run out of that resource, as well. Staffing is a major concern right now. Our healthcare workers live and work in our community, not only exposed in their work environments, but they're exposed at home, too, given how prevalent COVID is right now. If we don't have our workforce to help care for the patients, that's going to perhaps have the largest impact on care delivery across our region. When our healthcare workers are sick or when they have quarantined, it significantly adds to the burden we're already facing by the influx of patients that are coming in. Dr. Brian Kaminski: (10:02) ... burden we're already facing by the influx of patients that are coming in. Dr. Brian Kaminski: (10:06) There is another issue that we need to discuss. When patients come to the emergency room, they are treated for a number of different things, minor to very severe illnesses. What we've unfortunately seen is that because of the prevalence of COVID and some of the fear associated with that, we're seeing people neglect coming into the hospital for severe illnesses. Things like heart attacks, [inaudible 00:10:28] strokes, and they're delaying that care. That [inaudible 00:10:32] contributes to poor outcomes and longer hospital stays and even adds to the burden of patients being seen in the hospital and could prevent us from providing necessary care to other victims. So we want people to come in. Dr. Brian Kaminski: (10:44) We want to assure you that we have many safety measures in place when you come to the emergency department. We use all the protective equipment. We keep distance, we use air filtering devices. And what we find is that when we use those devices, people don't get sick. And when we apply those efforts, we actually prevent the spread of disease within the hospital. So we'd ask people to not have that fear. If you have a severe condition that would require you to seek care, please seek care. Dr. Brian Kaminski: (11:11) We also promise that healthcare workers are doing everything possible in our community to help us get through this, but we desperately need your help. We need the community to engage. The community to use those preventative measures and take these warnings so that we don't end up in a worse situation. We're already seeing this increase, but we're capable of flattening the curve. We've already done this once we can do it begin. So we really need everybody to pull together to start seeing an improvement and to reduce the spread and to get us back to our lives as we knew them. Dr. Brian Kaminski: (11:42) We're deeply grateful for all the sacrifices that everybody has already made. We're just asking everybody to keep on keeping on, because there is a light at the end of the tunnel. There is a vaccine, it is coming, we will get through this. And if we do it together, the support of the state, from Governor DeWine, the support of all of our local community members, the support of our local health department and our health system, we will get through this. So we thank you all very much for everything you've done. And now it's just time to buckle down more than ever. And I think that we can take questions. Speaker 1: (12:18) [inaudible 00:00:12:20]. Dr. Brian Kaminski: (12:24) We have a number of different ways that we serve both internally and externally and SeaGate Centre is something that we had in plans in the initial phase of this pandemic. So that is something that we can reactivate if need be, but we generally don't want to do that if we don't have to. So all hospitals in our area have the ability to surge from within to increase their capacity by using other spaces by cross-training staff members, to work in other areas. And it's much more efficient and much more effective to take care of patients in your own local environment with your staff members, then it is to externalize that. So it's our hope that we won't have to do that, but that is in the playbook and it's something that depending on the situation that we could activate. Speaker 2: (13:11) [inaudible 00:13:08]. Dr. Brian Kaminski: (13:22) Yeah, that's why predictive models out there that really show that we are not in the worst phase that we could be in. We happen to be in a worst state right now than we were at the peak of the pandemic when this started, but if you project this outward and you consider the number of people who have actually not contracted the virus yet and the amount of vulnerable people that are out there that are healthy right now that just have not met the virus, there is still a majority of our population that could still get sick and could end up needing hospital care. So the predictive models are concerning and if they play out, then we could be in much more serious situation. Dr. Brian Kaminski: (14:01) If you remember back to spring, some of those predictive models were very concerning as well, but we took a number of different measures that helped us flatten that curve and we didn't see what the prediction shows. So this is really the call to action and ask everybody to really do those things so that we can do it again. We did it once, we need to do it again here. We're much closer to a vaccine than we were before. So if we keep on doing those things then we can really get through this and get to a point where we can eliminate the disease. Speaker 3: (14:28) [inaudible 00:04:32]. Dr. Brian Kaminski: (14:46) Yeah. Well the concept behind flattening the curve is to reduce the rate of transmission. So the amount of people that are getting sick are getting sick at a slower rate so that you drive the virus down below its natural reproductive rate. If left unchecked virus reproduces at a rate of about three, meaning that for every one person who gets infected, they infect three