Florida Governor Ron DeSantis May 15 COVID-19 Press Conference Transcript

Governor Ron DeSantis: (00:00) This is something that should be done. We have seen in the past and in Florida, we've seen in throughout the countries, measles outbreaks, so if you're deferring those, because you're worried about coming in for coronavirus, don't do that, come in and do it, take care of the kids. It's very, very important that that's done, because if it's not, if we have a critical mass of people falling behind on that, you definitely could see some more adverse health consequences as the time goes on. Governor Ron DeSantis: (00:27) We're in the midst of our safe, smart step by step approach to bring Florida back. And I think that Northeast Florida has done a real fantastic job throughout this whole process, not only in terms of the health outcomes, by really doing a good job of having low infection rates, low hospitalization rates and low death rates, but also really being an energy towards reopening and getting people back to work and getting our society off the mud. You're not going to be successful in fighting any type of public health challenge if you don't have a functioning society. And so we know we need to do that, and we also need to be mindful of some of the public health challenges that have stemmed from the mitigation. I mentioned some of the things earlier, but there's also clearly a need and will be an increased need for behavioral health, so we want to be recognizing that and understanding that those are going to be issues that are not going to go away anytime soon. Governor Ron DeSantis: (01:26) As I said, I'll have some announcements about our next steps for the recovery, but before that, I want to kick it over to the mayor and then we'll go around and hear some good thoughts from everybody. Mayor Curry: (01:38) Well, governor just want to thank you. Welcome back to Jacksonville. I've said this before, when we were together a week or so ago, but it's worth saying again, the collaboration between you personally, and your team has been the model for how you get things done in a crisis, and the city of Jackson is grateful for that. Tom, thank you for hosting us here. Appreciate the entire team here at St. Vincent's and all of the people in our healthcare community that have really worked to get us through this very trying time. Mayor Curry: (02:08) Just want to take a moment to say that today's Peace Officer's Memorial Day. So I want to thank all of our law enforcement for all the work they do for us every day, and frankly, they've put themselves out on the line with this unknown virus over the last eight plus weeks. Mayor Curry: (02:22) And then just a couple of data points that are worth mentioning are Jacksonville Fire and Rescue Transports that are COVID related, suspect COVID related are way down, they are lowest they've been in weeks. So that's another data point that continues to trend with our downward trend in positives and testing. Mayor Curry: (02:38) And then to echo what the governor said about people getting the healthcare treatment they need unrelated to COVID, opioid abuse, it's up, it's high. We know people are dealing with mental health issues. If they're having chest pains, whatever it is, there's no reason to be afraid to be in a healthcare facility right now. In fact, you should do the exact opposite and go get the treatment that you need. Thank you, governor. Governor Ron DeSantis: (03:02) Great. Tom. Tom: (03:04) Thank you, governor DeSantis, and welcome to Ascension st. Vincent's Riverside. You and mayor Curry have both been here for us and incredibly supportive from the very beginning, and we're deeply grateful for your leadership. Thank you and your respective staff members for your tireless efforts to be consistently responsive to our needs and open door input in order to keep our communities healthy together. Tom: (03:27) Also want to take a moment to say thank you to caregivers and essential workers everywhere who have worked tirelessly and courageously to care for our Northeast Florida community. And I want to thank our broader regional community for all the love and support you've shown our caregivers, physicians, and associates, as we continue to work together through this trying and unfamiliar time. Tom: (03:50) And I do need to take just a moment to recognize and celebrate our caregivers, our physicians, and our associates across the central Florida and Gulf coast, including right here at Ascension St. Vincent's Riverside who have simply gone above and beyond heroically to provide the clinically excellent and compassionate and personalized care for which we're known in the safest way possible, every patient, every moment, every day. Tom: (04:15) Since early March, across our Ford and Gulf coast market, we've cared for roughly 3000 hospitalized patients who were suspicious of having COVID-19. And 300 of these individuals did indeed test positive. And our teams have done an exceptional job cohorting our patients together