Maryland Governor Larry Hogan COVID-19 Briefing Transcript April 3

Governor Larry Hogan: (01:13) Good afternoon. Before we get into the latest details on the war against the COVID-19 pandemic, I have some other sad news to share. A former Maryland Lieutenant Governor Kathleen Kennedy Townsend's daughter, Maeve, and her eight-year-old grandson, Gideon, went missing after canoeing yesterday afternoon on the South River here in Anne Arundel County. An intensive search has been underway since late yesterday, which has included teams from the Maryland Natural Resources Police, the Maryland State Police, the United States Coast Guard, and the Anne Arundel County Fire Department. I reached out to and spoke with Lieutenant Governor Townsend in this morning; and on behalf of the people of Maryland, I expressed our most heartfelt sympathies and prayers to her and to her entire family during this difficult time. As of this morning, Maryland has 2,758 confirmed cases of COVID-19. The number of positive cases has tripled in less than a week. There are positive cases in every single one of Maryland's 24 jurisdictions. 416 Marylanders who tested positive are currently hospitalized, 43% of whom are currently in intensive care. On a more positive note, 159 hospitalized patients have now recovered and have been released from isolation. In the past 16 days, 42 Marylanders have died from the deadly virus. Governor Larry Hogan: (03:27) There are now more than 5,500 cases in the national capital region and 104 people have died in the Maryland, Washington, D.C. And Virginia area. There are more than a quarter million cases in all 50 states across America and 1.1 million cases in 204 countries around the world. Nearly 57,000 people have died. Governor Larry Hogan: (03:56) As we've been saying for several weeks, older Americans and those with underlying health conditions are more vulnerable and at a significantly higher risk of contracting, of getting more seriously ill and of dying from this disease. A major concern to us is that we have cases and/or clusters of cases at 60 nursing homes and long-term care facilities across the state. The major outbreak in Carroll County at the Pleasant View Nursing Home has 99 confirmed cases among both residents and staff, has resulted in 42 patients being sent to 14 different hospitals and has resulted in five deaths. We immediately sent in National Guard medical units to provide support at the facility, and state officials from multiple agencies have been in constant coordination with local Carroll County officials. Governor Larry Hogan: (05:08) The Department of Public Safety and Correctional Services now has a total of 17 confirmed cases of COVID-19 in Jessup, Baltimore and Hagerstown, including two Division of the Parole and Probation employees, three inmates, four correctional officers and eight contractor staff. While we're intensely focused on these particular clusters, I want to be very clear. We now have widespread community transmission. This virus is everywhere and it is a threat to nearly everyone. Governor Larry Hogan: (05:49) Fifty percent of the confirmed cases of COVID-19 in our state are patients younger than 50 years old, and more than a quarter of the Marylanders who are hospitalized are under 50; 335 Marylanders in their twenties are positive for COVID-19, 485 Marylanders in their thirties have tested positive, and 509 people in their forties have already tested positive in Maryland for the coronavirus. Sadly, we have five infants who have been affected including a one month old. The reality is that this disease does not discriminate and no one is immune. I want to make sure that everyone understands the gravity of the situation that we're facing in the weeks ahead, and how important it is to stay home and to continue practicing social distancing. Marylanders are understandably worried by the spread of this virus and they're concerned about their own health, about the well-being of their families and their friends and loved ones. Small businesses are struggling just to stay in business, and far too many Marylanders have lost their jobs. People are struggling and wondering how they're going to pay their rent, their car payments or feed their kids. And the sacrifices that we are all being asked to make are incredibly difficult. Governor Larry Hogan: (07:34) I wish that I could tell you when we're going to turn the corner, when you'll be able to go back to work, to school or to church, or when any of us will be able to get back to living a normal life again. Unfortunately, I'm not able to do that. We simply don't know just how bad things are going to get or exactly how long this is going to last. Winston Churchill once said, "If you're going through hell, keep going," and that is exactly what we are all going to have to do. No matter how long and how hard the road ahead may be, we are all going to have to find a way together to keep going and to keep fighting this invisible enemy with everything we've got. And it may seem hard to believe right now, but I am hopeful and I do believe that our state will make it through this together, and that eventually we will come back stronger and better than ever before. Governor Larry Hogan: (08:54) Earlier today, I convened another teleconference with our Coronavirus Response Team of leading doctors, epidemiologists, and health experts as well as a call with all of our municipal leaders across the state. Later today, I'm convening another emergency meeting of my full cabinet to discuss our continuing coordinated response efforts. Governor Larry Hogan: (09:21) Earlier this afternoon, House Speaker Adrian Jones, Senate President Bill Ferguson and I signed emergency legislation into law to expand the use of telehealth across the state so that Marylanders can have access to their doctors and providers by phone, video, or email