LA Governor Edwards COVID-19 Press Conference Transcript July 11

Governor John Bel Edwards: (05:09) Good afternoon. And thank you for coming out on a Saturday afternoon. As you can imagine, because this wasn't announced previously, we obviously have made some decisions. I've made some decisions about some things we need to do as a state to better respond to the current situation as it relates to COVID- 19. I am joined today by Dr. Joe Cantor of the Department of Health, Dr. Katherine O'Neil, chief medical officer of Our Lady of the Lake Hospital and assistant professor of infectious disease at LSU. Also, Dr. Rainey Whitfield, the sports medicine family physician here in Baton Rouge. Governor John Bel Edwards: (05:49) Obviously, Louisiana continues to experience COVID-19 case growth statewide. Positivity is increasing. The percentage of tests administered on a daily basis that come back positive, those are increasing and hospitalizations are increasing. So it's become clear to me, especially after the numbers that we saw yesterday, that our current restrictions are not enough. Governor John Bel Edwards: (06:16) The appeal that we've been making to the people of Louisiana to do better abiding by those restrictions and doing better by complying with our mitigation measures just have not produced the results that we had hoped for and the results that we need. Yesterday, we had our highest day ever of new cases. I want to state that again. Yesterday, we reported the highest number of new cases to date, 2,632. Today, we announced 2,167 more. And positivity for the test that we announced yesterday and today both exceed 10%. And over the last week, we've been over 10% I think every day, except for two. Now, it is true that we are testing more people. And by the way, that's a good thing. The test doesn't create a case. A test is going to tell you where you have cases. At least those cases that have tested, because we know we still have asymptomatic people out there who have been affected. Governor John Bel Edwards: (07:24) They are contagious, but they are not being tested. But we are testing more. And as a result, we are seeing more of the cases that are out there. And in fact, I think it's a very good thing to tell you that thus far in the month of June... I'm sorry, the month of July, we're 11 days in. We have almost met our monthly goal of 200,000 tests. We're at 195,536 tests that we were recording in the month of July. Unfortunately, we also added 23 more deaths today, bring the death toll to 3,295. Now there's a lot of different ways and Dr. Cantor's going to paint the picture a different way in just a minute with some graphs and so forth. There's a lot of ways to talk about what's happening in Louisiana. But one thing that I think we should all be cognizant of is that as recently as June the 19th, Louisiana was number 10 in the country per capita cases. Today, we're number three. Governor John Bel Edwards: (08:27) So as you know, we had gotten as high as number two at one time. We made tremendous progress, but the case growth has eclipsed. So it's not just higher here in Louisiana. It's at a rate that is higher than all the other states who were ahead of us. And so today, we are number three behind only New York and New Jersey. Obviously, we hope to avoid going backwards. We hope to avoid closing business again, but what we cannot do is go back to a time where we're running out of hospital beds and ventilators, we cannot risk losing our capacity to deliver lifesaving care. And talk about hospitals in just a moment. Governor John Bel Edwards: (09:12) Yesterday alone, we added 75 new inpatients across the State of Louisiana for COVID-19. Today was 65 more. Current total is 1,182 COVID patients in our hospitals across the state. And on June the 13th, that number was 542. So we took a lot of hard look at the current order and how it could be modified to address some of our biggest concerns. Again, this is not an issue that's unique to Louisiana. What we're facing is being experienced across the country, including in our neighboring states. Many of whom are dealing with these very same issues. And I'm also mindful of some things that Dr. Tony Fauci said this week. He said, where we are as a country, we've got to focus on a lot of things, but primarily on three of them. Getting better compliance with mask usage, making sure people exercise physical distancing, and limiting crowd sizes. So obviously those are three of the things that we were thinking about. And so while you know that I've been extremely patient for the last few weeks, when I have said we are going to do everything we can to get more compliance with current restrictions and mitigation measures, today, we're going to have to move a little bit further than that. Governor John Bel Edwards: (10:39) And we are trying very, very hard not to revert to phase one or to phase two, because we're trying to balance the public health imperatives with the economy on the one hand with the ability to open schools next month, and a whole lot of other things that are going on. So today, I'm going to announce that we're going to stay in phase two as our current proclamation has us at least until July 24th. And we're going to examine what's going on at that time and figure out what happens after July 24th. But there are going to be some changes effective on Monday. Governor John Bel Edwards: (11:15) I will sign an executive order today. The changes I'm going to talk about will be effective on Monday. And by Monday, after midnight on Sunday night. The changes are masks are now mandated statewide for everyone, age eight and older, unless they have a major health condition that makes it difficult to wear a mask. And by the way, it is strongly recommended by the CDC and by us that children between two and seven also wear a mask. The mandate won't apply to them, but the guidance still does. Parishes and municipalities may opt out of this mandate if they don't have a high incidence of COVID 19. I'm going to get more into that in just a moment. Right now, there are only three parishes in the state that don't have that high incidence rate that the CDC has put forward. Governor John Bel Edwards: (12:15) Also, I want to talk about the fact that all bars with and without food permits will be closed to on premises consumption. They may engage in curbside pickup. Indoor gatherings will be limited to 50 people total. Now this does not, and I want to make sure this is very clear. This does not change what's in our proclamation for phase two, with respect to occupancy limits of businesses. Essential businesses have no limits. Non-essential retail, places of worship, other places have a 50% occupancy limit, but with the requirements for social distancing. These are social gatherings that we're talking about here, that the limit will be 50 people indoors and outdoors, but they will still require that they have to properly and strictly physical distance. Governor John Bel Edwards: (13:11) I do want to point out that what we have good reason to believe is a large contributor to the spread and growth of cases are informal backyard gatherings, if you will. So these are the birthday parties, the wedding showers, and baby showers, and those sorts of things where people are just having these rather informal gatherings. And they think, well, I'm only inviting my close relatives, my close