Massachusetts Governor Charlie Baker COVID-19 Briefing Transcript April 15

Charlie Baker: (00:00) Colleagues at Partners in Health to ensure we can do everything possible to identify and isolate people who are dealing with COVID-19 after the surge and beyond. We're working around the clock to obtain and distribute large quantities of personal protective equipment to support frontline workers and the command center working with state and local partners has helped distribute over 3.7 million pieces of PPE to hospitals, nursing homes, community health centers, public safety personnel, local boards of health and state agencies. This includes over two million gloves, over 820,000 masks, over 370,000 masks from the aircraft delivery and over 170,000 gowns. Late last night, another portion of the aircraft mask shipment arrived here in Massachusetts and in addition to that, FEMA notified us this morning that we'll be receiving one million pieces of personal protective equipment including 650,000 masks and 260,000 tyvek suits. State officials are in the process of inspecting and counting all this inventory and MEMA will work quickly to distribute these much needed to gear to our frontline workers once the inventory count and the inspection is completed. Charlie Baker: (01:21) And as I've said many times before, I'm incredibly grateful for the generosity and support of the Kraft family who helped us bring that shipment home. Getting enough gear, not just here in Massachusetts but across the country has been a challenge and will continue to be until supply chains adjust to the new normal on this. And as we announced yesterday, we're posting a daily summary of personal protective equipment distribution, which is available at mass.gov/covid19. Charlie Baker: (01:53) For several weeks now, you've heard us talk about the work that's been done with the command center and our healthcare community to determine exactly what the plan and the bed capacity that we need here in Massachusetts to manage our way through the surge. That plan includes an entirely new system to track bed capacity on a daily basis. Those stats are now posted publicly. As of the end of the day Monday, there were 17,500 beds statewide in Massachusetts that were suitable for COVID-19 treatment. That includes just under 6,000 acute care beds, just over 2,500 ICU beds and approximately another 750 beds that are available in the field hospitals that we've put up for patients if needed. The last number will increase as we bring more field hospitals online. Charlie Baker: (02:50) Yesterday, Lieutenant Governor Polito and I visited the new field hospital at joint base Cape Cod that will formally launch on Monday. Additional sites are being launched in Lowell, and down in Dartmouth on the south coast to ensure we sustain a regional approach to these field hospitals. Those three sites join the two that are already open, one at the DCU center in Worcester and the other at the BCEC in Boston. The beds in these facilities will serve as an alternative care option for medical professionals to treat patients, especially those who need less intensive care. They also leverage partnerships with local healthcare providers who know their communities and their populations well. Charlie Baker: (03:35) These sites would not be possible without the coordination between the National Guard, MEMA, our command center and many of our colleagues in the healthcare community who have stepped up in a big way to make this possible and to get it done in a very short period of time. Right now the number of patients at the two sites that are open is relatively low, just a handful, but these sites are being built to augment existing hospital capacity and we hope the surge in cases is not significant enough that we'll need to rely heavily on those beds, but we think it's important that they be there and that we have them. Because all along the goal has been to plan for the worst and that's exactly what we've been doing. Charlie Baker: (04:20) I'd also like to do an update today on our strategy with respect to longterm care facilities. Massachusetts is working to detect, prevent and manage the outbreaks of COVID-19 throughout the state and we are intensely focused on mitigating the spread of illness in our senior living facilities. In total, there are 383 nursing homes in Massachusetts, 255 assisted living residences and 93 rest homes. There are approximately 38,000 residents in nursing homes, 16,500 residents in assisted living facilities, and approximately 3,000 residents in rest homes. As we've all discussed before, these facilities, not just here in Massachusetts, but everywhere, are highly vulnerable settings for outbreaks of COVID-19. That's why we were among the first states in the country to implement stringent visitation restrictions and screening guidelines for staff. To protect the health and safety of our most vulnerable seniors and the dedicated staff who support their daily needs, we've continued to build a multipronged approach to respond to COVID-19 at these facilities. Our strategy includes expanded mobile testing. We are one of a very small number of states that have brought testing to our senior care facilities so that that work can be done on site. Personal protective equipment distribution, rapid response, clinical teams and other staff resources, crisis management support, 130 million in new funding and a nursing