other people. By using those methods, those preventative methods, wearing a mask, keeping our distance and all those things, we drive reproductive down to one or below. When it gets below one, it actually just starts to go away on its own and we suppress it to the point where it's no longer in our community. Dr. Brian Kaminski: (15:26) So we drove it down. We got to that point, but we also reopened. A lot of other things and went back to our normal lives because we were trending in the right direction. And then when we opened up significantly, we had an increase of a rate. Now you combine it with the fall weather and the fact that people are spending less time outside and getting together again, it's just surging at a rate that is trending towards a situation that could be unattainable for all of us. Governor DeWine: (15:53) Doctor, let me [inaudible 00:15:57]. Let me just try to answer that question as well. Look, Ohioans did exceedingly well in the spring, we did exceedingly well in the summer. We have, up until now, avoided any situation like we've seen in some other countries, that we've seen in other states where they've been overwhelmed to the healthcare system. So what is different about this? There's good news and bad news. And the bad news is it's more widespread now than we've ever seen it before. The goodness is there is help on the way. Governor DeWine: (16:32) For the first time we now see the end of this. It's not going to be for awhile, but we're going to start we hope vaccinating people in December. It's going to take a number of months until we get this out to the people in the state of Ohio to start really knocking this thing down, but help is on the way. And it's a good, I think very, very, been a good week where we've had two major drug companies announce that they're going to be able to come out with a vaccine that is 95% effective. Which is, the doctors tell me and the researchers telling me that it's a phenomenally high rate. Governor DeWine: (17:12) What I'm asking people to do, we have the curfew. We are now enforcing the mask in retail establishments. So those are two very, very strong things. But the third thing is we just need to slow down. We need to slow down our contacts. If we could reduce in this state, or everybody would try to reduce contact by 20, 25% over the next few weeks, one day at a time every day, just try to pull back a little. It will go a long way to reduce the spread of this virus. So we're in a critical dangerous time. We have [inaudible 00:17:49] counties in Ohio where in the last two weeks, one out of every hundred person has been diagnosed with COVID. So it tells us how widespread this is, but we can battle back. We battled back in the spring, we battled back in the summer. We can battle back again. Dr. Brian Kaminski: (18:08) Governor, there's been some criticism about this curfew. [inaudible 00:18:21]. Governor DeWine: (18:29) Well, you're absolutely right. It is about keeping people from getting together after 10 o'clock at night. Now this virus could spread anytime 24/7. We don't want to let the economy down. We don't want to have a total lockdown in Ohio. Why not? Well, there's a lot of bad things that happen when that happens. School would be out. No child would be in school. We know that that increases mental health challenges. We also know, for example, in the spring, when we had the shutdown evidence of child abuse reported went down. Now, I don't think anybody thinks child abuse went down, but the reporting went down because were not in school being seen by teachers. Governor DeWine: (19:15) We saw in the spring more deaths from drug addiction. The economic impact. So there's a whole bunch of impacts that we don't want to, if we can avoid totally shutting this state down. So [inaudible 00:19:33] what are the things that we can do? Last week we re-issued our mask order. It's always been in effect, but now we have inspected that. Northwest Ohio, every other part of the state who are going into retail establishments. And if you are a 65 year old person who runs the checkout and you've got diabetes, you have every right not to have people come in there who are not wearing masks and you're working eight, nine hours a day. Governor DeWine: (20:03) You're working eight, nine hours a day. It's only fair that everybody have a mask on. When you walk into an establishment today in Ohio, everybody should be having a mask on, unless they've got some medical exemption. That's fine, if they do. That will make a difference. We've seen in some of our rural counties, where we only have 20 or 30% mask compliance, we're going to take this up, dramatically. We add to that, what we're doing in regard to weddings, what we're doing in regard to funerals. Again, we're not interfering with weddings, not interfering with funerals, people can have what they want there, it's just wonderful. But, the meal afterwards has to be conducted in the same way that we conduct our restaurants, which is people wear a mask, except when they're eating. It means that people have to be seated. These are things that matter. We add on top that a curfew from 10 o'clock until 5:00 AM in the morning. Simply means that no retail is going to be open, other than maybe a grocery store here or there, maybe a pharmacy here or there. Everything is to be closed down, basically. Everything else is closed down, and just basically what it means is people need to be home. We think that will help, as well. Press: (21:26) Are you concerned some will say, "You can't tell me what to do. I want to go out. I don't want to wear a mask, either." What do you say to them? Governor DeWine: (21:26) To those who don't want to wear a mask, I would say if it was only about you, that's