Gov. Asa Hutchinson Arkansas COVID-19 Briefing Transcript April 6

Asa Hutchinson: (03:11) (silence) Good afternoon to everyone, thank you for joining us for our daily update on COVID-19. Thank you for your attention to this matter during this time of emergency, I'm pleased to be joined by a Dr. Smith, our Secretary of Health. And that today, as I indicated, Secretary Johnny Key, our Secretary of Education, where we're going to talk education and school a little bit later, and of course, Director A.J. Gary, who is here as well. Thank you all for being such a critical part of our team. First, let me give you the case update. Yesterday we had 830 cases, and since yesterday we've had an additional 45 cases, that brings us to 875 cases. We have 74 hospitalizations in Arkansas, and the number of deaths remained the same, Dr. Smith will elaborate on these. Asa Hutchinson: (04:16) I also wanted to talk to you about our efforts in slowing the spread in Arkansas. If we could bring up the graphic on the screen here, which, this is an indication that they measure in nationally and the different states on the time it takes or duration, to doubling our cases. Of course, that's a bad thing, we want it to slow down. But as you can see, whenever we started, we doubled it one day, and then it was four days we doubled it again, and in two days we doubled our caseload again, one day, and it took three days, three days, and then the latest is that it's been seven days in order to double the spread. Now, this is a national measuring stick that again, indicates that what we're doing in Arkansas is having some beneficial impact, significant beneficial impact, our social distancing, our restrictions on gatherings. Asa Hutchinson: (05:25) And so, I want to encourage everyone in Arkansas during this critical week to continue to do your responsibility, to follow the social distancing. When you can't, social distance, wear the mask so that you can protect yourself and you can protect others. We want to continue to slow that spread, and that is we still are going to know that we're going to go up every day in cases, but we want to slow the doubling time, we want to slow the speed of that spread. And then if you go to the next graphic that I have here as well, and I just received this today from Dr. Birx, who's with the vice president's office helping to lead the effort, and this is cumulative cases per 100,000, and so it's not just simply a number but it's looking at your population as well. And this excludes New York, New Jersey, Connecticut, Washington state and California, which is, those are the real hotspots that we have currently. The only one hotspot that's included is Louisiana. Asa Hutchinson: (06:36) And so again, these are the cases per 100,000 and if I might go over here, you'll see Louisiana is the top green line followed by Tennessee, our neighboring state, followed by Alabama, followed by Ohio, and then Arkansas is the dark blue, which I know you don't have as good as eyes, you're farther away I should say, but the blue is down here. And so again, just another indication that our efforts in slowing the spread makes a big, big difference for the impact on Arkansas, on lives, and what you're doing has been very helpful and successful, we want to be able to continue that. Now while we're having some success in slowing the spread, it is clear that this is still going to go on for some time. You hear that expressed nationally, but even though we're flattening that curve, it's still going to go on for some time. And as a result of it, we're going to have to continue with our mitigation efforts in this state. Asa Hutchinson: (07:51) And previously we announced that the school closure was going to go until April 17th with continued alternative methods of instruction, which is distance learning, and I want to applaud our teachers and our students for hanging in there and not giving up on this school year, but recognizing education has to continue even during this time of a virus. And so I applaud them, but based upon the public health concerns that Dr. Smith continues to express and in working with Secretary Key, I'm announcing today that the remainder of this school year is going to be closed. We're not going to allow in-school instruction, but we will continue with the alternative methods of instruction through the remainder of this school year. So for the remainder of this school year, there will not be in-school instruction. I know this is a hardship, but I think the teachers, parents, everyone, is prepared for this. And Secretary Key will be talking about this in more detail. Asa Hutchinson: (09:01) Finally, I asked Dr. Smith yesterday about the possibility of extending ventilators to the urgent needs in Louisiana, and I ask about five. He talked to UAMS who said they could make a five available without jeopardizing our population here. And so, I've asked them to send five ventilators and to coordinate that a transfer of ventilators to Louisiana, because this week I know Governor Edwards is going to be confronted with a real challenge. And so with that, Dr. Smith, I invite you to come, followed by Secretary Key. Dr. Smith: (09:46) Thank you governor. I'd like to give a little bit more detail on some of the numbers. We have, as the governor mentioned, 875 cases, which is 45 more than