friends. Well, guess what? Many of your close relatives and close friends are going to have COVID. And what you have to do is make sure that you are following these rules too, with anybody who is not part of your immediate household. So if you're going to have these informal gatherings, we really, really encourage you to keep them as small as you can, make sure that you were masks, and that you physically distance, and have them outdoors if you possibly can. That's the safe way to do that. Governor John Bel Edwards: (14:13) As I mentioned, the changes are going to go into effect on Monday night, right after midnight, because we did want to give business owners and the public time to comply. These orders will stay in place at least until July the 24th, which is when the current proclamation is set to expire. We will continue to look at the data and decide later what happens after July 24th. I do want everybody to understand we have been extremely patient, but we're making these decisions today because of the data that we have and the recommendations of public health experts. We're also following White House guidance, which basis reopening dating criteria, including declining new cases and hospitalizations and positivity. And right now, we don't have any of those. Governor John Bel Edwards: (15:02) In addition to the White House, including Vice President Pence, who leads the White House coronavirus task force. And by the way, we look forward to hosting him at Baton Rouge here on Tuesday, but they've encouraged the public to follow state and local orders regarding face mask and encouraged that government consider face mask mandates where cases and positivity are increasing. And certainly that is the case here in Louisiana. Governor John Bel Edwards: (15:29) Face mask and cloth facial coverings are easy. They're an effective way for people to protect each other from the spread of illness. And I've got three doctors here with me today who agree with that, and you're going to hear from them in just a few moments. So just to get back to the face mask a little bit. The order includes CDC guidance and requires face coverings for everyone ages eight and older, except for those with medical conditions that prevent the wearing of face mask, anyone consuming drink or food, anyone who is trying to communicate with a person who is hearing impaired, anyone who's giving a speech for broadcast or to an audience, anyone temporarily removing his or her face covering for identification purposes, and anyone who is a resident of a parish without a high COVID incidence rate that is opted out of the masking mandate. Governor John Bel Edwards: (16:20) Now, we look to CDC for guidance here and high incidents of COVID are considered those areas with more than 100 new cases per 100,000 people over a two week period. So again, those areas where you have more than 100 new cases per 100,000 people over a two week period. Those areas with a high incidence of COVID-19 with respect to the CDC guidance. Three parishes are below that threshold. They are Grant parish, Red River parish, and West Feliciana parish. And so we have set up so that the- Governor John Bel Edwards: (17:03) And so, we have set up so that the parish governing authorities can, with a communication, a letter to GOHSEP here can opt out of the face mask mandate. Now, let me tell you, whether they have doubt or not, it's going to be a decision for them. But it is still strongly encouraged that everyone who can do so to wear a face mask when they were outside of the home and interacting with people who are not part of their immediate household. Because, while these parishes may be the least effected in Louisiana, there is COVID currently in every single one of those parishes as well. Governor John Bel Edwards: (17:44) I would also remind people that, if you have a health condition that makes it where you shouldn't wear a mask, because you have breathing difficulties, then you have a health condition that makes you vulnerable to COVID-19. And you need to exercise extreme caution under any circumstances. And, remember, you are always safer at home. If you are vulnerable, if you are 65 and older, if you have diabetes, hypertension, kidney disease, heart disease, if you are obese, you are better off at home. And certainly you shouldn't be out there without a mask because you have a breathing difficulty any more often than is necessary. So, just to understand that. So, at the end of the day, while I know that this is going to be unpopular with and controversial with some, we know that face masks work. It really is that simple. The vast majority of the spread of this disease comes from people talking, breathing, sneezing, coughing. And that face mask limits the distance that those particles containing that virus are going to be sprayed to neighbors. Governor John Bel Edwards: (19:03) None of these steps that I'm announcing today were steps that I wanted to take. I have mentioned that over and over. None of them are easy, but I do think they're all essential. And I think you are seeing these steps that I'm announcing today being taken in more and more places across the country. And I look for that to continue. Governor John Bel Edwards: (19:21) And I did want to remind everybody that there's typically a 14 day lag between any change in behavior and when that change starts to show up in the numbers, whether it's the number of positives, or the number of hospitalizations. And it's even a longer lag time after that before there's a change in the number of deaths. So, we're not going to see any changes in the very near future. And I want people to understand, we have no reason to believe that the numbers that we've been reporting over the last few days are going to get any better over the next couple of weeks. In fact, they are likely to get worse. That's the unfortunate reality. And that's why we are taking the action that we're taking today. Governor John Bel Edwards: (20:05) Obviously, closing bars is not a step I wanted to take. But the reality is, here in Louisiana and elsewhere, bars are proven to be hotspots for the spread of coronavirus. And it's probably not true for every bar, but we know that it's true for many, many of them. And then, I want to thank all of those bar owners who did work hard to comply with the current restrictions. And understand nothing I'm announcing today is designed to punish anyone, especially bar owners. But it's a simple acknowledgement of the reality of the situation. Through our limited contact tracing results that we've gotten, we've identified at least 36 outbreaks impacting at least 405 people from bars since the start of the outbreak. And we know that that number in reality is much higher than that. And, if you remember, during phase zero and phase one, bars were closed. So, all this has happened in phase two. Governor John Bel Edwards: (21:08) And we also know that leading the spread over the recent weeks has been a younger age group, those who are much more likely to frequent bars. And, by the way, they continue to be a big driver of cases. And I think Dr. Kanter is going to tell you more about this in just a moment. But it's pretty clear that younger people are spreading. We were fearful that they were. We're very confident now, younger people were spreading a COVID-19 to older people who are getting this disease again in growing