Colorado Governor Jared Polis COVID-19 Briefing April 1

Jared Polis: (00:09) Thank you for joining us. Some historians think that April fool's day dates back to 1582 when France switched from the Julian calendar to the Gregorian calendar. The old calendar had a new year's date of around April 1st, and as the word spread about the change to the new calendar, people mocked and made fun of people that had the old calendar. Others believe April fool's day dates from old Roman traditions. Jared Polis: (00:36) No matter where it stems from, I think we can all agree that on this April 1st if we were where we are today a year ago, and anybody would say, "Imagine yourself in a situation where you and your family, you have to stay home. You can't go to work. There's a global pandemic. Schools are closed." I think anybody would have thought that was a very cruel April fool's joke. And unfortunately there are still those among us, not just in Colorado, not just in America, but globally who consider this something of a joke. And to them the message is clear, this is no joke. This is not an April 1st or April fool's day event. This is the very serious pandemic, the most serious global pandemic since the great Influenza of 1918, about one century ago. Jared Polis: (01:29) Really the only fool is us, and I mean us in the broadest sense, humanity, for not having had the necessary preparations in place to contain and prevent an event like this. We will as a species learn from this. I'm confident that the public health responses in China, in Italy and the United States, across the world will be in better place to prevent this kind of cruel joke on humanity to reduce the likelihood and incidents in the future. But we know we are where we are today. There's no Monday night quarterbacking for this, and this is not an April fool's joke and we need to move forward with figuring out how we can best contain this crisis, save lives, and ensure that people can go back to earning a living as quickly as possible and limit the economic damage. Jared Polis: (02:20) I know many Coloradans are wondering, in fact, we're all wondering, when will this be over? When can we resume some degree of normalcy? When can we leave our home and play with our kids on the playground? When can I start earning a living again? Frankly, a big part of the anxiety that many of us are feeling is not just the stress of staying in our homes, but also not knowing what the future holds. I have two friends of mine that have been diagnosed with COVID-19, one was hospitalized today, I left a voicemail for him just before this. This will touch almost all of us to be clear, whether it's your friends, family, whether you experienced loss or whether the medical intervention successfully saved the lives of your loved one. Just as we're seeing in areas that are a few weeks ahead of where Colorado is, Italy, New York, we know the trajectory of this virus and we're doing our best to contain it. Jared Polis: (03:19) I wanted to share with you the three factors. They weigh heavily on my own decision making process about how best to protect the people of Colorado and ensure that as promptly as possible people can start earning a living again and reopen our economy. My administration is working tirelessly in all three of these factors that need to be in place so that we could find our way back to a level of normalcy. That means both economic and social normalcy. And I use the word normalcy because it doesn't mean it's the exact same normal that it was, that we took for granted three months ago, six months ago, but at least the ability to enjoy the Colorado we love and be able to put food on the plate for your family. We have to get there sooner rather than later, and these steps are absolutely critical for us to achieve that. Jared Polis: (04:08) The first part is when will the viral spread be under control rather than expanding exponentially? I'm working constantly with our health professionals, our state epidemiologist, scientists at CU, reviewing scientific literature from across the world to find the best practices around reducing the spread of the virus and tracking the data in real time. And I'll get back to some of the data and the Arnott value in how fast the virus expands to others in a moment, as well as some of the health professionals that are guiding my decisions on this and informing all the decisions we make, but the most effective way to reduce this spread, absent, effective mass testing and tracing and quarantining, which are not yet in place, is to limit person to person interactions. That's what we are doing as a state and that's what you're doing. To save lives you're staying at home except when absolutely necessary to go out. Jared Polis: (05:07) Yesterday I telecommuted from home all day. It was on a series of conference calls. We went out once, we walked our kids and the dog at the same time around the neighborhood and we went back in, that was our only excursion out yesterday. Today, my only excursion out is to come to the emergency operations center here in Centennial to be able to provide you with this briefing. I'm doing the rest of my work, telecommuting, and I'm proud to say we have about 70 to 80% of the state workforce telecommuting. Jared Polis: (05:31) The state is a critical employer of course, we're going to continue to conduct the public business, but we want to model that behavior because other critical employers out there should also be seeking to take some of those same steps the state has taken as a critical employer, meaning we're hoping that even if you're critical, you have 70, 80% even more of your workforce that's able to telecommute or have staggered schedules to reduce the spreading through reducing those social interactions. Jared Polis: (05:58) The second piece of this puzzle that's informing our decision making is when will our medical surge capacity be built for those who are sickened by the virus so that they can survive and go on to healthy lives? Right now we simply don't have the medical capacity, the beds, hospital beds, the ICU units, the ventilators, the personal protection equipment to treat everybody who might get sick and has the potential to get better, and that means that without delaying the spread through their social distancing and stay at home, we need to use that time, that critical time to increase medical capacity. That'll be the main topic of today's briefing and I'll refer to our expert who's on the organizational chart at the emergency command center, Scott Bookman who will update you about the medical surge team and their timeline and description of that work to expand the number of beds. Jared Polis: (06:49) You'll be hearing directly from them about the monumental task at hand to build that medical capacity, the beds, the step downs. That means if you leave a hospital because you don't need medical intervention, but you're still contagious and can't go home, where do you go if you can't go back to your nursing center or senior center, for instance, if you're elderly, you need to go somewhere. It's about that. It's about the critical care beds. It's about all of those dimensions that we're building rapidly, Army Corps of engineers, our state, the private hospitals who I had a call with all the CEOs, each of them yesterday. So this is the critical work that we are buying