yesterday. We are up to 65 counties, having added one county, Izard County. Our distribution by gender and race are similar to what they were before, as is the distribution by age. We're at 2.3% of our total 875 are children, age 18 to 24 is 6.7%, 25 to 44 is 30.3%, 45 to 64 is 34.9%, and we have 225 individuals, that's 25.7%, are Arkansans age 65 and older. As similar to yesterday, we have 31.6% of the 875, have one or more underlying medical conditions. We have currently hospitalized 74 patients, that's 7 more than we had yesterday. We have- Dr. Smith: (11:02) More than we had yesterday. We have 22 currently on a ventilator that's five less, five fewer than yesterday. We have 16 deaths, which is the same as yesterday and we have 102 who have recovered. That's five more than yesterday. We also have 59 who are in nursing homes. That's one less than yesterday because one of the deaths that we had previously was assigned to a nursing home. And we have 122 healthcare workers amongst the 875 and that's eight more than we had yesterday. Of those 15 are physicians, 36 nurses, 15 CNAs and the rest are various licensed and unlicensed healthcare workers. Dr. Smith: (11:54) Talk a little bit more about our nursing homes. Just to give a summary, we are now following 13 nursing homes with either at least one resident or one worker who has tested positive. As I mentioned, we have one fewer. We've had a total of four deaths associated with nursing homes and we have a total of 32 nursing home workers who have tested positive. That's up five from yesterday. I want to talk a little bit about our testing. As the governor mentioned, we had reports from 949 test results yesterday, 822 of those were from the commercial lab. Our total positivity for yesterday was 4% in the Arkansas Department of Health Public Health lab, we had 76 tests and 10.5% of those were positive. Dr. Smith: (12:59) I want to comment briefly on what the governor mentioned about the doubling time. That's- Asa Hutchinson: (13:04) Let's put that graphic back up there on the doubling time. If you put it back up there. Dr. Smith: (13:11) As you can see that we have slowed the rate of growth and we hope to slow it even more. I want to really emphasize that to all Arkansans is that this is really a result of the actions that you all have taken in terms of social distancing to reduce this spread of COVID-19 in our state. And if we can continue to do this, we continue to flatten the curve as they say. And that's what we've been doing and we are very happy to be able to help out Louisiana in any way we can, but we don't want to become like them. And the things that separate Arkansas from Louisiana in terms of our curve is really the things that Arkansans are doing every day to prevent the spread of COVID-19 maintaining the six foot distance. Dr. Smith: (14:09) Now when that's difficult, wearing a cloth mask in public areas and all the many other things, the changes that have been very hard, very difficult to put into place and they're also difficult to sustain. But these are making a difference. And I want to encourage you in that. With that, I'm going to turn that back over to the governor. Asa Hutchinson: (14:30) Thank you Dr. Smith. Secretary Key. Johnny Key: (14:36) Thank you Governor. As Governor previously announced, our schools will remain closed for onside instruction for the remainder of the 2019 and 20 school year. However, we will be continuing through AMI delivery our alternative methods of instruction throughout the state. Arkansas AMI, which was the partnership between Arkansas PBS and the division of elementary and secondary education, has AMI content and lessons currently planned through April 17th that original date that had been set forward by the governor. We have the capacity to extend that for another two weeks through May 1st. That gives school districts time that to develop, it gives them about three or four weeks from now to develop plans to move forward with their AMI in their district. Digital learning classes can continue. These were the classes that we had arranged using assistance of Virtual Arkansas and the Arkansas Public School Resource Center. Those courses, our high school courses and can continue for the remainder of the year as well. Johnny Key: (15:41) Most districts have indicated they have the capacity to continue AMI delivery through the end of the school year. For the districts that need additional support and developing quality AMI plans, the division work with the education service cooperatives to assist these districts with our AMI plans. Also charter schools that will be receiving support from Arkansas Public School Resource center and the division as well. This includes looking to expand the capacity of internet connectivity where feasible. Many of our districts had been waiting to see what was going to happen with the rest of the school year before they move forward with purchases and trying to make sure that that was available throughout their district. And now we expect that more districts will make those services available. School districts may continue child nutrition services through meal delivery or meals to go options as long as they can follow the health department and CDC guidelines for hand washing, cleaning, social distancing and minimizing the number of people