Iowa Governor Kim Reynolds COVID-19 Briefing April 6

Kim Reynolds: (00:00) After confirming COVID-19 was here in Iowa, I issued a proclamation of disaster emergency, and I have taken targeted, systematic approach driven by data from our state's public health experts, epidemiologist team, and guidance from the CDC to implementing significant mitigation strategies aimed at slowing the spread of the virus, such as ordering schools and businesses to close, postponing elective and non-essential surgeries, and prohibiting gatherings of more than 10 people. Today, I'm ordering additional businesses and establishments to close through April 30th, including malls, social and fraternal clubs, bingo halls, bowling alleys, pool halls, arcades, amusement parks, libraries, museums, zoos, skating rinks and parks, outdoor and indoor playgrounds or children's play centers, tobacco and vaping stores, race tracks, toy, gaming, music, instrument, and movie stores, and camp grounds. All of the closures and restrictions outlined in the disaster emergency proclamations will be enforced specifically the limitation on social gatherings. At this time, I'd like to invite Commissioner Bayens from the Department of Public Safety to say a few words about how the state and local communities are working together. Commissioner Bayens: (01:20) Thank you, Governor. The Department of Public Safety and local law enforcement agencies throughout this state stand ready to protect and serve all of Iowans whenever they're called upon, including now during this health emergency. This week, the governor will be issuing guidance to local law enforcement officials and police departments throughout the state on their role in enforcing the orders outlined in the various declarations of disaster emergency. As the governor mentioned, violation of these orders could result in the filing of simple misdemeanor charges, but worse, your actions may needlessly place Iowans at risk. Law enforcement has no desire to cite or arrest anyone. Most Iowans are being responsible and doing their part. It is only a small segment that is throwing caution to the wind and ignoring the limitations on social gatherings. That small segment, however, can have an enormous impact on public health. Commissioner Bayens: (02:25) As a result, law enforcement will take reasoned and measured steps if we are forced to do so. However, first and foremost, law enforcement is asking Iowans to take their individual responsibility seriously and police themselves so we can conserve our law enforcement resources for those who truly need it. Should personal responsibility fail, law enforcement will always seek first to educate the public on the law and the need for it. Second, law enforcement will encourage Iowans to comply and disperse on their own if needed. Finally, should all other reasonable measures fail, then and only then will we do what the law requires and enforce the governor's orders. But again, I cannot stress this enough, that every Iowan has the ability and responsibility to do their part in slowing the spread of this virus. I would ask Iowans to own their behaviors and be part of the solution rather than the problem. Your willingness to do so is critical in protecting your own health as well as that of our first responders, our health care workers, and your fellow Iowans. Thank you. Kim Reynolds: (03:50) Thank you, Commissioner, and thank you to our local government officials and our law enforcement for your support in this effort. I believe Iowans care about doing the right thing for the greater good, and I believe we all want to protect the most vulnerable among us and safeguard our healthcare providers and essential workers who are the heroes during this uncertain time. I believe that most Iowans are being responsible, but I need every Iowan to take responsibility for their health and the health of others. This week is critical. Stay home. The best way to avoid being exposed to the virus or exposing others is to stay home as much as possible. Leave home only for essential errands like getting groceries, necessary supplies for medicine needs. Send only one person from your household and go to as few places as possible. Practice social distancing. Always keep at least six feet of distance between yourself and others regardless of if you're out in public or just outside in your neighborhood. Kim Reynolds: (04:52) Enjoy outdoor activities responsibly. Get outside. It's important for your physical and mental wellbeing, but again, maintain social distancing of six feet between yourself and others, and don't gather in groups of more than 10 people. Work from home if you can and only go to work if necessary. If your job requires you to work at a physical location, practice social distancing, careful hygiene, and frequently disinfect your work area. Isolate yourself if you're sick. If you or a family family member has symptoms of a mild illness, stay home, wait seven days from the onset of your symptoms and at least 72 hours from the time all symptoms have resolved to return to normal activities. Let's all do the right thing right now to protect each other. Kim Reynolds: (05:39) To all of our healthcare providers and essential workers, thank you. I know this is especially difficult for all of you. You are our warriors, and we can't win this fight without you. Thank you for showing up and for being the best self for the people who are counting on you. Please know that we have your back, and we'll do everything we can to