Ralph Northam Virginia COVID-19 Press Conference Transcript April 29

Ralph Northam: (00:00) ... Basis so that workers are able to be separated and protected from each other. I appreciate that guidance. I want to be clear that my number one concern here is our workers. Every one of them is a human being whose health deserves our protection. The majority of these workers have low incomes and are from communities of color. These factors place them at a higher risk. I am very concerned for them. Ralph Northam: (00:32) We took important steps this year to help workers like these. We raised the minimum wage in Virginia. We passed legislation to allow people who are not yet citizens to have driver's licenses. And we're working to make sure the expansion of Medicaid helps as many Virginians get access to healthcare as possible. Ralph Northam: (00:53) I grew up on Virginia's Eastern shore and I know how important these industries are. I fully understand the importance of meat processing facilities on our food chain and on Virginia's agriculture economy. And I thank the hardworking farmers, processing employees, truck drivers, grocery store workers, and all the members of this complex supply chain for their work to ensure that all of us continue to have safe, nutritious food during the midst of this health crisis. Ralph Northam: (01:28) But I also want to be clear that this depends on workers who are healthy and who are safe. If we declare that workers at meat processing plants are essential, then it is imperative that we continue to support their health and wellbeing. I was on a call earlier today with Agriculture Secretary Sonny Perdue to raise this very issue. Ralph Northam: (01:54) I sincerely hope that with this executive order, the President is signaling that the federal government will play a much larger role in keeping the employees of these meat processing plants safe and provide federal support to ensure every worker has protection, including adequate PPE. Ralph Northam: (02:14) I'm also instructing Virginia's Department of Health and Department of Labor and Industry to work with the plants to ensure they implement the CDC guidelines to protect our workers. They will work with the US Department of Agriculture along with the CDC, OSHA and the FDA, as well as state and local officials to affirm that facilities are following CDC and OSHA guidance. Ralph Northam: (02:41) We should know more about the situation in Virginia's poultry plants in the next few days. As our team and the CDC team works together to fully assess what is going on in the plants. We fully expect that all employees in these food processing plants will be tested and that those who need medical care have adequate access and a safe place to go if they need to be isolated. Then we'll have a much clearer idea of the needs of those facilities and what our next steps should be. Ralph Northam: (03:16) Accomack County has 229 positive confirmed cases as of this morning. So time is of the essence to stop the spread and protect our workers. Now I'd like to move to the issue of elective surgeries. Five weeks ago, Virginia Health Commissioner, Dr. Norm Oliver and I signed public health order two, which temporarily prohibited elective surgeries and limited dental procedures. Ralph Northam: (03:48) I sincerely appreciate the cooperation of our healthcare providers and our healthcare facilities. We did this to preserve our PPE for our frontline workers in our hospitals and prepare for a surge if that were to occur. I want everyone to remember where we were six to eight weeks ago. Our case counts and hospitalization rates were rising. We were worried that our hospitals would be overwhelmed by a surge in cases like we were seeing in Italy and in New York. Ralph Northam: (04:22) We were planning at that time how to build alternative care facilities. Around the country, people were worried that we'd run out of PPE and that our nurses would have to resort to wearing trash bags. We found that is totally unacceptable. Because everyone has worked together, we have avoided that. Our efforts to slow the spread of this virus are showing success. Ralph Northam: (04:48) Our hospitals have not been overwhelmed. We have been able to get more PPE and developed ways to decontaminate mask and gowns. Hospitals have ramped up testing with a much quicker turnaround time. Early on, remember? Test results were taking more than a week and now in most cases, it takes less than a day. Together we took the right actions and they have been successful. We slowed the spread of this virus for weeks. Ralph Northam: (05:22) Our teams have been in contact numerous times a day working together. Now hospitals and dental facilities are prepared to restart non-emergency procedures safely. They have worked four weeks to prepare to reopen and they are ready. And I want to emphasize and underline the word safely. Ralph Northam: (05:43) As I said on Monday, our hospitals, our clinics, our dental offices, these are safe. These are clean places to go. And so while we have been through this pandemic, I want to encourage all Virginians that your healthcare's important and I encourage you to resume that healthcare, and we will together do it in a safe manner. Ralph Northam: (06:03) So today, I'm announcing that elective surgery and dental procedures can resume when the public order expires at midnight tomorrow night, with guidelines in place to ensure safety for healthcare workers and patients and to maintain an adequate supply of PPE. We know that dental issues can affect the rest of the body, so it's important that dental facilities are included in this. Ralph Northam: (06:32) The Virginia Dental Association issued new guidelines to their members yesterday. I'd like to introduce Dr. Elizabeth Reynolds to discuss how dentists are planning to safely move forward. And before she comes to the podium, we have had a great relationship working together to be able to get where we are on Friday. And I would just like to thank Elizabeth and all the dentists across the Commonwealth of Virginia for their cooperation and also for taking such great care of our fellow Virginians. Dr. Reynolds. Thank you. Dr. Elizabeth Reynolds: (07:10) Thank you. Thank you, Governor and Dr. Carey for your administration's close