in dedicated isolated units in each of our hospitals. Together, we'd experienced some extraordinarily trying and stressful times, but we've also had many emotional celebrations and our physicians and our caregivers has successfully helped people battle and beat COVID-19. In fact, hundreds of patients have gone home after their time with us in the hospital, and we've lined our hallways and we've clapped and we've celebrated and we've given thanks with each and every one of them. Across our regional health system from the first coast to the Gulf coast, our Ascension medical group immediately opened drive through testing sites, and in total we've tested over 10,000 individuals for COVID-19. We have truly led the way in making testing accessible and convenient for symptomatic patients, and most recently for residents and staff of our area nursing facilities. And while the statistics are important to quantitatively understand the magnitude of the challenge that we faced for the last 10 weeks, we recognize that behind every number, is a precious human life and a beloved child of God. And together we've traveled this shared human experience like nothing any of us have ever lived through the images and the stories from which will live with us in our hearts and our memories forever. Tom: (05:46) And this important work has again highlighted for me, the immeasurable value of being part of a strong regional and national health system. It's empowered us to truly work as one integrated ministry, to share best practices and resources. We've been able to procure and resupply personal protective equipment, been able to access additional equipment like ventilators and dialysis machines whenever needed, we've been able to access essential medications, and we've been able to keep everyone on full salary continuation with no pay proration or job loss, even in an extraordinarily challenging economic environment. And none of this would have been possible were we not part of Ascension. Tom: (06:23) And here in Jacksonville, we're also blessed to have exceptional communication and collaboration with our local elected officials like mayor Curry and his entire staff, and between our city's health systems. From the very beginning, we've all worked together multiple times every week to ensure that we provide everyone in our community with the care they need, that we're maintaining open lines of communication and that we've operated aligned practices wherever possible. And we've hoped we've provided you with the input that you've needed and we've greatly appreciated our communication relationship throughout. Tom: (06:54) So in accordance with the governor's order, we began to reopen for non urgent procedures on May 4th, and we've grown steadily and safely every day since. And we're testing every patient preoperatively to make sure we're keeping our patients and our physicians and our caregivers safe, supported, and protected. And throughout all this, I have been deeply moved by the caring and compassion and courage and selflessness and esprit de Corps that I've witnessed every single day throughout our facilities and with caregivers and hospitals throughout the country. Tom: (07:23) So I close in saying this challenge is far from over, but I'm confident that together we will indeed emerge victorious, smarter and more unified than ever before. And with that, I'd ask our chief clinical officer Dr. Gilbert to share a few thoughts. Dr. Gilbert: (07:39) Thank you, Tom. First and foremost, also want to thank all of our doctors, nurses and the many wonderful caregivers and support teams across Ascension St. Vincent's and our wider Ascension ministry. And thank you to the governor, the mayor and our community as well for all of the support. We are truly blessed. Dr. Gilbert: (07:56) I've been an emergency room physician for almost 30 years, and I want to reassure everyone in our community that we're here for you if you need emergency care. If you are experienced symptoms of a heart attack, stroke, respiratory distress, emergency mental or behavioral health concerns, or other acute illness or an injury our hospital emergency room is still the safest, most appropriate place to get care. Dr. Gilbert: (08:18) We've seen a concerning drop in the number of people coming in for serious non COVID related issues. Staying home and healthy makes absolute sense, however, ignoring worse than symptoms and suffering out of fear of COVID-19 is simply not a risk people should take what their health. Timely treatment is critically important for achieving the best outcomes and lessening the risk of complications. I can confidently tell you that we were prepared and set up for safely treating patients, including those who need emergency care. Separate intake and care areas, waiting room distancing, staff screening, ongoing use of personal protective equipment to make sure our patients are cared for in a protected environment. And we continue to monitor guidance from the CDC and the Florida department of health