numbers. Governor John Bel Edwards: (21:44) So, public health officials believe going to bars is a higher public risk than visiting other types of businesses simply because you go to the bar and socialize. And, when you drink, you're not wearing a mask. And, when you drink, you lose your inhibitions. And, when you're listening to music, you have to speak louder to be heard. And you have to move closer to other people to hear them. And there's just nothing about that environment that is conducive to slowing the spread of COVID-19. And that's the unfortunate reality of the situation. Governor John Bel Edwards: (22:15) Before I turn this over to our doctors, I'm going to just say this one more time. I know that some of what I'm announcing today is going to be challenging for some, unpopular with others. It is the necessary thing to do. But it's the right thing to do under the circumstances. That's why we're going to do it. And we cannot let this illness win. And, if you, like me, are interested in keeping as much of our economy open as possible, if you don't want to have to regress and go back to phase one or phase zero in order to preserve capacity in our hospitals, if you want to open school next month and higher education next month, these really, in the grand scheme of things, are minor prices to pay, especially those people who don't like the inconvenience of putting on a face covering. Now, I don't like it. But, at the end of the day, I know it's the right thing to do. Governor John Bel Edwards: (23:15) Should not be a political issue either. And, for some reason, in this country and in the state of Louisiana, there's been a political dynamic that has kind of emerged around the whole issue of masks. That just doesn't make any sense to me. And I think people, if you will pay attention, even to the national scene, you have started to see and you're going to continue to see people of both parties who are going to be stressing the absolute importance of wearing a mask. Governor John Bel Edwards: (23:50) So, I'm going to turn this over to Dr. Joe Kanter for the Department of Health. He's going to highlight some data and some trends that kind of get into a little more granular detail than what I've talked about thus far. He'll be followed by Dr. Katie O'Neal. And then, Dr. Whitfield will come up. We'll talk about some things that they're seeing in their practices. And then I'm going to come back and answer a few questions at the conclusion of our three doctors. Dr. Kanter. Dr. Kanter: (24:17) Thank you. Good afternoon. Thank you, governor for the leadership you've shown all of us throughout this is challenging ordeal. And I do want to send a special thanks to doctors O'Neal and Whitfield for taking some time out of your clinical responsibilities to come join us to share some additional perspective. Dr. Kanter: (24:43) This has been a challenging couple of weeks in the office of public health and in the state, as we've seen progression of some of the progress that we made earlier on. And that's certainly frustrating. I'd like to take you through some data to show where we are now and paint the picture of what is necessitating the measures that were just described. And I'll say, at the end of the day, this is about the preservation of human life. And it's as simple as that. Dr. Kanter: (25:11) The masking requirement will apply to parishes that have a two week case incidents of a hundred cases per a hundred thousand residents or greater. That is the measure defined by the CDC as high incidence. As you can see from the map to my left, it's a good part of the state. It's 61 out of 64 parishes. Grant, Red River, and West Feliciana don't make the cut, but the other 61 parishes do. And this is representative of the degree of geographic spread this virus now enjoys throughout the state. It literally touches every corner of the state. And this map will be revised every two weeks with new data. And we will make that data publicly available on the Louisiana Department of Health dashboard online. But again, it is clear to us, and now clear to everyone else, that the level of COVID incidence is high in the overwhelming majority, 61 out of 64 parishes throughout the state of Louisiana. Dr. Kanter: (26:29) Of course, a lot has been discussed about what happens when you do more testing. Now, when you're battling a disease or anything else, you have to have visibility. You have to know what you're fighting and where it is. And that's what testing does. Certainly, when you do more tests, you'll find more positives. When we look at where the pandemic is, we take in a number of measures. So, in addition to the number of new cases increasing day on day, the percent positivity of all testing done is increasing. That's what this graph shows. Dr. Kanter: (27:06) And I'll just point out that the large spike at the end of March and early April of percent positivity where it goes up to the mid thirties percent, that was back when we were highly restrictive in tests. We were testing really individuals who were sick or had significant risk factors. So, that artificially inflated the percent positivity. The last week, the week of June 22nd through July 5th, as measured by date of collection, percent positivity for the state of Louisiana was 15.3%. That is a highly concerning number, very, very concerning. A lot of those people that test positive are asymptomatic. They had no symptoms at all. They have no indicator to themselves that they are infected and infectious. But yet, they are, and likely spreading it to friends, family, and other community members. Next slide. Dr. Kanter: (28:12) We talked a lot the past couple of weeks of the changing age demographics of our outbreak here. And young adults age 18 through 29 constitute the largest grouping now for COVID cases. You can see the light gray line go up quite dramatically. Over the past week or two, we are seeing what we feared that we would see, which is further spread from younger adults to older individuals. And this is highly concerning. COVID has a real tendency spread. And we had talked about this a couple of weeks ago. We had no expectation that the virus would stay within the 18 through 29 age bracket. We had concern for individual's family members, their parents, their grandparents, a grocery clerk, a bus driver, anyone who they come in contact with who might be on average more vulnerable. And that's what the most recent data is showing us. It's showing us that the virus is now spreading from those younger adults into older individuals. Dr. Kanter: (29:26) Now, as the governor mentioned, we still firmly believe, in phase two, that, if you have vulnerabilities, if you are increasing in age, if you have serious underlying medical conditions, the risk to you, to your personal health is greater. And you need to think twice about the risks that you take on. I counsel my patients and my friends and family who are old or have medical vulnerabilities not to go out, if at all possible, to have someone else make groceries for them, and so forth. The older individuals that the virus is reaching now need to be very careful about the risk that they take on. And I'd like families to help support them. Again, just because we're in phase two, if one is able to stay inside, able to distance, that's always going to be the safer thing to do. Dr. Kanter: (30:24) The other thing to mention is, and the