California Gov. Gavin Newsom COVID-19 Press Conference Transcript January 4

Governor Newsom: (00:00) Those numbers come in at 29,633 cases of COVID-19. This is substantially lower than the seven day average of 37,845. I caution as we work through the holiday and the holiday weekend in particular, these case numbers appear to be low. They likely are on the basis of our collection and testing just more on that. You could see the seven day average total number of daily tests has dropped below 300,000, to 285,500. On Saturday, it went up to [421,000 314,000 00:00:42] yesterday. So we're starting to get our cadence back in terms of daily tests, but there was a lag. There was certainly an impact associated with the holidays. So I caution in terms of total case numbers, that in terms of your consideration, the average case numbers, again, around 37,845 is the number really to focus on. That said, the positivity rate at 12.4% has remained relatively stable over the last two week period. Governor Newsom: (01:12) You can see here on this chart, 12.2% positivity rate two weeks ago on the 21st of December, 12.4% in this latest reporting period ending yesterday. Hospitalizations have increased at 18%. That is a more modest growth rate than we've seen in the past. We have foreshadowed this. We have socialized based upon our own planning and our own modeling an expectation of a lull before a surge on top of the surge coming from case rates and ultimately hospitalizations in ICUs associated with the holiday. So this is not where you hold your breath. It's good news, nonetheless, that we're seeing a modest reduction in the growth rate in hospitalizations, but I just remind you what you don't see on this slide and subsequent ICU slide, which shows a 22% increase in admissions over the last 14 days is this reality. Governor Newsom: (02:15) On hospitalizations, we've seen a seven fold increase in just two months. On ICU admissions, we've seen a six fold increase in just two months. So it shows what can happen in a very short period of time, a very condensed period of time, and that goes to the urgency of not only this moment, but the urgency that we have placed in anticipation of this surge and anticipation of this surge on top of the surge coming, what we believe in the next number of days and weeks of from the holiday season. Let's take a look at ICU capacity statewide, familiar slide, that 0% in Southern California, 0% in San Joaquin Valley. Again, representing not the fact that there are no ICU beds, just represents the fact we're now in our surge phase and our surge strategy for ICU, well identified additional ICU capacity, 7.9%, around 8% in the Bay Area. You can see the greater Sacramento region, [inaudible 00:03:19] 12.1%, a little above 15%, a little below 15%, now 12.1 in Northern California. Governor Newsom: (03:27) The one region in the state that has not been imposed upon as it relates to the stay at home order remains above two times above that 15% threshold that we've identified at 30%. The deaths, again, these numbers can be misleading from the weekend and then you stack on top of that weekend collection of data with holiday and so take a look more, I think, closely at that seven day average, 336 lives lost, families torn apart because of this pandemic. Just to put it in perspective, the last 14 days close to 4,000 Californians have lost their lives. This is a deadly disease. This is a deadly pandemic. It remains more deadly today at any point in the history of this pandemic. So I want to put that in perspective that 97 is deadly and devastating as that may be, that number is substantially lower than that seven day average, just a reminder of the seriousness of purpose we all must have at this moment to mitigate the spread and the deadliness of this disease. Governor Newsom: (04:36) As it relates to doing just that we have been deploying technical assistance teams all up and down the state of California. As you heard a few weeks back, we focused our energies on Los Angeles in particular. We're extending those technical assistance teams down there. Riverside San Bernardino and San Joaquin, we've also deployed teams. These teams, just as a reminder, are made up of our EMSA folks and OSHPD and Cal OES, that's Office Emergency Service, where I'm here today, and of course, CDPH, California Department of Public Health. So these are the coordination teams focusing on decompression, meaning reducing stress on certain physical location, space, equipment, supplies, the whole gambit, including oxygen and more on oxygen in a moment. Governor Newsom: (05:22) You could see as well, latest tally just shy of 1300. State and federal staff been deployed, continue to work, including over this weekend, over the holidays to try to get more federal supports. We are seeing some support in that space. We certainly look forward to more at Department of Defense, HHS, and others. You can just see examples of some of the folks we're using, including now 144 Cal Guard medical experts that have been deployed at key locations across the state. Governor Newsom: (05:49) Now back to the issue of oxygen and our oxygen strategy. It's important to highlight this. It's gotten some attention and I just wanted to give it a little bit more focused attention here today and socialize those of you that may not be familiar with the issue of oxygen supply in the state. Because of the strain, because of the stress down in Los Angeles in particular, and of course San Joaquin Valley been placed upon the hospital system. We have organized, and I'll talk more about it, a statewide oxygen strategy. We actually have a task force on oxygen that we put together. We stood up a week or so ago. You can see the framework of our strategy is predicated on five fundamental efforts and most important being just mitigation awareness at this moment, particularly for those hospitals and facilities that are not necessarily focused on it. Governor Newsom: (06:40) We are making sure that we're reaching out to every facility up and down the state of California to caution around what's occurred in some parts of the state and what is a preview of things that may come in other parts of the state. So we're sharing best practices, not just the information around this issue being of concern, but best practices for hospitals that have already overcome these issues and providing resources. Those resources include technical assistance team. I referenced that state oxygen team that we put together. We also have OSHPD, one of our state agencies working with the US Army Corps of Engineers, the best of the best. These guys have been with us since the beginning of this pandemic. They're part of our morning cadence of morning calls in terms of our logistics strategies. The US Army Corps of Engineers, the folks that are helping out with these alternative care facilities and technical assistance, a world-class group of folks. They're looking at the capabilities within existing facilities throughout the state and looking at making enhancements and they've done just that. Let's talk about that. Governor Newsom: (07:43) The oxygen support and the support that the Army Corps has already provided has been an exampled in seven facilities, five down in LA, two in San Bernardino, a little bit of a typo on this chart. We are also going to be sending that team down to Fairview to help support those efforts. EMSA has been deployed with, today, we'll be looking to deploy them for refilling capacity for these