contact with dentists and other health care providers in response to this crisis. I would also like to thank the dentist, the dental hygienists, the dental assistants, and front office teams for their professionalism and dedication to patients as we've continued to see our emergency patients here in the Commonwealth. Dr. Elizabeth Reynolds: (07:32) As you may remember, and as the governor mentioned earlier, the Virginia Dental Association issued a recommendation to its members on March 15th to postpone elective procedures. Our goals were to preserve the much needed PPE for our medical colleagues and hospitals and EDs, to keep our dental emergency patients out of the hospital system and to develop new guidelines to protect our patients and providers in a dental office setting amid this unprecedented and unknown crisis. Dr. Elizabeth Reynolds: (08:03) That said, as the Governor alluded earlier, we all recognize that the longer dental practices remained close to preventative and non-emergent treatment, the more likely that our patients untreated dental diseases will progress, increasing the complexity and cost for treatment. Dr. Elizabeth Reynolds: (08:21) As dentists, we have a tremendous ethical responsibility to both our patients and our dental teams. For that reason, we have worked tirelessly over the last month and a half with the governor's office to address issues like access to PPE, liability for healthcare workers. Thank you, Governor for your executive order signed earlier this week, and on returning to work as quickly and as safely as possible. Dr. Elizabeth Reynolds: (08:46) When the Governor's order is lifted at the end of the month, Virginia dentists will be following detailed interim guidelines from the ADA, the VDA, the Virginia Department of Health and the CDC to keep patients, dentists and our dental team members safe. The safety of patients, dentists and dental team members has been and always will be our utmost concern. Dr. Elizabeth Reynolds: (09:10) So as we begin to open our offices for non-emergent treatment, I too encourage Virginia ans to contact your dental health care provider if you have an oral health need. Some but not all offices will be resuming regular operations at the start of May and they can work with you to make sure that your needs are addressed. Dr. Elizabeth Reynolds: (09:29) Also, please know that dental offices have always been leaders in infection control and our offices now have new protocols in place to minimize the risk of transmission of the coronavirus. Those protocols will include measures like wearing masks to your visits, screening specific for COVID-19. Adjusting appointment times and schedules to allow thorough cleaning between appointments and minimizing or even eliminating patients in the reception area. Dr. Elizabeth Reynolds: (09:58) Also, in the coming weeks, most dental practices will be giving priority to those whose dental needs may precipitate urgent or emergent care if not addressed sooner. They will be giving special consideration to patients who have high risk for COVID-19. They will be minimizing the use of air and water to minimize aerosols and will be wearing different forms of protective equipment to minimize transmission. Dr. Elizabeth Reynolds: (10:23) Though access to certain PPE continues to be an issue for some practices, we continue to work with our suppliers and with the Governor's administration to address these shortages. We are excited and prepared to open our offices and begin safely seeing our patients for comprehensive care. Dr. Elizabeth Reynolds: (10:41) So again, I encourage anyone who may have had to postpone dental treatment or may be having a dental issue, to call your dentist now and work with him or her to develop a treatment plan. I know I speak for all my colleagues when I say we can't wait to get back to seeing our patients. It's what we do and this is what we love to do. Dr. Elizabeth Reynolds: (10:59) So thank you again, Governor Northam, Secretary Carey for your continued encouragement and engagement with the healthcare professions. We look forward to working with you and your office to be a part of the solution as we move forward with testing and a vaccine and the ultimate eradication of the coronavirus. Thank you. Ralph Northam: (11:19) Thank you, Dr. Reynolds. I really appreciate it. Dr. Elizabeth Reynolds: (11:19) Thank you. Ralph Northam: (11:23) Well, thank you Dr. Reynolds. In the past weeks, everyone in our healthcare system has really stepped up. They preserve PPE and found new resourceful ways to decontaminate it. People have followed our stay-at-home order and we are flattening that curve that we often talk about. Our hospital census levels have remained steady. So now it is time for our hospitals to resume non-emergency activities. Ralph Northam: (11:52) This is important because elective often means non-emergency. Elective surgeries include everything from knee replacements to some cancer treatments. These are procedures that can wait a while, but certainly not forever. I know Virginia's hospitals are committed to our ongoing partnership and I want to assure Virginians that if we begin to see cases and hospitalization rates rise again, we're all prepared to take swift and necessary action. Ralph Northam: (12:24) Now I'd like to ask Dr. Michael McDermott, President and CEO of Mary Washington Healthcare to give more detail on how our hospitals will move forward. Dr McDermott, thank you so much. Dr. Michael McDermott: (12:39) Thank you, Governor. Good afternoon. I'm Dr. Mike McDermott. I'm the President and Chief Executive Officer of Mary Washington Healthcare in Fredericksburg, Virginia and I'm Chairman of the Virginia Hospital and Healthcare Association's board of directors. During this pandemic, I've also had the privilege of serving as Chairman of the VHHA COVID-19 Committee and as co-chair of the joint Virginia Department of Health, VHHA COVID-19 Committee. Dr. Michael McDermott: (13:07) I'd like to start today by also expressing my gratitude to the Governor and the administration for the executive order addressing some of the liability issues that could arise in response to this COVID-19 crisis. I want to start by also expressing the hospital community's gratitude to G Northam and his administration