governor mentioned this as well, we have leading measures and we have lagging measures. And cases are on the leading side of that. Fatalities are a lagging measure. And we know on average in Louisiana, for individuals who will eventually die from COVID-19, on average, they became symptomatic 16 days prior to that fatality. The fear that we have now is, as the virus is spreading again to older and more vulnerable individuals, we will continue to see increasing hospitalizations. And, in time, we will see, unfortunately, increasing deaths. We have to turn this around. We've already doubled the number of patients hospitalized with COVID from the middle of June. We have to turn this around. Dr. Kanter: (31:22) This graph represents the number of new cases day on day. And the blue line is a seven day rolling average. I like to point out that, at this point in time, we have more cases coming in every day than we did when we were at the peak of the first part of this. Dr. Kanter: (31:42) And a lot has been said about the differences in our two peaks. And, the first time around, it was focused mostly in the greater New Orleans area. This graph takes out New Orleans. This is a representation of every region in the state minus the greater New Orleans region. I'd like to point out that this is a Louisiana outbreak. It is not a New Orleans problem. It is no longer a New Orleans issue. It is a Louisiana problem. And the shape of this looks frighteningly similar to other states, Texas, Arizona, Florida. We're not as far along as they are, thankfully. But we will, if we don't turn it around. And we have to turn it around. Dr. Kanter: (32:28) Now, the good news is we've already beaten this once. And I'll tell you, we know how to do this. We've flattened the curve and we've stomped down the spread of COVID once very effectively. And I know that we'll be able to do it again. Thanks. Dr. O'Neal. Governor John Bel Edwards: (32:45) Kind of hard, isn't it? Dr. O'Neal: (32:54) Thank you, Dr. Kanter. The governor asked me to give you an update on how we are doing in the hospitals. We knew that when we went to phase two that we would see a little bit more community spread and that community spread would result in a few more admissions to the hospital. And we were prepared for that because we had been through this before. What we weren't prepared for was the steep escalation in hospitalizations that started about ten days ago. We have quadrupled the number of patients in our own hospital. And we've seen similar numbers throughout the state. This massive increase in admissions was not expected. What we expected was to see a slow community spread because people were still socially distancing and masking. But that wasn't occurring. And now, we are overwhelmed. We have too many people in the hospital. Our hospitals are full. When our hospitals get full, just like we talked about before, it is incredibly hard to provide care for everybody. I want to give you a glimpse of the people that we're seeing in the hospital today. Of our patients with COVID-19, a third of them are in the ICU. Our youngest patient is 25 and he had no medical condition. Speaker 8: (34:03) Our youngest patient is 25 and he had no medical conditions when he entered the hospital. As you see those age ranges increased in the number of community cases, we see those same admissions increased in that age group and that's what we're seeing today. We have patients in their 20s, we have patients in their 30s and in their 40s and in their 50s in the ICU and they're struggling for their life. Those patients require a tremendous amount of care. Speaker 8: (34:28) When you admit them, they look pretty good and they need some oxygen. And when they get to their bed on the floor, they're fighting for their life and we're rushing them into the ICU. And this is a nightly occurrence in the hospital. It takes a tremendous team to do that work and that team can no longer offer care to everybody else who needs care. Speaker 8: (34:48) Those people who are waiting for a bypass surgery because they have heart disease, those people who are waiting for a joint replacement because they haven't been able to walk in six months and we've already put off their surgery once and those people who have a mass and are waiting for a diagnosis of malignancy. One of our palliative care doctors shared with me this week that she saw a patient in clinic this week, whose surgery was put off in February and again in March and again in April. And by the time that patient was diagnosed, they had metastatic disease and they are no longer capable of having a cure for their cancer. Speaker 8: (35:20) We can't allow this in the community anymore. We have to be better stewards so that the whole community is healthier from all of their illnesses and not just Covid-19. But to do that, we have to do things like masking and we all have to wear a mask. I have to wear a mask and I have to demand that if I'm going to have a conversation with you that you also have a mask on. And by doing that, we protect our community, we protect each other, we protect our families, and that's how we end up safe at our homes and not also patients in the hospital with Covid-19. Speaker 8: (35:53) The medical community asks the citizens of Louisiana, our community members, to help us to decrease the spread by thinking about each and every interaction you have socially with another individual, whether it's in your backyard, whether it's at work, whether it's passing people in the hall. Keep your distance, try to have that interaction on Zoom or by phone if you can, and keep your mask on and ask them to put their mask on. Speaker 8: (36:20) We've seen this have huge implications in the hospital in keeping our patients safe and so we know that it works and we know that if you do it, we can continue to provide everybody the expected quality of care that we expect to give people every day. We appreciate your participation with the community and for the safety of our patients. Thank you Governor. Speaker 9: (36:52) Good afternoon, everyone. First, I'd like to thank Governor Edwards for not only his leadership but for allowing me to participate in today's event and my colleagues for all the things that they're doing to save lives in the State of Louisiana. I've been practicing guys for over 20 years and never in my wildest dreams that I think that we would be here in this situation where individuals are losing their lives to something that actually is quite scary because we don't really know a lot about this virus. We're learning more and more each day, but we still don't know enough about the virus. Speaker 9: (37:18) And to be very transparent, no one that I know personally who trained at family medicine, trained to practice medicine during the pandemic. Our outpatient volume and that's why I'm here today to speak to you guys about the outpatient situation as it relates to the inpatient scenarios, but outpatient volume has not decreased or declined at all. We've been very quite busy and thank goodness for telehealth and telemedicine, where I'm able to see patients virtually over the phone and sometimes, they'll come to the office now if they have to be seen physically in touch. So, we're very thankful for the technology we have to take care of our patients. Speaker 9: (37:48) But the community spread of Covid guys is wide. And we're seeing