home family resource line. Secretary Sotos will talk a little bit more about that in a minute. Charlie Baker: (06:05) We've talked before about expanding our mobile testing program, working with our colleagues at the Department of Public Health and the National Guard to support longterm care facilities here in Massachusetts. How this works is rather than having people make a trip to the hospital or to a medical center, the Department of Public Health brings the test to them at their facility. This proactive onsite testing also heightens our visibility into how the virus is impacting these facilities even before facilities in some cases realize that residents are infected. With the data, residents can be quarantined and monitored to slow the spread as much as possible. On April 13th we updated testing guidance to encourage longterm facilities to conduct widespread testing for residents even if they have no symptoms, with residents or with their staff. Facilities can either get tested through the mobile testing program or they can conduct their own onsite testing using kits that we're making available through the Broad Institute. Charlie Baker: (07:11) As of April 14th, more than 4,500 tests have been collected at 264 senior living facilities and as of yesterday, another 77 facilities had requested more than 8,600 test kits from the Broad Institute and the Broad Institute will process those tests on behalf of those facilities. Charlie Baker: (07:34) Nursing facilities have also received a significant distribution of personal protective equipment. Since the beginning of March, we've provided nearly 1.3 million masks, almost 200,000 gowns and over two million gloves. Massachusetts is also mobilizing a rapid response clinical team capability to provide short term support to facilities with a high volume of cases or with critical staffing needs. These teams are made up of EMS technicians, nurses, and other healthcare professionals. Having these resources available for rapid deployment makes a big difference in the longterm care facility system and it's something that we have already gotten positive feedback from a number of community providers as a result. Charlie Baker: (08:21) The COVID-19 outbreak has undoubtedly put a strain on the staff and the dedicated healthcare workers who take care of many of our most vulnerable seniors. Staff shortages are also more likely to occur in facilities if more employees test positive for COVID-19. To meet staffing needs, our administration has stood up the longterm care portal to match individuals that have registered through the portal with the staffing requests submitted by facilities. We've also announced the $1,000 signing bonus to all individuals that register through that longterm portal to work for a certain amount of time and we've tapped into the MA response volunteer portal. To provide crisis management support, we've also contracted with a firm that specializes in nursing home crisis management. They'll be available to provide facilities with onsite operational support to assist with staffing, vendors, implementing infection control measures and other key elements of appropriate operation and design during this time. The firm will also support efforts to stand up dedicated COVID- 19 wings or units in existing nursing facilities. Charlie Baker: (09:36) I'd also like to say a quick word about nursing facility capacity. We've pursued three parallel options for expanding COVID-19 dedicated nursing facility capacity here in Massachusetts. First of all, converting existing occupied facilities to fully dedicated COVID-19 facilities. An example of this would be the Beaumont Facility in Worcester. Second, converting empty facilities to stand up a new dedicated COVID-19 nursing facility. An example of this would be the Pioneer Valley Recovery Center in East Longmeadow. And third, creating dedicated COVID-19 wings within a broader nursing facility. Charlie Baker: (10:18) We've built this three pronged approach to ensure that we have the needed capacity for our seniors and to adapt to the realities of COVID-19 infections that have clearly infected, impacted several facilities. The goal here is to be nimble and smart in our approach and we believe that these different build outs provide the appropriate setting for seniors and for staff to get and provide the best care. To date, in addition to the Beaumont Facility, the commonwealth currently has five dedicated COVID-19 facilities opening within the next seven to 10 days in Brewster, Falmouth, New Bedford, East Longmeadow, and Great Barrington with couple of others in planning stages. No one's ever done this before. The command center pulled this together using every available resource and we'll continue to adapt and respond to the situation as it requires. Charlie Baker: (11:17) Before I close, I just want to point out that this would normally be tax day. It's April 15th which I think most people know has been moved to July 15th. But it's also One Boston Day. It's the seventh anniversary of the 2013 Boston Marathon bombings. April 15, 2013 was a dark day for the city of Boston and the Commonwealth of Massachusetts in our country. The lives taken and the lives changed forever are never very far from our thoughts. There was a lot of sadness that day, but there was also bravery, compassion, and strength. First responders, healthcare workers and bystanders rushed in to help, putting