oxygen tanks. Then these what we call DMSU units. These are the medical support units. We have 42 of them across the state. They have oxygen that's components of those DMSUs, and we're starting to repurpose those. So we've got a logistics team, logistics task force that's helping with that. They're also leasing mobile oxygen systems so we have the ability to do more rapid deployment. Governor Newsom: (08:35) One of the other strategies, and this is important, that Dr. [Galley 00:08:38] and others have been working hard on this over the last number of days is home oxygen support to, again, decompress, reduce the stress on the system, get people the support and the connection at home to get the kind of oxygen that would allow them to recover and allow us more availability and more capacity within our existing facilities in terms of utilization, in terms of the stress on that capacity. So we've been working with vendors and we've been working across the spectrum to create a framework of support to help with this strategy of decompression and ultimately the strategy of mitigating the utilization of these systems that are leading to a series of issues, which get more complicated as it relates to system pressure, as it relates to the conversion of the liquid into gas and icy conditions that occur. Governor Newsom: (09:36) Again, too much information except to say, this is part of the larger strategy in terms of what the Army Corps is doing, but also what we're trying to do by getting people to move into home environments and reduce the utilization of those oxygen systems, the larger systems. As it relates to the state procurement efforts, we've got 160 units that have been deployed, rather 106. We've got 160 that are in our California medical stations that will look to redeploy. We talked about these EMSA stations, other stations. We're just looking at the panoply of oxygen support. That's in essence of what this slide says. Panoply of supports across the spectrum and looking how we can utilize more flexibility and broader distribution of these oxygen units all but down the state. But particularly in these areas, San Joaquin Valley and Los Angeles, the larger Southern California region that are in particular need and are under particular stress. Governor Newsom: (10:38) We also are looking to order 400 of these oxygen concentrator units, and that has been done. We're looking forward to adding to the 200 or rather 423 units that are already in our [cache 00:10:52]. We hope to get to 823. That's the stated new goal, at least for the state. Again, maybe too much information, but I thought again, purpose always to share with you what's shared with me, try to do it in real time. Just update you on some of these efforts. Talk about updates. We've got 90 people now in these alternative care sites. You're familiar, those of you who have tuned in, very familiar with these sites down Imperial Valley College, the Sleep Train Arena up here in Sacramento, Porterville and Fairview and then the Palomar alternative care site that now has in the San Diego region just taken in 10 patients. But 90 total that are part of this alternative care system. Governor Newsom: (11:32) I'll remind you, we have substantially more sites that have been put into what we call warm status. Other sites that are being stood up, which means they'll start to get operationalized. The outside time to operationalize these sites is about... Well, it's usually about 48 to 72 hours. In some cases, it'll get into that fourth day, but that's rare. So our ability to turn these on quickly, maintain, we're still in that position where we can turn these on quickly subject to again, the one thing and that's staffing, staffing, staffing, again, is the most important issue. Facilities are one thing. Staffing is the thing that is the energy and focus. Governor Newsom: (12:17) With that, our energy and focus has also gone to this notion of the light being at the end of the tunnel. Despite being in the tunnel, we recognize there's hope on the horizon. With that, I want to just update you briefly on the vaccines. A lot of attention, a lot of focus, a lot of stress, a lot of punditry in this vaccine space. Let me just update you briefly on what we are doing. You're going to get updates consistently on this, and I'll remind you a lot of this information is made available on the state site, the COVID19.ca.gov website, COVID19.ca.gov website. You can go learn about all the details and nuances of our phased plan strategy, the tiers and sub tiers. I'll update you in a moment. But again, go to that site when you want more information. Governor Newsom: (13:05) Just a brief update though, this week, I submit to the legislature a new budget for the next fiscal year. We are working with legislative leaders who've been magnificent about an early action strategy. In particular, we are looking to get some early action clearly to support our efforts on vaccination distribution. Again, we're in phase one A, health care workers and those seniors living in congregate facilities. As we expand to new bands, new phases, going from a group about 3 million people to tens of millions of people, IT is going to become more important, this end-to-end CALVAX management system, getting that fully operationalized, which is very, very... It's moving along very, very well. We are very close to getting it to where we need it to be. All our logistics and commodities efforts and the dry ice that continues to be an issue with not just Pfizer, but also storage and cold needs as it relates to dry ice for transportation and logistics purposes, even for Moderna. Public education campaign, just absence of a national public education campaign. Governor Newsom: (14:14) Clearly, the state needs to do more. We've given you some updates and some PSAs in a culturally competent way. Again, we've got to meet people where they are and that's underway, but not at the scale that we would like in terms of the social media and the peer to peer work, working partnership with community-based organizations, our organization, we call [LESTOS 00:14:35], building off the work we did with our census, but $300 million is proposed in that budget. I'll talk more about that in detail on Friday, but I was just giving you a preview of what's in that budget specifically for vaccinations. Governor Newsom: (14:50) We are working aggressively to accelerate our pace. We've said this from day one. It's like a flywheel. First 10, 15 days, we're going to slowly start building pace, going to start building up, and you're going to start seeing the more rapid distribution of this vaccine. I can assure you of that. Now that said, it's gone too slowly, I know, for many of us, all of us, I think. We want to see 100% of what's received immediately administered in people's arms. So that's a challenge. It's a challenge across this country. It's a challenge for that matter around the rest of the world, but that's not an excuse. Governor Newsom: (15:21) So we're already working this last number of days to increase the number of distribution sites and more importantly, to accelerate the efforts of who can distribute the vaccines. Dental administration, so dentists administering the vaccine, the pharmacy techs, National Guard, more of our National Guard deployed to begin the distribution administration. Our pharmacy program, that's a partnership with CVS and Walgreens and that's underway. We started that last week. We're encouraged by that. They're going to focus