that some folks got a little complacent and thought that things were okay. I've discussed with the Governor early today that when phase two open, I can look out my window as I'm doing telemedicine and see that the car volume increased significantly within several days of him opening up the state. So, I'm not sure if everybody fully understood what that meant. But there are increasing numbers as we know, across the country but particular in the state that I love and I'm a native, I'm Louisiana-born in Baton Rouge. Speaker 9: (38:16) These patients that I see as our patients when they get sick and I've seen a sicker patient and I'm seeing more patients that are sick or dealing with Covid-19 are trickling into the hospital. And as Dr. O'Neill said, that is affecting the beds that we have in the hospital. And we're truly concerned about overwhelming the healthcare system as it exists today. I've seen Covid in all demographics, black, white, Hispanic, young, old, men, women and children and the symptoms of the virus had evolved from three symptoms initially, fever, cough, shortness of breath and now, the CDC says we have nine. There's an article that came up yesterday or a couple of days ago that talks about new symptoms in the millennials and young people where they're having severe migraine headaches and bowel symptoms, nausea, vomiting, diarrhea. Speaker 9: (38:55) And we're also seeing an increase in exacerbation in the mental health problems in the community, a lot of the anxiety and depression. And that's something that really hits home for me because many of these folks who don't have the luxury of working from home, living paycheck to paycheck, who don't have paid time off, they are central workers that have to go to work that are dealing with anxiety and depression that I can't give them time off, they have to go to work and they're keeping our stores and the limited things that we have open alive and well. Speaker 9: (39:19) I can assure you however, that our healthcare system, the healthcare providers, the individuals that I work with closely, I've actually talked to more people in the healthcare system. We kind of go, "We need to refer, we don't know this guy," but I've been talking to my colleagues a little bit more because of the pandemic. Speaker 9: (39:33) We chose this profession and we're here to help but we cannot be successful in Louisiana without you guys playing your part. We've got to the social distance, we've got to wash our hands, but more importantly, we've got to mask. There are studies now showing that masking works. Me without my mask on, these respiratory droplets can go maybe up to 12 feet. And so, if you're having a mask on and not that it protects you but to it protects the people that are around you. So, if you've got the mask, the Governor said earl, he really didn't want to do this, but we're in a position now that we are losing lives to something that actually can be prevented. Speaker 9: (40:02) So guys, I hope that you're taking this message as seriously as we all are. I'm prayerful that all of us will hear what's going on and thank you so much again Governor for all that you're doing. Governor John Bel Edwards: (40:19) Thank you, Doctor. Okay so, I'll take questions in just a minute. I think I might have been either unclear or misspoke. The order will be signed today to be effective at one minute after midnight on Sunday night, Monday morning. So Monday, this is an effect. That was what I was trying to communicate. I think I may have said something different, I apologize for that. Having been preceded by three medical professionals, I did want to just comment about how much I appreciate and the people of Louisiana appreciate all of our medical professionals. There have been nobody who has stepped up the way that they have during this public health emergency, often at great risk to themselves and so forth. And it runs the whole gamut of the medical profession. It's the respiratory therapists, the doctors, the nurses, it's the EMPs and the paramedics, it's just everybody involved. Governor John Bel Edwards: (41:14) And I know as soon as you start naming particular groups, you're going to leave some out. So, I want to say how much I appreciate them. But I will also say that as Louisianans, we owe it to them not to overburden them again if we can help it. Not to flood our hospitals and cause the kind of problems that we've seen in Louisiana before, especially in the New Orleans region and then what we've seen around the country. And the simple fact of the matter is, we can prevent it. We've done it. And quite frankly, the fact of the matter is, we don't have to go back to phase one or phase zero in order to prevent it. If we will do the things the CDC is recommending, that the White House Coronavirus Taskforce is recommending, those things that we put in our proclamations, then we know that this disease, the transmission rate will slow, we know that that will happen. Governor John Bel Edwards: (42:06) So, let's be good neighbors to one another, realize we all have a role to play. And I have confidence in Louisiana just like we did before. We'll do it again. And we should take advantage of this opportunity we have. And by the way, this opportunity isn't going to last forever. If we want to bend the curve again and get this back under control without having to go back to phase one or to phase zero, now is our time, don't wait 'til tomorrow, don't wait 'til next week or next month because we won't have any time left at that point. So, I would encourage people to continue to pray for all of us and for our medical professionals especially. Join your prayers to mine that we will get through this as best we possibly can and as soon as we possibly can. But nobody should think it's going to be real soon where we have a new normal. And we will until such time as there's enough herd immunity. Governor John Bel Edwards: (43:03) And that's going to likely not happen until there's a vaccine out there that combined with those individuals who have the antibodies, because they actually had Covid or reaches that level that's necessary in order to cause this to dissipate and to get under control. And that's not going to be any time really soon. So, I would encourage everybody to be patient. With that, I will take your questions. I'm going to get some water too. Sam. Speaker 10: (43:31) Governor, can you talk more about so the mask mandate, is it just if you're inside an establishment, is it effective outdoors? Governor John Bel Edwards: (43:38) No, it's effective outdoors too. Speaker 10: (43:39) And how do you enforce that? What are the penalties associated with that? Governor John Bel Edwards: (43:44) Thank you for the question. So, it's indoors and outdoors when you cannot be physically distant from others. And I will tell you when you're going to go into an office building or into a retail establishment or a restaurant, those sorts of things, unless you meet one of those exceptions, that mask needs to be on. When you are outside and in close proximity to others. Governor John Bel Edwards: (44:07) So, let's just say you're at a park, but for some reason you're not six feet away from others, which by the way, you should be, you shouldn't really go to a park if you can't be six feet away from others who are not from your immediate household, you're going to need to have your mask on. And