Gov. Gavin Newsom California COVID-19 Briefing Transcript April 28

Gavin Newsom: (00:00) ... a deep dive on one particular indicator around testing and tracing, tracking, issues of isolation and quarantine. Today I want to update you on another indicator, and that's specific to businesses, schools and childcare facilities. But first I want to remind all of you what those six indicators are. I mentioned testing as one of the principal indicators. We've made real progress in that space. Not nearly where we want to go and need to be, but real progress we are now seeing in this space. Some 578,000 tests have been conducted in the State of California. We are averaging over 20,000 tests a day, and we are well on our way to meeting our 25,000 testing goal and getting to 60 to 80,000 very shortly thereafter. Gavin Newsom: (00:50) I mentioned just yesterday OptumServe that was doing these end-to-end tests have been deployed at 80 additional locations, primarily focused on rural California. I can announce today that we are putting those tests, end-to-end tests, in Sutter County and Shasta County as specific proof points of the movement in that space. All of those testing sites will be up and operational by Monday. Verily also focusing on expanding their testing with a socioeconomic lens to diverse communities, not just in rural California but inner city California. So real progress in that place. Gavin Newsom: (01:29) Yesterday, we updated you as well on some of our efforts to train the workforce starting phase one, 10,000 tracers throughout the State of California, partnerships that we're forming in that space, and capacity building that is also well underway. Gavin Newsom: (01:45) We talked broadly about other indicators, one of the most important being how we protect the most vulnerable Californians, how we protect people in congregate care facilities, in our skilled nursing facilities, assisted living facilities, other adult and senior licensed facilities throughout the State of California. We have well in excess of 8,500 of these facilities in the state, the SNFs, the skilled nursing facilities, represent 1,224 but thousands more in home settings, as many as two, three people, some six or seven in size all throughout the State of California. Gavin Newsom: (02:22) We've updated you on a consistent basis about our efforts in that place and the sincere concerns we have, demonstrable concerns we have, about protecting our seniors in those facilities. We continue to focus on that above and beyond anything else as it relates to the data that comes in every morning because of the vulnerability of those populations. But real strategies, real plans in that place give us some more confidence that we're moving in the right direction. Gavin Newsom: (02:53) Accordingly, we're doing the same for our homeless population. Another sensitive needs population that we have, as you know, advanced a series of announcements, particularly Project Room Key, partnership with FEMA to provide 15,000 hotel rooms. We already have acquired 12,500 hotel rooms in that portfolio. Thousands of individuals off the streets, out of congregate shelters, into these isolated units. Support on site, particularly three meals a day, being provided. This is among many, many different homeless strategies throughout the State of California. It's just one that we have consistently highlighted in that space. Gavin Newsom: (03:34) We are doing more as well in another indicator. That's obviously securing the surge capacity within the hospital system and outside of the hospital system, these alternative care sites that we have brought up. We've talked about the FMS sites, close to 2000 rooms we were able to draw down with support of the federal government. The work that we've been doing collectively and collaboratively with cities and counties all up and down the state to provide assets as points of surge, if necessary, to address any increase in hospitalization, increase in need for isolation of vulnerable populations. Gavin Newsom: (04:10) We feel we have done justice in that effort. Because of your good work on physical distancing, social distancing, because you have overwhelmingly abided by the stay-at-home order, you bought us time to put together those assets. Not only those physical assets, but begin the process of procuring a workforce through that health core adaptation in the workforce that we have now identified for a potential surge. Those individuals that have come back from retirement or willing to come back from retirement or people that have particular job skills that they believe can be transferred to meet the needs. We've got a matching system, and we've got that capacity now in place. Gavin Newsom: (04:50) So physical sites, human resource sites, and now some more good news on PPE. Yesterday we announced the 3.1 million masks that arrived on Saturday night. We have distributed 2.87 million of those 3.1 million masks to our regional sites throughout the State of California. Another plane is literally taking off today. It will be landing tomorrow, and we will be getting subsequent shipments. So PPE is beginning to loosen up. Not even close to where it needs to be, and I recognize that. I can just assure you the reason we put 2.87 million masks out yesterday is that was back orders just in the healthcare space. Gavin Newsom: (05:36) We want to broaden that beyond just the healthcare space, provide those masks and protective gear for people that are doing testing and make sure they're adequately supplied. Make sure people that are on the front lines, grocery workers are adequately supplied. Clearly our skilled nursing homes, in-home supportive services and across the panoply of our sectors that we'll talk about in a moment, to make sure that they have adequate supplies. But progress in that indicator is also being made. Gavin Newsom: (06:04) We talked about another indicator, therapeutics, and I just want to remind folks that California, like Massachusetts, New Jersey, like a few states, is well-endowed, well-resourced in the therapeutics space. I'll remind people, in California and outside California, that the State of California is the birthplace of biotech. Our life science capacity is second to none in biotherapeutics, bioinnovation, medical devices, San Diego, the Bay area. We are very blessed. The number of National Institute of Health funded facilities in this state is a point of envy for many other parts of the globe, not just across this country. Gavin Newsom: (06:46) As a consequence, we are in advanced trials with our partners in the private sector working with our UC medical centers and other medical centers, and there is real progress in terms of at least the capacity of understanding in this space. I'm not going to promote any particular drug or particular trial, but just as an example, remdesivir and their advanced trials happening in this state in partnership with Gilead, who is a state-based headquartered company, Genentech and others. In this space, we are making progress at least in understanding what's real and what's not in the therapeutic space with, again, points of consideration, always caution in that space. But that's one of our other indicators that's important. Gavin Newsom: (07:34) Today again, we'll highlight the issues around business and schools and childcare centers, but before I get to that, briefly, I want to just mention that other indicator, that sixth indicator. That is if we pull back and we modify our state-at-home order too early and we start to see an increase in surge in cases, hospitalizations and spread, then we have to have the ability to toggle back. We have to have the ability to adjust. We