congregating. So what are our expectations for AMI for the remainder of the year? One, is to be flexible. Our schools and educators should set reasonable expectations for time on task when developing their AMI plans. It is impractical to try to replicate the school experience when children are at home. So we need to help parents and students by establishing flexible schedules for learning that consider that they may need access to learning supports outside of the typical eight to three school day schedule. Johnny Key: (17:22) Another expectation is that our seniors will graduate. We have previously issued guidance that seniors in good standing as of the end of the third nine weeks will be considered to have met the state requirements for graduation. This does not mean that seniors are done for the year. Local requirements are still in effect and we still expect our seniors to continue their work, especially with regards to AP courses with regards to CTE courses and other locally driven courses. As a matter of fact, we heard that word that AP, the college board had made it available for students to take their AP tests at home and that guidance came out, I believe last week. Johnny Key: (18:08) We expect the focus to be on core content, math, literacy, science and social studies, and then coordinate the use of the other subjects such as art, music, and PE in conjunction with the core subjects to create fun learning activities for our students. We do urge caution with respect to introducing new content as this will likely have limited effectiveness in our current circumstances. Instead, we suggest focusing on the essential standards that had been taught up to the point of the school closure. Reviewing existing student data to determine where students need support and emphasizing mastery of that content should also be a focus. Johnny Key: (18:48) Support teachers such as special ED teachers, GT, English as second language teachers, content specialists should be collaborating with the general education teachers to meet the needs of those identified students. We also expect districts to provide clear guidance and expectations for their educators. It's important for the school to set times so that teachers can be accessible through a number of means to answer questions from students and parents and I'll stop where I started and that's encouraging districts to be flexible. Understand that the additional stresses for families created by this current health emergency will impact our students. This is a time for more emphasis on support and learning and less emphasis on compliance. And that concludes my remarks. Asa Hutchinson: (19:39) Thank you Johnny. Any questions? Speaker 3: (19:45) The ventilators. What's our supply now? Asa Hutchinson: (19:49) Our supply is I believe it's 800. But help me out, Dr. Smith you better be precise on that. Dr. Smith: (19:56) Yes. I don't have the exact numbers from this morning but it's just short of 800 total. And in terms of those that are not in use, it's somewhere between 500 and 550. Speaker 4: (20:10) Doctor, I have two physicians have asked me to ask you as Arkansas' doctor now that the President continues to suggest that the chloroquine family can be effective either as a prophylactic or as a treatment he did so as late as yesterday evening. Would you address yourself to that sir? A and B, are you aware of any demand in pharmacies, a surge in demand for these trucks? Dr. Smith: (20:42) As far as the first part of the question, I think there is a very limited evidence of benefit and I would really, as a physician, I would want more evidence of effectiveness before recommending it. I think it's reasonable to make it available to those who are very sick and for whom there's limited other options. But I think at this point it should be considered an unproven treatment. I don't see evidence for it as a prophylaxis, as a preventative. And we do know that with continued use with both chloroquine, hydroxychloroquine, those do need to be monitored by physician who's familiar with the side effects, which can include damage to the retina of the eye, which can result in permanent blindness as well as cardiac problems, especially when combined with a medication like azithromycin that also can prolong the QT interval. That's a little bit too technical, but it's just to say these are not medications without side effects and they should be monitored. In terms of supply. I'm not aware of supply issues, but obviously if lots of people. Dr. Smith: (22:03) ... aware of supply issues, but obviously if lots of people are trying to stockpile these for personal use or for off-label use, it will be difficult for those who are using those medications to treat autoimmune diseases like lupus to find them. I think that we need to be mindful that these are still prescription drugs. They should only be used under the care of a physician who's familiar with their actions and their side effects. Speaker 5: (22:32) Question about schools. Will this affect next school year timeline at all? Will it start early? Asa Hutchinson: (22:36) Steve, you will be tested on that question you just asked. Secretary Key: (22:42) So now that we have clarity for the rest of this year, we will be shifting to see how that impacts, because it will have a ripple effect into next year, so