and receive more real-time evaluations with social distancing. Governor Larry Hogan: (09:48) I've also enacted executive orders to ensure that those who provide support services to the disabled will be recognized as essential healthcare workers. We instituted special COVID-19 response pay for state employees on the front lines of this crisis, extended the special enrollment period for uninsured Marylanders to June 15th, extended the deadline for income and property tax returns to July 15th, and expanded the call center hours for unemployment claims. Governor Larry Hogan: (10:27) We're continuing to make rapid progress on our hospital surge efforts, and I have ordered the acceleration of the surge planning to be completed six weeks ahead of schedule. Work is under way on all of the expansions, which we can make immediately available, including existing facilities like hotels and convention centers across the state. Initial construction is complete for the field hospital at the Baltimore Convention Center, including facilities for patient and staff areas, partitions and other necessary fixtures are being finalized over the weekend. One hundred individuals have already been hired to staff the field hospital. In addition, the first wave of advanced medical tents have been assigned to various hospitals around the state of Maryland and to Department of Public Safety and Correctional Services facilities, with many more tents to be allocated in the coming days to address surge gaps across the state. Governor Larry Hogan: (11:34) On Monday, we opened drive-thru COVID-19 testing and screening areas at three motor vehicle emissions inspection program stations in Glen Burnie, Waldorf and Bel Air, and we opened a Prince George's County COVID-19 screening and testing site at FedEx Field. We're also opening two additional testing sites at the emissions inspection stations in Columbia, in Howard County and at White Oak in Montgomery County. Governor Larry Hogan: (12:02) In addition to ramping up our hospitals physical capability and adding bed space and to increasing our testing capability with these drive-thru testing centers, we're also working to increase the number of healthcare professionals. I issued an executive order two weeks ago to fast-track the licensing process for out-of-state healthcare practitioners and those with expired medical licenses. I also issued an executive order to provide more authority to designate emergency medical technicians and paramedics with special provisional status to work in Maryland clinics and field hospitals. This provisional status is now available to EMS clinicians, and from another state, students and EMS educational courses and individuals with expired EMS licenses and certifications. Governor Larry Hogan: (12:57) Last month, I activated the Maryland Medical Reserve Corps, a force of dedicated and trained medical and healthcare professionals ready to assist in a public health emergency. And I directed the Health Department to immediately institute a program to allow medical students, nursing students, and medical technician students from our universities, colleges, and community colleges to be able to assist and be a part of this effort. Already more than 5,400 people have signed up to be a part of this initiative from every single jurisdiction throughout the state. This spirit of service in Maryland is at its best, but we still need more help. And so I'm asking Marylanders with any of those skills that can be of service to please sign up by going to mdresponds.health.maryland.gov. Governor Larry Hogan: (13:55) As we continue to fight this unprecedented a worldwide pandemic, our first priority is saving the lives of thousands of Marylanders. But at the same time, we're also facing another huge battle against catastrophic economic collapse. And we are attempting to tackle both of these problems aggressively and simultaneously. Governor Larry Hogan: (14:23) Eighteen days ago, I issued an executive order prohibiting utilities including electric, gas, water, sewer, phone, cable, TV and internet providers, service companies from shutting off any residential customer's service or charging any residential customer late fees; and an executive order prohibiting the eviction of any tenant during the state of the emergency. Governor Larry Hogan: (14:50) Last week, we launched a $175 million comprehensive business relief program for some of our hard-pressed Marylanders and small businesses to get through this difficult period. On Wednesday, the Department of Labor- Governor Larry Hogan: (15:03) This difficult period. On Wednesday, the Department of Labor further extended our unemployment insurance claim hours to assist more Marylanders in need, and today we're taking some additional actions to help struggling Marylanders and small businesses who are facing such economic hardship right now. I'm enacting an executive order that prohibits mortgage lenders from initiating the foreclosure process. Nearly 70 of Maryland's largest banks, credit unions, mortgage lenders, state agencies, and other financial entities and institutions have already agreed to provide additional flexibility to borrowers to lessen the economic impact of COVID-19. Governor Larry Hogan: (15:49) Upon contacting their financial services providers, Marylanders are eligible for immediate relief, including a 90 day period of forbearance or deferral for mortgage payments during which no late fees will be charged and no negative information will be reported to credit bureaus. We are also requesting that all mortgage lenders and financial service providers abide by the forbearance and reduced payment programs established by federal authority. Governor Larry Hogan: (16:25) Today's order extends the prohibition on residential evictions to include commercial and industrial evictions, and also prohibits the repossession