for the incredible partnership and collaboration of this unified COVID-19 response in the Commonwealth of Virginia. Dr. Michael McDermott: (13:37) This has been an inclusive process and it involves countless stakeholders and diverse perspectives as we all work together to protect Virginians from this highly contagious virus. Everyone involved in this effort recognizes that this pandemic has had a significant effect on the Commonwealth, this nation, and the world, that includes the many patients and families that have been directly affected ... Dr. Michael McDermott: (14:03) ... COVID-19, and the frontline healthcare providers and first responders who continue to give their all in the fight against this illness, but the effects of this very serious situation also extend well beyond that. It has touched everyone in some way. Having worked closely with the governor and his team, I know that governor Northam is focus, throughout these unprecedented and trying times, has been exactly where it should be, on public safety and on the health of our communities across Virginia. Dr. Michael McDermott: (14:37) As we have worked through the many challenges associated with this pandemic, from access to testing and personal protective equipment to ensuring adequate treatment capacity and many other issues, the governor has been a steadfast ally in this coordinated response effort. Because this is unchartered territory in many respects. We have all had to make adjustments as this pandemic has unfolded and it shifted on a daily basis. Early on in the process, Virginia hospitals took the precautionary step of postponing non-emergency medical procedures to preserve PPE and to create additional treatment capacity in our facilities. This step taken by the hospitals was consistent with Governor Northam later order calling for a halt to such procedures throughout the Commonwealth. Dr. Michael McDermott: (15:29) When we talk about non-emergency procedures, I think it's important to define what we mean. They include things like cancer surgeries and many other scheduled procedures, and forms of preventative care that are important to the health of patients who need these types of medical treatment. While those scheduled procedures have been on hold, Virginia's hospitals and healthcare providers have been working diligently to care for COVID-19 patients and to secure the necessary supplies and resources such as PPE and expanded testing capability to support patient care during the response effort. Dr. Michael McDermott: (16:10) Throughout this ordeal, the Commonwealth and healthcare providers have actively monitored the real world conditions and situational demands caused by COVID-19. As we consider the current situation and the other medical needs of Virginia patients, we now believe the time is right to chart a path to begin providing non-emergency scheduled procedures to people who need that care in inpatient and outpatient settings to improve their health outcomes. Dr. Michael McDermott: (16:42) Virginia hospitals have more than 5,000 available beds to meet patient needs and continue the care for those impacted by COVID-19. Access to expanded testing continues to be an area of focus for the governor and for healthcare providers as our PPE supplies. Our hospitals follow best practice care and infection prevention protocols and are exceedingly safe facilities. It is important for all Virginians to know that if you need care, please do not hesitate to receive care to improve your health outcome. Dr. Michael McDermott: (17:20) The hospital community will work within the federal state and specialty group framework to guide us as we prepare to move forward with resuming scheduled procedures. This framework positions us to safely and responsibly take these next steps in a manner that is consistent with health care best practices. As we proceed in this direction, we will continue to work closely with Governor Northam and his administration to monitor the number of patients hospitalized for COVID-19 and other conditions, to track testing and PPE supplies and to protect the safety of our frontline caregivers as we work to slow the spread of this disease. And working together, we will be ready to adjust our approach in response to new challenges we may be confronted with as we continue to fight this very serious virus while meeting the health needs of our fellow Virginians. Thank you. Ralph Northam: (18:24) Thanks so much Dr McDermott. I'm grateful to our hospitals and dentists for their efforts to support public health during this difficult time. I'm also grateful to our veterinarians. Many of them voluntarily stopped doing any surgeries that required PPE so that they could donate that to those on the front lines. Our veterinarians have continued to care for animals throughout Virginia during this crisis, implementing social distancing and I would like to thank them for their full cooperation during this challenging time. And on just a side note, our two Labrador retrievers, Murphy and Virginia Pearl, love their veterinarians, and thank them as well for their cooperation. Virginia's veterinarians are allowed to provide the full array of services their patients require while using public health best practices. Ralph Northam: (19:22) Finally, I want to move to an entirely different topic, but a good news topic, and that is our student loans. The Federal Cares Act allowed many people with student loans to delay payments during this crisis, but that only applied to people with certain us government owned loans. Virginia is joining several other States in an initiative to help an additional 200,000 Virginians with commercial federal family education loan program loans, Perkins Loans or privately held student loans. Lenders will provide a minimum of 90 days forbearance on loans and waive late payment fees among other actions. This is great news for the 200,000 Virginians that are affected. Ralph Northam: (20:16) I want to close by talking about our resource challenges. A few weeks ago, we were tremendously concerned about whether we would run out of hospital beds and PPE, and we had very limited testing capacity. So we focused on testing the highest priority patients in our hospitals to help us manage capacity and ensure that doctors and