your decision. It's not about you. It's about you, and it's about everybody else. You can be a spreader, you can have it, you don't know you have it. That's what's so sneaky, so insidious about this virus, is that people many times have it, they don't have symptoms, but yet, they can spread it. For those who say, "I don't want to wear a mask." It's not about you. It's about all the people around you, and really it's the kind thing to do. It's the right thing to do. I look at this mask as an opportunity for freedom. It allows you to go out and do some things that you would not be able to if you were not wearing a mask. Press: (22:15) Governor, you were standing here a month or two ago, talking to the rural communities, talking to folks about masks, and [inaudible 00:22:28] Why did the message not resonate? Governor DeWine: (22:28) I think the message is starting to resonate. We're starting to get reports. I have people out about Ohio that people wear masks. After our announcement last Wednesday, about the enforcement of the mask rules in retail, we started seeing the increase in people wearing masks in retail. The further along we get, people see that there is more spread, now they're starting to know people who have COVID, starting to know people who have died from COVID. We didn't see that before. I think all of those things coming together, Ohioans are going to rally. We did it in the Spring. We did exceedingly well in the Spring. We did exceedingly well in the Summer. We dramatically increased in the summer, in July, mask wearing in our urban areas. We're now starting to see that come in our rural areas. I'm optimistic. I think the curfew is going to help. It sends the right signal. This is no ordinary time. This is an unusual time in our history. We've not seen anything like this in a hundred years, in Ohio. We get through. We got to hang in there, hang in there until the vaccine is here, and we start getting the immunizations throughout the state. Press: (23:42) [inaudible 00:03:48]. Governor DeWine: (23:42) That's a good question. I'm not ruling anything out. Our goal is to protect lives, try to keep people working, protect our schools, so that schools can educate our kids, protect our elderly in nursing homes, and protect our hospitals. Those are the essential roles that we have every day. I will do what I have to do to do that. I don't want to shutdown. What we want is a slow down. I'm just appealing to everybody. Slow down, pull back. Don't go out as much. Stay home more. These are the things that we need. And when you do go out, wear a mask. We'll wait. Maybe. Slow moving plane. Why don't you go ahead, I'll try to repeat it. Press: (25:04) [inaudible 00:25:07]. Governor DeWine: (25:17) My hearing is not as good as it was few years ago. We'll wait until it moves out. All right. Let's let's try it again. Sorry. Press: (25:44) [ inaudible 00:25:33]. Governor DeWine: (25:45) We don't have much time. We have very wide spread COVID in Ohio now. This is a train that continues to accelerate. It's math. The more people it goes to, it goes out faster and faster and faster. We know that. The faster it goes out, the harder it is to slow down. We also know we can slow it down, and we've got the tools. I think this is a time for Ohioans to rally, this is the time for Ohioans to say, "We got to slow this thing down." When I say our schools are at stake, I really mean that. What we're starting to see across Ohio is schools that are pulling back. I read just coming here on the plane, several schools pulling back, literately, yesterday and saying, "We're going remote now." They're having to do that because it's so widespread in the community. They're not able to find bus drivers. They're not able to get teachers. They've got too many kids quarantined. Governor DeWine: (26:45) I think what we have to do is think in our own lives, and the life of this state, what is important to us? What do we really value? Don't we value education? Don't we value protecting our grandparents, who are in a nursing home? Don't we value having the hospitals that are open, so that they can do the elective surgery, and the things that all of us need? All of these things are at risk. We need to rally. We need to do what we need to do. It could become a point where, yes, we will have to go to a shutdown, as we did in the Spring. That's not what we want to do. A second time is more harmful than the first time. Many businesses will simply go out of business if we do this. Governor DeWine: (27:32) Many people will lose their jobs, we'll have many more people unemployed. And, we have no backup unemployment coming from the federal government. One of the things we hope, and I've talked to many members of the Congressional delegation, we hope that they will get a bill, because a bill is very important. This lame duck session, there was no reason that Republicans and Democrats cannot come together to pass a bill, and that will help us a lot. Without that bill, things are very, very tough. Particularly, as this economy may slow down. Once it will happen, whether I order it or not, if people are afraid to go out, this economy just starts slowing down. We got to get a hold of this. Now, is a crucial, crucial time in our battle against this virus. A very crucial time. Press: (28:30) Governor. Governor. [inaudible 00:28:33]. Governor DeWine: (28:35) I don't think anybody really knows. We're going to start in December, but by the time... I heard estimates of March, April. By the time we get to the point where the average Ohioan, we can roll it out. We can get the most vulnerable populations as we go. For the average Ohioan, it could be late Spring. I don't think anyone knows for sure. I'm much more optimistic today