of cars, trucks, and mobile homes. We are also directing the Maryland commissioner of financial regulation to suspend certain lending limits for Maryland banks on a case by case basis in an effort to make more credit available to struggling small businesses. Governor Larry Hogan: (16:55) In addition, during this state of emergency, all executive state agencies will suspend debt collection activities. We're going to continue to do everything that we possibly can to help get Marylanders through this, to help them weather the storm and get back on their feet and to help them recover. I want to thank the overwhelming majority of Marylanders who have taken this situation seriously, who have remained at home and avoided crowds and practiced this much needed social distancing. Your actions and sacrifices are making a difference and not only are you protecting your own health and quite possibly saving the lives of your family and loved ones, but also your neighbors and your fellow Marylanders. Governor Larry Hogan: (17:54) This Sunday is Palm Sunday, the beginning of Holy week and Wednesday is the beginning of Passover. For those practicing in our Jewish community. In the Christian faith, we use this time to reflect on the sacrifice of one for the redemption of many. Regardless of your own faith or beliefs each and every one of us is now being asked to make sacrifices that may very well help us save the lives of others while it is currently unsafe to gather in churches, temples, and other places of worship across the state, at noon this Sunday, I am calling on all Marylanders regardless of faith to join together at home or wherever you are, in a moment of prayer or reflection for those we have lost, those who are sick and the doctors, nurses, clinicians, healthcare workers and first responders on the front lines around the clock working to bring about a new dawn in our history. Governor Larry Hogan: (19:23) Together give us strength and comfort to one another. Let us pray for each other. Let us pray for the great state of Maryland, for the United States of America and for all the people suffering around the world. With that, I'm going to turn it over to our Deputy Secretary of Health, Fran Phillips. Fran Phillips: (19:52) Thank you governor and thank you for your leadership at this difficult time when we are leaving no stone unturned to protect the health, the safety of Marylanders every day. I have a few brief remarks to make in connection with the developments that the governor mentioned going on in our nursing homes, in our assisted living, in our longterm care facilities across the state. I have some remarks to make and I'd like to first off speak directly to residents, the residents of nursing homes and their families, their loved ones and their friends, and I want you to know that we are doing everything we can to keep you safe. We are working relentlessly 24 hours a day to keep you safe and in your facility, which is your home. Fran Phillips: (20:40) Now we've heard from the governor the statistics about how, in fact, younger people, people under the age of 50 are surprisingly infected with what I call the sneaky virus. It is not a virus that is exclusively for people, but what we know is that older people and people with serious medical problems are disproportionately impacted. They get very seriously ill because of this virus. So it is very important that all people of all ages obey the social distancing in order that we can keep, particularly our nursing home residents, our vulnerable people, healthy. Fran Phillips: (21:22) What we're seeing in Maryland right now is we're seeing community transmission across the state and as a result, yes we are seeing that this virus has entered nursing homes in our state. Last week we had an extraordinary event, an event in Carroll County at the Pleasant Valley nursing home. It was extraordinary. It was one that remarkably recognized the diligence and the dedication of nursing home workers. And so the second thing that I want to say after talking directly to nursing home residents and their families is to thank the tireless work of countless thousands of nursing home staff today who are on the front lines working with your people, your residents, keeping them safe every day. I know it's not an easy job, I know it's a stressful job, but I want you to know how valued you are. Fran Phillips: (22:16) We do have outbreaks. We have outbreaks across the state now in many jurisdictions, these are not nearly on the scale of what we had last week at pleasant view, but we do have concerning outbreaks in nursing homes and what we are seeing in these nursing homes that by and large have instituted infection control procedures, have personal protective equipment, are screening individuals coming in, staff coming in, have banned visitors, and I know that's tough for family, but what we are seeing is that despite these measures, people are still getting the virus. Fran Phillips: (22:51) We are looking at that wonderful staff and we are looking to the staff that's coming into these facilities every day, and of course staff who had been symptomatic had been advised and absolutely cannot come to work even if that symptom comes on during the course of the shift. But what we are seeing here in Maryland and across the country is clear evidence that people can be infectious, that they can transmit this virus even before they develop symptoms. And so that is what we are seeing in these nursing homes. And I have some measures that we're going to talk about in order to control and to avert that kind of transmission. I want to talk first about the local health departments in every one of these counties, in every one of these outbreaks is on the scene. They are doing in investigations, they are offering guidance. They are doing assessments of individuals, of nursing home staff and