on SNFs, skilled nursing facilities and assisted living and other congregate facilities, and then our partnerships working, [inaudible 00:16:00] and others and clinics and doctor partnerships up... Governor Newsom: (16:03) ... working CMA and others and clinics, doctor partnerships up and down the spectrum. So more aggressive efforts in this space. And I'll talk to you more later this week about substantial increases in these efforts, meaning additional supports that we're putting in terms of the administration and the flexibility and the urgency of our distribution strategies. But here I'll just quickly update you on the total number of doses and then the next phase of planning. Governor Newsom: (16:28) So we've received, the state actually has in its possession, about 1.29 million doses. We've got 611,000 that are being shipped, they haven't arrived yet. The second doses are arriving this week. So those first doses, you'll get those second doses for those that are queued up. Now, here's how many we've put into people's arms, 454,000, 1.29 and 454,000 doses administered. So we got work to do on this. We'll work through that holiday and obviously as we move into January, we want to see things accelerate and we want see things go much faster. I can assure you governors are talking to other governors, chiefs of staff, the chiefs of staff looking at logistics, sharing best practices, what's working, what's not working across the spectrum. And one recognizes you've got to be iterative, you got to be flexible, and you've got to have a sense of deep urgency. And I hear that from folks calling me directly, people that are expressing themselves very forthrightly and understandably around their anxiety of when do I get these doses? Governor Newsom: (17:38) So let's talk about that. As I said a moment ago, we are in Phase 1, which is healthcare workers and longterm care residents. Again, congregate facilities, seniors. That's the current phase, about 3 million people plus or minus. Phase 1B is the phase that was discussed last week by our guidelines working group. And it has multiple tiers, within each phase there are multiple tiers. Just as there is with Phase 1 and Phase 1B, here are the tiers. The top tier, 75 and over, workers and education. So teachers, but what's the prioritization for teachers? Is it those that are doing in-person instruction or those that are doing distance learning? So that's the work that's being done. And by the way, that will all be updated very publicly on Wednesday. I'll get to that in a moment, but here's the tiers, 1B and that tier one, you could see who we're prioritizing. Tier 1B, or rather tier 2 and 1B, that moves from to 65 and over not just 75 and over, and you could see the other sectors in terms of individuals and industries, logistics, industrial, residential, commercial facilities, services that will be prioritized. Governor Newsom: (18:55) Now 1C will be updated and discussed, not signed off on this Wednesday, but will be discussed. That's the next phase and that's 50 and over that's the phase I would likely be in. And then people with underlying medical conditions down to the age of 16. So that's the next phase. Phase 1B is about 8 million people. Phase 1A, about three. Phase 1B, 8 million. By the way, that's plus or minus. And we'll land on that this Wednesday. So that number will get updated this Wednesday, I'm just giving you proximate numbers. And then 1C is this much larger cohort that includes I imagine many of you that may be tuning in. Governor Newsom: (19:36) But speaking of tuning in, I encourage you to tune in on the 6th, this Wednesday three to six o'clock. This is on the COVID19.ca.gov website. If you choose that, that will send you to the right place to tune in. And this is the community vaccine advisory committee. I'll remind you, 60 people, we put three committees together. We have a safety committee that we put together in the middle part of October. We partnered with Washington State, Oregon, and that Nevada, they've signed off on Pfizer, they've signed off on Moderna. Not only for efficacy, but safety. That was the eyes that we wanted to put on this in addition to the eyes from the federal government. Governor Newsom: (20:20) We have this drafting guidelines work group, they've been meeting consistently, and that is a smaller cohort of people than this community advisory committee of 60. That group is 16 people, they're the technocrats, they're sort of the experts and they're providing their rationale. And that rationale is being reviewed with an equity lens with this community advisory committee. Three o'clock to six presumably three hours, we'll see on the 6th this Wednesday. And they will also begin to socialize and roll out a little bit more information, not just locking in the tiers on 1B, they've already locked in the broader cohorts. The tiers will be locked in, that will be done, 1C and talk about how we operationalize better administrative processes as well. Governor Newsom: (21:11) So it's worth taking a look. A lot of people asking me about this and there's no greater place to get a sense of really what's going on in this very transparent process, this very countable process. But again, recognize the deep anxiety and need for urgency on all of this. And we are not going to require a cadence once a week of understanding, we are going to socialize a deeper understanding of what we're doing on a more consistent basis I assure you. Governor Newsom: (21:42) Speaking of updating you on our conditions on a more consistent basis, a new strain, this was brought up last week. We brought up fact that we have now detected. We do very comprehensive genomics testing in the state of California. I see some of the national news on this saying, "America doesn't do this." I think it's a little misleading because as part of this country, California has been doing a lot of genomics testing, anywhere from five to 10,000 tests a week just here. Just again, proximate where I am, UCSF, partnership with CZ Biohub, been doing a lot of these genomic tests looking for different strains, pretty consistently in Southern California they've been doing the same. By definition, four individuals in San Diego were identified with this UK ... lazy way of describing it ... UK strain, at least the strain that was identified first in the United Kingdom. One is now hospitalized. We also have two additional individuals that we identified in San Bernardino. Governor Newsom: (22:42) We have all kinds of new genomics tests. In fact, I was hoping, I think they're coming later this afternoon, the results of those tests. I was hoping to have an update for you. We imagine, in fact one should just anticipate, there'll be others identified and we'll know more about this in real time. And hopefully as late as this afternoon, tomorrow we'll be able to update you more on some of the latest genomics testing that's been done to understand more comprehensively what the strain is, looks like, and what it's doing. I'll get to that in a second, but just briefly. Governor Newsom: (23:15) Mind you we're contact tracing, our disease investigation is very aggressive in this space in particular and that's underway. And that's allowed us to understand a little bit more about those four individuals. Did they travel? Did they not travel? Are they in contact with someone who was traveling, et cetera? And so as that information comes available, some had already has been, but as more information becomes available, we'll