support you through this time. Be safe, and stay well. We will get through this together. In closing, I just wanted to let Iowans know that we are making some changes to the press conferences starting this week. We will be holding them Monday through Friday. We'll take a look at Sunday, but they will be at 11:00 AM going forward. I want to thank Iowa PBS for accommodating this change and for being such a great partner during this time. Thank you to all of the media outlets and reporters for your flexibility. With that, we'll go ahead and take questions. Speaker 3: (06:35) Governor, what was the threshold that was crossed with a data point to lead to these additional closures, and can we also get an update on the score of the six regions? Kim Reynolds: (06:44) Yeah. Yeah. As always, we take a look at the data and we take a look at, "What are some additional places where people are gathering that we don't feel are essential businesses or essential services?" As we continue to look through the list, I've said all along, I'm not hesitant to add as we feel necessary. As we see people gathering, as we take a look at what some non-essential activities may be, then we'll continue to add them to the list. Do we have the update for the regions? Okay. Sarah: (07:14) I don't think I have the exact map with me, but I will tell you that none of the six regions at this particular point in time have met that threshold metric of 10 or above. The regions five and six on the eastern side of the state, they do continue to have our highest scores, and that's where we have our longterm care outbreaks that have been confirmed, as well as the most cases in our state. While I don't have the numbers specifically in front of me in terms of where each region is at this morning, I can confirm that none of those regions have risen to the level of a 10 as of this morning. Kim Reynolds: (07:52) I can incorporate it in the press conference tomorrow, those, because we monitor that morning and night and then throughout the day. We are watching that carefully, looking at the data, and analyzing the situation as it evolves on a daily basis. Speaker 3: (08:06) Appreciating y'all don't have the numbers in front of you, can you say if any of them have gone up or down? Kim Reynolds: (08:13) I don't want to give out. We can get back to you on that. Okay? We're happy to. We're happy to get you that information. I just don't want to misspeak and then cause some concerns where there probably isn't a reason to have any concerns. Dave: (08:30) Governor, it would appear from what you're saying today and what you released yesterday with these long term care facilities... You now have Cedar Rapids, Tama, and Washington. Can you talk about what the state is doing to protect since those... You have so many people who are closed in. Obviously, the centers themselves already done their own rules about no visitors and all that. But obviously, you have a lot of people who have relatives who live in these facilities who are clearly concerned about what's happening. Can you kind of detail what's going on and where this is going? Kim Reynolds: (09:09) Yeah. We knew that from the very beginning. We have an older population. We have over 444 longterm care facilities. We knew that they would be the most vulnerable based on the data that we were receiving as we moved through the COVID-19 crisis. As early as March 10th, we met with the longterm care facilities, the associations to talk about what they were doing, what we were recommending, to make sure that we were prepared and ready. As early as March 10th, they started restricting visitors except for end of life circumstances. The Department of Public Health, required longterm care facilities to report if two or more residents of staff had respiratory illness, again, to get in front and to make sure that we were managing and hopefully preventing the onset of longterm care breakouts because we knew that those were our most vulnerable. Kim Reynolds: (10:02) The state, also with our facilities and the Iowa Veterans Home, restricted visitors also based on not only Department of Public Health but CDC guidelines and CMS guidelines as well, so they mirrored what they were doing. The Public Health issued guidelines for extended PPE use in our longterm care facilities. Even on April 1st, they recommended using PPE face mask and eye protection in longterm care facilities for all patient interactions. I'll let Sarah talk about that, but they work with these facilities one-on-one to just make sure they're getting the resources and the information that they need. But I want Iowans to know that we knew that this would be an extremely vulnerable population, and that's why we took very significant measures early on to start to really limit access to protect and to make sure that we were doing everything we can to mitigate the effect of COVID-19 on our vulnerable Iowans. Dave: (11:03) I'm sorry to interrupt you. Do you see that this will reach a threshold where you actually have to essentially evacuate? Because you have a lot of residents, as you know, that share rooms. We're hearing that your roommate may have it, and there's no place else for you to go. Kim Reynolds: (11:23) Yeah. [crosstalk 00:11:24]. Dave: (11:24) Families have been concerned with that. Sarah: (11:26) Yeah. Thanks, Dave. What I can say is the metrics for a confirmed outbreak in a longterm care facility are that we have identified at least three residents with a positive test result. I'm just going