residents. I just had a call with all of the health departments around the state. They're all vigilant and looking very, very closely at their nursing homes. Fran Phillips: (23:53) So in addition to the staff, in addition to local and state public health response, there is also the facility operators and I want to talk directly to the individuals, to the companies that manage these very, very important components in our healthcare system, components that are starting to feel the surge and will continue to be part of our response. I'd like to call out and say specifically some direction to the nursing home industry itself at this time of crisis. Fran Phillips: (24:20) First and foremost, you must protect your residents. You must take every measure that has been directed to you in order to reduce transmission and to implement, fully implement, every single infection control piece of guidance that has been provided to you either by the state or by the CDC. Secondly, you must protect your staff. You must have proper personal protective equipment for your staff, and you must educate your staff. The staff are vital to taking care of your residents and that's essential for nursing home operators to do. Fran Phillips: (24:51) I've talked about asymptomatic transmission. Today we will be issuing a directive to all nursing homes, all assisted living for universal masking. That means any staff person in any nursing home, in any assisted living facility that has direct contact with residents must wear a mask throughout the course of that day, that is absolutely important because as I said, this is to protect the resident from inadvertent transmission from the staff person by virtue of this virus, the staff person may not even be symptomatic, so the mask must be on to intercept that transmission. Fran Phillips: (25:28) Another point, every nursing home, every assisted living facility that begins to suspect that they may have an outbreak, they may have a symptomatic person, do not use one of the labs that requires mail order specimens, Maryland state lab, our laboratory that is operated 24 seven, Maryland government is reserving lab capacity to do these urgent kinds of lab testing. We can turn around a lab test far faster than any of these remote commercial laboratories. So if you suspect an outbreak and you're operating a nursing home or assisted living, send that specimen to the state lab. Fran Phillips: (26:06) And lastly, fortunately we are having experiences with nursing home residents who become ill with this virus, who some of whom may need to be hospitalized, but they're recovering. And when nursing home residents recover, they need to come back home. So I'm asking all of the nursing home operators to work with your staff to make sure that your people can come back home safely after they have recovered, come back home safely in order to protect the other members, other residents in that community, as well as to bring back people who we know cannot languish in hospital beds, who need to come back to their home in nursing homes. Fran Phillips: (26:45) So we know that this is going on, the numbers are climbing and we also know that this is a very stressful time for folks in general, everywhere whose lives are tremendously disrupted. I'd like to close by just offering another phone number and that's 211 press one. 211 is a statewide phone number for folks to call if they have questions, if they have concerns, if they want to reach out. I know this can be a very lonely time for folks. So 211 press one would be a gateway to some assistance. So with that I'd like to turn it over to Secretary Green's, secretary of Department of Corrections and Public Safety. Secretary Robert L. Green: (27:27) Thank you. Good afternoon. The Department of Public Safety and Correctional Services has been in this proactive emergency from the very beginning and receiving great guidance from the Maryland Department of Health, and I want to personally thank Fran for always being available to us and guiding us through this. At the very onset of this crisis, we were given the expert advice, expertise and availability of our Department of Health in Maryland Emergency Management Agency and the Center for Disease Control to help direct out every move in keeping the health and safety of the population that we are responsible for and our staff safe as we continue to weather what has become a marathon. This is not a short term race. Secretary Robert L. Green: (28:11) As of yesterday evening, as governor Hogan noted, we have 17 cases confirmed of COVID-19 within our system. The department's 17 cases are as follows, three inmates, eight contractual employees, four correctional officers and two parole and probation employees. We've been taking strong preventive measures in all of our facilities to protect the health and safety of our staff. Very early on, March 12th, we were directed and shut down intake into our system in its entirety. We shut down visitation, we shut down programs, volunteer services. While that is difficult and we depend greatly upon those that come to help us in our system, it was an immediate and early intervention step that has helped us to stay the course to where we are today. Secretary Robert L. Green: (29:03) Statewide, we have privatized healthcare who provide care, and we have infirmaries in each region of our state as well as a number of negative airflow cells and areas to house people that are infected. We've significantly modified our operations as a department, enhanced our hygiene and sanitation practices consistent with the recommendations of the Health Department, Maryland Department of Health and the Center for Disease Control. We've required temperature checks and health checks for all of our staff at every entry point into our facility. We've shut down all entry points into our system. Again, individuals