share it with you. Just to remind you though, this new strain, this new variant is more contagious we believe, but not more severe in terms of its impact, in terms of your condition. And we do, yes, believe, and you've heard this, you've read it, and seen discussions, TV about this, CDC does believe that vaccines will protect, the current available vaccines. We're getting good news. Hopefully Johnson & Johnson will join, and other vaccine manufacturers will come into the queue later this month, including AstraZeneca, but that may be even later still for different reasons. CDC though believes will protect against this new strain. Governor Newsom: (24:21) Just underscores, that's why I put the slide up, just underscores the importance of our preventative measures, particularly now with a strain that's more easily transmittable, meaning transferable, meaning you're more likely to get this strain. That's why it's more important to consider all of the common sense things that you know well, and I don't need to burden you with, in terms of just distancing, and the social distancing, physical distancing, and hygiene, and all those things in turns of mixing and masking, which are important. Governor Newsom: (24:53) Speaking of important as well, at least eight million people have found that the California Notify app is important. It's easy to get, easy to download. Go to Google Play, you can just download it easily on Apple. It's the notifications, opt-in. Eight million people have opted-in, add it to the phone, it's just a notification. In terms of using technologies, an additional tool to notify you if you've been proximate to someone who's contracted COVID-19. I just wanted to give a brief update, we've talked a lot about our notification system and encouraged that roughly 20% of the state has already adopted it, or at least utilized it, downloaded it, and encourage you to consider the same. Again, go to Google Play and go to the Apple store and learn more about California Notify. Governor Newsom: (25:40) And just briefly I wanted to, because it's an incredibly important, look to update you on supports for our small businesses. Half a billion dollars in grants were put up as a bridge. I'm going to be talking a lot more about doing a lot more for our small businesses this Friday when we release the budget. This was done in the interim partnership with the legislature. Sense of urgency that we placed on this in addition to what we put in the existing fiscal year for small businesses and tax credits and waiving those fees associated with the franchise tax board for all startups. Here's the half a billion dollars in small business grants that also go to cultural institutions, that also are available to nonprofits. This just opened up. $25,000, it's a top grant you can receive. These are just grants. These are not loans. And we just want to make sure people are aware of it and in need, just avail themselves to learning more about whether or not they qualify. Governor Newsom: (26:42) And so they're open right now, this grant process. It was going to close the door on the eighth. We just extended it to the 13th and that's why I just wanted to highlight this first application round was extended through the 13th so folks know that. We're doing daily webinars, we're doing it in multiple languages, we're trying to be as inclusive as we possibly can. But here's the site, you may have seen her on the scroll below, but I'll just put it up again. CAreliefgrant.com. CAreliefgrant.com. You can go on your smartphone, on your laptop, whatever, pick it up. It's worth taking a look. If you know someone who's a small business person, you know someone runs a cultural institution, or a nonprofit it's really worth taking a look at this site, sending them that information and making them aware of the opportunity to get this support. Governor Newsom: (27:35) And again, I'll remind you, this Friday we'll talk a lot more about additional supports. We may even preview it before Friday because it's so urgent, so critical that we're there for small businesses in terms of waiving fees and associated burdens. Particularly as we work through this final push, this final phase of this pandemic. Light is at the end of the tunnel, there's real hope and promise with these vaccines. As stubborn as the initial application has been, getting this flywheel, continue to see more and more progress, more and more rapid distribution, broader community distribution. Governor Newsom: (28:14) But in the interim, we are entering in to now this what we anticipate, what we anticipate the surge on top of a surge. It's going to put a lot of pressure on hospitals and ICU's coming out of the holidays. And so we're getting into that phase right now. Later in this week, we'll really have a better sense as that lag that I referenced at the top of this presentation begins to give way to more understanding of what's happened in the last week, as we see more test results, come back as we see case numbers that are representative of those new test results, as we update our positivity rates, and update our R effective, by the way, the R effective dropped to 0.95, which is encouraging, but again may not be truly representative of the sample that is truly more indicative of what occurred last week, based upon again, sort of the holiday lag and reporting. Governor Newsom: (29:11) So that's why this week, it's a long way, forgive me, it's a long way of saying this week is critical in terms of a bigger understanding of where we are. And if we're going to hit that surge on top of a surge on top of yet another surge, is the way at least I describe it, but more broadly it's been described as surge on top of the surge. So we'll update you real time on that and encourage folks again to learn more about all these things by going to COVID19.ca.gov website COVID19.ca.gov. So with that, happy to answer any questions. Speaker 1: (29:47) Angela Hart, Kaiser Health News. Angela Hart: (29:48) Thank you, Governor. So I just want to confirm for all the reporters that the budget is in fact on Friday. And then for my actual question, homelessness communities across California are being hit. Increasingly we're seeing things we hadn't seen just a few months ago with outbreak, pretty significant ones in outdoor encampments, in homeless shelters, as well as in some of the non-congregate facilities that the state has helped provide. And so I just wanted to ask you, is there any other help on the horizon from the state in your budget or otherwise for communities really struggling to contain and address the COVID pandemic as it relates to homelessness? And I understand Project Roomkey has been reauthorized every month, but I think I just want to anticipate a little bit of your question and say that a lot of communities that we've heard from over the course of the pandemic has said those are life saving for the few who are lucky enough to get inside, but there aren't simply enough. So would love to know what's on the horizon. Thank you. Governor Newsom: (30:53) Right. Yeah, good enough never is. Over 10,000 human beings are currently getting the benefit. Not a small number, over 10,000 ... I think it's closer to 10,700 plus or minus, I'll get you that new information ... are getting the benefits of Project Homekey. Over 23,000 people have been supported, 23,000 people through Project Roomkey, which started less than a year ago. We're really proud of that. And I appreciate you recognizing that it was just