this mandate applies to all of those locations. And there are those exemptions for individuals and there's those exemptions that are possible for those three parishes for now if they choose to opt out. Governor John Bel Edwards: (44:38) Again, even if they opt out, the CDC guidance doesn't change and I'm encouraging everybody to wear a mask or face covering if they possibly can. With respect to enforcement, we are going to require businesses to tell people they have to have a mask on. Now, the businesses and organizations, they're going to be allowed to accept a representation from someone that they meet one of those categories of exemption. Governor John Bel Edwards: (45:09) But other than placing law enforcement officers at every business or every office building and so forth, there's just no other way to do it. And we're not going to be out there with a goal to write citations. We really want people obviously to comply with the mandate. We want businesses to make a real effort to put signs up, encourage people to put the mask on if you want to be there. And then, if someone doesn't meet one of the exemptions and refuses to wear a mask, they should be asked to leave. Governor John Bel Edwards: (45:47) And at that point in time, if they don't leave, they're trespassing. And so, that's how we look to enforce this. I will tell you that the mandate in short, it does apply to churches but we are not going to be enforcing it in churches. We're not going to be citing pastors, we're not going to be doing those things. But I am encouraging them to understand that that particular setting, because you have people there often for an hour or longer, it really is important that they wear that mask. Speaker 10: (46:23) If you were to sign a business, what would the penalty be if you're going to have to ticket that business? Is it fine, if so, how much? Governor John Bel Edwards: (46:33) Yeah, but understand that wouldn't ... I'll get that answer to you. That's not going to be a first resort. When we go to a business, we remind them what the requirements are and make sure that they understand, because sometimes people have a genuine misunderstanding of what the requirements are and so forth. The first efforts are always going to be to secure compliance, not on enforcement via a fine and so forth. But I will get back with you on that. Understand that the individuals, if they won't leave, it's just a simple trespassing at that point in time. Yes, sir. Speaker 11: (47:13) Going off of that, I have another question, but will the citations be for the business owners or the regular- Governor John Bel Edwards: (47:18) Business owners. Speaker 11: (47:19) And then, I know some of the medical professionals, they mentioned elective surgeries. Obviously, you didn't pull back on those today. Kind of where are you on possibly maybe going back to cutting off elective surgeries? Governor John Bel Edwards: (47:29) Well, the Office of Public Health has not told me that that's something they're recommending now. I will tell you that you have some hospitals around the state who are different places in terms of their staffing availability to deal with Covid-19. And I know that some of them are making decisions for themselves as to whether they're going to curtail certain types of nonemergency medical and surgical procedures in order to have that staff to deal with their Covid patients. Governor John Bel Edwards: (48:01) And so, it hasn't risen to the level of a statewide issue yet where I've even been advised that we should consider doing that. But I do know because time gets away from me, but the other morning, I had a call with about 20 CEOs and medical directors of hospitals from around the state and there were three major issues. One involves tests and not the availability of test collection kits like we had before, that's available. It's the turnaround time at the commercial labs primarily. Second was, Remdesivir, making sure that the allocations of that were sufficient because they've been allocated based upon what previous patient counts were. And some hospitals have seen large increases, but they weren't necessarily getting the Remdesivir that they needed and thirdly, was around staffing. Governor John Bel Edwards: (48:52) And so, I know that there were some hospitals that have already decided to make some changes about how they operate in order to free up some folks. We haven't been asked to do that at the state level yet. Yes, sir. Speaker 12: (49:06) Hi Governor. So, as far as those medical exemptions from wearing a mask, firstly, if you can kind of elaborate on what those exemptions would be. And secondly, if somebody does fall under that, do they have to carry a doctor's note or what's that [inaudible 00:49:21]? Governor John Bel Edwards: (49:21) Well, first of all, as I mentioned, that business owner, if that were you and you walk into my business, I may ask you say, "Sir, would you mind putting a mask on?" And you say, "Well, I do because I'm exempt from it because I have a medical condition or whatever," that business owner is allowed to accept your representation. So now, if you had something that would document that I'll be thinking to be in your interest to have it on your person, we're not going to require the business owner to ask you for that. Governor John Bel Edwards: (49:53) And at that point in time, you're allowed to be in that store without a mask and so forth. As far as what those conditions are, I'm going to ask for one of my physicians to come up here. I don't know whether Dr. Kenner or Katie, whoever wants to come up and talk about whose conditions it would be that would mean you don't have to wear masks. Speaker 13: (50:13) Thanks for the question. And I mean to be clear, it's a tiny, tiny minority of the patient base out there. Some people have respiratory function that is so diminished that putting a mask on can cause a little bit of anxiety and really their window is so narrow that that's enough to put them over. Obviously, kids younger than two don't do well wearing masks and then it's a case by case basis. But there's a larger point to be made here and it's that, and I counsel patients on this too, if you have a condition that you think makes it untenable to wear a mask, it is also likely the case that you are at an increased vulnerability for Covid- Speaker 14: (51:02) ... that you are at an increased vulnerability for COVID exacerbations in the first place. You are a vulnerable individual, and I don't want you putting yourself in a position to be at risk and to get sick. And that's the larger message to convey to people, is that if you really do have a condition that you feel you're not able to wear a mask, you really need to look at your own risk profile. And is it worth doing the activities that you'd like to do? Governor John Bel Edwards: (51:30) Yes ma'am. Speaker 15: (51:31) Okay. So in terms of casinos, will they be limited, considering they are only allowed to have 50 people in there? Governor John Bel Edwards: (51:38) No. That 50 person limit has to do with social gatherings, as I mentioned. All of the Phase 2 requirements with respect to occupancy will remain in place for commercial businesses, whether they're essential, non-essential. So that is not the situation with respect to casinos. Governor John Bel Edwards: (52:02) There's nothing in today's order that changes Phase 2 for