their lives on the line in the process. Neighbors, friends, and strangers held each other up with acts of kindness. The city and the commonwealth rallied. Rose to the occasion and turned tragedy into strength. Charlie Baker: (12:15) Now, as we all endure a worldwide pandemic, we are rising to the task to meet it again. Every day, nurses, doctors, public safety personnel, and countless others, essential workers in the public and private sectors are rushing to the front lines. Millions of Massachusetts residents are sacrificing, upending their lives to protect one another from further spread. There's no doubt we have tremendous challenges ahead, but the one thing I am absolutely sure about, and it is never in doubt, is the remarkable people of Massachusetts. We will get through this. We will get through it together just like we have so many times before. Charlie Baker: (13:03) And now I'd like to turn the podium over to Secretary Sudders for some updates from the command center. Secretary Sudders: (13:16) Thank you, Governor. Thank you, Lieutenant Governor. As the Governor said, it is important to remember that we are strong and resilient in the Commonwealth of Massachusetts. And there is one other group the Governor references, but one of the groups of folks who come to work each and every day, despite sometimes how the media presents things, are in fact our nursing home workers. Each and every day, despite what sometimes we read in the papers, nursing home CNAs, workers, staff, come to work to take care of some of our most vulnerable older adults. And I don't want people to forget that. Because we often talk about our first responders and our healthcare workers, but there's a whole other group of people that the Governor referenced, who are our human services workers, our personal care attendants, who help people with disabilities stay home, and our nursing home workers and our home health aides, as well. Secretary Sudders: (14:17) On nursing homes: as the Governor noted, we're working with long-term care facilities to detect, mitigate, and manage the outbreaks of COVID-19 throughout the state, and we're intensely focused on the spread of illness and making certain that our nursing home residents are receiving the care they need during this unprecedented public health emergency. Secretary Sudders: (14:37) As part of the multi-prong strategy that the Governor enumerated, we've committed $130 million in stabilization and support funding. In early April ... or in April early ... but, in early April, we announced and across the board 10% MassHealth rate increase, which is worth about $50 million, for all nursing facilities, effective April 1st, as part of that first out of the box early stabilization package. Additionally, facilities that create dedicated COVID-19 wings or units, and who follow necessary safety protocols, will be eligible for an additional 15% rate increase, or a net increase of 25%. The 10% that I mentioned plus this additional 15%. That's worth approximately $50 million. So now we're up to a hundred million. And we're assuming that probably two-thirds of the industry ... Of that 398 facilities that the Governor mentioned of the industry, will be able to provide these units. Those funds support additional staffing, infection control, dedicated staffing units, so that the staff are not migrating from non-COVID to COVID units, and the additional costs of supplies throughout the state of emergency. The balance of $30 million is our estimate for standing up fully dedicated skilled nursing facilities such as Beaumont, the Wingates, East Longmeadow, and the others. And within our rate increase is an expectation that we will see increased salaries for our frontline nursing home staff as well as, as we said, expenses related to supplies and the others. In addition to the $130 million not included in this figure is also a 10% rate increase for rest homes, which is a different funding formula, but we do not want to forget the funding for rest homes. Secretary Sudders: (16:41) So it's 130 million for nursing homes and then a 10% rate increase for our rest homes across the Commonwealth. Just a couple of other updates around our ability to try to keep the residents and the citizens of the Commonwealth informed. As you know, as the Governor said, we implemented a nursing home family resource line. As of earlier this week, we have had more than 1100 individuals contact our nursing home resource, line which is a dedicated line to connect family members, who are anxious about what's happening in their nursing home for their loved one. Additionally, just a little bit of an update about Buoy, because we're pretty excited about what Buoy offers individuals in the Commonwealth. As you know, when we announced Buoy Health as a coronavirus resource for Massachusetts residents just a few weeks ago, more than 70,000 people have now used the online tool. Buoy's health tool is free and live for all Massachusetts residents, connecting you to the next appropriate health care resource and staying in touch with you. Secretary Sudders: (17:47) It's not to be used in place of emergency medical care, but it is a tool to support those who may be worried about their symptoms, which is true for many in our state at this time. And, finally, just an update on reporting. As the governor has noted, and it is our commitment to continue to improve our public-facing reporting. For