nurses and other caregivers weren't burning through PPE with patients who might be negative for COVID-19. Now we have more testing capacity and we're able to ramp up our testing of moderate and low risk patients as well as priority groups like nursing homes and our first responders. Ralph Northam: (21:03) Dr Karen Remley will be here on Friday with a more comprehensive update on our testing strategies and capacity. I'd like to turn it over to Dr. Oliver, but before I do, I will remind all of you that we receive input from various forms, individuals through various means, and one of the things that has been requested is that our data be reported via zip code in Virginia. And so I'm pleased to report, and Dr. Oliver will address this as well, that from here on data will be reported via zip code. So Dr. Oliver, welcome. Dr. Norm Oliver: (21:46) Thank you governor. Good afternoon. As the governor said, we will be presenting that data at the zip code level going forward. It will take a few days for us to do the data transformation that will be necessary to present that, so it won't happen immediately, but you should see that in the next few days, and then going forward. I want to give some statistics on the current numbers regarding COVID-19. Total cases now come to 14,961, that's 622 new cases in the last 24 hour reporting period. Deaths stand at 522, and that's 30 new cases in the last 24 hour period. Dr. Norm Oliver: (22:34) We have currently 206 outbreaks of COVID-19, we consider an outbreak two or more cases in any given site. And of that 206 outbreaks, 116 of them are in nursing homes across the state, actually longterm care facilities, so that would include assisted living facilities. In those 116 outbreaks in longterm care facilities, 1,407 cases are accounted for there and 111 deaths. We continue to try to give reports on the racial and ethnic breakdown on cases and deaths. Dr. Norm Oliver: (23:21) As you know, we have had challenges over the weeks in getting complete data on that, for both the cases and the deaths. The number of cases for which we do not have that information is now 4,751. The number of deaths without the racial and ethnic data is 68 for a percentage of 32% in the cases and about 13% for the deaths. For African Americans, the cases, the proportion of cases that we have where it has been reported, is 27%, and for deaths is 26%. We don't have a good breakdown today of that for Latino population, we are working on that as well, and I expect by the beginning of next week on both our website and here at the [inaudible 00:24:21] we'll be able to report that out to you. Thank you very much. Ralph Northam: (24:26) Thank you Dr. Oliver. We'll be glad to take your questions. Speaker 1: (24:27) First question is from Tim Barber with WJLA. Tim Barber : (24:35) Hey governor, we know you were talking to business leaders the other day about possibly doing a regional reopening, opening sections of Virginia one at a time. Would that be by County Health District or something else, and we're is the Commonwealth with that plan? Ralph Northam: (24:48) The question is about when we ease restrictions and allow businesses to reopen that have been unopened, and how we will look at that, if we look at regionally, will that be by healthcare districts, will it be by counties, and what I would say to answer your question is that we're still working through a plan to do that. Again, not to be a broken record, but we're looking at data to include the cases, the new cases in Virginia every day, the number of hospitalizations, the ICU beds, our ability to have PPE to those that need it, our ability to test. Ralph Northam: (25:33) But I will say that there have been great discussions of our last meeting. Formerly, I was on Monday afternoon and just so individuals know, that haven't seen that list of businesses, we have businesses that represent Pulaski, we also have another business in Abington, and we also have another business that's statewide, Walmart, who has stores throughout Virginia. So we are really getting some good information, some good feedback, not only from the rural parts of Virginia but other examples like Virginia Beach, which is where I'm from, or at least where I lived for the last 20 years before coming to Richmond, how we reopened our beaches safely. So talking to restaurant owners, hospitality industry. I could go on and on, but just great information. Ralph Northam: (26:25) So that's a long winded answer to your question, but we're still working through the planning stages and we have one more formal meeting. And I would also emphasize that there are, obviously, numerous businesses, both small, medium and large sized businesses that want to provide their input. We've heard from a lot of those businesses as well when we were having the formal meetings. So I encourage all of you to continue to provide your input, and we're just as excited as as anybody else in Virginia to ease these restrictions to get our businesses back open, to get our economy back up and running, but we certainly need to do it responsibly and we need to do it safely. And that's what this group is really focused on. Speaker 1: (27:11) Regarding the reopening, I know the four checkpoints you had mentioned was the PPE and the hospital bed capacity, I know Dr McDermott said that we have over 5,000 right now. And you're saying there's enough PPE for elective surgeries. Does that mean those two thresholds have been met for that phase one reopening, and can you say where we are with all of those checkpoints? Ralph Northam: (27:30) Yeah, actually Dr. McDermott might want to comment, but the question is, have the criteria that we've been looking at too to reopen businesses, have they been met by our hospitals? And so there were certainly challenges of as far as if and when we would have a surge, there were challenges initially with PPE, challenges with the ability to test as needed. And so the answer to your question, they have been met. And I think if you go back and look at one of the curves of the charts that we gave- Ralph Northam: (28:03) ... I don't have any charts today, but they haven't changed that significantly. You'll see that that hospitalizations, and ICU admissions and need for ventilators, which is what we were really