to adjust safety practices and safeguards accordingly. Dr. Gilbert: (09:07) So if you're experiencing a life threatening emergency or think you might be, don't delay. Go directly to an emergency room or dial 911. We're here for you and ready to care for you. Dr. Gilbert: (09:17) And now Esterlliter Redmond, our Chief Medical Officer for Ascension Medical Group for Florida and the Gulf market. Esterllita Redmond: (09:26) Thank you Dr. Gilbert Stat. It can't possibly be said enough, thank you to everyone on this panel and to our caregivers, essential workers and government leaders everywhere. Esterllita Redmond: (09:37) Across North Florida, Ascension Medical Group has worked hard to provide drive through testing, particularly for those who are symptomatic. As Tom mentioned, we've tested nearly 10,000 individuals across the state so far. In partnership with the Florida Department of Health, we've also recently begun to provide testing to both staff and residents of longterm care facilities. This work really speaks to our mission, to provide care to all people with special attention to those most vulnerable. Esterllita Redmond: (10:10) We've also seen a major increase in virtual care. We've had our virtual care platform Ascension online care since 2017. Over a typical six week period, we would see an average of about a hundred virtual visits across Ascension Florida and Gulf coast. Esterllita Redmond: (10:28) But from March 15th through April 30th, we've had more than 25,000 virtual visits across the market. We will be advocating that this openness to virtual visits remain in effect from now on for the convenience of our patients. For those who do need to visit their doctor or any of our outpatient clinics in person, I would like to echo Dr. Gilbert Stat's sentiments and reassure everyone that all of our locations have the appropriate protocols and procedures in place to ensure everyone's safety. Esterllita Redmond: (11:03) Please continue your routine to stay healthy, especially if you have preexisting conditions. Call your primary care provider or specialist first to discuss whether an online visit might be an option for your care. If you can't talk to your regular doctor, or if you need nonemergency care more quickly, virtual care like Ascension online care might be right for you. Esterllita Redmond: (11:27) As we began to reopen and get back to some sense of normalcy, I would also like to remind everyone to continue to practice social distancing, practice good hygiene when it comes to coughing and sneezing and thoroughly wash your hands. Hand sanitizer is great, but fully washing your hands with soap and water for at least 20 seconds whenever possible is even better. Esterllita Redmond: (11:51) Please don't get complacent. This virus is still here, and we all need to work together to keep ourselves and everyone around us safe. Thank you. Now I'd like to introduce Mandy Clipper, who is our Clinical Service Line Director for Pulmonology and Infectious Disease. Mandy. Mandy Clipper: (12:08) Thank you, Dr. Redmond. As we've worked through this trying time together, we appreciate all of the community and government support that we've received. We are also thankful for our caregivers, many of them working in new and different roles to ensure that we are doing everything we can to provide testing and care for those in our community with COVID-19. This is being done in addition to continuing to provide care to everyone else who needs it. Mandy Clipper: (12:37) I especially want to thank our team who worked over a weekend at the beginning of this pandemic to quickly establish a drive through testing site. Through their hard work and dedication, we were blessed to get the testing site set up in our community and then work with other organizations to help set up additional drive through testing opportunities. Mandy Clipper: (12:59) To further ensure everyone's safety, we've also established respiratory clinics for symptomatic. Mandy: (13:03) ... For everyone's safety. We've also established respiratory clinics for symptomatic patients. We were able to take the patient's history and other elements of a typical doctor's visit virtually, the patient can then visit us in person where the provider will come out to check their vital signs, perform a physical exam, and testing if needed. We're working hard to make sure we're providing care to everyone who needs it through our drive through testing site and our dozens of outpatient clinics. We are so grateful for everyone's prayers and support throughout this process. Governor Ron DeSantis: (13:36) Well, great. Can we ... one of you, maybe one of the physicians talk about ... we use the term elective procedures, and I think sometimes people think that, that may mean some type of cosmetic procedure, I guess cosmetic would be included in elective, but it's obviously broader than that. So what's the importance of people's health in terms of some of these procedures that are considered elective, are they also still necessary for