have to have the ability to fix it, and so that's a foundational indicator, number six, in terms of our capacity to deliver on the promise, what we're promoting today in this roadmap for reopening. Gavin Newsom: (08:12) So forgive me for being long-winded in that space, but I wanted to, again, contextualize the framework. Six indicators. When those turn green, when they move from red to yellow, it guides our decision-making and allows us to make determinations. Dates don't, but data does. So let me as now I introduce this fifth indicator, again, none are prioritized but it happens to be the fifth indicator, around businesses and around issues of our schools and childcare centers. Gavin Newsom: (08:45) I want to make this clear. We believe we are weeks, not months, away from making meaningful modifications to that indicator and in this space. Weeks, not months. You'll ask me, well, is weeks one week or three weeks? Weeks, not months. Again, based upon the data, based upon the indicators. We'll talk specifically about hospitalizations and ICUs and community spread. Gavin Newsom: (09:15) Dr. Angell will come up in a moment, and she'll show you our model, the graph of actuals, so you can see the stability in that space. But we're still by no stretch of the imagination out of the woods there. It's just stable. We're not seeing substantial declines. But again, California and Californians know we never experienced the big surge that other parts of the globe and certainly other parts of our country had. But the stabilization is a point of some cautious optimism, and that indicator allows us to make the presentation that we're making today. Gavin Newsom: (09:50) So let's talk specifically about what we're talking about over the course of the next few weeks to think about and to consider and more importantly to plan for in real time. Those are areas of our economy. Let's talk with business around manufacturing of non-essential materials, logistics for non-essential movement, areas around retail, i.e. curbside retail for non-essential items, issues that have been broadly defined around the need to address our kids in schools. Gavin Newsom: (10:25) We clearly have shut down. People are well aware of this. The schools are shut down for the remainder of the school year. Learning continues at home, distance learning and the like, but we recognize there's been a learning loss because of this disruption. We're concerned about that learning loss even into the summer. So we are considering the prospect of an even earlier school year into the fall, as early as late July, early August. So we are beginning to socialize that. We have made no decisions definitively in that space, but I just want folks to know the concern around learning loss and the concern about waiting until later in the year into the fall for the new school year. Gavin Newsom: (11:09) As a parent myself and having talked to many other parents and educators, even the kids, I think we might want to consider getting that school year moved up a little bit. So that's one of the things that we want to begin to socialize in this indicator. We need to prepare for that, and we need to start preparing for the physical changes in the schools and the environmental changes in the schools that are necessary in order to advance that conversation and make it more meaningful. Accordingly, in the child care space itself. Gavin Newsom: (11:44) We are able to make these, again, announcements and begin to have a more public conversation with you about opening up with adaptation and with modification, meaningful changes to our stay- at-home order, again, because people have taken seriously, overwhelmingly the stay-at-home orders and physical distancing. But I want to caution everybody if we pull back too quickly and we walk away from our incredible commitment to not only bend this curve but to stop the spread and suppress the spread of this virus, it could start a second wave that could be even more damaging than the first and undo all of the good work and progress that you've made. Gavin Newsom: (12:32) That can happen like this. The virus has not gone away. Its virulence is still as acute. Its ability to be transmitted still is dominant, and so we, by no stretch, are out of the woods. There is durability to this virus, and there may be, we'll see, seasonality. So we could be lulled into this quiet sense of confidence, change our behavior, put ourselves at risk and put this broader agenda of reopening with modification at risk. Gavin Newsom: (13:03) So again, I caution everybody as I will be doing, I assure you, on a daily basis of the importance of our individual behavior, not just governmental behavior, individual behavior, and to the extent business is making decisions and modifications of our business leaders, men and women on the front lines, entrepreneurs, not just organized business advocates of the importance and power of their individual decision making in this space as well. We need to protect not just the business community but customers of those businesses. Gavin Newsom: (13:36) It's one thing to open a business, but if there's no demand, it's a false promise. As someone who has had the privilege of starting many, many businesses, I recognize that I'm not a job creator. It's our consumers. It's the people spending the money that create the opportunity for growth and job creation. So I deeply want to emphasize the importance of protecting customers and, of course, one of the business's foundational resources, most fundamental, and that's workers. Gavin Newsom: (14:05) At the same time, we're protecting businesses as entities in the abstract. But again, I am deeply sensitive to the needs for the business community to at least get some clarity. We're trying to provide that over the next few weeks so they can start to plan and look at their own supply chains, look at their own ability to change the physical environmental conditions in their businesses, and look at the guidelines that we'll be advancing very specifically and prescriptively sector-by-sector for guidance on what we can do and what we can't do at this stage. Gavin Newsom: (14:43) We are not going back to the way things were until we get the kind of immunity that all of us look forward to or a vaccine that we look forward to. So one has to be cautious in this space but also patient in this space as well. But in patience, we recognize in the imperative to meet that impatience in a pragmatic and thoughtful way is why Dr. Angell will be up in a moment to talk more specifically about these new phases that we'll be rolling out with this indicator. Gavin Newsom: (15:15) Let me briefly introduce those phases as I introduce Dr. Angell. We have looked at this indicator, and we looked at it through the prism of four phases. Phase one we're currently in, which is planning, workflow, focusing again on supply chains, physical and environmental considerations. The planning to do what we need to do on PPE, the planning we need to do to make sure the conditions are set so that we can move forward with modifications of the stay-at-home for businesses as one example. Gavin Newsom: (15:51) As we move into phase two, where businesses can begin to reopen, we need to make sure that that guidance is abided by and it is organized in a very deliberative way. That- Gavin Newsom: (16:03) ... and it is organized in a very deliberative way. That's the job of Dr Angell. She runs [inaudible 00:16:07] Public Health in the state of California. It's her statewide guidelines that will drive the decision making. Gavin Newsom: (16:13) Same time though we want to drive localism. I've often said, forgive me for repeating myself