focused on with COVID-19 have remained essentially flat throughout this. So I guess to sum up, I think what Virginians have done and certainly what the hospitals and healthcare providers, and dentists, and veterinarians have all done has allowed us to keep that curve flat and not get to a point where our capacity was overburdened. Any additional thoughts on that? Dr. Michael McDermott: (28:43) Let me just ... I would just say, the governor, I think you did a very great job of going back in time a little bit and kind of recounting where we were at different points in time. I think that's very important to do. Things have changed rapidly as we've gone through this COVID-19 crisis, and I think it's important that we always act with reality. How it is today, not how it was in the past, and certainly not how we hope it was or hope it will be in the future, but act based on data as it is today, and I think, the governor and his administration have done a great job of doing that. Dr. Michael McDermott: (29:18) If we were to roll back three weeks ago, and I'll just give my example of where we were in Fredericksburg. We had patients presenting to our hospital facility and we had a certain capacity to test. We might be able to do 30 tests a day, but we might have 60 patients presenting to our facilities that we really think should have been tested. We had to allocate those tests to the most serious patients at that point in time and maybe 30 of the patients who didn't require hospitalization and were going to get sent home. We had to send them home without a test. Now, they might've been positive for COVID-19, they're not going to be counted in the numbers that we have in our Commonwealth testing. They went home and recovered on their own. Dr. Michael McDermott: (30:00) Now when you come into our hospitals, our testing capacity has improved significantly. We test every patient that comes into Mary Washington Healthcare today, if they have signs and symptoms of COVID-19, we have the availability to perform testing. We also have the availability to extend that out into our communities, to even patients and their private physicians. If the physicians write an order, we have ways where they can safely come in and have that testing performed. So we might see more COVID-19 positive cases happening in the Commonwealth of Virginia. But looking at our hospitalization numbers, our ICU numbers throughout the Commonwealth, we can see that those have stabilized significantly, and so that can lead to some of the variations in looking at some of the data. Speaker 3: (30:50) The next question will be from Jimmy LaRue with the Suffolk News Herald. Jimmy LaRue: (30:55) Thank you. Governor, earlier you mentioned efforts regarding poultry processing plants including the quest for federal assistance at the CDCT website. Do these efforts apply to all meat processing plants in the state, including those for pork products or is it only for poultry? And if only for poultry, when will efforts for other processing plants be underway? Ralph Northam: (31:17) Great question. I just so happened to have our secretary of agriculture with us today, Secretary Bettina Ring, and Bettina, welcome. Bettina Ring: (31:31) Thank you governor, and thank you for that question. Yes, so the CDC guidelines that were just released this weekend, actually apply to meat and poultry facilities, meat processing facilities, and I think the additional measures that the federal government's putting in place, the additional assistance that they're providing us, most of our processing facilities across Virginia are actually inspected at the state level. So their state inspected, some federally inspected facilities, but this additional assistance is going to allow us to really look at best practices and apply those across the state. Thank you. Ralph Northam: (32:07) Appreciate it. Speaker 4: (32:08) Yeah. There've been a number of reports now about private labs in Virginia who say they have unused capacity for COVID-19 testing. I was wondering if the state has contracted with any of those labs and if no, why not? Ralph Northam: (32:22) I'm going to allow Dr. Remley to address that. But thank you for the question. Karen, thank you. Dr. Karen Remley: (32:30) So excellent question. Some of those labs do not take insurance. They want to bill the patient directly, and some other labs are ready and standing up and ready to go. So we're making a database of all of those labs so we can make sure that everyone who orders tests, whether it be hospital systems, doctors offices, working with the federally qualified health centers, the free clinics. We'll talk more about this on Friday, to make sure we use every amount of capacity we can in this state and to also make sure that we're taking care of Virginia businesses, which are also those labs. Dr. Karen Remley: (33:00) So we're really I think I talked to you all six days ago, so tomorrow will be the seventh day and the governor gave me a heavy lift, but we're going to make it work. But really trying to get all that information together in one place so we can maximize the use of every test that might be available for Virginians. Speaker 4: (33:17) Maybe I wasn't clear, but couldn't the state has contracted with those labs to perform testing for Virginia and then have the state of Virginia help fund that testing? Dr. Karen Remley: (33:26) One, those labs were not available to test back as the governor and Dr. McDermott explained so well, four or five weeks ago, yes. But four or five weeks ago, everybody was struggling to bring up their laboratories. So the public health labs now, which include not just DCLS, and Dr. Tony is in charge of the UVA, VCU and soon, Virginia Tech, have a large capacity that we can use. But in addition, many of the hospital systems have their own laboratories and so I'm happy to say that there are no hospitals to our knowledge right now that are using the public health labs anymore. They're all able to use either their own system, partnering with UVA, or the commercial laboratories to do their testing. That's why we're able to expand, be able to say to doctors throughout the Commonwealth, "There's testing available, let's get those patients tested." We'll talk more about that on Friday. But there's a kind of