time for and you're buying time for by staying at home. You staying at home is allowing the state and the hospitals to rapidly expand those numbers of beds so that people don't die just from lack of the right medical intervention that could save their lives. Jared Polis: (07:45) Third, we need to resolve the supply chain issues, and I want to update you on where we are on that. The supply chain issues around personal protective equipment, around tests is hampering our ability to treat those who are ill. We've had too, many of the hospitals have already had to, for lack of personal protection equipment, alter their protocols, so masks are used for longer periods of time. There's changes in the standards of care that have had to and will likely have to be made, and we don't want those to happen simply for shortage of supplies. And that's why we're working around the clock. And I literally mean around the clock, because some of the supplies are coming from China, and we have to call them, their morning is our late night, and so we are calling people at midnight, at two in the morning, at six in the morning, all different hours of the day across the global supply chain to get what we need from Colorado. Jared Polis: (08:38) Nobody wants to get back to the semblance of normalcy and jumpstart our economy more than you do and more than I do. We all want to get back to normalcy as soon as possible. The important thing to say is that the better we are able to stay at home, the sooner we will be able to return to earning a living and have the medical infrastructure in place to save the lives of, it could be your sister or your brother or your parent or your kid or it could be yourself, that's life is saved because we'll have a bed and we'll have the treatment that they need to save their lives. Jared Polis: (09:14) Families across our state need to put food on the table, need to pay their rent. I'm grateful that the federal government will be sending $1,200 per person, 2,400 per couple of $500 per kid to almost everybody. If you haven't filed taxes because you haven't needed to, there's an expedited form that you can file to make sure that you get your $1,200 payment. That's a huge help. I don't know where we would be without that, but we know that that is no substitute for reopening our economy and making sure that people can earn a living. While we're working tirelessly to return this state to normalcy, to productivity, to being able to enjoy ourselves as soon as possible, the better the compliance with the stay at home order, the sooner we can squash the threat, start earning money and enjoy our lives again. Get back our lives in many ways. The sooner we can end this very cruel April fools joke. Jared Polis: (10:07) Slide three, it gives a update. This is again not the 4:00 PM update, which will be issued shortly. It's a mid day update. We now have 3,338 cases identified in Colorado, 612 people are currently hospitalized, 50 counties, 77 deaths. Our hearts go out to the families and loved ones of everybody who has been lost in this crisis. We've tested over 18,645 people continuing to be one of the leading States in the number per capita of tests being granted. There'll be a further update at 4:00. Jared Polis: (10:45) As we indicated at previous events, I want to talk about the Arnott value now. The Arnott, the number of people that one positive person is likely to in fact was between three and four in Colorado before any social distancing measures went in. That was a catastrophe. We were literally seeing a doubling of the virus every one and a half to two days in Colorado. Now I want to return to this concept of Arnott value through our physical distancing measures. We're trying to knock that number down as hard as we can. We have to get that number below one for the virus to start to die out. Jared Polis: (11:21) We showed the progress being made in the sentence that it was doubling approximately every five days instead of every one and a half to two days. We'll continue to chart that. We hope that that increases, but ultimately doubling every six, every seven days can still buy us time, but we have to ultimately get that below one. We'll be reducing rather than increasing for us to be effective in stamping this out, and being able to return to normalcy. Jared Polis: (11:52) Now, in an ideal world, we'd want to get this number as close to zero as possible, so the likelihood of anyone being infected, going about their daily routine is very low, but when Arnott value is below one, the number of people with the virus goes down rather than up, and that's clearly where we need to get. Now keep in mind there's a lag in what you'll still see, the hospital beds go up, tragically the deaths go up because of the timing. Jared Polis: (12:16) So we're not anything close to an Arnott of zero today, but let's just say for a moment that if somehow this stopped transmitted in Colorado, you would have additional people that were admitted to the hospital in eight days, in 10 days, who had contracted it five days ago who manifested symptoms and needed to go to the hospital a week later. And so you would still see that increase even if the transmission stopped. The transmission hasn't stopped. If we're staying at home, it's going down more. I hope you are staying at home. It's not just for saving the lives of others, it's potentially for saving your own life. And it's also for minimizing this horrific economic devastation and disruption so that we can get back to work and earn money and support ourselves and our families sooner rather than later. Jared Polis: (13:03) So we know right now we're doing this reduction in Arnott with a mallet and all of my thoughts and efforts in our innovation team and others are working to get to a place where we can do that with a scalpel. Where it's identifying quarantine rather than these devastating measures that impact every single one of our lives. We now go to the visual representation of Arnott. This shows Arnott of three just so our viewers know what this means one person spreading up to three to nine. This is why this virus has been so dangerous. It's extremely contagious and that's why these extreme measures are being taken. Jared Polis: (13:40) Unlike for instance, influenza, which has a great amount of resistance in the general population, A, people who've had their flu shots, but B, people who've had it and have had increased resistance because the pathogen has been out there. This is a novel Coronavirus pathogen. There is little to none built up antibodies or resistance among the general population. That's why this is spreading like wildfire. Just as the 1918 influenza did when there was very little resistance among the population before the virus began. Jared Polis: (14:12) Next slide. One of those three areas I talked about is our need for a personal protection equipment. This shows what we have in our requests that I outlined to Vice President, Mike Pence, in writing that our congressional delegation is aware of, and also in touch with the Vice President on, Senator Bennett and Senator Gardner. This shows by percent and by numbers, the amount that we have of the different materials that we've broken down that are needed for this medical search. What we know now is not only are we facing a healthcare crisis, we're also facing a supply chain crisis. It's