again on this and that is localism is determinative in this respect. I recognize the regionality in this state, the variants in different parts of the state, but I also recognize in that respect local health departments have points of view that must be considered as well. And so for example, the Bay Area announced today extending their stay at home order through the end of the month. I am not here as governor to make an announcement preempting their right at the local level to be even more stringent. I'm going to respect that and I want folks to know, not just in those six Bay Area counties, a few extra cities, that's the case, but all across the state of California. Gavin Newsom: (17:05) Accordingly, we have a regional variance that we also want to recognize for people that want to go even sooner based upon regional conditions. And I'm well aware. I'm being received memory letters, most of them very publicly provided to me in tweets, in public pronouncements even before I had the privilege of reading them personally. I recognize a lot of those regions are, are moving forward, making their recommendations. Dr Angell will talk about what the expectations we have of making any regional augmentations. They're going to be stringent. We're not just because people think they're ready to reopen, even more loosely than the state guidelines, we're not going to just blithefully do that without, for example, community surveillance obligations that are attached to those regional efforts. Dr Angell could talk more about the seven that are currently underway, the five that we will be doing very soon, and 12 different counties in total, but community surveillance becomes foundational if we're going to loosen on a regional basis any of these new guidelines that we'll be rolling out over the next few weeks. Gavin Newsom: (18:24) So that's phase one and phase two. Again, retail logistics, manufacturing, nonessentials, schools that we began in the summer and preparation, the early falls. Childcare facilities and centers with strict physical distancing and environmental considerations at hand. Workforce protections, customer consumer protections. Gavin Newsom: (18:47) There's a third and fourth phase, just four phases. The third phase is personal care. It's the areas around, well a lot of discussion around gyms and spas, and nail salons, and people wanting to get haircuts. All of us. Those would fall into the third phase category. Dr Angell again will lay out some details on that and then of course ultimately the fourth phase, which are these highest risk activities. Not the higher risk activities in stage three, the highest risk activities, that's the larger public venues. The conventions, the concerts, the larger entertainment venues with crowds that would be in that category. Don't want to get ahead of myself. She'll walk you through those four phases. Phase two is really the phase that is upon us we believe in the next few weeks and perhaps most important in terms of at least getting everybody's attention and focus so that we can prepare for it and real time. Gavin Newsom: (19:50) I'll just close before I put Dr Angell and just say this. When I say prepare in real time what we're doing, I mentioned yesterday, I'll be doing it right after this press conference and this presentation, we'll be meeting sector by sector with our recovery economic recovery team. We'll be meeting today on the retail sector with some of the biggest retailers, some of the well known brands like the Gap CEO will join us, but with small businesses, small retail sector to help them help us work on the guidelines for this second phase that again, we're hoping to advance in the next few weeks. So that's just an example of the work we're going to have to do sector by sector every day over the next days and weeks in order to prepare for this augmentation, this modification to the stay at home order. Gavin Newsom: (20:39) So I've spoken long enough. Forgive me. A lot of what I said will be said much more definitively and succinctly and most likely eloquently by Dr Angell, who I'm proud is here to make her presentation. We'll follow up of course with questions and I'll do my daily update as briefly as I possibly can. Gavin Newsom: (21:04) With that, dr Angell. Dr. Angell: (21:06) Thank you governor. It's a pleasure to join you today with the message of what I would describe as a cautious optimism as we've just heard. Optimism that's based upon us looking at the data and understanding where we are today and giving you some insight into the way that we're thinking about where we might be within potentially weeks and the months to come as our governor has just mentioned. Again, we're guided by the data and so I'm pleased to share with you a little more insight as to thinking about how we're moving forward anchored in that. Dr. Angell: (21:40) So I'd like to start first with a reminder of what we shared with you two weeks ago when we came and shared with you our original roadmap and that was to discuss with you that everything that we do will be a reflection upon six indicators. These indicators reflect sort of domains of work that we know are inherently important as we think about moving forward in ways to modify our stay at home order in a way that minimizes risk. Dr. Angell: (22:05) Now remember, this is not about a process that is going to remove the risk from all of us, but it will be a process in which we can think about until that time when we are all protected from COVID-19, at that time where we either have broad scale immunity or vaccinations or other mechanisms through which we know we can be safe, there is going to be a time where we have to be very, very thoughtful about the way we move. And these six indicators, which I have here, are the ones that we've just been reminded about. Again, I'm going to mention them to you, so as we go through we can understand really how this has informed our work today. Dr. Angell: (22:42) So the six indicators that we shared with you included the following. First is the ability to test, contact, and trace, isolate and support those people who might've been exposed. A very, very important tool that we have in particular as we're thinking about moving from the first to the second as we were just as was just described to us stage, and I'll give you more information on this, but really a very important tool for all of our communities to be able to keep ourselves safe as we move around further. Dr. Angell: (23:09) The second is the ability to protect those who are at high risk for COVID-19. Those are individuals who are in congregate care settings or those who are 65 or older or those with comorbidities that we know for whom if they're exposed, their risk is much greater. And around everything that we've done, we've made sure that that's been a very central part of our dialogue and our activities. It's also critical that we maintain surge capacity for hospitals and healthcare systems. As I mentioned, as we move to this next stage, it's not about removing the risk entirely, it's about minimizing risk. Even as people move in an environment with minimal risk, there is the possibility of increased cases and we must make sure that our care delivery system is there to support them in need. Dr. Angell: (23:52) Therapeutic development to meet the demand is an area that we're working on as well to make sure that we help move the work forward. Dr. Angell: (23:58) And then finally we're going to talk today about the indicator that focuses on businesses, and schools, and childcare facilities, making sure that we support and make sure those environments are safe for them. And that's what this next period is all about. Dr. Angell: (24:13) And most importantly, and as I move on to this next slide, is our ability to determine that we are moving in a way that's safe and best for Californians. Also, recognizing that there is some risk involved. So Dr Ghaly presented to you this slide that helps share with you a little bit about what, at this moment, has given us the sense that it is the right moment to start talking about preparedness for a potential modification and that is a recognition of the way in which, and this is a surrogate marker, for the amount of COVID-19 and how COVID-19 might be moving in our communities. Dr. Angell: (24:48) We are doing that at this time because of the absence of broad-scale surveillance. We are doing that at this time with something that is an excellent indicator for us at this moment, which is an understanding of trends and hospitalizations over time. And this slide has shown us from the very beginning, first of all, when we introduced our stay at home orders and over this period of time it appears, and we're watching this cautiously, but appears that we've reached really a period of stabilization over the past couple of weeks or so in that the total number of hospitalizations from COVID-19 and the total number of admissions into ICUs from COVID-19 have remained stable. Again, as the governor mentioned, we're watching this carefully and should that change, that will certainly change the way that we talk about our opportunities to move forward. But at this point, this is the right moment for has to have this conversation with you. Dr. Angell: (25:35) So let me move on to what the progress will look like, but a couple of quick reminders. First of all, that COVID-19 is not going away soon. This is going to be a while, but there are things as long as COVID-19 is here, there are ways that we can modify the way we move around in the environment that will make it more possible and that's what we're moving towards. So we're talking about modifications in the stay at home order, but they will be guided by health risk and our commitment to equity as we think about the kinds of interventions that are appropriate at this time. Dr. Angell: (26:06) The final thing that's really important for all of us to remember though is that ultimately, we all have some responsibility in this. The responsibility exists at all levels, from the individual. From the way you make decisions about the way you move in the environment. From businesses, from the ways in which they change the environment to lower the risk. And ultimately also to government, in the ways that we help support and lift up appropriate policies. So the fourth stages that we discussed, the first stage is the stage that we're in. This is the stage where we are all either at home or engaged in the essential workforce. We know that there's work that still needs to be done here before we move on to stage two and that is about making the essential workforce environment as safe as possible for all of those who are workers and for any of those who may be staying at home, but maybe interacting with the essential workforce and with essential businesses as part of doing those activities of daily living that we must do like going to the grocery store. That's where we are focused right now and we will continue the work that we are doing across all of those indicators to make sure that we are safe and secure as can be in the current stage. But we are also planning forward to stage two. Dr. Angell: (27:17) So stage two will be a focus on those lower risk workplaces. So the goal here will be creating opportunities for lower risk sectors to adopt and reopen. And when I talk about lower risk sectors, which I'll go into a little more detail later, we're talking about things like manufacturing that may not have been a part of the essential sectors that are currently opening. We also in stage two, we'll be talking about modifying our school programs and including childcare reopening. Dr. Angell: (27:50) The third stage is when we get into those areas that may be higher risk. Those sectors that we think will take a lot more modification to adapt in a way that can make them places where people can move with lower risk. So those kinds of environments we'll be talking a little bit more as well, but we really want to create an opportunity for those, but we know it will be longer in coming and so that is why those fall into stage three. Again, those are things like getting your hair cut, getting your nails done, doing anything that has very close inherent relationships with other people where the proximity is very close and we need a very thoughtful process to ensure that people don't put themselves at great risk in doing those activities. Dr. Angell: (28:31) And then finally, stage four is the point at which we know that we can begin to modify our stay at home order and have people moving much more freely because the risk is much lower. And that will require therapeutics to be in place. Dr. Angell: (28:45) Okay, so safety and preparedness. Stage one, this is where we are right now. The things that we're going to be actively doing is continuing to build out our testing, contact tracing. We're going to be building up our stores of PPE to make sure they're secured, not only for our current needs, but also in anticipation of what will be needed for stage two, when we do begin to open other sectors that may also rely upon PPE. And we'll also be really focusing on maintaining our hospital surge capacity for the time being, but also anticipating that we may need more as we move forward. Dr. Angell: (29:18) We'll be continuing to make essential workplaces as safe as possible as I mentioned. That includes really thinking about the physical work environment that we're in, changing workflows to make sure that people are safe. We're going to make sure that we enhance our safety net for our essential workers, continue to move forward, making PPE more available, and then also continuing to remind all of you in your daily behaviors that there is something for all of us to do. Maintaining our physical distance and doing all of those things that we've reminded you can help to keep you safer and at lower risk. Dr. Angell: (29:57) In stage two, we're going to really start focusing on lower risk workplaces. That means gradually opening some of those workplaces with adaptations. These include things like retail, allowing for curbside pickup, manufacturing, which can include things like toys, clothing, other things, furniture that was not a part of the central sector. Talking about offices. This can include things like PR firms and consulting and other places where telework is not possible, but by modifying the environment itself, it can make it lower risk for individuals. And then ultimately, talking about opening more public spaces, things like parks and trails that may have historically been limited because of our concerns. Trying to think about how we can modify that to make them safer for individuals to enjoy the outdoor spaces because we know physical activity is so important to our health and this is also about health clearly. And then finally, another area that we need to think about besides the physical environment is really the environment, the safety net itself. So what are we providing for workers so that if they get sick that they can be supported to stay at home if they need to, rather than feel like there is a need for them to go to work. Dr. Angell: (31:11) Then there's the whole environment of childcare and schools. And so for adults, maybe we talk about work for adults and for our younger adults, our children, school is their place that's so important and critical for