a plan to get that moving too. Dr. Michael McDermott: (34:23) Great. Next is Megan Pauly with VPM. Megan Pauly: (34:30) Thanks governor. Virginia was one of the first States to close K through 12 schools. Is it your understanding that in part because of that and other quick social distancing measures in the state that FEMA and other federal agencies prioritized getting testing supplies to other States where outbreaks were more severe? Maybe perhaps partly explaining why testing in Virginia has been lower per capita than elsewhere? Ralph Northam: (34:57) I appreciate the question regarding closing schools and did that direct FEMA to give supplies to other States. I don't know if I would go that far. But I will say a couple of good things. One is that we were just notified yesterday that a FEMA will be sending Virginia 200,000 additional swabs, which will help us significantly. The other thing that I think is important to say, we took an aggressive step back at the beginning of this pandemic when we saw the numbers going up in Virginia to close our schools for the rest of the year. That was probably one of the most difficult decisions I've had to make. As you know, it affects our children and their families. But I think it's been very important as we have tried to flatten this curve as much as we can. Ralph Northam: (35:51) I've heard a lot of people say, "Well the kids are safe and they don't have significant consequences if they contract the virus." But what was concerning to me, and I think our healthcare team is that, while their outcomes are much better than adults, especially the elderly and those with complex medical conditions, they live in homes where there are elderly individuals, whether it be their grandparents, great grandparents. So if a child were to contract the virus and take that to school and then spread it to other children. Then that goes into homes and effects the parents, grandparents, and great grandparents. Then that's where we have problems with the surges and the increase in cases every day. So again, another long winded answer for you, but that was some of the thought process that went into doing what we did to close the schools, and we really wanted to give Virginians consistency and let be able to plan because we knew this virus was going to be with us for a couple of months. Ralph Northam: (37:00) I think the other question that I often get, and I wish I had a crystal ball, but as you know, I'm a glass half-full person, is whether our children will be back in their schools in the fall and if we continue to do what we're doing and the great assistance that we've had from our superintendents, our teachers, our secretary of education, we're all working as hard as we can to make sure that your children, our children are back in school in late August, early September. Speaker 5: (37:35) Yeah, I know that last Friday you guys had said that you were tracking the percentage of positive cases and you're wanting to see that 14 day decline in accordance with the White House guidelines. Yesterday, some of us were looking at data that we have and there was a 17% increase. So two things. One, does that mean that we're not going to be ready for phase one by May 8th, as you have suggested? Or are you guys looking more at a trajectory as in can one day have an increase disrupt a 14 day otherwise pretty good picture? Ralph Northam: (38:09) Sure. Great question and I'm not going to give you a lesson in statistics, as you know I'm a biology major, but the question was are we looking at this trend, the 14 days, and for example, if there's one day where we get a blip in the numbers, does that mean we start over and the answer is we're looking at trends, and I think that's important for everybody to understand. I think the other thing that's important to understand is that when we do more testing, as we've ramped up our tests, then you're going to have, in most cases, more positive results. So that affects the numbers. It also depends on the turnaround time. As you know, a couple of weeks ago, our turnaround time was sometimes five, seven, nine days. So that throws a whole nother variable into how to follow those trends. Ralph Northam: (39:01) Then finally, who are we testing? If we're testing individuals that are in the emergency room and for example, in our chicken processing plants on the Eastern shore, in our nursing homes, then your positive rate is going to be much higher than if you just went out and tested the general population. So again, not to get them to a lesson on statistics, but it's not quite as straightforward as the average person might think that, "Well, we're just going to follow the number of positive cases each day." So we're looking at all these trends, as we were looking at different models, and I think that the answer to your question is that there's nothing set in stone, but we're really focusing on the trends. Speaker 5: (39:46) So do you still feel like we're on track for the possibility of a May 8th phase one? Ralph Northam: (39:49) That's a great question. Right now, our numbers continued to, again, taking all those variables and factors that I just mentioned, our numbers haven't flattened out yet. Now, a followup question that I might anticipate is, well, what about in some other areas of Virginia? Because it's not the same. I mean there are certain counties for example, that don't have any cases right now. So that's why we're really trying to think through this with thoughtfulness and reason and fairness, and at the end of the day, doing everything that we can to keep Virginians safe. So a lot of discussions are going on behind the scenes that we're trying to take everything into account. Speaker 5: (40:35) So not definitely yes, but not definitely no? Ralph Northam: (40:36) You said it, not me. Dr. Michael McDermott: (40:40) Next is Luanne Rife with The Roanoke Times. Luanne Rife: (40:44) Hi governor. So with so many labs doing different types of testing, how confident are you in the accuracy of these tests? I mean we're hearing people who have been told to expect false negatives, or that they have a false negative. So what does this mean and what value is this information? Ralph Northam: (41:03) It's a great question and I'm going to ask Dr. Tony to come up regarding