hampered our abilities to effectively respond to the healthcare needs. This is a global supply chain crisis, not only Colorado, not only United States of America, but the European countries and the countries across the world are all. Jared Polis: (15:03) ... engaged in this mad scramble for equipment. I can't begin to express to you the frustration that I have about our inability to get the masks and supplies that we need into our healthcare system that usually costs 58 cents and are plentiful. Now, we know that the national industrial capacity will kick in. This is a short to medium-term issue, another reason that these extraordinary stay-at-home measures are needed. Because in a matter of a month or two months, there will be masks flowing out of our ears. They'll be all over, because the industrial capacity will be focused on that. But that doesn't help us for what we need next week and the week after. We know that not having gotten nearly enough from the federal government, we've really taken it upon ourselves as a state to engage in the purchasing that we need and the supply channels we need to make sure that the supplies for the people of Colorado are met. Next slide please. And I have to tell you how crazy ordering in this environment is. It seems like every Coloradan, or at least the thousands that have contacted us, have a contact or an aunt or uncle in China or somewhere that's helping us. I want to thank the Chinese province of Hunan, that is kindly sending us 10,000 masks. But we've also had to really scramble to be able to talk to Chinese factory owners and others. At one point, I even considered should we send over our own state 747 to China and trust our negotiators to be able to fill it before it came back. We didn't have to do that. We've placed a number of purchase orders and we have a number of supplies that are in transit or in the supply chain. Now, all subject to verification, this might be April Fool's Day, but Colorado isn't going to be anybody's fool. We want to verify that the masks work and are not counterfeit before we pay for them. And this is a challenge in building through these relationships with suppliers that our state has never worked for. Jared Polis: (16:57) Now first of all, it's a challenge that a state actor, a public actor, in the state of Colorado has an advantage in over private actors and hospitals. Because when we're dealing with Chinese suppliers, they can inherently trust the state of Colorado more than they might trust X hospital or Y hospital or Z hospital that they might never have supplied. Might not know about their credit rating. And might not know how legitimate they are other than being able to check their website. People fortunately do trust the state of Colorado, but we need to trust, but verify. Meaning, thanks to scientists at CSU who were able to have testing equipment, we're taking samplings from PPE that will be arriving or has arrived at DIA in the coming days, to be able to scale up those relationships with those trusted suppliers in China, as well as trusted domestic suppliers, to be able to meet that need. Jared Polis: (17:46) We placed orders, issued purchase orders, for two and a half million N95 masks. A million surgical masks. 25 face shields. 250,000 gowns. 1.5 million gloves. 750 ventilators. I've talked to so many folks as intermediaries at no profit to themselves who have helped with their connections, with suppliers in Asia, suppliers across the world. But we will verify as these materials arrive, thanks to scientists at CSU and others that are willing to step up and help. At this point in the crisis, personal protection equipment equals lives. Ventilators equals lives. It's a difference between our healthcare workers being able to stay on the job, stay healthy, and being able to help continue to serve those sickened, or whether they themselves also become victims of the virus. Jared Polis: (18:42) We see other States where medical staff are forced to use homemade masks, or using ponchos or trash bags in lieu of gowns. We hope to avoid that situation in Colorado by working all of the contacts we have with the private sector leadership we brought into the innovation sector. The calls at all hours of the day and night. The quality vetting and the personal vetting to make sure that Colorado can be a leader in opening these international and domestic supply chains, as well as ramping up our domestic manufacturing capabilities in Colorado, which takes a bit more time. Jared Polis: (19:17) We know the private sector is scaling up their manufacturing capacity in each sector, each of these items, gowns, gloves, mass ventilators. Each has their own timeframe. Each has their own constraints. But we expect that supply chain issues will be resolved over the course of summer. Now, that's not soon enough, which is why we are being extremely innovative about how we're doing the purchasing and opening up new supply chains ourself as the state of Colorado, operating in the domestic and international marketplace in very aggressive ways to be able to make sure that we have what we need for the people of Colorado. Jared Polis: (19:54) We're working creatively and rapidly sourcing these critically constrained supplies to bridge our healthcare system from where we are now to when the normal supply chains our restored and domestic manufacturing can fully kick in. We've asked every relevant sector of the economy to do an inventory and offer up personal protection equipment. That's why the early orders around stopping elective surgeries. That's why the early orders around stopping elective dental procedures and cleanings. That personal protection equipment needs to work its way to our hospitals and our first-line responders and then we hope that that gap can be alleviated. Jared Polis: (20:34) And of course, we know that those procedures, while they can be put off, we know they're not elective. We want people to be able to get their teeth cleaned of course, and we want people to be able to have the back surgery they need to ease their pain. But we know that things that can be delayed are, and we hope that that is part of that return to normalcy once we address these issues around personal protection equipment and hospital beds. Cause another thing that's being looked at that Scott we'll get into with some of these ambulatory care clinics and others are being looked at, the step-down facilities or even as hospital beds as well. Some of that capacity will be needed in the weeks ahead. Jared Polis: (21:11) We're also working with manufacturers in Colorado to repurpose operations to make these needed supplies and we'll continue to work with new suppliers until Colorado's needs are met. There's been, as I indicated, thousands of inbound inquiries. Many well-intentioned, but don't pan out. Many are scams, and some gems that we are tracking down and and leveraging and operationalizing for the people of Colorado. Jared Polis: (21:37) My administration is really working hard to move heaven and earth to acquire the needed materials to support the medical surge, as well as reduce the spread of this virus in Colorado and ensure that we do have the testing in place to isolate and contain future surges so that we can return to normalcy and productivity sooner rather than later. You can help by signing up at helpcoloradonow. org. We need