extended by the federal government, working with the Biden transition. We've been working aggressively to get more clarity beyond just the 30 day extensions, which I think the counties fundamentally and understandably need to give them more confidence of the supports in terms of those federal dollars being drawn down. Governor Newsom: (31:37) In addition to that, you may know we were able to do something remarkable, at least humbly I submit remarkable considering, 94 projects, 51 jurisdictions in the state, $846 million invested under time and below budget to get these permanent units up and operational, and that's happening in real time. So you ask the question specifically the- Governor Newsom: (32:03) ...It's happening in real time so you ask the question specifically, the project room key now has evolved to home key, which is a permanent framework where we have already secured over 6,000 units, unprecedented, California history. I don't know of another state in American history that just in a few months, literally a few months, just since July was able to draw down to close escrow. We closed escrow on these projects. And so over the next number of weeks and months, those start to be utilized at scale. So those will also provide additional support. We put in hundreds of millions of dollars under an emergency appropriation, at least close to 62 million specifically recently to help support some of the County functions and efforts to provide some support services on top of the hundred plus million we had provided in the July budget. Governor Newsom: (33:04) We continue to look forward to the support being manifest that the state provided in the existing fiscal budget. Remember we're halfway through the fiscal year, the state put an unprecedented amount of money, what we refer to as the HAP program to provide cities and counties support and CoCs support for homeless. And we have a second round of money that's being distributed literally in the next few weeks specific to your question in terms of additional supports in that space, that was over $600 million. So you're talking about unprecedented, even in a COVID environment, supports to cities and counties. And as a former County mayor, I never looked to the governor to do all of that work. It was not the governor's job, it's the county's job and the city's job to then do all of that groundwork to help support these efforts. Governor Newsom: (34:00) We're just providing more support than has ever been provided in our history. And I recognize good enough never is. And so the answer to your question, long winded response to the totality of your question at least is yes, we will be doing even more in the budget that we will be submitting to the legislature and partnership with the legislature we've been working for weeks and weeks to see where we can land to recognize the urgency of now as it relates to potential early action, but also the urgency to be prepared as we move away from room key, to make sure that we are addressing the needs of those that are transitioning. Governor Newsom: (34:42) We are working with LA County specific to issues were on skid row. We have great new partner. The new mayor down in San Diego whose been extraordinary and now is opening his hands in terms of support and vice versa in terms of our efforts to collaborate without any ambiguity. And that's also very impactful, but those counties that have moved away from convention centers to solve the problem have done much better than those that relied on convention, larger congregate facilities, as it relates to the transmission of disease. And that's one of the best practices we're also socializing and sharing with mayors and with County health directors, as well as County leaders up and down the state. Speaker 2: (35:31) David Baker, Bloomberg News. David Baker: (35:35) Yes. Governor, I want to ask a couple of questions about vaccinations to date. I wanted to find out if you could tell us, first of all, how many of the doses that have been administered have been Pfizer versus Moderna. And I also wanted to find out with the Moderna vaccine, have we seen any of the kind of delivery hiccups that we saw in the first week with Pfizer? And then finally I wanted to see just what you thought were the biggest roadblocks or obstacles out there ramping up the testing or the vaccinations faster. Governor Newsom: (36:10) No, I appreciate it. So we'll go back to the slide. 454,000 have been administered. I'll get you an update and you'll probably receive it before I'm done responding to your question in your inbox in real time, as it relates to the Moderna versus the Pfizer. Let me just answer the second part of your question as it relates to some of the early hiccups with Pfizer, we actually have experienced more challenges to be candid with you with the Moderna distribution in this respect. Remember Moderna, we're not dealing with directly Pfizer, we deal directly with, but Moderna has an intermediary McKesson. And McKesson's one of the great companies, at least in terms of their logistics manufacturer distribution in the country. But that has been a little bit more of a struggle getting responses back in the first number of days. Governor Newsom: (37:02) Again, I'm not here to take cheap shots. I'm not here to point fingers. Quite the contrary. I have respect and admiration for everything operation Warp Speed has done in terms of just getting these doses to market and into people's arms. Now you've asked the right question, what more do we need to do? And how do we fast track those efforts? And that's why I put this slide up as it relates to our efforts to work with dentists, to work with pharmacy techs. I mean, every day here at the state operation center, we have a logistics team. We stood this up months ago on the vaccine and it's like a military operation in terms of the mindset, in terms of our desire to move and move efficiently and quickly, but also strategically as it relates to the equity frames that we have set forth. We finally got that pharmacy program up with CVS and Walgreens they're taking a portion of the vaccines directly. They go to them first. They don't go through our spoken wheels, as it relates to our distribution strategies. Governor Newsom: (38:08) We're working more collaborative with clinics and doctors. And as I said in the next few days in much more prescriptive detail, I'll update you on some new strategies to deal with some of the roadblocks, 1,297,000 doses received, 454,000 administered, not good enough. We recognize that. And the size of 21 States combined, it's a logistics opportunity. And that opportunity is manifest with a sense of urgency that is required of this moment and the urgency that people demand in terms of execution to the administration of these doses. And so you'll be hearing, as I said, a lot more detail on that in the next couple of days. Speaker 2: (39:02) Patrick Healy, NBC4. Patrick Healy: (39:06) Hi governor, if I can just follow up on that last question. It looks like approximately 25% of the available vaccines have not been put in the arm yet. How much of that is due to healthcare workers declining that they say they don't want to receive the vaccination and yet the hospitals have ordered the delivery of these vaccines [inaudible 00:39:26] be given? Thank you. Governor Newsom: (39:27) Yeah. We have anecdotal evidence on that. I heard one of my colleagues, one of my governors gave a specific percentage and I asked the same. I said, do we have