them and their learning. And we really, really feel strongly that when it's safer for them, when we can create environments that allow them to go back, we do want them to go back. We realize, however, this is going to take more planning. And that's why we are discussing this now because we need to roll up our sleeves now and be really thinking critically about how to do this, as has already started. We need to continue that discussion and continue it more in earnest. So we're talking about summer programs and the next school year, potentially starting sooner, perhaps in July or August. We're talking about childcare facilities and trying to find ways to help them provide more care, to create more childcare availability to our workforce. Dr. Angell: (32:03) More care, to create more childcare availability to our workforce in particular. We think it's fundamental that we focus on this because we have to address learning gaps which have occurred as a result of this. We've been protecting all of us by limiting the amount of access in this environment, but we have to make up for those gaps that may have occurred over this time. We'll be focused importantly on making sure that the environment is safe for kids but also safe for teachers, safe for others that are in the school, safe for those who are providing essential services and supporting those environments where our kids will be. And ultimately as we open up schools, as we make sure that childcare is more broadly available, it also makes it more possible for parents to go back to work. So school will look very different, but we really are focusing on enhancing those opportunities. Dr. Angell: (32:55) So what will we be doing? What do we need to do to get from stage one to stage two? From the essential sector environment that we're in? From the stay at home with quite limited engagement to one that will create more opportunities for lower risk workplaces. So the things that need to happen and that we'll be focusing now together will be first of all focusing on government actions. So what are the kinds of policies that we need to have in place that will allow people to stay home when they're sick? We need to provide guidance and we'll continue to do that and make it available for how people can reduce risk. To continue to provide people with the best scientific information that we have about this virus to help people prepare themselves, to move into an environment that is fully safe, but certainly lower risk so we can all make decisions ourselves in a very informed way. Dr. Angell: (33:46) Businesses will need to think more about wage replacement so that workers can stay home when sick. They'll need to be implementing adaptations to lower risk workplaces now so that when we are ready in a few weeks, those changes will be in place. And when the data tells us the moment is right, those environments can start to open. Dr. Angell: (34:05) And then again just to emphasize that in those places where workers can continue to work from home, we'll continue to encourage businesses to support those opportunities because really staying apart at this time still is the safest place for all of us. Dr. Angell: (34:22) And then what about as individuals? Well, we all need to continue to practice safety precautions, which is the physical distancing, using face coverings when appropriate. We need to avoid all non-essential travel, that will continue on. That's an important thing that decreases our potential exposure to others. And we also need to, as individuals continue to support and care for those people that we know are at higher risk. Continue to make those phone calls to people that you know are in their home and socially distancing themselves. Continuing to make sure that their needs are met and thinking about how you might be part of the solution for them. Dr. Angell: (34:59) So when are we going to be ready for stage two? So again, we will refer back to those six indicators. As mentioned, all of those six indicators are not exactly the same. There are some that may be more important to this stage than to stages that come in the future. But I want to share with you some of our thinking now, about which elements of the indicators that we've discussed earlier will be key. Dr. Angell: (35:23) So first of all, we'll be watching those hospital and ICU trends carefully and thoughtfully. And they need to remain stable for us to remain confident that we are in a position where the stay at home orders could be modified in a way that would continue to maintain lower risk. We need to maintain hospital surge capacity. So that as we move through to the next stage we can be confident that if there are any increased infections from increased movement, that we do have the facility to be able to respond and to support and care for those patients. Dr. Angell: (35:56) We need to make sure that there is PPE available to support the demands that will come not only from the existing environment, the existing conditions that we're in, but also anticipating what the needs will be for the future and being sure that we're confident we can secure those. We need to make sure that there's sufficient testing capacity to meet the demand. That's been a key focus of much of our work and you've heard a lot about our plans. We'll continue to work diligently on that. And finally, we'll be looking at contact tracing capacity statewide. We'll be working with local health authorities and governments to make sure that the capacity is there. Dr. Angell: (36:36) So I want to talk a little bit about the opportunity for regional variations, which I know also has been a hot topic of discussion as the governor had mentioned and as the state public health officer, I'm in constant communication with local health authorities in understanding really where they are and where their needs and desires are. During stage two, counties can choose to relax stricter local orders at their own pace. That's very much about what we've been talking about in the Bay Area. The stay at home order is the basis for everyone, but there are some counties in which the local disease epidemiology was such that the local health officers felt that it was important to be stricter, and we appreciate respect and we think that's exactly the right thing when local health officers understand the needs of their community, that they act appropriately following the science. Similarly here, as we lift some of them and make some modifications in our stay at home order, there may be counties that aren't ready to go as fast. And that will be supported and that is a regional variation which is absolutely fine. Following stage two, once we have a statewide COVID-19 surveillance system in place, it will make it possible for us to understand what other types of regional variation might be possible. And the reason that's so important is that we know that this virus, doesn't respect boundaries of counties necessarily and we know that as there are modifications in orders, people move differently across there. We need to understand not only what's happening in specific counties, but what's also happening in surrounding counties, to really understand if the disease transmission that has occurred and if we can modify in a way that's safe. We'll be working very closely with our local health authorities and governments and consulting for that. Dr. Angell: (38:29) The final two stages that we discussed are stage three and stage four. Stage three is the space that we get into when we're talking about higher risk workplaces. And that's one of the later phases because we know that will take much more modification. We need to know much more about the movement of