volunteers. Any donations if you're in a position to give. Anybody with medical training to help bolster our staff. But it's not just medical training that's needed. We need folks from all different walks of society that might be able to help, sign up at helpcoloradonow.org. I'm proud to say that we've recruited over 2,500 medical volunteers. And I want to say, thank you Colorado for stepping up in our time of need. This is one of our most difficult times, but it's also a time that we all can show what's best about Colorado. That might mean sign up as a medical volunteer. It might just mean that you and your family are succeeding at staying at home and avoiding interactions for these weeks ahead. Jared Polis: (22:47) Alongside equipment and personnel, one of our biggest challenges is scaling the physical space for the beds and others. I showed you this chart on Friday, which is all the different divisions working at the emergency operation center. Great Coloradans that have stepped up and are reporting to work virtually or physically at the Centennial Emergency Operations Center, where everybody has their temperature screened entering. And we're also enacting best practices around social distancing, both in this room, between our members of the press and on the floor of the operation center. Jared Polis: (23:17) But today I want to take a deeper dive to help inform you about the work of the public health and medical section. The section that is charged with surgeon medical capacity. The section that is charged with making sure that Coloradans don't die because there's no bed to put them in and no oxygen to put them on. I want to introduce you to our Colorado Department of Public Health and Environment Incident Commander, Scott Bookman, to walk you through the work that his team is performing. I'll turn it over to Scott. Thank you. Scott Bookman: (23:48) Thank you Governor. Thank you all for being here today. So the next slide please. Scott Bookman: (23:54) The mission of the Public Health and Medical Section, which is focused on healthcare surge, is to save lives by ensuring the stability of Colorado's healthcare system and to increase capacity within that system. We're operating under a number of different assumptions. The first one is that healthcare institutions across the state have been preparing for COVID-19 for many months and have already taken steps to increase internal capacity. We are grateful to everyone in the healthcare system who has already been working on this since January, preparing their hospitals to surge. We do however assume, that our healthcare systems will also work within their normal patterns until they are overwhelmed. Therefore, the role of the state is to support healthcare systems by providing coordinated access to private sector resources to acquire PPE, ventilators, and other critical equipment. We also need to coordinate the recruitment and utilization of volunteer medical professionals to provide surge capacity within that system. Finally, we need to provide information on the status of the healthcare system and then create systems that overlay our normal healthcare systems to provide coordination and response when the system becomes overwhelmed. Next slide please. Scott Bookman: (25:15) It is incredibly important to understand that the physical space and capacity within our healthcare system will be challenged. Our job is to create more space within that system. We already have over 500 hospitalizations. We know that that is a lagging indicator and it will continue to grow. We need to be prepared. Our operating challenge is that the models are telling us that we will see a surge that may overwhelm our hospitals sometime between April and July of 2020. We also know based on the clinical evidence by areas that have been previously hit by COVID-19, that these patients are going to require intensive care. They are going to be severely ill and they are ventilator-dependent for anywhere between an average of 11 to 20 days. And they won't be done with healthcare at that point. They will still need to be released from the hospital into other lower acuity facilities, and then receive treatment in the outpatient setting after that. And just like in normal life, different cases will have different outcomes and different levels of severity within them. Next slide. Scott Bookman: (26:29) What I'd like to show you right now is our concept of operations for medical surge that we're developing here at the State Emergency Operations Center. It's a four-tiered system by which we will classify patients and the facilities in which they are treated. The goal here is to make sure we're getting people the right care, at the right place, at the right time. It is also important to understand that people may move across these tiers depending on their illness progresses. So tier one, in red, is within our hospitals. These are critical care patients that are likely to require ventilators, dialysis and other ICU-level care. Our goal is to increase the ICU capacity in the state to 5,000 beds by April 18th. That is what our models show that we will need. We are doing this by partnering with our hospitals to work with them to gather extra PPE, extra ventilators, extra beds, and anything else that we can do to support them in those efforts. Additionally, we are looking at using critical access hospitals and other long-term care facilities that can provide additional surge within tier one. Scott Bookman: (27:43) Tier two is an important multiplier for tier one. This is where we'll use ambulatory surgical centers, freestanding emergency departments and critical access hospitals to create additional capacity within our hospitals. Our goal is to be able to move people out of a hospital as soon as possible and into a lower acuity setting, so that we can keep those critical care beds in the hospitals intact. Scott Bookman: (28:10) In our tier three, these are our subacute patients. These are people who will require daily monitoring by a doctor, twice-daily monitoring by a registered nurse. They may have some respiratory therapy needs. This is where we're looking at larger facilities. Arenas, convention centers, stadiums, even warehouses that we can convert to field hospitals. Our goal is to have 2,000 additional beds of this tier by April 18th. We want to thank the Army Corps of Engineers for their help in building out this capacity. It will look similar to what you're seeing in New York City right now in Central Park. Scott Bookman: (28:50) Finally, tier four is for non-acute care patients. These are people who are asymptomatic. They're needing quarantine or basic super supervision. This may include people who are experiencing homelessness. These will be hotels, dorms, skilled nursing facilities. Any other lodging facilities that we can find that we can turn into medical shelters and medical care facilities. We again want to thank the Army Corps of Engineers for their work in helping us build out these tier four facilities. Our goal is to have 10,000 of these beds by May 15th. Next slide please. Scott Bookman: (29:26) We have set some wildly important goals for our medical surge section to hit, and I want to run through them with you today. Number one, we need to increase the total number of tier one critical care beds in Colorado from about 1,800 to 5,000 by April 18th. Number