people to eventually get? Speaker 1: (14:05) I mean, basically elective procedures are procedures that can be scheduled. They're not an emergency nature. But as we push things further and further out, that can change. So as we've pushed back patients getting catheters for dialysis, getting joint repairs, they're home suffering in pain. So we're constantly reassessing so you can get the right priority of those patients coming back into the operating room. So we're back doing that now, operating and bringing those patients back in as clinically needed. Governor Ron DeSantis: (14:30) But if we had just indefinitely suspended these that would have had health consequences, correct? Speaker 1: (14:35) Absolutely. They would become emergencies if you put them off too long. Governor Ron DeSantis: (14:38) Well, we're glad that that folks are doing that again. You've seen how the epidemic has affected this part of the state. Obviously I think that this part of the state handled itself very well. Are you in a situation where, as we go forward, if there were to be an outbreak somewhere you guys have the capacity to be able to handle what would come down the pike? Speaker 2: (14:59) Yes, sir. We do. We're watching the data every single day meticulously and our plans are fully in place should we see any bump in terms of how we would respond, but we've got more than adequate capacity in our ICU and our medical surgical beds with all of our clinical equipment and all of our staff. Governor Ron DeSantis: (15:14) Great. One of the things we're seeing is you have, particularly outside of Southeast Florida, a really low number of cases in all these counties. When you see it be out of the ordinary, it's usually one of three things, a prison outbreak; which we're seeing, a longterm care facility, then there are times as we bring new testing centers in places you'll see a temporary blip then it usually crashes right after that. Governor Ron DeSantis: (15:42) Now obviously the prison is a enclosed environment. That's got to be handled within there. Then the test sites, sometimes when you test more, you identify more cases that's a good thing because you can isolate those people, give them care if they need it. The longterm care is going to continue to be a challenge. We've put a lot of resources towards that from the beginning in Florida, it was clearly the most, biggest vulnerability and I think that was the right thing to do. Governor Ron DeSantis: (16:08) Mayor, you guys were really quick on things like drive-through testing, the city, the sheriff, fire, and your office. Will you guys be involved in longterm care testing for staff and really looking at these longterm care facilities and making sure that we're doing all we can to assist them and keeping the virus out? Speaker 3: (16:30) 100%. In fact, if you look at the recommended testing per, I think it's per 100,000, we already have the capacity to do that. And we're adding, we took a big chunk of our care money from President Trump and the federal government to add significantly more enhanced testing citywide to make sure that everybody has access. And I would just add to the answer Tom gave on hospital capacity, all the hospitals and my office, every week we collaborate officially, formally, and then informally. We're all on the same page and we're all prepared. Governor Ron DeSantis: (17:04) And I would just tell people, particularly if you're somebody that's working in a longterm care facility, we have the Jaguar stadium. We have this facility. We're going to continue having that drive through test site. You really do need to be getting tested probably once every two weeks, because what we found here is that there have been some facilities that didn't follow the regulations and the restrictions and allowed sick people to go in. That obviously created problems. Governor Ron DeSantis: (17:31) But there have been places where you may not have a temperature. You may not have interacted with anyone with known, but you may be carrying it and be asymptomatic. So if a staff goes in, it can spread amongst the staff, spread amongst the residents and that's when you have these outbreaks. So the periodic testing of the staff is really, really important. Governor Ron DeSantis: (17:52) This is one way. I know Ascension's doing other testing. Can you talk about some of the things that you guys have been doing? Because, I know you've been doing some good stuff with the longterm care facilities. Speaker 4: (18:02) Yes, in collaboration with the Florida Department of Health we have started testing nursing homes. Today we tested seven nursing homes along with ALFs, and it's been a really good experience for us, for the nursing homes, and for the associates. We stand ready to continue to provide that testing to nursing homes and longterm care facilities. I'd like to turn it over to Mandy in case you wanted to add anything. Mandy: (18:26) No, I think it should just be mentioned that the testing we're doing is at facilities that have not