we're going to start working to determine what that net effect is and how to best mitigate any problems that carry over from this year to next year. Speaker 6: (23:02) Secretary Key, could you tell us, sir, if you have it at hand, approximately how many high schools seniors there are now and in the public system? [inaudible 00:01:16]. Secretary Key: (23:15) Well, I think for the public system, I think the estimate would be around 35,000. I can get you a closer number when I get back to the office, but a typical class size in Arkansas, K through 12 is in the 35,000 to 38,000 students. Speaker 7: (23:37) AP has set their ground rules for taking tests. Has the ACT? Have they said anything yet about online capabilities? Secretary Key: (23:44) We're working with ACT right now on rescheduling. Nothing so far on at home, but we're working with them on just scheduling the onsite exams. Speaker 7: (23:57) Then how is this going to affect professional development for teachers? Are some of that going to have to be reworked? Are we going to, like you said, be flexible on some of that as well? Secretary Key: (24:06) Yeah, so right now has been a good time for online professional development. I know that a lot of districts have been utilizing that to help teachers get their hours. We also need to be in mind that under new legislation, teachers have PD requirements on the science of reading, so this would be a good time to get caught up on that. That PD is something that we'll be looking at closely as we go forward. Speaker 7: (24:30) I guess what are some of the factors that need to be looked at when it comes to the school report cards, kind of factoring everything in? Secretary Key: (24:39) Well, the school report card that is based largely on the ACT Aspire assessment, obviously there will be a considerable impact there without the Aspire exam administered this year. The other components are also impacted, because attendance certainly is part of that. Growth is a part of that in reading levels, so there are a number of things that we'll be looking at as it relates to that part of the report card going into the next school year as well. Speaker 7: (25:06) Do you have any idea on how you're going to weight things considering as of right now? Secretary Key: (25:10) Not right now. It's too early to tell. Speaker 8: (25:14) Mr. Secretary, I think you told, I believe, that most districts have the capacity and the resources to continue AMI through the balance of the school year, and that those that did not would get extra resources from the state department, but is it possible to categorize those who may be in need of special assistance from state? Do they tend to be rural, smaller? Secretary Key: (25:37) I'd guess rural, smaller. Those that are in more remote areas of the state tend to be the ones that are going to need some more support, but in some of those instances we've also seen them be very creative. Some of their delivery methods will be by printed packets, and some do have online capacity, so it's really a mixture of the needs that are out there. I'm sure that after this announcement this afternoon, my email and phone has probably started ringing already over at the office from some of those districts seeking that support. Asa Hutchinson: (26:18) Let me go to the remote caller. Is there a question from anyone listening remotely? Andrew: (26:27) Yeah. Hey, Governor. This is Andrew with AP. I wanted to ask about the directive that was issued on Friday dealing with elective surgeries. Concerns with this issue have come up within other States. Is it your belief or your expectation with this directive that abortions should stop in Arkansas under this directive? Asa Hutchinson: (26:51) I'm going to ask a Dr. Smith. Do you have a comment on that directive? Dr. Smith: (26:58) Well, the way the directive is worded, and I have it with me, is that it applies to any procedures that can be put off, that can be safely deferred. Our directive is not intended to replace a physician's a judgment on that, but it says "procedures, testing and office visits that can be safely postponed shall be rescheduled to an appropriate future date." Then there's a number of specifics under that, but I think that a standard would apply across all practices. Anything that can safely be deferred and postponed should be. Andrew: (27:47) It sounds like it's still giving a lot of freedom though to determine what that fall under. Asa Hutchinson: (27:55) I think Dr. Smith answered that in reading the directive there. Frank? Frank: (28:00) Governor, there's been some good news about the projections of total fatalities from the University of Washington. The numbers are falling here dramatically. However, our numbers are still more than double the numbers of California, Oregon, places that put early stay at home orders in place. I wonder if you can comment about the fatality projections falling dramatically, but also are we missing an opportunity to lower the number of fatalities by not having a stay at home statewide order? Asa Hutchinson: (28:33) Can we put the second graphic back up there? So California, let's see where California is. Frank: (28:43) California's not on there. Asa Hutchinson: (28:44) Okay, so California is accepted because they're one of the hotspots, so if you look at cases for 100,000, we are in