disease to be able to make data-informed decisions about what's safe for folks. So these include places like personal haircare places, entertainment venues where people are sitting closer together and sporting events without live audiences. Other things that fall into this space are in-person religious services like churches and weddings. And we'll need to think carefully about what kinds of provisions can be put in place so that people can join but in a way that doesn't expose them to increased risk for COVID-19. Dr. Angell: (39:12) And then ultimately the space that we all look forward to, someday as we move forward and work diligently together is stage four which would be the end of the stay at home order. And that's when we'd be opening all of our highest risk workplaces, without modification necessary at that time because at that time we will know that we have identified a way that we can keep people safe from COVID-19 either from population immunity or from vaccinations. Dr. Angell: (39:39) So with that, I just want to remind you that this is a time not of staying in one place where you are in stage one but it's actually an important time of work. And that's why we wanted to give you this opportunity to understand our planning at this time. The first thing I want to tell you is that if you want to be a part of the solution, you need to stay home if you're staying at home and if you're a part of the essential workforce, we want you to stay home when you're not working. That is the best way to protect yourself. But if you do need to go out, to go to the grocery store, make sure that you continue to practice physical distancing and all the other things that we tell you. That's the first thing you can do to be part of the solution. Dr. Angell: (40:15) The second thing is that we're enlisting all Californians to help inform the development of the guidance for sectors across our economy. If you're somebody who has particular insight, if you're a business person yourself, you're going to be invited to provide information and we'll put the website up shortly for you. But we want to hear from you, because ideas that you have about how you can create safe workplaces are ideas that we want to know about. We're going to be providing this guidance and a framework ultimately to help companies, businesses and our schools reopen in the way that reduces risk. But it really will continue to rely upon all of us to keep this moving forward. Thank you. Governor: (41:02) Thank you Dr. Angell and, of course Dr. Angell will be available as will I for questions. But the foundational point of emphasis we want to advance today is phase two as was presented by Dr. Angell is in weeks, not months. Phase three and four, months, not weeks. And I think that's important so people have a sense of where we are and where we believe based again on the data, we are going. What I just said can substantially change if the data changes, if the health prevalence and the spread of the disease changes. If our behavior radically changes and we put ourselves at higher risk. But risk is the frame that we're advancing. Governor: (41:47) Lower risk, we will focus broadly across sectors to begin reopening. Higher risk, we'll be more cautious, not weeks, but months. And highest risk, along the lines of that stage four where we are back at concerts and convention halls and with tens of thousands of fans in large stadiums, will take some time. But nonetheless, we believe we do have a framework that we can achieve and we can achieve together with the kind of earnestness of effort that Dr. Angell advanced in terms of being able to break these things down in very, very prescriptive terms and begin a framework of again, not just protecting those sectors of our economy but protecting the workforce within those sectors and consumers that attach themselves to those sectors as well. Governor: (42:44) Let me, as I do daily, attach you to the latest data and numbers to reinforce and strengthen what you saw on the screen a moment ago as it relates to the stabilization, but also caution you as today's numbers should about where we are as it relates to the suppression of this disease. Yesterday we had 45 individuals that lost their lives. Today we have 54 individuals that lost their lives. I mentioned that's roughly half of what we saw last week where we really saw a peak in the terms of [inaudible 00:11:17]. It's still too many lives torn apart and again, not stats, not data, real people, real families, real loved ones. And so our hearts go out to each and every one of them. Governor: (43:30) We also mentioned yesterday there were 1300 new positives in the state of California. Today I announced there are 1,576. 1300, now over 1,576 individuals that have tested positive. Yesterday, I mentioned that there was an increase in the hospitalization rate of 1.4%. Today actually went up to 2.5%. The only good news in that data is ICU numbers today went down slightly and were stable yesterday. Just gives you a sense, again, we're not out of the woods stable, though those numbers are relative to so many other parts of the country, we still need to see that downward movement and we're going to monitor that data on a daily, hourly basis over the next few weeks before we move forward with these modifications. Governor: (44:28) If the data changes, we start to see some spikes, some increase in our community surveillance, we start seeing numbers that raise alarm bells, that's an indicator that's no longer green or even a caution light turns red and as a consequence, we adjust in real time. So, just want to remind folks of the dynamic nature of this effort and the very sober framework to which we make decisions, again on the basis of fact and data, not ideology, not what we want, not what we hope, but what actually is and what we confidently can predict in the short and median time. So, a lot of work for a lot of sectors of our economy to do in the next few weeks. We look forward to doing that with them and, certainly for the schools, I just want to, once again as, a father of four, that learning loss is very real. Governor: (45:25) And from a socio-economic frame, from a racial justice frame, this is even more compounding and more challenging and so it is incumbent upon us I think to think anew in respect to the school year. And again, I'm looking forward to those robust conversations about the prospects of an earlier school year that I do think is warranted considering the consequences of neglecting our next generation because of the inconvenience and the realities of this virus and its spread. That's broad-strokes where we are today. I'll just end as I always do. As a reminder before we open up to questions, that you too can participate not only in a sector by sector conversation, we have our digital roundtable in that respect again for retail today. But moreover, to volunteer your time, your passion, your attention, your focus, your particular expertise to californiansforall.ca.gov website, californiansforall.ca.gov website. Happy now to answer any questions. Speaker 2: (46:31) Mariana Dale, KPCC. Mariana Dale: (46:35) Hi. Thank you. So today you talked about expanding childcare facilities and availability in the coming weeks. I talked to a lot of providers who say they still can't purchase supplies and that the $50 million that had been promised on April 10th has still not been distributed to childcare centers and agencies. What's the status of that funding and when can childcare providers expect more support? Governor: (46:59) Yeah, as I said, 2.87 million masks were distributed in the last 24 hours. As soon as we get the supplies in, we get those supplies out. We're