had positive cases, so we're doing this merely as a screening for their residents and their associates. I think the nursing facilities have done a great job adhering to the advice that they've been given from the local and national government regarding cleaning and social distancing, et cetera, and we're seeing that in the results that we're getting. Governor Ron DeSantis: (18:51) Yeah, and it's amazing in Florida how many facilities we have here. Obviously, there've been cases, there have been outbreaks, but our rates are so much lower than a lot of other States. And we have thousands of facilities that never had a single infection this whole time. Then you have other facilities where you may have had one or two, but it was contained and you didn't have a cluster or an outbreak. That's really, really important to be able to do it. Governor Ron DeSantis: (19:18) So I think the screening, the staff, being able to pick up somebody before they're showing symptoms, that can really be the difference between preventing a major outbreak in one of those facilities. And as we've seen, there are certain venues that this disease does better in than others. It doesn't do terribly well in outdoor environments. I mean, I know when mayor did the beaches, I was very supportive of that. Governor Ron DeSantis: (19:45) There were a lot of people out of state who were saying, "This is the end of the world." Obviously, totally fall on their face again with these predictions, but that's because the environment is not conducive. What's conducive are enclosed environments where you're in repeated close contact with people. So you see prisons, you see these meat packing plants throughout the country. Then obviously you do see some of these assisted living facilities and nursing homes. So it's a vulnerable population, but then it also can be a conducive environment. Governor Ron DeSantis: (20:14) Now, we do have some skilled nursing facilities that have the ability to isolate, negative pressure, all that, but the not all of them do and many of them don't, and particularly in some parts of Southern Florida, it can be a real challenge. So, that really is kind of something that we're all going to go on. Governor Ron DeSantis: (20:28) So I'm going to make some announcements, but just within our plan from the beginning about protecting the state and fighting COVID-19, our number one from the beginning was protect the vulnerable because we understood that this disease had a disproportionate effect on the elderly and people with underlying conditions, increased testing, very important. That's been a team effort. The state has done a lot of resources, local, the healthcare providers. It's been great. The appropriate social distancing, that's been done very, very, I think, well on behalf of the people of the state. Governor Ron DeSantis: (21:03) Supporting our hospitals and healthcare workers, we've distributed huge amounts of PPE throughout the state and will continue to be helpful when we can on that. Then preventing the introduction of the virus from outside the state, I'm working per the President's request on a proposal for how we deal with international travel. Travel from China and Europe is suspended, but we still have people coming in from Brazil, which has having outbreaks, so we've got to get a handle on that, so we're working on that. Governor Ron DeSantis: (21:32) Then I continue, we've screened for our New York quarantine over 50,000 travelers since we instituted the quarantine. I'm convinced that that absolutely helped limit mitigate the spread in the state of Florida, because you had a massive outgrowth or a massive Exodus from New York down to Florida once New York went on mitigation. But protecting the vulnerable is something that is not going to change as we move forward and as we reopen Florida, and we've done a lot up to this point, which is very, very important, but we've got to do even more. Governor Ron DeSantis: (22:09) You're seeing throughout the country that the bulk of the fatalities are now linked to nursing homes in most States, and some of that was through some bad policy choices, but still even in places where things were done well, you're seeing that. So, we just got to understand the threat and got to do it. Governor Ron DeSantis: (22:27) So we very early recognized this. We required all the staff to be screened and any vendors to be screened. That was to identify people that were ill and that could spread the virus in these facilities. That requires temperature checks, it requires asking where people have gone. We also mandated the wearing of PPE, like face mask. Anyone that has any contact with a resident has to have gloves, which is also something that's very important in helping mitigate the spread. Then we restricted visitation at longterm care facilities on March 15th. That was a tough thing to do because you're depriving family of being able to go in these facilities, but the risk of an outbreak was such that we felt we had to do it. Governor Ron