coming from a County and local detention centers, I thank them for their cooperation in helping us slow the movement of individuals coming into our system and we have done the same for them. Again, another key way in which we can control movement throughout our facilities and make sure that we keep the inmate population healthy. Secretary Robert L. Green: (30:03) Make sure that we keep the inmate population healthy. We've modified movement to include meal services and how we do that to protect individuals. We've implemented telework for many of our staff. Our parole and probation staff are now on telework priority and managing their cases with enhanced supervision into the community utilizing telework. Secretary Robert L. Green: (30:23) I'd like to highlight some work of our Maryland correctional enterprises. This is one of the top 10 enterprise programs and a correctional facility within the country. And we're beginning, started ramping up two weeks ago, making products that our community needs, we need, so that we can lower our burden on the supply chain. So as to date, our Maryland correctional enterprises has stood up and are making gowns. These are not disposable gowns, re-washable gowns for our staff in our system and for us to also provide into the community. Secretary Robert L. Green: (31:01) We are making face shields, the acrylic face shield. We have manufactured to date 5,000 of those and have cut enough product to manufacture 50,000 face shields that we will be able to send into our community to help our healthcare professionals. Secretary Robert L. Green: (31:17) Masks, as the governor spoke about masks and Fran as well, we have manufactured to date 4,000 masks and we're on track to keep that going as long as we need to, but those are masks for our staff and masks that we can also deploy into the healthcare field. Most recently, as of 11:00 PM last night, we finalized our hand sanitizer operation and are now producing 41 cases of 16 ounce bottles of hand sanitizer, a product that has the right ingredient and alcohol level to make sure that it kills the virus on individual's hands. We all know that that is a much in need product and we are pleased to be able to do that. And I think this is important to note that the population, the individuals that are involved in these work programs are pleased to be doing this work, this service for their community, their families and their hospitals around our state. So I want to thank them. I want to thank Maryland correctional enterprises for being so innovative and responsive to what they are doing. Secretary Robert L. Green: (32:24) Further, we've rolled out video visitation across our system for the inmate population in this human crisis to stay connected to their families. We've stood up free phone calls for the inmate population to stay connected to their families as well. We have a hotline for families that are concerned about their loved ones incarcerated in our system and I'd like to provide you that number. That number is (410) 769-6419. That hotline is answered by a live operator 24 hours a day and we'd be happy to assist you and get information that you may need. Secretary Robert L. Green: (33:02) And finally, I want to just recognize and thank the incredible work of the men and women of the department of public safety and correctional services. In these very trying times. They are there, they are present, they are focused and mission of public safety is in the forefront of their eyes, their focus and what they're doing. I could not be more proud of the men and women of the department. Thank you. Secretary Robert L. Green: (33:27) At this time I'll turn it over to Dr. Salmon, our superintendent of state schools. Dr. Salmon: (33:37) Thank you secretary and thank you governor for your incredible leadership. Since the announcement of extended school closures last week, our school systems have worked continuously with our staff at the Maryland state department of education to activate their plans for the continuity of learning. I am so proud to say that we're building comprehensive plans for the continuity of learning in a manner on a scale never before experienced by anyone in the history of our state school system. Dr. Salmon: (34:06) School systems have distributed thousands of devices to students and families to provide them with these online capabilities and secured platforms for delivering instructions and an interface between teachers and students. Many systems are also distributing educational materials through mailings and pick up at food distribution sites. All of our jurisdictions have resumed instructional activities at this time and we know that the number and capacity is going to climb as we move into the next week. Dr. Salmon: (34:40) As virtual learning and instruction ramp up, discussions continue on how to move forward with key decisions that affect our students and school communities on a number of issues including graduation requirements, assessments, certification and a baseline of standards which need to be met by the end of the year. We are working with local superintendents on a daily basis to develop guidance on these issues. I encourage all students and parents to continue utilizing the resources shared with them with their local school systems website and also the Maryland state department of education's website. Dr. Salmon: (35:17) We have maintained and continue to grow a robust operation for the provision and delivery of meals to school aged children throughout Maryland. Just in the last week, we serve more than 880,000 meals to children at 619 sites set up across the state. This is nearly double the amount from the previous week, and illustrates the successful and monumental efforts by the nutrition staff at the state department, local school systems, food services personnel, and also volunteers. Dr. Salmon: (35:50) We made the decision early to expand sites for meal distribution regardless of this eligibility of students, and with the rapid increasing unemployment and with a waiver from the US department of education, any site can now be approved to provide meals to any children. We continue to explore additional options in order to limit numbers of interactions while also providing meals. Dr. Salmon: (36:15) The seamless transition to comprehensive grab and go service has been a tremendous example of the dedication from our food service directors and providers across the state, and we are confident that these efforts will carry on with success. We've also heard, and I've had many emails from countless families and childcare providers throughout Maryland about the status of tuition payments and the preservation of family slots childcare programs that have closed or currently only serving the children of essential personnel. I understand the anguish and concern from families that the prospect of continuing to pay tuition in order to maintain a slot in childcare facility for the future or paying tuition for childcare services they are not receiving is not reasonable or tenable given the strain financial circumstances that many find themselves. Dr. Salmon: (37:10) We are working on a solution to provide financial relief to families during this state of emergency and we'll also allow them to maintain their status in the childcare facility to which they send their children when we return to normal operations. We strongly encouraged childcare facilities to be flexible in enforcing contract provisions against families while the childcare facility is closed due to the COVID-19 state of emergency. Dr. Salmon: (37:39) This pandemic has had a significant impact on families across the state and many are experiencing severe hardship. During this time of emergency, we must seek to work together and strive towards equitable outcomes. We hope to have a plan forward very soon and we'll work to our fair reasonable resolution for families and for childcare providers. Thank you. Speaker 4: (38:06) Thank you. I'd be happy to take a few questions, but first we also have with us Tiffany Robinson, who's our secretary of labor, who we can have her answer any questions you may have about the unemployment or some of our financial programs we talked about. I just want to say, I mentioned earlier that I'm going to have another emergency call with our entire cabinet. You heard from some of the leaders of our agencies here today, I just couldn't be more proud of not only these leaders of the agencies but the people that work for them on their teams. I mentioned, we talk about the healthcare workers on the front lines and the first responders, but there are truly heroes in every single one of our agencies that are working around the clock to help people under unbelievable circumstances and I just want to thank all of the people that are under very difficult circumstances, really working hard to try to help people in this time and thank all the state employees for everything they're doing. And with that, I'd be happy to take some questions. Speaker 5: (39:00) [inaudible 00:39:00] because of potential cases and mortality [inaudible 00:39:10]. Speaker 4: (39:12) I think that's probably a question for Fran Phillips. I'm not sure if she's going to answer you but I'll let her take a crack at it. Fran Phillips: (39:19) So yes, there are models and then there are models and I think we've all seen a lot of coverage on different models coming from different parts of the country and in fact from also from overseas. We have looked at these models, we are trying to understand if these models somehow converge and what their meaning is for us here in Maryland. The two key points on the modeling is what is the volume and when does it come. And I can tell you that we, under the governor's direction have input from this task force of experts. And while there's models online and models that are being promoted, the governor has looked to these experts not only to give professional direct advice, but also to interpret some of that modeling. And so that's work underway right now, we are being informed as much as we can and we actually are, with real time getting information from these experts. Fran Phillips: (40:09) I don't have a date, I don't have a number for you, just to say that we are looking at all these modelings, which of course are as good as the assumptions that are built into that. Speaker 6: (40:17) [inaudible 00:40:21]. Fran Phillips: (40:21) Well, certainly a fundamental number that we look at is the cases. So the cases that are reported every day, the incremental increase of the cases that are reported every day. Clearly what the governor has said is that we are on the beginning of a curve, the curve is all going up and we are accelerating in terms of the percentage of new cases. So where that's going, how soon, that is not something that we have a clarity on at this point. Speaker 6: (40:46) [inaudible 00:10:47]. Fran Phillips: (40:47) I knew somebody was going to ask me that and so let me just say about masks, and you see during the course of this pandemic, which seems like so long and it's only been a matter of weeks, the evidence that's coming out from across the world actually on how the sneaky virus operates is evolving. So at one time we thought absolutely, there would be no problem with transmission if there weren't symptoms. Now that information is changing and in fact I understand that there will be some federal guidance coming down as far as masks. Here's what we're talking about masks. Masks are not to protect you from incoming virus. Masks are to protect everyone around you from the virus that you may not be aware that you have. And in the course of speech, we transmit little, tiny droplets and it could be