the first time, starting today, we will release novel coronavirus cases by cities and towns as the state takes additional steps to assess and report the burden of infection across the state. This new reporting, which will be updated weekly, each Wednesday marks the latest in a series of new data points and information that we've recently made publicly available, in addition to the data on the daily COVID-19 dashboard. Our testing efforts, as you know, have increased. We know that every community in the Commonwealth has experienced the impact of coronavirus. Secretary Sudders: (18:44) Many of these cities and towns reported this information directly to the residents. As is standard public health practice, we will not release the number of positive cases if there are fewer than five in a municipality of 50,000 or less, in order to protect privacy. Having the ability to look at this virus through the lens of its impact on specific cities and towns will help us identify potential hotspots, inform the public health response, assist cities and towns working to slow the spread, and help the state appropriately deploy resources. In recent weeks, we have also provided data on total COVID-19 cases and death by race and ethnicity, so the public can see for themselves the impact of the illness and death on communities of color. We've acknowledged that this information is not nearly as complete as we want it to be. I do notice progress every day, but it could occur faster, and the public health commissioner has issued an order mandating enhanced reporting of demographic data. Secretary Sudders: (19:51) We also now report cumulative data on positive cases and deaths at nursing homes and other longterm care facilities and the number of facilities with positive COVID-19 cases. We have also started to report the daily number of COVID-19 inpatient cases by hospital and the number of coronavirus patients in the ICU by hospital. Every day, we continue to report on the total number of COVID-19 tests, the number of tests that were positive, the number of deaths, and those deaths by age group, gender, and county of residence. We are also now providing a daily summary of the distribution of personal protective equipment by type of facility, of entity, and by region of the state, so the public knows where the state supplies are going. With that, governor. Charlie Baker: (20:40) Questions? Reporters: (20:42) Governor, are we in the surge already, and is the state in the best possible position to be [inaudible 00:07:48]? Charlie Baker: (20:49) Well, we said all along that we thought the surge would start somewhere between the 7th and 10th of April, and I would say, at this point in time, based on the conversations we're having every day with our colleagues in the hospital community, that we are in the surge. Charlie Baker: (21:05) Yes. Reporters: (21:05) Governor, can you tell us- Reporters: (21:05) Are we in the best position possible? [inaudible 00:21:08] anything else you'd rather like the people to do? Charlie Baker: (21:13) We spent a lot of time talking about three things with the healthcare community and the public health community. One was doing everything we possibly could through orders and advisories and guidance and instructions and public commentary to stop the spread. Okay? And to do all we could with regard to social distancing, essential businesses, and all the rest, stay home advisories and the like. Number two was to work with our colleagues in the healthcare community and the public health world to try to figure out exactly what we thought the timing would look like with respect to the surge here and what kind of capacity we would need to have in place to make sure that we would be able to meet it. And that led to a variety of things. For example, we were one of the first states in the country to cancel elective surgeries so that we could free up both gear and people and space to manage COVID-19 when we hit the surge. Charlie Baker: (22:19) We were also one of the first states in the country to put a whole series of orders in place with respect to making it possible for retired folks to come back, out of state folks to get licensed to practice in Massachusetts, accelerate the graduation of medical school students, nurses, and others. And, as long as they were working alongside a licensed practitioner, that they would be able to play and participate. We put $800 million into our provider community to deal with the fact that, in a COVID-19 world, their revenue bottom ... Their revenue just literally fell, because a lot of people just weren't going anywhere near healthcare organizations generally. And, by cutting off elective surgeries, we took away one of the most important revenue generators a lot of our providers have, and we one of the first states in the country to issue an order around telehealth so that we could create distance between people who were concerned about their state of affairs and their symptoms and a clinician, so that they could engage and get reimbursed, whether it was a phone call or a video chat. Charlie Baker: (23:28) The secretary mentioned Buoy as well. I think were the first state in the country to put an online tool for people to do self diagnostics to determine if they needed to reach out to a care provider or not. And then, the third piece was to use the models, ours and others to try and figure out about when we'd get there