DeSantis: (23:14) Then also prohibiting hospitals from discharging COVID positive residents back to a longterm care facility. At that time, you had some States, like the States Pennsylvania, New Jersey, New York, some of them, Michigan I believe, who actually required longterm care facilities to accept COVID positive patients. You had American Healthcare Association, people said, "Don't do that because you're taking somebody that is contagious and putting them in basically a tinderbox." I think the results were you've had huge outbreaks in those States. Governor Ron DeSantis: (23:46) We did the opposite. We understood that it could affect our overall capacity in terms of hospitals, but we viewed it as, okay, if you're putting these patients back in, you're going to end up seeing really rampant spread, then you're going to double with more people in the hospital, not less people in the hospital. So that was I think, an important decision, and actually the Florida Healthcare Association, they've said that they think it's saved thousands of lives. Certainly when you compare Florida to these other States, how we've done in this environment, very, very important. Governor Ron DeSantis: (24:15) We've also dedicated, established COVID dedicated nursing homes to kind of help with this issue. The one here in Dolphin Point in Jacksonville, that's a relationship between the state of Florida and Dolphin Point. What that allows you to do is if you have a longterm care facility, you identify a resident who's positive, just because you're positive, even at that age, doesn't necessarily mean you're going to end up in the ICU, but you do need to be isolated. So the resident that doesn't require hospitalization per se, but does need isolation, a place like Dolphin Point can do that. They have the negative pressure. They have the ability to isolate. So you're having transfers out of nursing homes into places that can mitigate or prevent spread. That obviously helps those residents who are still in the nursing home. Governor Ron DeSantis: (25:05) So this has been a good model. It's required us to put in resources to it, but I think it's a good use of resources because if you're keeping somebody in the nursing home, then the disease spreads you're going to have way more health problems than moving one patient to this. So we have other places around the state where we're going to follow this model, but I think that this is something that would be good. And I think a lot of the hospitals appreciate it too, because they have beds and the beds want to be for the people who really need the care. Governor Ron DeSantis: (25:36) Some of the nursing home residents obviously need serious care, but some of them just need to convalesce, so this allows that opportunity without running the risk of spreading through a longterm care facility. We have a whole host of agencies that have been involved, AHCA, Department of Health deploying for infection prevention and control. The Veterans Administration, US Veterans Administration, the VA Secretary is a good guy, called me. He said, "Hey, do you want us to do a ..." Governor Ron DeSantis: (26:03) VA Secretary's a good guy called me, he said, "Hey, do you want us to do a field hospital or this or that?" I was like, "Honestly, we have these veterans nursing homes, go in there and help us identify infection, test, do what we need to do." And they said, "Yeah, we're there." And not only do they do, they do more than just the veterans nursing homes. So they'd been on the ground as well, which has been very, very important. So you have a huge amount of visits, thousands of visits from these various teams from the very beginning of this. And I think that that's helped reduce the infections that we've seen. Governor Ron DeSantis: (26:33) The PPE is important because we're requiring them to do this. But in point of fact, most of them didn't have this type of PPE. I mean, some of them had some, but we really needed to put our money where our mouth is. And so we've delivered 10 million masks just to longterm care facilities in the state of Florida, a million gloves, half a million face shields, 160,000 gowns. And so that shows Florida's commitment to supporting these facilities that house, our most vulnerable residents. Governor Ron DeSantis: (27:04) And then of course the Florida National Guard, we created 50 National Guard strike teams because we started to see, okay, we have all these screening procedures, we have limitations on visitors and they're following the procedures and then you still were seeing an outbreak in certain parts, Swanee County, for example, and it was because of asymptomatic. So we said, "We need to get people on the ground testing, particularly with an eye to identifying any asymptomatic carriers." And so they've done 238 facilities in probably the last four or five weeks, 50 different teams, 32,000 residents and staff, it's really, really been effective because as they've identified cases, they've been able to isolate those cases and