two, we need to increase the total number of subacute tier three surge beds in Colorado from zero to 2,000 by April 18. We also need to increase the total number of non-acute tier four beds from zero to 10,000 by May 15th of 2020. Speaker 2: (30:02) Additionally, we know that we need to create and implement a patient transport unit within the public health and medical division by April 10th so that we are prepared to deal with the surge and move patients as we need to. And then, finally, we need to increase the completeness of our EM resource data from a baseline of 62 to 90% by April 18th. This will give us the key information on the status of our healthcare system so that the state can act to coordinate the movement of patients as we need to. I believe that this plan, along with the drastic physical distancing measures that we are taking will allow us to deal with the surge of patients without overwhelming our public health capacity here in Colorado. Jared Polis: (30:50) Thank you. Before I get to a few other updates on actions that we took today and are taking today, I also want to address our work around rapidly scaling up the testing. Now, I hear from people, "Hey, I have symptoms. What do I do to get tested?" To be clear, you don't need to be tested because there is no clinical difference. You need to self isolate in your home. The only advice, if you have flu like symptoms, that has been issued by CDC and world health and others is instead of ibuprofen, which means instead of Advil, use Tylenol, acetaminophen or use aspirin. You can also use Afrin. But nine and 10 of you won't require any type of medical intervention depending on your age if you have this virus. Jared Polis: (31:33) The last thing we want you to do is going out and somehow trying to go into a hospital and you might be contagious and get tested. That means somebody needs to use the personal protection equipment to test you. And then, there's nothing to tell you to do other than to go back home unless you need medical care. So, nine out of 10 people require no medical intervention. Stay in your home, stay isolated with any flu like symptoms you have. If you do any medical care, if you're having that difficulty breathing, if you're in dire crisis, please call for that immediate medical attention. Of course, you need that, but reserve that for those who need it. 90%, depending on your age or more of folks will not need medical intervention. The only clinical advice you need to know is rather than ibuprofen, use acetaminophen or aspirin if necessary. You don't have to use any of those if you don't want any, but you can use those to bring down your fever. Jared Polis: (32:24) We are rapidly working on scaling up testing. We have one of the highest testing percentages. We're working on all forms of testing. We now have the state processing capacity of thousands of tests per day. We moved the response time down from four to five days to about a day for processing tests, and we continue to scale that up. But if you have it, you don't want to go out and about just for the sake of knowing what you might have because there's no clinical difference. If you need medical attention, seek it. If you have flu like symptoms, stay at home and under all circumstances, if you are healthy, you need to stay at home whenever possible. You can still go out to the grocery store and take that walk around your neighborhood with your dog, but otherwise, stay at home unless absolutely necessary. Jared Polis: (33:07) Look, I want to thank all the members of our team, of the Colorado National Guard, of the Army Corp Engineers, our state workers, our hospital workers, so many others. Everybody's working hard, everybody's long hours. What we need you to do to honor those who are working hard every day is to stay at home to the best of your ability and help protect their lives as well as yours. I'm also grateful to see so many stepping up and helping to meet these challenges. I have a few additional announcements today. Today, I'm extending the closure of all schools in Colorado through April 30th. This is consistent with president Trump's views and guidance on restrictions and in-person gatherings, and should go on at least for these next 30 days here in April. The practice of announcing executive orders for 30 days is something that typically happens during times of crisis. Jared Polis: (33:57) I expect that many districts have made or are making the decision about whether to stay closed for the remainder of the school year. As a statewide policy, they will need to remain close through April 30th. We will obviously evaluate the health situation at the time, but many of them have successfully transitioned to online instruction and many of them will independently be making that decision that people don't need to come back for those final few weeks. And of course, at this point, we don't even know if that's possible from a statewide perspective. But we do have the degree of confidence needed to extend that order through April 30th pursuant with the president's guidance. Across the state, superintendents, school leaders, teachers are stepping up and building remote learning plans so students don't lose out on valuable instruction because of this crisis. Thank you to our teachers, thank you to our principals, thank you to our superintendents. Colorado children will not fall behind academically because of their inability to attend in-person classes in their school. A lot of great examples across our state, Englewood school district prioritized family engagement by setting aside time each day for teachers to connect with families to answer questions that they have. In Canyon City, the school district has partnered with iLearn Collaborative, a local nonprofit, to give specific professional development to teachers on how to operate this new virtual environment. Jared Polis: (35:16) In Durango, educators even held a virtual parade to let students know that they're there. Here in Colorado, our educators are innovative and strong. We need to continue to prioritize creativity and to do the best we can in this virtual environment. And as parents, as a parent myself, it's important that we express our gratitude to educators in our schools for stepping up and meeting the needs of our kids. It's, of course, important educationally, yes, but it's also very important for kids to have that schedule on that routine to help make sure that they can more effectively manage these challenging times. That routine that education gives them is such an important part of that normalcy that occurs in our households every day. I want to thank our parents and teachers and educators and students for all adapting to this situation as best as we can to ensure that we can keep people safe, prevent the spread of the corona virus, save lives, and that our education of our kids will continue. Jared Polis: (36:20) We also want to pass along an important announcement on behalf of so many of our mountain communities, especially Gunnison County and other mountain resort communities. We've still gotten reports, unfortunately, of alarming number of people who are trying to travel to our mountain resort area. Some of you might be second homeowners, others might be traveling there for recreation. I want to be very clear and say in this, and we'll continue to repeat this, this