and how much capacity we needed. I would say, at this point in time, I believe, with the addition of some of the other stuff that's coming online over the course of the next five to seven days, we are pretty well positioned to deal with this. Reporters: (24:04) Can you tell us a little more about the [inaudible 00:24:06] shipment, exactly what was in it? Was there any difficulty in retrieving it? Also, when do we expect a FEMA shipment to come in? Charlie Baker: (24:15) The FEMA shipment that I just talked about? Reporters: (24:17) Yes. Charlie Baker: (24:19) I'm not going to count that one until it gets here, but I would expect it to be in the next few days. On the Patriot one, it's currently being inspected an inventory, and maybe tomorrow we'll have more to say about that. There were no significant issues or challenges associated with getting it up here. Reporters: (24:37) [inaudible 00:24:39], the 131 that you mentioned for nursing homes, is that the first withdrawal from the rainy day fund? Is that where it's coming from? Charlie Baker: (24:46) No, I think it's just coming up ... You want to speak to this? Reporters: (24:49) I heard stabilization funds. Secretary Sudders: (24:51) Oh, okay, I've- Charlie Baker: (24:52) That's a different stabilization fund. Secretary Sudders: (24:54) I meant to ... Like we're stabilizing, to support and stabilizing nursing homes. It's not a stabilization fund. It's meant to stabilize nursing homes. Reporters: (25:02) Okay, but this is new money? Secretary Sudders: (25:02) So, no. We have approximately $982 million on a gross basis ... It's about just under $400 million on a net basis in the MassHealth budget that has not been used for other sur- for elective surgeries, for example, and elective procedures. So it is a reallocating. A way to think about it, Bruce, is reallocating within the base budget for FY '20 ... What year am in? FY '20 ... It really is one long day, I just have to tell you. In FY '20 budget, so it's really taking funds that we'd already had received in the budget and reallocating it to stabilize health care, nursing homes, PCAs, home health agencies, and the like- Reporters: (25:48) And secretary- Secretary Sudders: (25:48) ... through primarily rate increases. Reporters: (25:50) Secretary. Reporters: (25:51) Secretary. Reporters: (25:52) [crosstalk 00:25:52] for the first time- Reporters: (25:52) [crosstalk 00:25:57]. Secretary Sudders: (25:55) Whoa, whoa. I'll take them both- Reporters: (25:56) [crosstalk 00:00:25:55]. Secretary Sudders: (25:56) One at a time. Reporters: (25:57) Okay, okay, thank you. Sorry, [inaudible 00:13:01]. Secretary Sudders: (26:01) She was like ... she was halfway through her question though. Reporters: (26:03) I'm sorry. Secretary Sudders: (26:03) Sorry. Speaker 3: (26:03) You had said there's an expectation that there will be an increase in salary for these dedicated nursing home employees that are getting some rate increases. We've heard from some of the unions that the temp workers that we want to bring in are getting brought in with higher salaries, and yet the people that have been there and are union members are basically frozen and not getting the increases. Is there anything you can do about that? Secretary Sudders: (26:27) Yep. If you think about these rate increases, so one was a 10% across the board, and then there's a 15% addition of you create these COVID wings within facilities, and we know 85% of your costs are people costs, so there will be an attestation from the nursing homes in terms of how the costs are being spent. That's why I'm saying quite publicly, we expect that the staff who are coming to work each and every day deserve to have a recognition in their salaries. I have also heard those concerns, and it's very important that we support our line workers. The other thing the governor mentioned is through our longterm care portal is a signing bonus, which is often used during times when people try to recruit. If individuals work for a certain period of time, and we're still trying to work out what the number of hours are, individuals would get a bonus at the end of that period of time. Again, trying to ... and that's bringing in employees and not staffing, like a staffing agency, again, trying to increase the staff. Speaker 4: (27:37) You had mentioned to the first time starting today, you're releasing the data by cities and towns. Some cities and towns have already been doing that. What changed? What was the change? What was the reason for the change, and where can people find that information. Secretary Sudders: (27:50) Right, so it will be posted on the website where everything gets sort of posted on the website, and it'll probably be later today. 