to walk through with you the things that our staff walk through with each of these facilities every single day in terms of measures that we're asking them to take. Our understanding is that these facilities, they want to do everything they can to protect their residents, and they are walking through this with us on a daily basis to ensure that they're doing everything they can to prevent the spread of infection within those facilities. We asked them to immediately send home any employee that becomes I'll, isolate all symptomatic residents in single rooms, cohort staff so that dedicated staff are working with ill residents and not with healthy residents. Sarah: (12:21) We are asking employees to use face masks and eye protection at all times for all resident care, and we've actually gone ahead and made that recommendation for all longterm care facilities in our state, in addition to those that are experiencing outbreaks. We've asked them to consider gown and glove use at all times for all resident care to the extent that the PPE is available, but certainly in facilities where outbreaks are being experienced. We've required them to screen all employees for fever and cough or breathing problems at the start and end of each shift, and this recommendation applies... It's actually a mandatory order from the governor for all longterm care facilities, not just those experiencing outbreaks. Again, for all facilities, no visitors should be allowed in the facility unless it's an end of life situation per CMS guidance. We're asking these facilities to screen all patients for fever and cough or breathing problems daily. Sarah: (13:19) We're asking them to coordinate with their local health departments, EMS, and hospitals to plan for higher care needs. That includes plans for when and where to transfer patients and how to communicate a COVID-19 risk to the transport team as well as the accepting facility. We're asking them to understand that if residents do become ill, those residents may worsen on day seven to eight of their symptoms. We're asking them to work with their local public health agencies to ensure that test kits are readily available for any additional residents that become symptomatic. We've asked them to identify any other healthcare facilities where staff work, including recommendations that staff not work and other facilities if possible, and at a minimum, if they do need to work, to use a face mask and eye protection for all patient care in any healthcare setting where they may be working. Finally, we're asking them to establish a communication plan with staff, residents, families, public health, as well as members of the general public. Dave: (14:21) With the testing, since that's been a concern both in our state and across the country, how do you make sure that... especially the employees at these facilities can get those... Kim Reynolds: (14:36) That has been a priority. Dave: (14:36) ... before they have to reach the really serious level that a lot of other people do, or are they treated the same as everybody? Sarah: (14:42) Part of the testing criteria for the State Hygienic Lab of essential workers are identified as a priority for testing through the test that the state has available, and certainly employees of longterm care facilities would fall into that essential workers category. We have also been facilitating testing at some of the facilities that have been identified with longterm care outbreaks by working with the State Hygienic Laboratory and local public health agencies to make sure that we do have testing capabilities in some of these facilities where there are concerns. Kim Reynolds: (15:14) As we bring more testing capabilities on with our hospitals and with other labs, that has really allowed the State Hygienic Lab to focus on those areas that we need to so we can get in front of it. I just want to reiterate something that Sarah said, and it's just that our longterm care facilities across the state are doing everything that they can to make sure that they're taking care of their residents and were extremely proactive very early on, reaching out to us to really coordinate and work together to protect a very, very vulnerable population. Just a heartfelt thanks to all that they're doing day in and day out and, again, their workforce, that are the heroes standing up to take care of sick individuals. They've been really proactive in all of this as well. Speaker 6: (16:00) Last question in the room. Speaker 7: (16:01) Go back with testing and how... What's the advisement to local public health officials for folks who might be positive but you can't get... or are not being tested because they don't meet the other criteria as far as contact tracing goes? Kim Reynolds: (16:18) [inaudible 00:16:16]. Sarah: (16:18) Local public health would get involved with contact tracing upon confirmation of a positive test. What I understand your question to be is if somebody thinks they have COVID-19 but they haven't been able to get access to testing, our advice would be the same that it has been from the beginning. If you're ill, whether you believe that you have COVID-19 or any other respiratory illness, we are asking you to isolate yourself in your home, and we're asking you to isolate yourself in your home for at least seven days after your symptoms begin and to stay isolated for at least three days after your symptoms resolve, including your fever. Sarah: (16:57) In addition to that, public health recommendations at this particular time