is not a vacation. This is a pandemic that the world has not seen since over a hundred years. It's not a vacation. For starters, the mountain community has much higher rates of infection than the rest of the state, so you're putting yourself at additional risk by going there. That's just dumb. Not only is that contributing to the spread of the virus, but you're putting yourself in jeopardy. Jared Polis: (37:10) Furthermore, from the beginning, we've been very concerned about overwhelming the public health systems in our relatively small mountain communities. They simply don't have the capacity to handle the kind of surge cases and intervention that we might have here. And they're also at a higher altitude, which is bad for anybody with a respiratory condition. Grocery stores are struggling just to keep up with demand from local residents in our mountain communities, so please stay in your primary residence, stay at home, be smart. It's much more likely that your primary residence has better access to necessities and groceries and healthcare resources than any of our mountain communities that are getting slammed by this virus. Jared Polis: (37:52) I also want to salute those that are doing work and participating in the US census. Today is census day. That's a civic duty to participate. You should've gotten your census form in the mail. You can fill it out at census.gov. It's not like you have a lot of other things to do. Please fill out that census.gov form immediately and make sure that we're counted because it's very important. It's more than just about some number of how many people live in Colorado that demographers look at it. It's actually about how much money Colorado gets and Colorado families get. It means billions of dollars over the next 10 years in federal funds for projects. From building roads, if you care about traffic, fill it out, to health care because we're competing with other states for critical resources. Jared Polis: (38:41) Across the United States there's about $880 billion that's allocated just based on the census count. That's about $13 billion a year. Now, in Colorado, it's not only about making sure we're politically represented in Washington and the voice of Colorados are heard, but it's really about making sure that Colorado gets its fair share. So, pause your Netflix or your Apple TV for just a few moments and fill out your census form that you got in the mail. It has a code. You go to the site, you do it. It took us six minutes, really quick, and make sure that we're getting the best bang for our buck and the federal government. There's also a way to physically send it back if you don't have that internet access at home. Census.gov for more information. If you lost your form, if you didn't get it, call (800) 772-7851 to request a new one so that we can make sure that your voice counts here in Colorado. Jared Polis: (39:40) I know that this isn't easy. I know everybody is asking, "When will this be over? When can we go about our lives? When can I start earning a living again?" And the message should be clear to all of us that, based on the science and the data, the more that we succeed at staying home, the fewer interactions we have, the sooner this crisis will end. That doesn't mean the virus won't be with us for some matter of months until there's a vaccine or successful treatment, but the fewer interactions we have, the sooner that the crisis will end and that we can return to normalcy, which means being able to earn a living for your family and enjoy the Colorado that we're all so passionate about. That's our responsibility to others, to ourselves, for our own lives, to help reduce the economic disruptions. Let's succeed at staying at home. Thank you, and I'll be happy to take some questions. Speaker 3: (40:35) Governor, can I ask you about the tier level that... At least more than 20,000 additional beds. Where are the medical professionals going to come from? Speaker 2: (40:54) We are working very hard to recruit as many volunteers as we can. We're also looking at staffing agencies, we're looking at our partners in the National Guard, we are looking anywhere we can to find as many volunteers and paid professionals as we can to join our team. Speaker 3: (41:10) That's a heck of a deficit right now. Speaker 2: (41:12) It's a big lift. We have a lot of work to do and we have a lot of work to do quickly. The more people stay at home, the more we slow the spread of this, the more time we have to prepare. Jared Polis: (41:22) Colorado was able to get some emergency nurses to enter the state. We've relaxed licensure requirements, automatically renewed people, over 2300 people with some kind of medical credential, paramedic nurse have volunteered. Obviously, other medical professionals are working double shifts, working very, very hard to help meet this crisis. But that's one of the most important reasons that we do need to stay at home. To be clear, all of those beds are not intensive. Some of those beds might simply require monitoring, some require oxygen and monitoring, and some high skilled for ventilation patients and others. So, there's a whole continuum of care across those different beds that need to be built. Telephone question please. Speaker 4: (42:03) Hi, this is [inaudible 00:42:04] Bloomberg in Denver. What are the projections for Colorado for the total number of fatalities and cases and also, today, how many COVID patients are ICU and how many are on ventilators? Thank you. Jared Polis: (42:20) We'll be happy to get more of a breakdown on the number of patients. We do normally do our update at 4:00 PM. The numbers I gave you are just preliminary midday numbers so we'll try to provide more information at four. We showed that if no steps were taken, the public health estimates from CU Health, from Kaiser, the local interpretation of national projections, of international projections, showed that the loss of life would be in the mid tens of thousands of people in Colorado. We hope and we expect the that is avoided because you're staying at home and because our schools are closed and because our bars and restaurants were closed early. We're hopeful that you know if the president is correct about the national number of fatalities from this disaster, we hope that Colorado does not stand out as a state that has a higher percentage than other states. In the room, yes? Speaker 5: (43:16) Governor, your plan calls for deadlines by April 10th [inaudible 00:13:20], but the Institute for Health and Metrics and Evaluation estimates that Colorado exceed its available hospital capacity in just five days. Is there a short term plan in place and are you worried about exceeding medical capacity sooner than what you've outlined? Jared Polis: (43:37) I mentioned all the hospital CEOs on a regular basis, just yesterday, the major hospitals CEOs, and then group calls with some of the smaller ones. They are ready, many of them have already added beds. I don't have that number today to tell you we have, but these numbers are the statewide goals, but many of the providers have already added beds and the number of beds is higher than it was three or four weeks ago. There's also two other factors that help Colorado, our mountain communities, our resort communities, keep in mind that they have more hospital capacity than a normal community. Their size would