4:00 is a good time to start checking the website for data, and I know sometimes it's a little later than 4:00, but 4:00 is a good time to start checking for the data. We can make sure you get the links. What did you ... Sorry. Charlie Baker: (28:10) Joey changed. Secretary Sudders: (28:11) Joey changed. Sorry. Speaker 4: (28:11) What was the reason? Secretary Sudders: (28:13) Again, public health folks are always trying to balance privacy and release of data, and clearly we have so many cases in Massachusetts that as long as we stay true to serve the principle of not less than five in a municipality of 50 that this is important data to share to the public, particularly for us to be able to identify hotspots and the like. We have always been sharing the data with local municipalities. Local municipalities have always had the opportunity and the right to share that data with their communities. Speaker 4: (28:43) Do you feel like people who live in certain communities may see that data that could have an impact on their way of releasing this or change behavior? Secretary Sudders: (28:56) Well, across the state we continue to emphasize the need for individuals that all of us have our obligations and responsibilities around social distancing, wearing face coverings if you're in places where you can't have social distancing, and our personal hygiene and the like. What you don't want is to raise such a level of fear and anxiety, but information to help all of us plan as we're in the surge, and at some point think about life post-surge. But this is really to give all of us information. For me, it's really around identification of potential hotspots. Speaker 5: (29:34) [crosstalk 00:29:34] Will this data be retroactive to the beginning of this [inaudible 00:29:39]. Secretary Sudders: (29:39) Really. It starts today, effective today going forward, I'm not making any commitments about going back in time, but it starts today, and it's every week. Every Wednesday, you will see this data publicly reported by us. Speaker 5: (29:51) [crosstalk 00:29:52]. But it's going to have all of the historical data. Secretary Sudders: (29:54) Right, but I'm not going to- Speaker 5: (29:54) The cumulative information will be in there. Secretary Sudders: (30:00) Yes, the cumulative, but it won't be every week going back. I'm sorry. Speaker 6: (30:04) Governor, you've been concerned about shortages of PPE. With the increased numbers that you're talking about today, are you satisfied Massachusetts has what it needs, or this is an ongoing process? Charlie Baker: (30:11) Well, I guess what I would say is that I will never be satisfied that Massachusetts has what it needs with respect to gear generally, because one of the biggest lessons I hope that we and others have learned through this whole experience is you have enough gear until you don't. Then once you don't, finding it and acquiring it becomes enormously difficult. From my point of view, whether you're talking about traditional PPE or you're talking about test kits or you're talking about a lot of the other elements of how this game will need to be played to manage this virus both through the surge and beyond, we're going to keep chasing all elements of that stuff, because I'm honestly never going to be comfortable that we have enough. Charlie Baker: (31:13) I think, look, I hope this is a real learning experience for public health folks, government officials at every level and people in healthcare that just in time, which is kind of the inventory model that everybody's used for a really long time to avoid putting working capital in place and not just using it, which I understand, is a perfectly appropriate way to manage a lot of things. I don't think it's an inappropriate way to manage this stuff, and I hope one of the big lessons the country and folks like me and other folks in the healthcare world learn from this is having a big gigantic stash of gear is not a bad thing when it comes to stuff that you absolutely positively have to have when you need it to keep people safe. Speaker 6: (32:12) Where did the Kraft plane come from when it arrived overnight with this gear. Was it another trip to China? Charlie Baker: (32:18) This was not ... It was not a Kraft plane that came back. I think it was a commercial. I'm not sure about the nature of the plane. They just drove down to pick the stuff up in New York. Speaker 6: (32:31) Why was it in New York? Charlie Baker: (32:35) Because some of the stuff that comes from China or other places lands in different places. We had a shipment of stuff that came in to Logan the other night that came into the U.S. through Alaska. I think the bottom line on this is you work through the logistics associated with both the airport you're flying in and out of, the rules of engagement associated with getting out of the U.S. and into whatever country you're flying to, and then the rules of engagement associated with getting back. They depend. Some of this stuff comes back into California and then comes from California to New York or to Boston. It's driven by capacity. It's driven by rules. It's driven by international guidelines and protocols, and it's a little bit of a game of hopscotch. It's a really big game of hopscotch, but there's a lot of stuff that comes in through a whole variety of different routes and processes. Speaker 7: (33:42) Governor, the Mass. Nurses Association have raised concerns about mask decontamination methods. They say it's not scientifically proven to be effective, and they're concerned they're not keeping people safe. Are you satisfied with what's been coming out of some of [inaudible 00:33:58]. Charlie Baker: (34:02) So I listen to Paul Bettinger, who's one of the nation's if not the world's leading infectious disease specialists talk about this decontamination process. When I was over in Somerville, the lieutenant governor and I both did. I would not pretend to say that I understood a lot of what he said, but I understood the part he said at the end, which is that masks that come out of this facility are every bit as clean and decontaminated as a new one that comes