in those droplets that the virus is harbored. So the recommendation on masks, absolutely positively for healthcare workers, as I mentioned earlier. Fran Phillips: (41:45) For healthcare workers involved in hospitals, many of them need to have the very high quality N95 masks. Others who are not engaged in that kind of risky kinds of procedures, use surgical mask. But there's a third tier of mask, and that's what's called the cloth mask that we are seeing now coming into production. A cloth mask is better than no mask in terms of not transmitting from the person wearing the mask to the outside community. Thank you. Speaker 7: (42:23) [inaudible 00:42:24]. Fran Phillips: (42:25) Yeah, I can give you some information, it's from earlier this morning and I want to stress that this is changing.,This is a changing situation. We do have 60 nursing homes that have evidence of virus in the nursing home. And so for a nursing home, actually the technical definition for an outbreak is one confirmed case. So we have 60 nursing homes as of earlier this morning that reported at least one confirmed case. Of those 60, 46 had somewhere between one and four cases. So that's what we got as of this morning. Another 12 have higher levels of that, between seven and 10 cases. And then of course there's that outlier, which is Pleasant View, which had an extraordinary number of cases. Fran Phillips: (43:11) Now, I will say that it's important that we smother these nursing homes with infection control. Everything that we can do as far as investigation and interrupting that transmission. But do not think that that virus is only in those nursing homes. So what we see now is as the governor said, this is evidence across the state of community transmission. This virus is here and it's in our communities. Speaker 8: (43:32) [inaudible 00:43:32] in the ICU? Fran Phillips: (43:43) That's right. Speaker 8: (43:44) [inaudible 00:43:44] any break down, is it compromise immune system? [Inaudible 00:43:54] Fran Phillips: (43:54) Thank you. It is actually true that these are very, very sick people. I don't have a breakdown on their ages. We do know that there's a wide span of ages of people who are hospitalized. We know that this is a serious respiratory condition and for some people, it can very, very quickly become a situation of acute respiratory distress. Fran Phillips: (44:13) Our hospitals are stepping up around the state, the intensive care, the critical care specialists, all of the nurses are working with these patients. We are monitoring that every day through the Mims system so that we have near real time understanding of what's going on in our hospitals. Fran Phillips: (44:40) Yeah. Thank you. I haven't been to the grocery store in a month and a half, and that's a little delightful, but I think you're raising a very good question. And I think now our understanding of this virus, first of all, how prevalent it is in our communities and how important it is that we keep social distance. This is six feet. This is six, so six feet, this is six feet. And that's the kind of separation between you and someone who might inadvertently be carrying... Fran Phillips: (45:03) Separation between you and someone who might inadvertently be carrying a droplet. Wearing a mask is not a bad idea. Wearing a mask can be protective. What is important to say is that the most critical place for these masks to be is on the faces of healthcare workers. So while we continue to have a shortage and we are working through every possible channel to bring in all of the equipment that we need to protect ourselves, we need to prioritize and make sure that those very, very heavy duty medical masks are reserved for hospital workers. Speaker 9: (45:35) [inaudible 00:00:33]. Fran Phillips: (45:43) Well, thank you for that. And now as we're beginning to understand that we can have apparently healthy staff in a nursing home, unsuspecting, without symptoms, who are going about their business and so inadvertently infecting patients. What is happening now in some of these clusters, in some of these outbreaks, is that with the health department and a local staff, we have go teams that are going into those nursing homes and testing everyone on the unit where there was a confirmed case. And we're looking at whether or not we've got transmission that we don't know yet below the surface, so to speak, in order to understand how to best interrupt that transmission in places where people live together. And again, these are frail and often very vulnerable people. Speaker 9: (46:22) [inaudible 00:01:25]. Fran Phillips: (46:24) Correct. It's more testing of other people in that unit. Governor Larry Hogan: (46:35) I haven't really seen the letter, but, I mean, it just hadn't been on the top of my priority list. I know it's just part of the federal list of what is a priority and what isn't a priority. But it hadn't been anything I had any time to talk about today. Governor Larry Hogan: (46:50) I really hadn't given it any thought. Governor Larry Hogan: (47:02) Well, I think we're all running on adrenaline. This is just an unprecedented crisis that none of us ever imagined that we would be put in this position. But we know how much is at stake and we've got the lives of 6 million people counting on the work that we do. And so, I'm doing fine. My family is doing great. I don't see my kids and grandkids other than on Skype and FaceTime. But first lady and I are doing fine. I'm not getting a whole lot of sleep but I feel pretty good and we're just working hard. I'm drinking a lot of coffee and a lot of Diet Coke. Speaker 10: (47:47) [inaudible 00:47:39]. Governor Larry Hogan: (47:49) I think maybe I'll let Fran Phillips discuss that one as well. But it's obviously one of the biggest frustrations and pinch points with all the governors across America. It's something, as chairman of