the false negatives, false positives, and I think maybe she'll be able to elaborate a bit as well on, there are different tests, the antigen test, the PCR test that that most people are using right now versus the antibody test. I'm sure you all have heard the same reports that we have, a lot more inaccuracies with the antibody tests that have been promoted so far. So anyway, any further thoughts. Thanks Dr. Tony. Dr. Tony: (41:36) So the question is about the performance of the different tests and people performing different types of tests. So what I can say is when you're looking at the different types of tests, just as the governor said, there are molecular tests that perform amplification and look for the presence of the virus. Then there are serological tests that actually don't look for the virus, but they look for the body's immune response to the virus. Now, both of these tests- Dr. Tony: (42:03) ... important tests. They provide important information that help us understand the course of the disease. When we're thinking about false positives and false negatives, the molecular tests are the highest performing tests. They have the highest sensitivity, they have the highest specificity, and most of the tests that are being performed have been approved and authorized by the Food and Drug Administration for meeting a level of performance that is of high performance and high acceptability. So these are high performing tests and they do meet a threshold of acceptability and comparability across all the different tests. What's more important, I think, is the timing at which these tests are being performed. When you're looking for the virus, you have to think about the course of the disease. If you test too early, you're going to get a false negative because you haven't had time for the virus to grow to a point where you can detect the test. Dr. Tony: (43:07) If you test the antigen test at the wrong time, you're going to get false results as well. So it's important that these tests are used during the right time, during the right course of the disease in order to get the most accurate result and that you can make the best predictions as to what the test result means. With respect to the molecular tests, I do think the ones that are being performed at our clinical hospitals, the ones that are performed at the state lab, and even at the commercial private laboratories are high performing, high accuracy and sensitivity. And so they are high confidence tests. Ralph Northam: (43:46) Thank you. Speaker 7: (43:46) This is a followup question for [inaudible 00:43:50] but if it's going to be just a general trend over 14 days, could you maybe keep us updated on where we are in that 14 day period as we go on? Ralph Northam: (44:01) That's a great... Yes. Speaker 7: (44:03) Sorry. And my second question which is unrelated is can you talk about the fiscal impact of having paused elective surgeries for hospitals as well as dental practices? Ralph Northam: (44:15) The first question, as far as giving you the day to day data that we're following, we do have those graphs and we chose not to use them today, but on Friday I will promise I will bring them and let you know and see where we are on the curve. I think that that visual is very helpful. So that's number one. And I will let the hospitals and dentists answer it as well, but I will tell you before I let them comment. The question was how has the closing or discontinuing elective surgeries and procedures in both the hospitals and the dental office and the veterinarian's office, how has that affected them fiscally? And the answer to that is it's been significant, [Mel 00:03:08]. And running a dental office, or a hospital, or a veterinarian clinic is like a business. And so you have to look at where your revenue is coming from. And certainly elective surgeries are part of that revenue. And also how many beds are being occupied? How many dental chairs are being occupied? Ralph Northam: (45:33) So when we discontinued those elective procedures, there are beds that are empty. And again, that was for a reason. We've gotten past that stage. But certainly not being able to do the procedures, which I would call... And again, I'm a physician. I own a practice in Hampton Roads. That's some of our bread and butter. And so that all affects the bottom line. So the answer to your question, it does affect them fiscally. But the thing that I would close by saying is that this wasn't about money for anybody. This was about safety for Virginians and making sure that we were ready for that surge. And I just, I thank the hospitals, I thank the outpatient clinics, the providers, the dentists, the veterinarians. I thank them because they've sacrificed to do the right thing. I don't know if you had any further thoughts. Dr. Michael McDermott: (46:26) Yes. I just want to echo that statement by the governor that the decision to stop non-urgent medical procedures was absolutely the right decision at the time that it was made. We needed to build capacity within our health systems to handle a potential surge of Virginians that would need highly intensive care. And we needed to do that. And nobody's saying in any way that was the wrong decision. It was absolutely the right decision to be made. But as we've learned as we've gone through the COVID crisis, and as the Virginians have worked so well to follow the stay at home orders, the social distancing, we have bent the curve. We have not seen the type of surge that they experienced in Italy or in New York. And that is fantastic news. Dr. Michael McDermott: (47:07) And so it brings us to this moment in time when we look at our data and everything that's happening to say now is the time to make sure if you're a patient in Virginia that has an unmet medical need, it's safe for you to come and have that need met at this point in time. I would say the financial impact to Virginia hospitals and health systems is well over $200 million at this point in time, but that is insignificant. The more important thing to do was to build the capacity within our hospitals to make sure that we were able to care for Virginians if they needed it through this COVID-19 crisis. Marissa: (47:43) [inaudible 00:47:43] Up next will be Bill Atkinson with the Progress-Index. Bill