obviate bigger outbreaks. Governor Ron DeSantis: (27:51) We also introduced a mobile testing lab, so this is the minute rapid test. So we can do about 500 tests a day with a 45 minute turnaround. So this is a mobile lab in a converted RV that will go into communities, teams will go to different facilities even, bring it back, run the test and then you have the results the same day. That's a huge thing because if you send it to a commercial lab and it takes two, three days, well you can't... [inaudible 00:00:28:21] these people aren't going to be isolated that time, so you could have spread. So this is really, really significant. Governor Ron DeSantis: (28:25) And then we're also doing, the Department of Health, I think CDC is going to be helping, sentinel surveillance of longterm care facilities. So a surveillance system is not that you test... you're not testing every single person, you're testing representative samples to try to identify any incidents of the disease in various communities throughout the state of Florida. They do it with influenza, we're obviously going to probably end up as a country doing this society-wide for the coronavirus, but certainly for the longterm care facilities. Very, very significant. Governor Ron DeSantis: (28:57) So I raised that just to say that as we go forward, that having our eye on the ball there is very, very important. I think it's 32% of the fatalities in Florida are in the age group of 85 or older. And I think it's about 84% that are 65 and older. Of all the fatalities we've seen in Florida, that we've not yet seen a fatality under the age of, I believe 25. So there's a big disproportionate impact here in Florida from people 65 and over, but I would say even more disproportionate as you get into the type of age group that would be at these facilities, you can open up an economy and still protect that. Just like you saw other States that refused to protect the facilities, even though they were shutting down everything under the sun, that didn't prove to be effective. And so with the collaboration of local governments, with the mayor, with healthcare providers, this really needs to be an all hands on deck approach because if we can help keep it out of these facilities that's going to be a huge part of winning this battle. Governor Ron DeSantis: (30:05) All right, so phase one, we went to phase one, but I made clear that we are going to go smart, safe, step-by-step. There were things in phase one, and this is the White House Task Force phase one guidance for what you could "open up" and if you look on some of those things, schools, organized youth activities, we kept daycare open the whole time in Florida, so that was not ever closed. Governor Ron DeSantis: (30:34) The senior living facilities, obviously we were restricting the visitation there too. Large venues, so the white house guidance said, you can do sit down dining, movie theaters, sporting venues, places of worship, obviously under physical distancing, we determined in Florida not to do the movie theaters in our initial phase one, we did do limited sit down dining, and then the places of worship we're never closed. I don't think constitutionally, you can close it, it's ridiculous. You can go to a liquor store, but you can't go to church, give me a break. So we really work with the pastors to make it safe, and they understand that there's risk if you don't do it the right way. But I think that collaborative approach respecting people's constitutional rights is the better approach. But we knew we could have done more large venues under that guidance, but we decided that it was best to do, and I was recommended on my task force to do some more things that we did. Elective surgeries, we did put online because I think that's a public health issue too, very important. Gyms could be open and bars remain closed, obviously the bars are closed in Florida. We did not turn on the gyms, at that point we were working on different safety procedures or whatever, so we really did kind of an initial phase one. We did not exhaust everything that we could have done in phase one. We wanted to go safely smartly, and then we wanted it to be step-by-step. And so now we're in a situation where you see kind of what we did, retail limited, restaurant indoor seating was limited. My recommendations for my taskforce were to be a little bit more robust on this, but again, we wanted to make sure that we're being very, very cautious with what we're doing, smart. Governor Ron DeSantis: (32:18) I got a request after we went into initial phase one from the mayor of Orange County, Jerry Demings about barber shops and hair salons and basically he had a task force, a lot of physicians involved and they're like, "Look, you can do this in a low risk way if you do some of these things." So I went down to Orlando, met with some of the salons and one of the barbershop owners, they've got great protocol. You go into these shops. It's like being in an operating room now, it's unbelievable. So we had