the NGA, I can tell you we've had numerous discussions on. But I don't know about ... I know we're searching for them and attempting to get them all over the country and all over the world, but I don't know about the costs and things like that. We can probably talk about it. Fran Phillips: (48:11) I don't know about the costs either. I don't know. And I think that might be a moving target, but in terms of looking for the capacity, what do we need in Maryland to prepare for a surge over and above what we have right now in our hospitals? The most important thing we're doing right now is procuring more ventilators whether that's through the federal channels or whether it's through the private market. Everything that we can, we're out there looking to increase our capacity. We're also looking at ventilators that are here in Maryland right now, which are operating in surgical centers. These are the ambulatory surgical centers now closed because they're not doing those kinds of procedures. These are ventilators not typically used in an ICU. These are ventilators that provide anesthesia for short term procedures, but they can be converted to support folks in ICU. So we're looking at all those. We have an inventory of all those anesthesia ventilators, also ventilators that may be on ambulances or transport ventilators, and then there are ventilators in our colleges and universities. So in terms of medical schools, nursing schools, community colleges that teach respiratory therapy. There are ventilators there. Believe me, we are scouring this state for all of the available ventilators that we can put into use. Speaker 12: (49:22) [inaudible 00:00:49:26]. Fran Phillips: (49:24) Oh gosh. Yeah. Fran Phillips: (49:31) I wish I had a clear answer for you on that. You can see on our website that the amount of testing that's underway is increasing so that now we report not only the positives but also the negatives that come back. I mentioned earlier the commercial labs. These are high volume national labs. And typically those specimens which are typically run through physicians offices, they are sent out and they come back several days later. And the reason, the point that I was making about, for example, nursing home outbreaks is that we don't want to wait several days. We want the information as fast as we can in order to take the steps that we need. Now, you've seen some reports of these point of care labs, these testing that can happen and return results in just a matter of minutes. We have asked, we have ordered, we are looking for those devices as well as the cartridges. We don't have them. We want to get them. And so we're doing everything we can to expedite and to really expand the testing capability in the state. Fran Phillips: (50:27) I can't tell you that because we don't have visibility on all of the negatives from the commercial labs. As I said, on our website, you've got the reports of positives and negatives. That's a ballpark if you add that together. But we really want to ramp this up not only in our state lab, which is prioritized for certain cases and the commercial labs, but also our hospitals. Our hospitals really want the capability to test. They have labs. And in fact, I just spoke yesterday to the CEO at a Frederick Memorial hospital. They're ready and raring to go. They don't have some of these critical raw resources, the raw materials that are necessary to do the test themselves in the lab. So they too are having to send out to out of state. Governor Larry Hogan: (51:07) Let's let somebody else. Hold on a second. Let's let somebody else. You're kind of being rude to the other folks here. Okay, go ahead. Speaker 13: (51:14) [inaudible 00:06:17]. Governor Larry Hogan: (51:22) I wouldn't really say I've been hesitant to complain about it. I've been actually leading the national discussion with all the governors about why we haven't gotten this stuff. And I've had eight different meetings of all the governors and six different conference calls with the president and vice president where I brought this up on every single call. So we got nothing at first. And then last week we got them to put FEMA in charge. We got the first distributions of anything to anywhere. But it's still a small percentage and I continue to push, but it's very frustrating. Speaker 13: (52:11) [inaudible 00:00:52:07]. Governor Larry Hogan: (52:11) Yeah, I have been on the phone with the head of FEMA, the regional coordinator of FEMA, with the president, the vice president, every leader in Washington. So it's not like we're not- Speaker 14: (52:21) Next question please. Speaker 15: (52:22) [inaudible 00:52:27]. Governor Larry Hogan: (52:22) I'm sorry, I didn't hear that one. Speaker 15: (52:22) [inaudible 00:52:31]. Governor Larry Hogan: (52:39) That's a great question. I don't know, Fran, you want to take a shot at how we can do telehealth with people that don't have access? Fran Phillips: (52:43) That is a great question. Governor Larry Hogan: (52:45) I don't know the answer to that one, but it's a good question. Sorry. Fran Phillips: (52:48) Yeah, that is a good question. The telehealth expansion is very important though, because that is for every discipline, every kind of medical service or social service that one could get, one could need. This is a way to do this remotely. So setting aside the particulars of your question, there's a very important element across the state, particularly in areas that don't have telehealth and that's rural areas. And that important element to the response are community health centers. These are community, they're federally qualified, they're community health centers, they know their communities and they have outreach. So they may not have internet, but they have telephone. And so we really are relying on our rural partners in that way. Governor Larry Hogan: (53:23) Thank you all.