echo what the governor has just mentioned this morning. We're asking everybody to stay home. Leave your home only for essentials like groceries or trips to the pharmacy. If you do need to leave your home, practice social distancing by staying at least six feet away from others. That would apply if you do have to leave your home to go to work or whether you're leaving to go to the store to get essentials. Then again, as I just mentioned, if you are ill, regardless of whether you think you're ill from COVID-19, and you're not able to be tested, or any other illness, we ask that you isolate yourself from others in your household. Speaker 7: (17:38) If somebody shows all the symptoms but they can't get a test, public health is not... Kim Reynolds: (17:43) But they have other means of doing that. Call your doctor. The same thing applies. Call your doctor. Walk through the symptoms. They will do an assessment. If they believe that you need to be tested, they will bring you in. Speaker 7: (17:55) Yeah. I'm sorry for not being clear. Kim Reynolds: (17:58) Okay. Speaker 7: (17:58) I'm talking about for potentially passing it to other folks who then may be asymptomatic... Kim Reynolds: (18:03) Oh, like asymptomatic. Speaker 7: (18:03) ... [crosstalk 00:18:03] pass it along to other people. Kim Reynolds: (18:06) Well, she just said, "If you're sick, stay home right now until..." If you don't have the ability to go in, but you're feeling mildly ill, I am telling everybody stay home. You need to only go out for essential reasons. Otherwise, if you're feeling ill especially, stay home. Speaker 6: (18:24) Kay Henderson. Kim Reynolds: (18:25) Do you want to... Sarah: (18:26) Well, I was just going to add. I think the question you're really asking is about asymptomatic transmission and some of the information that comes out. Maybe you might not be feeling ill, but you might be concerned that there's asymptomatic transmission happening in a community. As we've said, we should all assume that the virus is circulating in our communities at this particular point in time, and when you do leave your home, that's why social distancing is so incredibly important, because social distancing is what will prevent the transmission of the virus when we do have to be out of our homes, when we do have to be around others. If we can maintain a distance of at least six feet between us, that is a public health mitigation measure that will help us prevent the transmission of the virus from asymptomatic individuals to the extent that they are out in our communities. Thank you. Speaker 6: (19:16) Kay Henderson, Radio Iowa. Kay Henderson: (19:19) Governor, the small business grant program you unveiled in March was a total of $4 million. Many small businesses are having difficulty obtaining the small business administration loan program. Will you expand the state grant program? Kim Reynolds: (19:36) We're meeting this week. Debbie and her team were supposed to get them scored through the weekend. They've been working diligently to score the applications that they've received. By this week, we'll take a look at it, and my expectation is that it will be expanded. I don't know to what extent right now, but we will be meeting with her. If not today, it's tomorrow. Oh, Today. Okay. We'll be meeting with Director Durham today to walk through the scored applications and make the decision moving forward. That's probably something we'll be announcing either tomorrow or Wednesday to let you know where we're at and the decisions that have been made. Speaker 6: (20:13) Caroline Cummings, next question. Caroline Cummings: (20:17) Good morning, Governor. Sarah, you said that none of the thresholds have been met in the regions about stay at home, yet there's more business closures and you guys are both encouraging everyone to stay home. I've had a lot of viewers reach out me, and they're just trying to understand why when you say what we're doing is equivalent to a stay at home order and yet there is this threshold that is out there to meet to issue a stay at home order, is it fair to say that what we're doing right now is sheltering in place? Then separately, some people are wondering if this would just bolster the message that this is serious. I'm wondering if you have an answer to that. Kim Reynolds: (21:04) Yeah. Well, I have said stay home. I have ordered that you can't gather in groups larger than 10, and we are going to hold Iowans accountable to following through with what I've ordered. We have said stay home if you're sick. Stay home and limit your number of trips to essential reasons only, groceries, medications, doctors, exercise, but exercise responsibly. We have taken a very targeted and incremental approach we have expanded as necessary, as we have. We take a look at additional areas that might add to the risk of transmission, where it's the highest, and we've added those to the list where possible. But as I said last week, almost 80% of our workforce is essential workers. They're going to continue to travel. The rest of us needs to be as responsible as we can. We need to practice what we're asking you to do, and that is stay home as much as you can. Kim Reynolds: (22:00) I also have to balance it with other areas too, wellbeing, mental wellbeing, and making sure that if you ask people to stay in longer than they need to, then they are really going to stop paying attention to what you're asking them to do. We have to be targeted. We have to be specific. I'm using data to base our