straight out of a factory, and certainly having a guy like that say that is good enough for me. The other thing I would just say here is the whole point behind this exercise was to create capacity with respect to what everybody has said is one of the most important elements of keeping frontline healthcare safe, which is access to respirator masks. Speaker 8: (34:59) Governor, has the program of contact calling actually started? Charlie Baker: (35:02) You want to speak to that? Sure. It never stopped, really. It's just getting braver. Secretary Sudders: (35:11) Right, it's just angrier. We are ramping up the ... I'm assuming you're talking about the community tracing collaborative partners in health. That is actually in the process of ramping up. We've been doing a soft launch in about eight communities north of the city. It's sort of ... I don't want to say attached, but it's associated with the rapid testing that we're doing up in Lowell, so we have started. I think Partners in Health has hired 250 of the individuals to work with them, and we're working with the local boards of health on contact tracing. One of the interesting things so far in the soft launch is initially the model was based on for every individual who's COVID-19 positive would have 10 very close contacts, and at least in the soft launch at this point, it seems to be six, so I guess that's good news. Secretary Sudders: (36:07) Obviously we're also rolling it out in multiple languages, and I believe the number of applicants they had was 15,000 individuals, so they're in the process of hiring. They're contracting with community health centers for the local community health work and other clinical supportive services. That's why we're really collaborative. Obviously, Partners in Health is the lead on tracing and data analytics and the like, but obviously it has to have strong local community partnerships and community health centers. 38 of them to date have signed up to be part of the collaborative. Speaker 9: (36:40) Senator, when the- Secretary Sudders: (36:44) We'll have a more robust briefing for you probably in a week or so on this. Speaker 9: (36:49) The data on the municipality, you said it helps identify hotspots. How would a person look at the data? Deaths, positive tests? What do you look for to determine whether those are the hotspots? Secretary Sudders: (37:04) You look for a number of factors. Obviously, if you saw from, say, one week to the next week, a significant increase in number of COVID-positive cases, that would, and if you did not have necessarily robust drive through testing. If I use, for example, use Patriot's Place, where we have drive through testing and the like. If you have drive through testing, I would expect the areas around there you might see increased numbers of cases tested. But in a community that doesn't have particularly onsite testing capability and all of a sudden you saw a number of positive cases, you'd want to start to ask questions. If you didn't have ... That would be one. A second one would be the age of individuals when we look at the county-based data, and obviously we would have access to municipal data. If you all of a sudden saw younger individuals tested positive, we expect older adults are testing positive because the vulnerabilities and comorbidities. Those kinds of things you would look at. Secretary Sudders: (38:11) But for me, it's really what I see a rapid increase in the number of positives in a community and the surrounding communities? That would suggest that we might have a hotspot going on. That's the kind of thing that I think is important. It's also important for local boards of health. If you think about the roles local board of health have in terms of, to go back to Sharma's question, social distancing. Is social distancing working? Are we ensuring that our grocery stores are maintaining the limitations in terms of what they have, in terms of capacity coming in and out of your grocery stores and the like? I think at the local level, it's very helpful for both enforcement of the restrictions we've put in place as well as ensure there's social distancing and the like. But from a public health perspective, it's really are we seeing increases all of a sudden in particular part of the state is just one of the obvious things you would want to look at. Charlie Baker: (39:03) And then one more point to your comment or your question about the Medicaid funding. The other thing that happened was the Feds changed the match. They increased it by 6.25% which, I think that was in the second stimulus? Speaker 12: (39:23) [inaudible 00:00:22]. Charlie Baker: (39:24) Doesn't get a lot of attention, but it was a big deal. Not just for us, but for every state. Speaker 13: (39:30) Governor, [crosstalk 00:39:30] the $1, 200 checks that are coming in, what kind of sectors or industries, in your judgment, what's the best things Massachusettsans' can start spending that money on now? Next weeks or so? Charlie Baker: (39:42) I thought the $1,200 checks were going to individuals, right? Speaker 13: (39:45) Yeah, that's what I'm saying. Where can individuals spend that? Where would you like to see that stimulus affect? Charlie Baker: (39:53) Well, the thing I worry the most about these days, and it gets back a little bit to kind of a curve ball on Bruce's question, is food. If you think about the conversations that we have with folks about all