than I was two weeks ago. We now have two vaccines, that are clearly moving, and that look like they're going to be coming out December and January. Press: (29:10) Speaking of rallying, [inaudible 00:29:10] 90 days in jail. What's your reaction to that? Governor DeWine: (29:24) First of all, no one has... None of our health orders have not imposed any jail time. Look, no one is going to be concerned if you take your dog out at 10:15, and walk outside, let it go to the bathroom, or take it a walk. No one is going to care about that. What we don't want is people coming together, and coming together where there can be spread. It's a time out. It's an opportunity for us to pull back for seven hours in a 24 hour day, to try to break this. For those who- Governor DeWine: (30:02) ... to try to break this. And for those who are critical of this, I understand, but we have to do some things in Ohio. And I would just say that lives are at stake. And it's not just lives. As the doctor said, he has patients. I just left a doctor in Cedarville who has patients who now have long term, apparently permanent medical problems because of this virus. They don't show up on the charts. They don't show up in the death category. They're recovered, quote unquote, so they don't show up if they're in the hospital anymore, but facing a lifetime that has been fundamentally changed. They may have a [inaudible 00:00:51]. Condition. They may have their ability to breathe compromised dramatically. So this is not some game. This is life and death. This serious. And we have it within our power to do some basic things that can knock this virus down. Dr. Brian Kaminski: (31:25) Well, the whole principle behind the curve, as you heard Governor DeWine say, is to reduce the time that we have people in contact with each other. We know that that is by far the most powerful way that this illness spreads. So people talk about surfaces and buildings and things like that. It's human to human contact that does it. And we know that after 10:00 PM, the type of contact that we see tends to be closer, more intimate. And when you mix that with alcohol, people's inhibitions go down, their likelihood to adhere to those measures go down. So with think that any of action that's going to reduce that human contact, we know factually, we don't need data to tell you that those types of things, reduce the spread of the illness. [inaudible 00:02:12]. Dr. Brian Kaminski: (32:20) Well, in a similar fashion to what Governor DeWine just described, as the state has a whole arsenal of things that they could use to help reduce the spike that we're seeing right now. The hospitals have that too. So that's just one other tool in the tool belt that we would deploy if needed and it's one of those things that we absolutely don't want to do that. We want to continue to provide the care that people need. We call them elective procedures, but sometimes they're extremely necessary. We say elective, just not emergency. They might be absolutely necessary. So those are the things that the community depends on. And we want to continue to do that, but it is one of those things that's on the plate as a tool to perhaps use in the event that we get to the point that we're becoming overwhelmed. [inaudible 00:33:12]. Well, a couple things. First of all, it's somewhat difficult to identify COVID. It sounds like it might be simple. We all know what the symptoms are, but sometimes people come in with symptoms that are just a little bit different, a little bit off. And after we do a little bit of investigation, we find COVID, but what we've done, and the benefit of going through this in the spring, is we've learned how to equip our facilities and how to create processes that protect the health care providers and protect patients and family members from being exposed. So we've changed the way that we handle air in our facilities. We've changed the way we put our patients in waiting rooms. We have separate areas. We've changed the way that our healthcare providers approach patients. Dr. Brian Kaminski: (34:16) We all wear a mask, if not an N95, then [inaudible 00:04:21]. And we have procedures for reducing transmission, not only to ourselves as healthcare providers, but to other family members. So we've benefited from having been through this in the first round, and we can use those techniques to all of the patients coming in, whether they have a suspicion of COVID or another illness or just coming in for an elective procedure, that [inaudible 00:34:42]. Just to protect everybody. [inaudible 00:34:47]. Dr. Brian Kaminski: (34:57) Yeah. Across the board we've had to do that. So every hospital in the system has a COVID unit and we had to expand it in a number of different hospitals that are all seeing COVID patients right now. Speaker 4: (35:09) Anybody else? [inaudible 00:35:18]. Governor DeWine: (35:35) Really, we don't want government knocking on people's doors and asking them what they're doing. So no, there's no way we can or should patrol what people do in their individual lives, but I think everyone should remember that when you're with someone, you don't know if they have a virus or not. And what is really human nature, what we find is human nature is that when we're with family or friends, we're not as careful. And so we just have to be careful that we can still do a lot of things if we wear a mask and just have to be careful about that, yeah. Anything else? [inaudible 00:06:20]. Yeah. This is six so in six days, I go from here to Cleveland and then Youngstown and Columbus. Cincinnati, I started at my home in the Dayton media market in Cedarville. So this is our second stop. And from here we go to Cleveland. So thank you all very much. Doctor, thank you.