because they normally serve tourists that balloon the population of these counties three or four times seasonally. While they still get overwhelmed, they have more capacity than a non tourist community. The second factor is that in addition that we've already cleared out the beds that would have been used from people by elective procedures. So, we're above that normal baseline of beds because elective procedures are being delayed. Telephonic question? okay. We'll go to one in the room. Marianne? Marianne: (44:44) Yeah, one of your earlier slides talked about the supply chain. We're hearing a lot of stories about states having to compete for the supplies they get ordered, and then somebody else comes in and swoops in and gets the orders that you may have placed. How confident are you that you're going to be able to get those supplies? Speaker 6: (45:03) Jared Polis: (45:03) We don't believe ... We don't know that we have supplies until they're in hand and validated, because we have to be able to purchase from folks that we've never purchased from before. We're competing not just against other states, but private companies and countries across the world, and when they arrive on the plane and when our CSU scientists test the masks, test the gloves, then we'll be able to say that we have them here. Until we reach that point, I don't know what we will have and what, we won't have. Jesse? Jesse: (45:35) Governor, you just said that you're extending the school closures until April 30th. What are you doing about the stay at home order that's set to expire even before your school order was set? Jared Polis: (45:43) The stay at home order is the most extreme mallet that we are using to reduce the spread of the virus that's being done in an urgent basis. We are going to look at the science and data in real time to find out when that can roll off and when we can return to more normalcy. I hope, and I know we all hope that that doesn't have to go to April 30th. On the other hand, according to the president's guidance and the data we have today, it quite likely might need to be extended beyond April 11th. But it's not some ... It's not a call we're going to make on April 1st we don't know where we're going to be in 10 days. We're going to give people notice. We're going to make it based on the data we have a few days ahead of time, but it depends on how successful we are at staying at home. Jared Polis: (46:24) If we're successful staying at home and reducing the spread of the virus, we can roll off that most severe stay at home order sooner. That doesn't mean that things become normal right away. Even before that order, remember workplaces were 50% capacity. We closed restaurants and we had to close clubs, so it's all about when we can provide the maximum degree of flexibility in economic activity at the minimum risk. And it also depends how we're successfully implementing the health surge that Scott Bookman outlined. Telephone please? Erica Meltzer: (46:57) Yeah, this is Erica Meltzer. From Chalkbeat. Sure. Going to squeeze in two questions here. One, why not just cancel the rest of the school year now, and two, you cited a number of examples of distance learning that districts are doing. We know districts are doing good work, but also it's been very uneven. Internet access is uneven. Students have some pretty diverse needs. What support are you providing to districts to make sure that all students can learn? Jared Polis: (47:24) I talk regularly with the commissioner of education, Katie Anthis, who's doing a good job. The Colorado Department of Education along with much of the state workforce is telecommuting, only a few people have to go in. But we're maintaining all of those critical state services, yes. Just as we highlight examples of districts that are doing a good job, I know there's some districts that have a learning curve and are trying to get there. There's also some districts that are still in an extended spring break or even their normal spring break this week, so there's districts whose classes haven't resumed. I know that those that aren't quite yet there on being able to deliver the quality of curriculum materials and pedagogy are working very hard to get there. It's keeping the superintendents, the teachers up late at night, working hard to make sure that while children will always remember this school year for their entire lives as one in which they were out of school for a number of months, that they won't lack the academic achievement that they need to advance to the next grade level. Jared Polis: (48:22) We are confident in that schools will not be able to resume statewide by April 30th. There are some districts that, based on that parameter or on their own information from their county health department are saying they won't be able to return to their school buildings at all this school year. We certainly advise that school districts prepare for that. School districts are also preparing to not have physical commencement ceremonies, for eighth graders, for seniors, and really I've seen districts go two ways. Some are creating a meaningful virtual experience for those graduating kids. Others are saying that they'll have them march sometime next year and come back and honor them physically. Some might even do both. Jared Polis: (49:06) But we see across our state great innovation by amazing school districts and superintendents and teachers and principals, and I want to thank them for our work. While our children are not at the highest risk from this virus and they are at a lower risk than other Coloradans, we want to make sure that they're not at risk for losing a year's worth of education and that everybody is ready to advance their grade level and be able to graduate and go to college or enter the workforce. Question from in the room, first time folks, anybody who hasn't asked one? Yes? Speaker 7: (50:36) [foreign language 00:04:45]. Jared Polis: (50:38) [foreign language 00:05:04]. Telephone question please? Erin Prater: (50:43) This is Erin Prater with The Gazette and Colorado Springs. I touched on this a bit at your press conference a couple of days ago. [inaudible 00:50:49] continues to have the highest fatality rate in the state when it comes to counties. At 5.1%, it's the sixth highest in the nation when it comes to counties. What's your reaction to this and any additional advice for the residents of El Paso County on what they can do to squash this curve in the county? Jared Polis: (51:08) So the higher rate in El Paso County is not because El Paso County doesn't have first rate health care and resources in hospitals. It's because of the demographics of who was affected. The unfortunate bridge clubs spreading, and others that have disproportionately affected some of the most vulnerable. It's very important that all Paso County residents stay at home to reduce the spread of the virus in El Paso County. The more that we can succeed at doing that, the more lives we save, and the sooner that we can return to economic normalcy in Colorado Springs and El Paso County? Yes? Erin Prater: (51:42) ... Greater need for El Paso County residents to stay at home versus residents at counties in other parts of the state? Jared Polis: (51:49) It's a statewide order. It's the law of the land in all of our counties. People need to stay at home except when absolutely necessary. And