recommendations on. Taking additional steps, I will do that if we hit the criteria. I'm not afraid to do that, but it has to be significant, and we have to meet the thresholds. We're watching very closely the different regions, we're looking at the data every single day, and we're analyzing what else, if anything, that we need to do to make sure that we flatten the curve, that we protect the most vulnerable, that we are doing everything we can to protect our healthcare workforce and our essential workers that are out on the frontline doing everything they can to take care of us. We need to do our part to take care of them. We do that by limiting our trips from our home. Speaker 6: (23:05) KCCI, go ahead. Todd: (23:06) Hi, Governor. It's Todd at KCCI. Can you talk a little bit about, when will we reach our peak, and is it soon? Are the numbers looking different for numbers of dead? Because I know that a University of Washington study talked about things backing off a little bit from 1,400 to 400, and whether or not maybe things are looking better. Kim Reynolds: (23:30) Part of that was, remember when I talked about that last week, they hadn't included a lot of the mitigation efforts that we had put in place. The assumptions that they were showing, the projections didn't include school closures, didn't include business closures, didn't include limited travel. A lot of the mitigation efforts that we put in place were not included. Now they have started to include some of the mitigation efforts that we have taken beginning on March 15th clear through April 2nd, when we extended most of them through the 30th. As they're starting to bring some of those on, it's reflected in the numbers that you're seeing. But I'm going to have Sarah talk to you about where we're at on the projected peak. Sarah: (24:15) Thank you, Governor. I would just like to reiterate that models are just models. While it's important to pay attention to the information on those models, what's most important is for Iowans to do what the governor has asked them to do, which is to stay home if you can, as much as possible. Preventing additional transmission of the virus in our state is the number one thing that we can do to flatten the curve. As the governor mentioned in her opening comments, we do expect to continue to see our case counts rise as well as the number of deaths we have in Iowa rise over the next week. I think we heard the Surgeon General say yesterday that this is going to be a difficult week for our entire country. We expect it to also be a difficult week in Iowa. Sarah: (25:06) As I said a week ago, we thought we would see the peak here in another two to three weeks. That's about the period of time when you look at the virus life cycle, a 14-day incubation period. That would be what we would expect based on the mitigation measures that the governor has already put into place. While models are great, they're helpful tools, what we really need Iowans to do is to act now, to stay home, to protect our healthcare workforce and our essential employees that do need to leave their homes to go to work. Speaker 6: (25:41) Two questions left. Second to last will be Rod with the Cedar Rapids Gazette. Rod: (25:47) Yes, I was wondering, you indicated that the numbers this past week were up significantly. Did those track with what your models were showing or did they... Kim Reynolds: (26:00) I think it... yeah. Rod: (26:01) ... outpace them or underachieve. Or no, not achieve, but under... Kim Reynolds: (26:08) We talk about that too with Dr. Pedati, and I think last week and throughout this weekend she said they have pretty much tracked what she expected from the information that they have been collecting. I think they do follow pretty much what her expectations were. Speaker 6: (26:25) The last question is going to go to Jason Clayworth of the Des Moines Register. Jason, go ahead. Jason Clayworth: (26:31) Good morning, Governor. Will you agree today to make available the specific scientific studies or evidence, as well as the names of the specific people or groups used as the rationale or base for your 12-point system you're using to determine if and when you will issue a stay-in-place order? Also, are you aware of any state that is using this metrics? Kim Reynolds: (26:55) Yeah, I do. I think actually a couple of states have contacted Dr. Pedati to start using some of the metrics. Actually, I think they align fairly well with what the CDC is looking at as well with the website that Washington is using. Is that correct? I think they somewhat align with what they're using. Sarah: (27:12) Yeah, I think so. Kim Reynolds: (27:13) I'm proud of the experts that we have working on this, the Iowa Department of Public Health, the epidemiologist team. I listed several of the individuals that were working on the COVID-19 and the metrics and what they were looking at, basing their recommendations to me on the data that they were collecting. They align and coordinate with CDC, the other epidemiologists across the state. There is a lot of coordination and communication that is going on. I think if nothing else, we recognize that every day something is changing and the data is evolving. We're learning more as we move through the coronavirus pandemic. We're going to continue to base our decisions on data. We're going to make the best recommendations that we can based on the data that we have here in Iowa, always consulting with the CDC and other experts across the country. Thank you. Thank you.