safety precautions, and then we introduced that the following week, so that started on Monday to do those and so I think that that's been going very well. But that's kind of our initial phase one and then obviously bars, gyms closed. Governor Ron DeSantis: (32:58) As I mentioned, we are requiring hospitals to test all individuals discharged to a longterm care facility for COVID, even if they're not in for COVID. Obviously you need two negative tests if your COVID positive to go back but if you're just in for something else... And I think they're testing people anyways with that, particularly everyone who comes in, so that we really think that that's good. And then we are telling longterm care facilities, if you can't isolate, we need to transfer those positive residents to places that are going to be safe for everybody. And that falls into Dolphin Point and some of the other things that we're doing. Governor Ron DeSantis: (33:37) All right, so that's where we were with initial phase one. Here's kind of what you see, if you look at some of the cases. Now, clearly we were having the bulk of our cases at the beginning of April. If you look on April 3rd was the peak for new cases, that was reaching that number with way fewer total cases than what we've been doing recently. So if you see, as we got into early, it kind of plateaued throughout the middle part of April, and then you have seen a decline as we've got to the end of April and through May. And really in the last, I would say week, anytime you have anything over four or 500, it's usually related to a prison or a nursing home. And that's what we've seen, particularly in the last couple of days, these prison outbreaks. Governor Ron DeSantis: (34:25) So in terms of new cases, clearly fewer cases coming in, even with more testing than what we were getting at the height. And if you look at kind of the end of March, I mean, the testing was still just really starting to accelerate. I bet you if we had done the type of testing we're doing now, those numbers would probably be twice as high back at the end of March, beginning of April. Here's the positivity rate, so the positivity rate is important when they talk about the gating criteria, you look at the number of cases for the trends or, maybe and/or, but, or the positivity rate. And the reason is, is if you really are trying to expand testing, you're probably going to identify some new cases, particularly in asymptomatic people. But if the overall number is still low in terms of who are testing positive, then that's a good sign. And I think you can see end of March into beginning of April, we were at roughly 10, sometimes it even jump up to 15. Governor Ron DeSantis: (35:21) Now we never really rocketed high, like in New Jersey or in New York where they were having, I think New York initially was like 60% were testing positive and New Jersey was in the 40s for a long time. So it had always been manageable here in Florida, but you have seen the decline. And if you look at the past 10 days, you're in 2.6, 1.8, 2, 2.7, some days. The last two days it's increased from there driven by the prison outbreaks. What you see in the prisons is if it spreads, you have a higher percentage that will test positive than in the general public. And so, whereas the general public is still probably about two and a half to three and a half percent of everyone who tests positive, in the prison it's going to be more like 15% to even 20% will test positive there. And so that's really reflected, I think on the 4.8 there for that. But clearly you've seen a decline in the positivity rate since the apex of the outbreak. Governor Ron DeSantis: (36:18) And then look at the test, so just as the 45 day new cases went from left to right, you saw a downward trend here when you go left to right, you clearly see an upward trend. Some of the jagged parts are more just based on how this stuff's reported. So if I have 7,000 one day and then 20,000 the next, probably means I was probably somewhere in between there, it's just when the labs return it. But we pretty much do 15,000 to 20,000 is kind of where we've settled into. We have capacity to do more. If people want to test at our drive through sites, walk up sites, by all means, do it. The test are there for you, but quite frankly, we've not had huge demand at some of these. Governor Ron DeSantis: (37:00) I mean, I remember Jacksonville was kind of the first indicator. We set it up, people came out, then they dropped and the criteria expanded and it just has always been very manageable. That's a good sign because if people are sick, they're probably going to want to go in, so it's probably a signal that there's less incidents of the disease. At the same time, if people feel, if they're asymptomatic, if they just feel they may have been exposed, come in, come to Jaguar Stadium [inaudible 00:11:26], go to our other sites throughout the state. But clearly you've seen an increase in testing and our capacity is more than the 20, I guess the most we done-