going to start seeing a cadence of substantial increase in PPE, not just procedural masks, but soon N95 masks, gowns, shields, gloves, other personal protective gear, as it comes in, it comes right out. And it's not just for childcare workers, but across the panoply of support, in-home supportive service workers, grocery workers, logistics workers, manufacturers, farm workers. We have a lot of migrants, seasonal migrant farm workers now coming into the State of California, working on protocols and procedures for PPE in that sector as well. So across the panoply. But you're absolutely right. As it relates to childcare, I had a wonderful meeting yesterday, virtual meeting with the women's caucus. The entire subject matter was on childcare, the number of pop-up childcare facilities over 300 now we've opened recently, the hundred million dollars that we put in- Gavin Newsom: (48:03) Now we've opened recently the hundred million dollars that we put into the sector and emergency aid. You're correct, 50 million of it was for PPE. Getting those out on the sites to the sites is critical and can't come soon enough, and so that was highlighted. Kim Johnson, to answer your question, at the Department of Social Services, on the line, she's working to monitor the distribution of those funds and make sure that the advocacy of those funds takes shape. It's not just for PPE, it's for deep sanitization and for physical modifications just temporary to accommodate for new size cohorts based upon our guidance for childcare workers and for their children. Gavin Newsom: (48:44) This is a point of passion for me. Last year in January, announced a substantial enhancement in childcare funding in the state of California. And just as late as January of this year announced our next phase of investment with the budget deficits looming. I caution that the progress in that space may be impeded by the new reality of our obligation to balance a budget. No printing press here in the state of California. Gavin Newsom: (49:10) And so I can assure you this is an area of deep concern and concentrated effort because childcare is economic development. Childcare is foundational to getting people back to work. If they cannot get the kind of quality childcare that they deserve, they are less likely to get back to work and jumpstart this economy. And so I deeply recognize there's a reason it was incorporated into the business sector, the childcare component, the interrelationship between the two. Speaker 4: (49:46) Doug Sovern, KCBS radio. Doug Sovern: (49:49) I have a question I want to ask you about the state's model. But as the father of two kids in kindergarten, I would be remiss if I didn't ask you to elaborate a little bit on reopening the schools early. Specifically, why, what the thinking is there? Is it a matter of getting more in-person education before next flu season? Or I'll let you explain why. And also when? Parents will want to know when that announcement or decision might be made. Doug Sovern: (50:12) But then also I'm curious, California's model has seemed to be an outlier, certainly overly pessimistic at best compared to the other models that are out there projecting a much later peak, a much later surge. And I'm wondering if now have you guys tweaked the state model? Do you believe we are past the peak? Is the worst behind us? Was there something wrong with the way the data was being fed into that model? And what have you learned that might let you adjust that or approach it differently next time, God forbid, there is a next time? Gavin Newsom: (50:44) Well, I'll let Dr. Ghaly put that model together, and has been updating on a weekly basis, that model, preemptively answering that question in real time, going back a few months. By the way, every state in our nation doing the same, including some of the well-known chronicled modelers that even yesterday came out with an adjustment to their previous adjustment out of the state of Washington only highlighting and reinforcing [inaudible 00:51:07] your question. Gavin Newsom: (51:08) But as it relates to the data in terms of our decision making, the reason we're making the announcement today is regardless of our model, the facts that are coming in, the facts that are presenting themselves on ICUs, on hospitalizations, and spread, give us confidence in the next few weeks, we're able to make these stage two adjustments. Gavin Newsom: (51:27) Let me be specific, Doug, we want to get you back to work, or at least allow you more time to work sooner than later. Our kids have lost a lot with this disruption. I am not naive. We announced a week or so ago, my wife and the superintendent public education, some good work that's been done on new wifi hotspots, on distance learning, the application support of thousands, over 70,000 tablets and Chromebooks and other capacity, to provide distance learning. Still inadequate to the magnitude of six million children all throughout the state of California in rural districts and in some urban districts that just simply don't have the high quality download speed and capacity or anything to download into. Gavin Newsom: (52:15) And so there's been a learning loss. And you can either just roll over and just accept that or you can do something about it. So that's our thinking. If we can maybe start up the school year a little earlier, that would help mind that gap a little bit, close that gap a little bit. It's a deep conversation. The reason I'm having it with you is I was having it privately over the last few days. I want to socialize those private conversations as quickly as I can with you. Gavin Newsom: (52:40) I mentioned over the next few weeks, this is in the stage two of our framework of decision making. So the next few weeks, we'll get some more clarity to answer your question on the possibility of that, what the costs are, what that actually looks like. It's a conversation above and beyond just summer school. With that, I'll ask Dr. Ghaly to come up. Dr. Ghaly: (53:08) Thank you governor, and thank you for the question. We continue to look at our model. We have been here for the last few weeks talking about not just the model, but the actual cases that we're tracking both in the hospital and our ICUs. We have conveyed a message of cautious optimism. Dr. Ghaly: (53:28) We knew when we put together the models many, many months ago now, weeks ago when we shared them first with all Californians, and started to talk to colleagues around the nation about what their models were and how they were using them, we knew that these models were not going to be precise. That they would point us in the right direction, and I think they have. Dr. Ghaly: (53:52) We continue to update them and look at them closely to make sure that we aren't being misguided in how we use them. And we believe in today's announcement and the announcements over the last couple of weeks that our models and the actuals are preparing us for this area of stabilization with our data, with our hospitalizations and ICU visits. Dr. Ghaly: (54:16) As we increase our testing capacity that bears out in what we're seeing as a percentage positive among those increasing number of tests across the state. That we are preparing in weeks, not months, to begin to modify those, and that we're going to continue looking at that model and making the adjustments so that we can use it as a planning tool. But that our actuals mean more, and that we will continue to look at that to guide decisions that come from the state, to inform our local partners with their individual county level data, so they too can make those plans as they consider how their local orders guide the decisions at that