churches, for essential retail, non-essential retail, including casinos. The change with respect to commercial establishments is limited to bars and perhaps to a commercial establishment that would offer an indoor venue for some type of a gathering. Governor John Bel Edwards: (52:24) Yes. Speaker 16: (52:25) So can you talk about- Governor John Bel Edwards: (52:25) I'm coming to you next. I'm sorry. Speaker 16: (52:28) Indoor restaurants that are not bars, but do serve alcohol. I know New Orleans stopped any sale at the bar itself. Can you talk about what, if anything, is changing at indoor dining establishments, and if nothing is changing, I guess, why not take on indoor dining at restaurants as well as bars? Governor John Bel Edwards: (52:47) Well, because the information that we have from contact tracing and otherwise is that the restaurants are not posing the same type of risk of transmission as bars. I think typically people are in a restaurant for a shorter period of time than bars. They're more likely to go in and come out wearing a mask and only not wear a mask while they're seated at the table and that sort of thing. Governor John Bel Edwards: (53:14) Now, I am aware that there are restaurants that have bars in them. They are going to be allowed to seat patrons at their bars and serve them food, and while they are consuming food, they can have a drink as they normally would, just as they could at a table, by the way. But the bars in a restaurant will not function as a bar. It will function as an extension of the seating area for the consumption of food. Governor John Bel Edwards: (53:37) Yes, sir. Speaker 17: (53:39) Yes. Will a guidance be provided to state agencies for state employees? Governor John Bel Edwards: (53:45) Well, yeah, first of all, this applies entirely to state employees as well, and all of whom are going... And by the way, for the general public coming into a public building, whether it's state or whatever, it's going to apply to them too. Governor John Bel Edwards: (54:01) So, state employees will be wearing a mask. Yes. Speaker 18: (54:05) Governor, Texas has taken a sort of different tack to enforcement than you have. They've sent out their alcohol and tobacco control arm and essentially shut businesses down, if they find they are violating the rules. I'm wondering if you think what we're doing here, which is, you haven't issued any penalties, it's more of a warning system, if you think that's working? And why not just go out there? Don't they know the rules at this point? Why not suspend their license for 30 days? Governor John Bel Edwards: (54:31) Well, I just announced we're closing every bar. Speaker 18: (54:34) Yeah. But I guess- Governor John Bel Edwards: (54:35) I don't know how to be more categorical than that. But secondly, we- Speaker 18: (54:39) Well, especially with the mask mandate too, I guess I'm curious, because this is another enforcement mechanism. So you said you're going to work on gaining compliance. I guess, why not be stricter when it comes to enforcing this stuff? Governor John Bel Edwards: (54:51) What I can tell you is, and I didn't get an update today on what the number is. The last time I got an update, we had visited more than 3,100 commercial establishments. That was restaurants and bars and retail altogether, and that's Office of Public Health, and primarily the State Fire Marshal's Office. What I can tell you is that the vast majority of those were not out of compliance. Those that were, the vast majority very quickly got into compliance because it was something relatively simple. In almost every instance, the employees know they have to have a mask because they've got one around their neck. They're just not wearing it. And when you go in and you tell them to wear it, they put it on. Governor John Bel Edwards: (55:37) And so what we're trying very hard to do, is make sure that we're going in, because we're doing compliance checks or because we're responding to a complaint, and y'all might be surprised at the number of individuals who will either leave or choose not to go into a commercial establishment because they don't believe that the individuals are wearing masks. And then they will call the Fire Marshal's Office, make a complaint. We go out there and very, very quickly that individual puts the mask back on. And typically it's an employee who, for some momentary lapse, they take it off. They don't put it back on. And for whatever reason, there's not close enough supervision to get that mask back on them very quickly. But we're going out there and we're working with those individuals. Governor John Bel Edwards: (56:24) Now, I have instructed our Fire Marshal's Office that on repeat business to the same establishment for the same problems, to start issuing citations. So I do believe you're going to see that going forward. But I'm going to repeat something here, and I hesitate to do it, but I'm going to do it anyway. Governor John Bel Edwards: (56:44) I've said from the very beginning, a public health emergency of this nature, if the people of Louisiana are going to insist that we enforce our way through it, we're not going to be successful. And we're going to continue to have people unnecessarily spreading this disease and then other people, who through no fault of their own, because they might be wearing a mask, they might be the most responsible citizen out there, but they will contract it because someone in their close vicinity chose not to be a good neighbor. Governor John Bel Edwards: (57:22) And then those individuals are going to go to the hospital and fill that bed and cause all the problems for our hospital systems and our medical providers, and not just to the COVID community, but to anybody who needs a medical service. And if the people of Louisiana are going to say, "Well, we're just not going to listen to any of that and we're going to make them enforce our way through it." Well, we're going to be unsuccessful. Governor John Bel Edwards: (57:48) But you know what? I believe in Louisiana. We're better than that. Our people have always been good and resilient. We're a faithful people. We know what it means to be a good neighbor. And now it is important to be a good neighbor. And if you don't like the mask mandate, then don't like it, but wear your mask anyway, if you're going to be out in public. If you want to criticize me, criticize me. This isn't an easy thing to do. It's hard. And I understand it's going to be controversial. And I know that because we've already seen some wild and crazy things being said about mask and mask mandates. So be it. It's the right thing to do. It's the essential thing to do. But don't sit back and say, "We're only going to be successful if you enforce our way through this." That is just the wrong attitude. Governor John Bel Edwards: (58:40) Yes, sir. Speaker 19: (58:41) Switching gears to the Vice President's visit. I talked a little bit about federal [inaudible 00:58:46] with Dr. [Cantrell 00:58:47] last night, about some of the testing issues that y'all may discuss next week with the feds, including turnaround time for test results and the reagents. Can you kind of talk about how the decision for the Vice President to come to Baton Rouge specifically during this came to be, and then about those testing issues that may be discussed? Governor John Bel Edwards: (59:09) Well, I think there are a number of