actual data and information? We've got a survey out. We're looking forward to the results of that, which will be the closest approximation to actual data that I can provide you. When that comes back, I was hoping it would come back this weekend, this holiday created some little stress in terms of that response. But as soon as I get that, I will surely share it with you and share it with others so people have a better sense of that. But look, regardless of those that are unwilling to take the shot, it's their right. We have plenty of people that want to take that shot. Governor Newsom: (40:15) And the key is to make sure while we are enforcing the rules of the road, we're not necessarily enforcing against just common sense and the energy of someone who says, look, I don't want to waste this dose. Why don't I get it to someone that may be out of... But we're using a little more flexible language in terms of our conversations with a lot of our point of care folks so we can address some of these lingering concerns around opening up a vial and then having doses and some that can expire. Remember these vaccines can last a long time, but once you pull out of that vile and you have a particular number of doses, that's when you've got to move quickly. And we have some instances where folks have not utilized those spinal doses. Governor Newsom: (41:04) And we're trying to address that concern without putting people in a position where they feel like they've done the wrong thing. We're just looking for gross negligence. People that are skipping a line that no, they shouldn't be skipping the line. People taking care of people of means and influence not the rest of us. That's where we want to enforce aggressively. We're not going to force against people trying to do the right thing and common sense. So that's all part and parcel of the conversations we're having and the iteration and the flexibility that we are also trying to magnify in advance. Speaker 2: (41:38) Vicky Gonzalez, KCRA. Vicky Gonzalez: (41:42) Governor piggybacking on that, when talking to counties surrounding our area Sacramento, they typically do appointments to get survey [inaudible 00:09:49], to see how many vaccines and doses the facility needs. So there have been a few instances where there are extra doses. You were mentioning that there's kind of a loose plan. So is there not a specific wait list or backup plan distribution list to ensure that dose, one doesn't get wasted and two, go to someone that is most in need? Governor Newsom: (42:12) Yeah. We're moving expeditiously to make sure that happens have been for days when some of those first instances came up to make sure people are able to transfer those doses immediately. Let me ask Dr. Galley to talk a little bit more about the specifics of that since we're very aware of this bottleneck concern, and we've been having some very, very robust and very positive conversations with our providers all up and down the state. Doctor? Dr. Ghaly: (42:45) Yes, governor. Two parts to the answer to that question you gave. The first part, we are actively working to clarify, make sure all of the vaccinators understand what to do with those remaining doses when they open up a set of vials and they might have a dozen or two dozen doses left to give out to make sure that it's clear who they can give them to, and really to encourage the continued sort of drum beat of get people vaccinated while making sure that they're still doing as much as they can to target the most vulnerable, the most exposed, those who've been prioritized. But already the CDPH guidelines put out and give flexibility to the vaccinators to choose a population that fall within those priority groups. Dr. Ghaly: (43:36) They may not be exactly the first second tiers of 1A, they might be in the third tier, but ensuring that we have lined up people who of course are in that tier 1A and can benefit from the vaccine and if necessary and only if necessary, be able to use those doses for others as well. So working on those two fronts, clarifying the guidance that is already out that gives those vaccination sites flexibility to make sure they aren't wasting any vaccine. And then also continuing to add more description to how we make sure we have people lined up in the case that there's some extra doses that we get it into the most vulnerable and those who we know would benefit the most from receiving the vaccine. Speaker 2: (44:31) Jeremy White, Politico. Jeremy White: (44:34) Hey governor, thank you for the question. I want to echo some of my colleagues questions about the piece of vaccine distribution. You noted that California has received about three times as many doses as it's been distributed. So I would just ask simply where are those doses that California has and has not yet put into people's arms? Governor Newsom: (44:51) Yeah. Well, they're all across the state. They've been distributed to counties, they've been distributed to providers, they've been distributed throughout the system. Dr. Galley can amplify and talk more specifically. Dr. Ghaly: (45:02) Yeah. Governor, they are throughout the state. And one of the things sort of getting back to the last answer as well, we realized that there are doses and freezers and ready to be used, trying to make sure that we align those doses and those providers who have the doses to make sure that it gets out into the community. Many counties, many providers have already worked through some of the initial hospital-based healthcare providers. So now it's making sure we have the systems in place to get to all the other frontline healthcare providers, making sure that the doses get to the vulnerable in the congregate care facilities. And the work of the moment is making sure we bring together those vaccinators with the population, who based on our priority groups are sort of next in line to be offered the vaccine. So working hard on that in the next couple days, but certainly today, those vaccines, those vials of vaccine are spread throughout the state. No one particular place, no one particular facility, but broadly across California. Governor Newsom: (46:11) Dashboard by County in terms of the total amount distributed by County, total amount administered, injected. So that provides framework. And then obviously within that, a subset. We've got a very comprehensive registry. We've got protocols that predate this pandemic as it relates to immunization protocols that are well-established, just a reminder 19 million or so flu shots are administered every single year in addition to all the other vaccines that parents in particular are well aware of that all go through a very comprehensive system, that's well-established. So within that system lies the response to your question. Now that said, I think there's a little mythology, and I want to just clarify this, that somehow, and Dr. Ghaly perhaps in fact, I'm just going to put this over to you so you can offer it with a little more clinical precision, but the vaccines don't arrive magically in some state facility. Governor Newsom: (47:08) I think there's sort of this notion that, well the States receive them. We don't receive large crates of vaccines. And then Dr. Ghaly starts to send them out. The entire distribution is done very, very differently. Again, Pfizer, directly and Moderna through McKesson as an intermediary directly to providers. But Dr. Ghaly, perhaps you can explain that a little bit more so people have a better understanding because I think there is