the bottom nine of all 50 States. You can see that from there. In terms of the deaths, I assume you're talking about per 100,000. The hospitalizations in all the projections I've seen is that we have been beating that curve, but do you have a specific comment on the deaths? Dr. Smith: (29:24) At 16 our number of deaths per capita is pretty low. Now, we were one of the later states to have our first cases, so it's probably not a fair to other States to compare us in a single point in time, but maybe to look back at when we had our first case when they had their first case and track it forward. When we've done that, we actually have tracked pretty close to California. Of course, they've had cases for a lot longer, so they're at higher levels than we are, but at the same point in time, we're pretty close to two where they were at this time in the outbreak, in their outbreak. That curve, that trajectory for California is lower than Washington state and much lower than New York state, which are the other two States where we have actually a fair amount of data, because they had cases very early. Speaker 9: (30:26) Are the stay at home orders really effective in keeping down infections and fatalities as well? Dr. Smith: (30:37) The question is whether stay at home orders are effective, and that really depends on how well people adhere to them. What we're trying to accomplish is decreased opportunities for spread of COVID-19, and if people adhered to a stay at home order, then it would be a highly effective way to do that. If people adhered to the directives that we have in place, those also are highly effective ways of preventing the spread of COVID-19. But what people actually do and what they can sustain over periods of time, that may be a different story. What we are seeing with our numbers suggest that what we're doing has been effective, and hopefully it's something that we can continue to sustain long enough to get us over the hump and get past this epidemic. Asa Hutchinson: (31:35) Can I add one thing there? That Arkansas, when it comes to a healthy population, we do have some health challenges here in Arkansas. Secondly, we have an elderly population to a certain extent, and I think all of those do impact some of the results, sadly. Yes? Speaker 10: (31:57) In terms of the ventilators, are we still trying to get more ventilators, or is the thought that we're not going to need more at this point? Asa Hutchinson: (32:07) No, good question. We still have an order in for more ventilators, but our thinking is that there's an urgent need for ventilators in Louisiana this day, so we want to help save lives this day. We have a little bit more of a cushion, and we hope that we can continue to flatten that curve and reduce exposure so we don't need that many ventilators. But if we do, we have them all in order to beef up our supply. Speaker 7: (32:39) Do we have any issues with our national stockpile of PPE, because we've seen reports from Alabama where they've had expired PPE down there. Asa Hutchinson: (32:46) I'm not aware of any issue here in Arkansas on that quality. Speaker 11: (32:50) Governor, what are your thoughts on Senator Trent Garner's amendment to limit funding for the Arkansas Economic Development Commission in China? Asa Hutchinson: (32:59) Well, I think it's shortsighted. Whenever you look at the [inaudible 00:33:03]. Governor Asa Hutchinson: (33:03) I think it's shortsighted. Whenever you look at the second leading economic power in the world, and to think that when we have a presence of Tyson's Foods, the sale of our agricultural products to China, whenever Walmart is there in China, to think that we're not going to have a relationship, and a business relationship in the future is shortsighted and somewhat isolationists. Whenever you look at, I mean, I'm a realist. And so, whenever we have the current challenges, we have reduced our staff allocation there. And so, that's going to reduce and be in effect this June 30th, I believe it is. And so, that's already in the works, but I'm concerned about the amendment itself that it sends a message that we don't want to sell agricultural products to China, our rice, our soy beans, our poultry. And secondly, we have to continue. Even though we might not have a physical office, we've got to have a presence there, and be able to facilitate that relationship from a commerce standpoint in the future. So I have those hesitations, and I've expressed those to Senator Garner. Yes? Speaker 12: (34:24) Governor, the same projections. They're saying that if we stay on the path we're on, we're going to have plenty of hospital beds at the peak. We're going to have plenty of ICU beds at the peak. For people that are sacrificing now, as much as for them that what they're doing is working, and that we can deal with this peak, and conquer this peak, if they continue to do what they're doing at this point? Governor Asa Hutchinson: (34:56) Yes. If they continue to do what they're supposed to be doing, what we've asked them to do, what our directive say and social distancing, when that doesn't work, to wear masks, reducing the size of gatherings, we're going to continue to flatten that curve. And let me emphasize, if we are not successful there, and the spread accelerates, then Dr. Smith will be looking at additional measures to