level. Dr. Ghaly: (55:05) We know that many folks are looking at the models and deciding whether we were too pessimistic or too optimistic, whether those led us to be too conservative or too liberal with some of our decisions. And we stand firm in our decision to do the things we've done over the last many weeks, and as we move forward to use that same information to guide decisions. So we are always looking at these models. We're always interested in updating them so they're more usable. But we continue to look at those actual data points to guide the decisions as we move forward. Gavin Newsom: (55:45) Decisions not conditions, again, determine our fate and future. And that's why I just want to mind everybody have their own individual decisions, importance of physical distancing, continue to advance the stay at home order. If we make bad decisions, conditions can radically change. Models can change overnight. Actuals, reality is radically impacted, again, by those individual decisions. Hundreds, hundreds a day, millions, millions of people marching, we hope, in the right and same direction, we'll get out of this sooner if we maintain that directive sense of focus and continue to advance our commitment and resolve. Speaker 4: (56:28) Final question, Sophia Bollag, Sac Bee. Sophia Bollag: (56:33) Governor, I'm wondering if you can give us a more specific update about the testing status in nursing homes and elder care facilities? How much testing are we doing in those facilities, and is it enough? And if not, how much more testing do we need to be doing in those facilities to reach a point where you're going to feel satisfied? Gavin Newsom: (56:56) Oh, a lot more. It's not enough, that's the honest truth. I've been very clear with the testing task force. One of their top priorities was focusing on all of our licensed facilities, not just skilled nursing facilities. As you know, we've made three or four announcements in the skilled nursing facility and licensed facility space, including increasing the testing as a priority in that space, increasing the supply of PPE in that space, and as you know, redirecting National Guard to help support medical guardsmen and women in that space, including folks from the USNS Mercy. We retrained over 600 nurses. We're doing those daily check-in calls. We have organized ourselves in a much more thorough and deliberative way. Gavin Newsom: (57:46) We're currently, Sophia, just to update you, we're monitoring 192 skilled nursing facility sites that have a test positive, either a staff member or a patient. Currently, 2,302 individuals that we're currently monitoring just in the SNF space. Again, that's a universe of 1,224 skilled nursing facilities, about 119,000 total capacity. It doesn't include total number of staff. Forgive me for throwing those numbers out except I think they're important. Gavin Newsom: (58:19) But the answer to your question is we need to do more, and this is part of moving from phase one to phase two. It's one of the principle indicators on testing that will allow us to continue to make some real progress. Speaker 4: (58:37) Final question, Carla Marinucci, Politico. Carla Marinucci: (58:39) On the call, you mentioned reopening, and I think one of the questions is the reopening of the legislature. Several members of the California assembly have expressed concern about the need for remote voting. The speaker has said that there's a constitutional necessity for physical presence, but what do you think on this one? I mean, does the pandemic require a new assessment of legislative business and how to get it done in California? Carla Marinucci: (59:09) And if I could quickly, several people on Twitter have asked us to ask you this today, including Hank Plante, why is the California EDD website so woefully unprepared and frozen on this big day when freelancers and contractors are supposed to apply for PUA unemployment because [inaudible 00:59:26] for many people? Gavin Newsom: (59:27) Yeah, as it relates to independent branch of government, legislature, they'll make their decisions based upon their best assessment and analysis. I know that I'm aware of those decisions. In fact, I had a brief conversation with the speaker today. I haven't been tracking it as closely as I've been tracking all of these other decisions, but I respect whatever determination they make, and have the confidence in their leadership to make the right decision for their members and those that they're trying to represent in the state of California. Gavin Newsom: (01:00:02) As it relates to the UI issues and the PUA issues, we've been very aggressive on a daily basis, as you know, to try to tackle, and as quickly as we can, to address the magnitude of the number of calls that have come in. Yesterday, I made some announcements about 600 additional personnel on top of the 1,340 that we had hired for the call centers. And we talked about the new texting technology. We talked about the new chat bots that we put into place. We talked about the total number of connections that we actually have made, went from 417,000 minutes of individual talk time last week to 1 million just yesterday from the previous week. So substantial increase in connection and volume. Gavin Newsom: (01:00:52) $5.3 billion, that's the new number. $5.3 billion has been distributed through that system just since March 15th. 926 million just on Sunday alone. I'll repeat that, $926 million was distributed just on Sunday. So you're correct. We have the PUAs up today, and not surprising, the first few hours we've got to figure this out, but we said we'd get it up today, and they're putting it together. They're architecting it today. Julie and her team at EDD doing everything in their power to continue to get these UIs out and start to get the PUAs up. Gavin Newsom: (01:01:36) But here's the good news on the PUAs, a lot of states have put up PUA sites. It's just an application. Takes weeks and weeks to get the checks. Our expectation is not only when the site is more stable today and tomorrow, next few days, there'll be 24 to 48 hour turnaround in terms of those checks being distributed. So you're just dealing with unprecedented amount of call volume, and folks over at EDD, an unprecedented amount of responsibility and work to improve, to do better, to do more. You deserve that. Hank deserves that. The American people, 40 million strong in the state of California, particularly the 3.5 million that have applied for unemployment insurance since March 12th, and those that will be applying under the PUA deserve it. And so we'll continue to to do all we can, everything in our power to improve upon that experience in these historic and unprecedented times. Gavin Newsom: (01:02:37) And no, good enough never is. And yes, every day this is one of our top points of conversation, concern, and effort. And I can assure you that I'm not only being held to account, but some of the brightest people that I know are as well in this space. Gavin Newsom: (01:02:58) Look, as it relates to being held to account, let us not be judged not to have been held in account of supporting others at need at this time of need for millions of Californians. It's not just applying for unemployment insurance or Pandemic Unemployment Assistance, PUA, but also those that need your contribution of blood, maybe your willingness to just to call and check in on a neighbor, a senior, maybe deliver a meal in a safe way, or provide some care and support. Please, if you're willing, you're able, go to californiansforall.ca.gov, californiansforall.ca.gov website and share your passion with real action. Take everybody, stay safe. Look forward to seeing you tomorrow at noon.