some sort of misunderstanding, understandably, so when they hear well, we've sent it to the States. Dr. Ghaly: (47:43) Yeah, absolutely governor. And from the beginning, there's a multi-step process. The first thing that this state does is wait to hear what our weekly allocation is from the federal government. We get an amount for Pfizer. We get an amount for Moderna. We then assign those amounts based on a number of different factors... Dr. Ghaly: (48:03) Sign those amounts based on a number of different factors to each individual local health jurisdiction, who then work with their providers who are registered to order the vaccine and those providers order it through the state directly to the CDC. And then the next step is that the Pfizer and McKesson, in the case of Moderna, deliver the vaccine directly to those vaccination sites. Some of those vaccination sites are county local health trusted or local public health offices, but many are the hospitals and the clinic systems that do vaccine routinely for not just flu, but all other vaccinations. So it's really built upon not a state infrastructure, but that public... Sorry, that healthcare delivery infrastructure throughout the state. And this is certainly part of the ongoing strategy is to continue to work with those providers to make sure that not just those who come to the hospital, or work in the hospital, get vaccinated, but that those sites become a sort of larger vaccination sites for their broader communities. Dr. Ghaly: (49:10) Some of those workplaces that we're focused on. So really working on that strategy now through a number of different entities of the state are really at the local levels and not just the local health departments, but these broad set of healthcare delivery partners across the States, including some of those sites that could be employer based or at work sites as well. So all of that is part of the ongoing strategy, but absolutely the vaccine does not come from the federal government or one of these manufacturers to the state to redistribute. It goes directly to a county designated sites that are registered with the state to administer the vaccine. Governor Newsom: (49:52) Myriad of sites all up and down the state. Now it's just about putting the pressure of distribution, putting, making sure people are held accountable, making sure the system's transparent, where there are bottlenecks, that we have flexibility as we identified maybe in the rules, but it needs to be socialized and shared more broadly. And obviously the rules of the road that are established through the Drafting Guidelines Workgroup. We want to stay broadly within that, but obviously we recognize now in terms of this all hands approach, that needs to be advanced. Again, we'll talk more about that next 48 or so hours in more detail in specificity, but I can assure you, there is a much more aggressive posture now in terms of local accountability, in terms of the administration. Speaker 3: (50:38) [Alexi Kosaf 00:50:38], SF Chronicle. Speaker 4: (50:42) Hey, governor, going further on this point about the distribution of vaccines, there's a shot tracker managed by Bloomberg News that shows California near the very bottom of all States in the bottom 10, in terms of the number of doses received that have been administered. So are there some particular challenges in California that you think have led to us being slower than other places in getting vaccines administered? Are people refusing vaccines at higher rates? Are there not enough staff to administer the vaccines? Is there some logistical smash through, like you mentioned with the Moderna intermediary? Any insight on that you could provide would be [crosstalk 00:03:27]. Governor Newsom: (51:27) Dr. Galli, perhaps you can amplify that. And by the way, I'd love to see an update on that data, but forgive me, Dr. Galli. Dr. Ghaly: (51:38) A couple answers to that question, Alexi, first off we know, and maybe this is the case in other States, but in California, we expected that over the last few days that there is some delay in getting the data put into the larger state database that tracks all of the vaccination. So we expect that there's going to be an uptick that might be a national phenomenon too. It wouldn't surprise me if other States see that lag, especially over holiday weekend. So we of course expect and have been told that a number of sites have done more than it seems that is reported, so stay tuned on that. I think in my mind and what I have been in conversations with our team on and our local partners on is that, through some of our work to make sure that we're liberalizing who might be able to get the vaccine when, that we don't have in California, a shortage of individuals who are interested in being vaccinated, and certainly no shortage of people who are a high risk frequently exposed who want to be vaccinated as well. Dr. Ghaly: (52:44) So bringing those things together, making sure that our prioritization allows us to stay focused on the equity and fairness principles that have driven our entire response, but also that facilitate those to get vaccinated. So I don't see this as a problem of a logistics one or one of issues with in any significant way with the manufacturers or the distributors. Certainly California would benefit, I think as every state would with more supply of vaccine so that we could do this even faster. But I think bringing these sort of prioritizations together, making sure that we're focused on empowering our vaccinators to do more on this front is going to be the key that helps us increase no matter where we are. And I can't speak to Bloomberg tracker or any other tracker in specific because I haven't seen it, but I know that for California, that we are working hard to make sure that a 100% of what we get, we get out as quickly as possible, because we know there are a whole host of Californians who should be vaccinated, and we would like to get them there as quickly as possible. Speaker 3: (54:00) Final question, Alex Michelson, Fox 11. David Baker: (54:06) Thank you, governor. We know that the rate of spread right now for coronavirus is alarming, especially in Southern California, in the San Joaquin Valley with 0% ICU capacity, the mayor of Los Angeles saying one person, every six seconds is getting coronavirus. So I'm wondering, what do you think in terms of the regulations that you have in place now are working and what might not be working and what additional tools in your toolbox might you have going forward? While you were talking, the prime minister of the UK, Boris Johnson announced a national lockdown. I mean, what more could we be seeing to try to bring this under control is as you suggested things are probably about to get worse? Governor Newsom: (54:52) Well, I appreciate it. Let me just take advantage of Dr. Galli and I'll build on what Dr. Galli's response is. But doctor, you're down in LA, he's been focused explicitly on what's happening in Southern California and has a much more nuanced sense in real time with the technical assistance that we provided in that analysis. And of course, unique relationship to the County as well and formerly served there. Dr. Ghaly: (55:17) I think this is an important question. And I'd say there's a three-part answer to it. First and foremost, we need to be and continue to be focused on what is already occurred, which has thousands of Californians, thousands of people in Southern California who are infected, who been exposed and are