recommend. And so our options are open in the future, but we're hopeful. And you mentioned the projections, also. There's probably 20 different projections out there for Arkansas. And then whenever you do have a model, and this is what's interesting, we can have a model from the University of Washington, for example, and the University of Washington will give a model for Arkansas, but it changes day by day. And so yeah, well it's a big range, but I looked at what model they gave us a week ago, and then I look at the model they give us today, and because of our success they changed the model. And so, it's a changing environment out there, which just reflects, we actually don't know completely how this develops. But I'm grateful for those projections, and whenever they give us a projection, we want to beat that projection, and reduce that spread. Dr. Smith, do you have a further comment on that? Dr. Smith: (36:27) I agree, we need to use the information we can, that we have available to plan wisely, so the things that we do today will improve our situation a month or two from now. And although we seem to be in a good place in terms of the slope of our curve now, we do know that in some places, at least, there's been that, what we'll call linear, just gradual increase. And then at some point, it's gone up to more of an accelerated or exponential phase. And so I have a healthy respect for this virus. It is my hope that we'll continue to see only slow growth that eventually peaks out, and starts to come down. And that's why we're doing all these things that we're doing, and making the sacrifices that we're making, but we also have to plan for the possibility that something more like Louisiana, or one of the other places might occur here. We just don't have enough experience with this virus to say confidently that we know exactly what's going to happen one month, two months, three months from now. Speaker 13: (37:31) Doctor, there's a number of tests you did yesterday, how far off is that from the actual capacity we have in the state? Dr. Smith: (37:37) Well, we're doing as many tests as we can right now, but we're working to grow that capacity. Both of the Arkansas Department of Health Public Health Lab, UAMS, and of course the commercial labs have decreased their backlogs. The report I heard this morning from our federal partners is that their turnaround times are much shorter than they were. So we're hoping that we'll see even more testing done per day moving forward. Speaker 13: (38:08) [inaudible 00:38:08] those tests were UAMS, that ... Dr. Smith: (38:12) Yes, I have that. I believe they were steady at about 50, but let me give you an exact number, 51. Speaker 13: (38:23) [inaudible 00:38:23] total? Dr. Smith: (38:25) No. When we've separated that out. Speaker 13: (38:26) Oh. Speaker 14: (38:28) Do you foresee us taking transfer patients from Louisiana? Is that a possibility? Governor Asa Hutchinson: (38:35) No, I do not. I think that hopefully they'll be able to manage it there. Obviously, that would not be helpful. Even if you look at non-COVID patients, that could potentially compromise our systems as well, and our capability. But we want to help them, and we hope that they can be successful there. Just like, I'm sure they don't want Arkansas overload that goes there. Let me add on the testing side that I would remind you that this week Walmart and Quest Labs should be up and running. I know they had a soft opening, I think, yesterday. And so what that will give a priority to a first responders, healthcare workers. And so, that should be able to add to the mix as well. One final question. Speaker 15: (39:34) [inaudible 00:39:34] What resources are going to be available to those with 504 plans and IEPs? Speaker 16: (39:39) That's a good question. The first thing I would say on that is our teachers and the special ed experts in the districts need to stay in close contact. They need to review those IEP plans, those 504 plans, and align the assignments for those students based on those plans the best they can. Other components of those plans, such as occupational therapy, speech therapy, physical therapy, they have to be mindful of those, when we do come back and identify what those students may have missed, and be able to compensate for that treatment or for that support that they need. Speaker 15: (40:16) And I guess the last thing here, are we going to bend some of the rules, considering the situation for the lottery scholarships, and then also the Arkansas Challenge as well? Because I know some of that's tied in with [crosstalk 00:40:28]. Speaker 16: (40:26) It is, and under the authority granted by the governor's emergency order, we have already posted some waivers for some of those on our website. And as more of those come to reality, the necessity for waivers, we'll be talking to the governor about those, too. If I may, there was a question that a student asked me, and asked me about graduation ceremonies. That will be subject to the Health Department guidance on social gatherings. We know there are districts that are working to plan something, either virtual graduations, or onsite graduations when the restrictions can be loosened, but that's something that at this point is very much up in the air. Governor Asa Hutchinson: (41:15) Thank you all very much today.