Atkinson: (47:50) Thank you, Marissa. This question is for Dr. Oliver, but I would also be interested in hearing what the governor might have to say about it given his medical background. You talked about granular data a little while ago. I want to drill down a little bit further. Ever since the city of Colonial Heights announced its first COVID case back on April 7th, the numbers that were reflected today showed that city's total has gone up to 49 in just a three week period while surrounding localities that started reporting cases much earlier had not experienced such a spike in growth over that time. Bill Atkinson: (48:20) Now, two of the four deaths in the city were at a nursing home that we've been able to confirm. We haven't been confirmed much else from those nursing homes. But the question I have is two-part. First part, is that increase considered more normal than alarming in the process of reporting the cases? And does that raise Colonial Heights up the list of localities to watch? And my second part would be has VDH been able to glean specifically whether the crux of those numbers or deaths have been in assisted living center or throughout the city? Ralph Northam: (48:48) Do you want to try that? Dr. Norm Oliver: (48:54) Two questions. One, whether the rise in cases in Colonial Heights would qualify that jurisdiction as a place that would need special attention and the public health efforts that we have around our response to COVID-19. And the second question is whether the health department has broken down the stats in Colonial Heights to consider whether the nursing home in that area are particularly contributory to this rise. On the first question, I think Colonial Heights and a number of other areas across the Richmond-Petersburg area, as well as across the Commonwealth for that matter. There are any number of areas where you will see particularly high pockets of disease incidents. We've spoken before about the fact that communities of color have been particularly hard hit. And I believe that communities of color and other areas that have been epicenters of incidents for the disease are going forward be one of the areas that we want to focus on as we expand our testing capacity, our case identification, contact tracing, and so on. Dr. Norm Oliver: (50:17) So that would be my answer to the first question. To the second question, I would have to say that our Chesterfield office, the Chesterfield Health Department, which has a local health department in Colonial Heights, has been following very closely the situation there. They are the ones who lead the whole process of contact tracing. And while we don't post all the numbers on that on our website, I can assure you that we are completely on top of where those cases are, who the contacts are of those cases, and doing utmost to try and contain the spread of the disease. Speaker 9: (50:59) Thank you, Governor. The Department of Corrections is releasing inmates that have tested positive of COVID-19. Their policy says early release must be compatible with the interests of the society and public safety. So for community members who are concerned about these inmates possibly spreading the virus that are released, could you respond? Ralph Northam: (51:25) Mm-hmm (affirmative). [inaudible 00:51:25] Speaker 10: (51:30) Thank you for the question. The question is the Department of Corrections releasing individuals, returning citizens with COVID virus and is that a part of the governor's early release program. And the answer is no. There are individuals being released from the Department of Corrections based on their release dates. Obviously, Corrections cannot keep someone past their mandatory release date regardless of their health considerations. But the early release program that is really going quite well, I might add. The Corrections has already reviewed about a hundred inmates for early release and that's going quite well, but they would not be released, not to be released if they have the COVID-19 virus. Speaker 9: (52:16) And also there are some inmates who are being released that had 20, 25, 30 years left. I thought they were only going to be released if they had six months to a year. Speaker 10: (52:34) Again, that is correct. The question is some are being released with long terms left on their sentences. The governor's early release program that the legislature did act favorably on, on the 22nd of April. It's gone quite well. And the process and the procedures that we directed Corrections to do is less than one year left on their sentence, less than one year. And then they've prioritized nonviolent offenses, those with home health plans, and those with a low risk assessments. So they're low risk to commit another offense. And so those are the procedures that they are following. And based on those procedures, they've already approved 100 inmates and they've released approximately 62. But the 25 year sentences would not be the governor's early release program. No. Ralph Northam: (53:36) Well again, thanks to all of you for being here today and hopefully some good news for everyday folks, whether it was through the loans or whether it was our hospitals, and dental office, and veterinarian offices being able to get up and running again. But I want to follow up on the question about when. I thought it was a great question of when we will be able to lift these restrictions. And we're going to do it as soon as we can, as soon as it can be done safely. But let's get back to the basics. We know what works to minimize the spread of this virus. Ralph Northam: (54:14) And I just want to, as we leave, encourage you to continue to follow the guidelines of the social distancing, physical distancing, the staying six feet or farther apart, staying in crowds that are less than 10, or gatherings, frequent hand washing. We know that that works. Covering your face if you sneeze or cough, all of these things. These are basic, but that's what's allowed us to get to where we are today. So even when we ease these restrictions, we need to continue to follow those guidelines. So it's Wednesday. We appreciate all of you listening and watching today and we look forward to being with you on Friday. And as always, we appreciate your input. So thank you very much.