kinds of things, one of the biggest things we've heard about is issues around access to food and food banks. And the draw and demand on on many of our food bank operations around the Commonwealth, which is a pretty clear indicator that you got a bunch of people out there who are struggling. Charlie Baker: (40:30) And I would hope and anticipate that one of the things that would come with a lot of those direct checks to people is that folks who are struggling with decisions about food and pharmacy and rent and whatever else it might be, can apply that in a way that makes it possible for them to sustain themselves. But that's also a big part of why we're ramming as many people as we possibly can properly through the existing unemployment system and while we're working really hard to figure out how exactly to make the pandemic unemployment piece work as well. We know there's a lot of people out there who need help. Speaker 11: (41:13) [crosstalk 00:00:41:11]. Governor, the death toll is probably going to go over 1,000 today. What does that number say to you? Charlie Baker: (41:19) I've said this before that, I pay attention to the numbers, but what I really think about mostly are the stories and the people who are behind the stories. And, I think I said this when we put the original limit on gatherings in place, that the first thing we'll Lieutenant Governor and I heard when we did that was from the funeral home folks who basically said we were stealing the opportunity that families and friends would have to say thank you and goodbye to family members and friends. And honestly that was one of the more brutal consequences just psychologically of this whole thing. Charlie Baker: (42:12) And so when people talk about the numbers, the first thing I think about is all those people who ... in some cases, my best friend lost his mom to COVID. And, he and his mom had a great relationship. And because they had a great relationship, they never left anything unsaid. You just knew that about the two of them, that this wasn't going to be one of those situations where, oh my gosh, I wish I'd had the chance to tell her son whatever, or to tell my son whatever. That never happened with them. But, that didn't make the fact that it was an extraordinarily painful process for their family to go through this loss of a critical ritual that people believe in and hold on to, it's this chance to say goodbye. And when you talk about where the numbers are going on this, what I'm really thinking about is all those people who aren't going to have a chance to say goodbye. And I really hope people have a chance to make sure that they don't leave anything off the table with respect to their loved ones. Charlie Baker: (43:54) My own situation is, my wife gives me a hard time all the time about the fact that, Baker men never really say what they think about anything to anybody when it comes to personal things. And even on these goofy phone calls I have with my dad, I try to say more. Because you just don't know anymore what the future's going to hold. And I really hope that people understand that their healthcare community and the folks who are going to be responsible for helping us work our way through this surge are going to do everything they possibly can to save as many people as we possibly can, so that they don't have to deal with this situation, and their families and friends don't have to deal with it. But those numbers to me are about lost opportunities and the significance and the importance of loved ones putting it all out there and making sure they don't leave anything unsaid. Speaker 11: (45:03) Sorry for [inaudible 00:45:02]. Charlie Baker: (45:03) Thanks. Speaker 12: (45:05) Thanks everybody. Speaker 13: (45:09) How's Dr. [Burrell 00:45:06]? How's Dr. Burrell? Charlie Baker: (45:10) Dr. Burrell. Secretary Sudders: (45:16) I'm smiling a little bit because she and I had our first face-to-face, socially distant meeting late yesterday. So she's been cleared to come back to work, so that's good. So thank you for asking about that. Speaker 12: (45:30) Thank you everybody. Audience: (45:31) [Crosstalk 00:45:31] ... we have one more question just about, we've heard a lot of concerns from the [inaudible 00:45:31] they still have to go to the grocery stores to get food. I don't know if you've ever [inaudible 00:45:37] at this point of maybe moving something online. I know other states have a pilot. But the fact that [inaudible 00:45:45] order online for their food. Secretary Sudders: (45:50) Yeah. I have heard from my friends with visual impairments, so people who are blind or visually impaired in particular, and we're looking at what a couple of other states have done in terms of the ability to do online ordering, as you said. So, it hasn't happened yet, but I'm actually looking at what some other states have done as, as a possibility for Massachusetts. Audience: (46:10) Secretary, with respect to staffing, how many new people [inaudible 00:46:15] program and [inaudible 00:46:17]? Secretary Sudders: (46:19) So I do have that ... can we just get back to you? I do have that answer for you, but I just, it's not coming at the top of my head at this moment, but I do have the answer.` I can tell you how many people have come through the long-term portal. I just can't think of what the number is right this second. We can get back to you. Speaker 12: (46:32) Thanks everyone. Got to get going.