again, that means you can, yes, as my own family did yesterday, we walked our dog and our kids once around the neighborhood, and other than that, we stayed home. Please do that to the extent possible. Yes? Speaker 7: (52:20) [foreign language 00:07:16]. Jared Polis: (52:27) [foreign language 00:07: 24]. Yes? Speaker 8: (52:59) Previous ... In recent days, you've said to us that the ventilator shortage is about 7,000. This chart you're giving us today says you guys want 10,000 ventilators. So that's a big difference. What does that say about how your office's expectations are evolving regarding the surge that's coming? Jared Polis: (53:15) Let me find that. But what we're generally doing, and I'm doing this on masks, I'm doing this on gloves, we're doing this on ventilators, is I'm setting our goal a bit higher than what we hope we need. We don't want Coloradans to die from lack of ventilators. We don't want the disease spread from lack of personal protection equipment and if some of the orders fall through, if some aren't delivered on time or are defective merchandise, we want to make sure that we still have enough to be able to save the lives of Coloradans. We're hopeful that based on people succeeding and staying at home, I'm very hopeful that we won't need 7,000 and we won't need 10,000, but nevertheless we want to prepare for that eventuality because I want to make sure that Coloradans know that I am doing my best and our team is doing their best to make sure that Coloradans don't die simply for lack of equipment. One more from the phone, and then one more from the room. Phone please? Alec Braeden: (54:23) Hi, Alec Braeden with Fox 21. Similar question about the ICU beds. On Monday CDPHE said that they have about 1, 800 right now and they wanted 5,000 by summer. What new information came in to move that goal up to two months to get 5,000 beds by mid-month? Scott Bookman: (54:43) This is Scott Bookman. We're continuing to evaluate the models and we are looking at the worst case scenario, and the worst case scenario is it happens really soon and we want to be prepared for that. We want to have as many beds as possible, we want to have as many ventilators as possible, we've set some interim goals and then we've set some longer term goals. That's why you see the numbers get bigger over time. We know that if we need 5,000 ventilators, we should strive for 7,000. Eventually there are mechanical failures. We want to make sure that we have enough to save lives in Colorado. Jared Polis: (55:18) And I want ... The people of Colorado should know that I'm pushing these men and women, I'm pushing these guys as hard as I can. Whenever they're giving me something. I'm saying, "Can we do it sooner? How can we do it sooner? How can we prepare for more?" So anything they're giving me, I'm looking at every possible way that we can have it sooner. Because if we need [inaudible 00:55:39] later anyway, at least we had it ahead of time. And the other scenario I'm worried about is that this continues to worsen globally and it's harder if not impossible to get that equipment when we need it, even if it's later. So I want Coloradans to be able to know that we're pushing everybody as hard as we can to have it sooner rather than later if the global free for all and competition becomes even worse. Last question from the room? I'll take yours after that. Last two. Go ahead. Speaker 9: (56:09) Dr. Moss told us last night that the apex of this in Colorado, early on that he had maybe talked with you about was May 1st, he then said it's looking good because of the stay at home that it may be now April 17. What are you hearing about at least realizing that things change? Jared Polis: (56:25) So I don't have the exact things he said, but he probably didn't say because of the stay at home cause we don't know the epidemiological impact of that yet. What we have is the impact of the bars and restaurants closing. It's promising we're going to attract that every day in terms of the doubling time and the virus, but the virus is still doubling. Because of this lag factor we won't see the exact impact of the stay at home for about another week to 10 days, about a week from now. So we're going to be reporting on that in real time. But what we're seeing now in the reduced spread, closure of schools, closure bars, closure of restaurants. Those are the measures that went in early enough where, remember, four or five day incubation period, five to eight days needed until hospitalization. But we do see initial indicators that those steps have helped push back the date of that peak, and given time for this medical surge that Scott Bookman briefed you on today. Go ahead. Speaker 10: (57:20) I find it interesting that you mentioned that you were at one point even considering sending your own 747 over to the- Jared Polis: (57:29) Not mine personally, to be clear. I don't have one. Speaker 10: (57:29) The state plane. Can you talk ... Elaborate a little bit more about why that wasn't a viable option and what are specifically the viable options that you're trying to utilize now? Jared Polis: (57:39) We look at everything, because one of the challenges is these are suppliers we've never worked with before. I was ... We were trying to figure out whether it's easier for me to get our expert on the ground with the plane there to validate the equipment there or whether we were able to get it here and take a sampling. Thankfully those suppliers are taking a leap of faith with us and they're moving the equipment here. We'll pay them out the second we validate their equipment. Forget about net 30, forget about net five. We're going to pay on the minute that we have that equipment in Colorado and we've validated it. We validated the gloves, we validated the mass. Jared Polis: (58:13) If we need to go that extra step, we will. If I need to get those CSU folks into China with a plane ready to load, we'll do that. But so far we've been able to work with the suppliers using the good brand and the full name of the state of Colorado as a public entity that's trusted internationally to be able to get those suppliers to show that bit of trust in us that if we can validate those supplies, we will pay them instantly. And we're thrilled to do so and build those relationships to scale them over time. Jared Polis: (58:44) Thank you for participating. This is not where any of us hoped we would be on April 1st, April Fools' Day, or any day of the year. But here we are and as Coloradans, as Americans, as residents of the world, we all are doing our best to stay at home, to save lives and hasten the return to normalcy so that we can earn a paycheck and support ourselves and our family. Thank you for doing your part, and thank you for doing your part to help save the lives of our medical professionals and others and our most vulnerable who are putting their own lives at risk every day. We're asking you to stay at home, I know that you're doing your best to do so, and I encourage you to continue to do so as we show the data of what this accomplishes, and we grow the medical capacity to reduce the likelihood that any Coloradan loses their life simply because we didn't have a bed or a ventilator that could've saved them. Thank you. Speaker 11: (59:36) Governor Polis, can you take one more from the phones? Jared Polis: (59:38) We're done. Thank you.