infected, whether that happened before the winter or December holidays or during those. We are seeing the issues with that transmission squarely in our hospitals and the state working with local partners, working with the hospital delivery system, working with first responders to make sure that every patient who needs hospital level care goes to a facility that's able to meet their needs, that we're doing all that we can to equip those hospitals with the supplies, the staff, we talked about oxygen, we're talking about additional nursing, traveling nurses arriving to the state today and over the course of the week. New department of defense teams all meant to stabilize and strengthen the hospital delivery system that is going to continue to do what it does, which is take care of people who need that care. Dr. Ghaly: (56:27) And they are doing the job that they can with the resources they have and we continue to build that up. The second piece is of course, all of the issues around the regional stay at home order, prior issues with our masking order, all of these things are also tools, the most important tools to help us get transmission under control. We knew and did a lot to reduce transmission over the last two weeks. We knew it was going to be high. We believe that the efforts collectively not just ours at the state level, but at the local level, a lot of individual decisions were made to make it less concerning that it would have otherwise been. But we are anticipating higher cases in the coming week coming out of this new set of sort of conditions in the last two weeks. Dr. Ghaly: (57:16) And so what is it that's going to help us get that under control? I think it's going to require us to do what we've been talking about all the time, make a hard choice to reduce our mixing and stay at home. The bottom line is because COVID is so prevalent in our communities, especially in mine, in Southern California and Los Angeles, it is just more likely that you're going to be exposed to somebody who has COVID. The same activities that you did a month ago today are just so much more risky than they were from COVID transmission perspective. And you may simply think, "Well, no big deal, I'm young, I won't get that sick." but then you carry it to somebody else in your community that is much more vulnerable. Maybe it's somebody you live with, a family member. Maybe it's somebody at the grocery store that you interact with, even for just a few minutes in line, but those sorts of things become higher risk. Dr. Ghaly: (58:07) And for us to get this under control, we need to continue to beat home that, the drum of that message and make that choice. We do believe that the regional stay at home order, as well as our efforts together to message and make different choices did make an important difference over the last few weeks to reduce that sort of curve, that very steep uptick was flattened just a little bit. And I believe that we did buy ourselves a little bit of room if you will, to see and be able to deal with what we have in front of us with this sort of holiday surge that the governor mentioned. What more can we do? Obviously, whatever we do, we need to make sure that it has the impact that people and the state can be compliant with that in order to have the impact that I think we all care deeply to see. Dr. Ghaly: (58:58) And that COVID fatigue, that COVID resentment that we've talked about is certainly at play here. And we need to continue to work together to make sure we support one another, to make tough decisions and stay at home and reduce our mixing. And then the third part of the answer is really about the vaccines. They can't come soon enough. The governor has said it, we're sort of in the deep dark part of the tunnel, there is light ahead. It will help us, but it's not going to help us right this moment. Even if a 100% of the doses that California has received were in arms already, it would not be soon enough. So we need to look forward to the vaccine and the solution that it's going to bring us as part of our midterm and longer term response. But right now, it's about reducing our individual and our community risk of transmission by doing the things the governor and many others have reminded us to do. Keep your mask on, stay at home. If you do go out, keep that mask on and keep your distance as much as possible. Governor Newsom: (59:59) And I appreciate the comprehensive response of Dr. Galli. I'll just add on, I'll quickly show you just a slide here that is suggestive. We saw mobility down 23% on New Years compared to baseline traffic a year prior. Now that would make some sense, but what's interesting, those are volumes that we haven't seen since late March when we did the initial stay at home order on March 19th. And so people are reducing their activities in mixing, which is helping mitigate the spread of this virus. Accordingly, you can see here, we've also stepped up our enforcement again, not in a way to be punitive, but a way of educating and addressing and this is very relevant down in Southern California, particularly LA and the mayor has been outstanding in terms of highlighting yet the issues of super spreader events, larger parties. And so we have been deployed in partnership with the cities and counties, with efforts to reach out to bars and restaurants that are still operating, but not operating appropriately. Governor Newsom: (01:01:02) You can see just on this slide, 26 counties in particular, over 1600 bars and restaurants were visited, next day, close to a 1,000 were visited. We also have been working in other parts of the state in partnership with San Diego on an effort to do similar outreach and visits. Again, not I'd been punitive, not looking to fine folks, though there have been some fines, but to get people into compliance or get people to do the right thing accordingly, we've seen the same efforts with large events. There was this annual SnowGlobe concert, got a lot of attention at least up in Northern California. And that was a proactive effort led by the ABC and others to work to address some of the enforcement. So you educate a lot more on PSA's, we've talked a lot about that. You encourage through just enlightened enforcement, not getting punitive, but compliance enforcement. We see data bearing out that there is, because of the stay at home order, mitigation in terms of the mixing. Governor Newsom: (01:02:02) And obviously all these non-pharmaceutical interventions in the common sense impact of wearing face coverings are foundational. And as Dr. Galli said, critical that we accelerate the pace of distribution of these vaccines as well. And with that, I'll accelerate the pace of signing off and just express gratitude to all of you for the opportunity and privilege of your time. We'll be updating you consistently this week. And of course later this week, talking more about the budget and budget supports for small businesses. Budget supports for restaurants, for bars, budget supports for families and individuals, budget support specifically to get our kids back in school safely and budget support more broadly across the spectrum. That is our annual right as we release our next fiscal year budget this week, every year in January and begin the process of deliberating with the California legislature. So with that, look forward to updating you more on the vaccine distributions and look forward to updating you more on the progress to mitigate the spread and terminate this pandemic. Take care.