things happening all at one time that made Louisiana and obvious place the come. Number one is, as I just mentioned, we're back to number three per capita in the country for COVID cases. You recall it was just about 10 days ago that we announced that the federal government at the direction of Dr. Birx and the folks at HHS and the Office of Public... Not the Office of Public Health, but anyway. They picked Baton Rouge and specific to do surge testing. One of three metropolitan areas around the country to do surge testing, to get above our baseline by what we were hoping would be 5,000 people per day. By the way, we haven't met that. We are increasing every day, but we haven't gotten to 5,000 yet because of the steep increases in cases, but the even steeper increases in positivity in Baton Rouge. Governor John Bel Edwards: (01:00:04) So Louisiana has been on the radar, literally front and center of the White House Coronavirus Task Force since the very beginning, when we had the highest case growth in the country. We've never come off of that radar. And so I think that's a big reason why the Vice President chose to come to Baton Rouge and to Louisiana. Governor John Bel Edwards: (01:00:26) While he's here, he's going to talk about higher education and what we're doing to safely resume, hopefully, on campus in-person instruction on time. What that mix of education is going to be like between in-person and perhaps distance learning, and those sorts of things. And I also think LSU is a tempting target for anybody, because it's LSU and we're the current national champions, and he gets an opportunity to come down and be on that fine university. And we're going to actually meet in a large space in the clubroom, on the south end of the stadium. So for all of those reasons, I think he picked Louisiana. Governor John Bel Edwards: (01:01:17) One more question. You get it. Speaker 20: (01:01:21) Governor, Clay Schexnayder sent a note to Republican members, sort of warning them of the dangers of signing this petition, and some of them were conservative members. Going forward, have you talked to Clay Schexnayder about this new mandate, and are you worried about the petition at all gaining speed [inaudible 00:01:01:38]? Governor John Bel Edwards: (01:01:38) Well, so I speak frequently with the Speaker and with the President of the Senate and really lawmakers, regardless of whether they're in leadership. I mean, I speak to them frequently. I did have an opportunity to talk to them specifically about the proclamation I'm going to be signing today. But what I try to make sure is that they're getting regular updates and they're seeing the same numbers that we're seeing, and they know the trajectory that we're on. And so that hopefully by the time we make a decision, it's something that they probably have already envisioned that we're likely to do. Governor John Bel Edwards: (01:02:16) But yeah, I have had an opportunity to speak to them about this, to make sure that they understood, and this is one of the differences. And Dr. [Kanner 01:02:26] got into this, I think, really well. The first time we had a surge of coronavirus in the state, there were an awful lot of people who said, "Well, that's a problem for [inaudible 01:02:35] in Jefferson Parish. It's not a problem for us." That is obviously not true today. And in fact, New Orleans, that is not a driver of our current increase in cases. Now that could turn around, it might be the case tomorrow, but this is literally statewide. The hottest area in the state for case transmission is in Lake Charles, Louisiana right now. The second hottest is in Lafayette. Governor John Bel Edwards: (01:03:04) And so, there's a big difference here,, and I really think that some of the legislators who signed onto the petition, which, by the way, I think would be a tremendous mistake for us to be, I think, the only state in the nation without a public health emergency at the time when we're number three in the country in per capita cases. Our positivity is over 15%. We've got the highest case growth that we've had, the entire public health emergency. Our hospitals are filling up again, and all the coordination that we need to do, all the resources we need to make available to our hospitals and to our parish governments and other political subdivisions, all the coordination we have to do with the federal government, not to mention making sure that we're able to take advantage of all the resources that they can only send of Louisiana, if we have a declared public health emergency, and the ability to make sure that we can take advantage of the Stafford Act, which allows FEMA to pay for 75% of reimbursable expenses, all of that would be threatened by some sort of a silly partisan petition. Governor John Bel Edwards: (01:04:09) I mean, look, they can do it if they want, that would be a tremendous mistake, and the people of Louisiana would pay an even higher price from this pandemic, if that happens. And I'm going to encourage, as sincerely as I know how, any members who haven't yet signed it, not to sign it. And I'm going to remind those who have signed it, that they can have their name taken off it. But it would be a tremendous mistake. Governor John Bel Edwards: (01:04:39) Look, thank you all for coming today to this press briefing. Obviously these are not the kind of briefings or decisions that I look forward to. They're not easy, but they are essential. And our ability to communicate them to the people of Louisiana, really, you all play a huge role in that. And so for the people in this room today, I want to thank you for the work that you're all doing, and I'm going to wrap up with just some comments directed directly to the people of Louisiana. Governor John Bel Edwards: (01:05:09) We've been here before. We can get back on top of this and we can start driving cases down. And we can do that, if we would just understand, we all have a role to play. That role is simply being a good neighbor under these circumstances. And it's different to be a good neighbor than it was before, because being a good neighbor today means you don't go pay that personal visit, but you call somebody, you text them, you Zoom with them, whatever. Governor John Bel Edwards: (01:05:38) But it also means that you wear your face mask. You physically distance when you're outside of your home and in proximity to people who are not part of your immediate household. That you wash your hands frequently, you stay home when you're sick, and that you take of those people who are especially most vulnerable. Governor John Bel Edwards: (01:05:54) And if you're out and about... First of all, understand you're safer at home, always, but if you're out and about, don't patronize a business that isn't operating safely, because if you will do that, then we know that businesses will in fact operate safely. Governor John Bel Edwards: (01:06:14) And then the last thing I would ask people to do is to make sure that they are praying for our state and our country. This is a very difficult time. And so, I'd ask you to join your prayers to mine. And I'm absolutely confident we're going to get through this. It won't be easy, it won't be quick, but we're going to get through this. But it will be quicker and it'll be easier if more people will comply with what we're asking them to do. Governor John Bel Edwards: (01:06:39) Thank you all very much.