Massachusetts Governor Charlie Baker March 19 Coronavirus Update

Charlie Baker: (01:40) Let me just say first of all that I've been to this facility before to get a sense for how much capacity these folks have to move tests, and while it seems relatively quiet here now, part of the reason it seems relatively quiet is a big part of the operation here. It takes place at what we might call off hours. Tests come in toward the end of the day as clinicians over the course of the day issue orders, and then this place hums like a beehive at night and it goes back ... And this stuff that's been tested over the course of the evening goes back to the provider first thing in the morning with results. And when we first got into this space with respect to constraints around testing, I called Steve fairly early in that process. He mentioned they finally got approval on March 9th to really double down on this, and I called him right around that same period of time and said, "I certainly hope that Massachusetts is going to have a big role to play." Charlie Baker: (02:46) I've been to that site, they have ton of great people there and a lot of capacity. And he basically said, "Of course." And as soon as we get to the point where we make the pivot and have the ability to start doing significant testing, you should come out and visit with us. And that's the reason why the lieutenant governor and I and Secretary Sudders are here today. I think everybody knows at this point that the CDC broadened their guidelines with respect to who could be tested. A little less than a week ago, we incorporated those guidelines almost immediately. We believe that over the course of the next several days and weeks, there will be an enormous increase in the amount of testing that takes place on a daily basis here in the Commonwealth of Massachusetts. Charlie Baker: (03:35) Can't happen fast enough. But I do believe that with the pivots and the adjustments that are being made by organizations like Quest here in Marlborough and by many of our hospital partners and by the state lab and other organizations, we will get to the point where we're doing the amount of testing every day that we believe we need to be doing. The other thing I do want to mention is many of you know, we submitted a disaster request to the Small Business Administration several days ago. They turned around that request and acknowledged and approved Massachusetts small businesses for disaster recovery relief. And we fully expect we'll be working with the SBA to ensure that their resources are brought to bear to support small businesses here in the commonwealth. And with that, I'm going to turn it over to the secretary of HHS and the command center director, Mary Lou Sudders. Mary Lou Sudders: (04:31) Good morning everyone. Like the governor, I had the privilege of coming to Quest probably about a year ago to see it in operation. And as the governor said, when this place hums, it's actually ... It's humming from about 11 PM at night into the early morning cause the tests come in, as the governor said from providers, clinicians and the like, and then the lab technicians and the epidemiologists and others sort of do the testing throughout the night in order to turn it around. Just to remind people of where we were. Mary Lou Sudders: (05:05) So at the beginning of this, only the CDC could do testing and then our state lab on, I think it was February 28, the days are sort of blurring together. Our state lab got approval to do testing and then we started to have companies such as Quest really step up to provide testing. So it will be this combination of the CDC, but really our state labs, commercial labs like Quest and then a number of small regional labs are connected to academic medical centers, Broad Institute and the like that we will have. We will have expanded significantly by next week testing in Massachusetts with fast turnaround for individuals. To be clear, the turnaround ... Some questions came in yesterday. The state lab is a 24/7 operation and it turns around its test in a 24 to 48 hours. With Test's ability to test in Massachusetts much more locally. I know that the amount ... The speed to get test specimens in and responses back to providers will be quickened. Mary Lou Sudders: (06:15) Our goal is to have as much testing capacity as possible and to also triage testing. And I don't mean ... And what I mean by that is to ensure that our health care workers get tested really fast, to ensure that our first responders get tested really fast, to make sure that folks who are critically ill and in hospitals get tested really quickly with those results turned around so that if they needed to be moved then from an ICU to med surge bed, we can do that to continue to increase capacity within our healthcare system. So we are ... We're really pleased that Quest and Steve and the tremendous people who are here really stepped up to help in the COVID 19 process. And I'm sure there'll be questions on [inaudible 00:06:59]. I'll turn it back. Charlie Baker: (07:04) So normally I would let you come up and ask what questions people have, but I'll just start that process and you can ask whoever you want. Speaker 4: (07:13) How many tests have there been? Big is the backlog and why is the state not disclosing? Charlie Baker: (07:19) I don't think of the state as having a backlog. I think of a state as having work in process. These guys have work in process. The academic medical labs that have come up have worked in process. We have work in process. We don't think of it as a backlog. We're going to be reporting every day the tests that had been completed, the tests that have been positive, the tests that have been done- Speaker 4: (07:38) What about the tests that have been negative and the tests they're still doing? Charlie Baker: (07:41) Well, the tests that are negative are obviously the ones that aren't positive, minus ... Or excuse me, are the total number of tests done minus the number that had been issued that are positive. Speaker 5: (07:50) The 20,000 tests per day number that you mentioned, is that nationwide, or- Speaker 1: (07:57) That's nationally, that's nationally, so throughout our entire network. So have over a dozen facilities that will do testing for Quest Diagnostics. So that number I provided is nationally. This facility will eventually get to about two to 3,000 per day. Okay? Speaker 5: (08:13) [inaudible 00:08:15]? Speaker 1: (08:15) Well, we're ramping as we speak. We hope by next week we'll get to a higher number than we are right now. We literally just brought up the laboratory developed tests, and we're bringing up that automatic platform. It doesn't mean that citizens in the state of Massachusetts are not getting tested today. In the meantime, we're actually bringing those specimens down to our Virginia facility. We're actually ... We're going out to California, so this will enable us to be able to satisfy the Massachusetts demand here with this new capacity. Speaker 5: (08:43) Will Massachusetts tests be prioritized here and [inaudible 00:08:46]? Speaker 1: (08:47) Yes, we're actually working with local hospitals on upgraded delivery systems throughout the state. Boston, Worcester and Springfield, and we're working them of how they get their cap capacity fulfilled and also other holes that might be coming in from the state. And obviously what we want to do is to be able to optimize turnaround time for the whole country, and in, in that respect, clearly Massachusetts has the same objective. Speaker 6: (09:11) So what is the turnaround time [inaudible 00:09:12]? For the tests for Massachusetts residents that will be processed here, what turnaround are they looking at? Speaker 1: (09:18) Well, right now we're saying it's three to four days. Okay? It's all very dependent on demand and us bringing up that capacity. So we hope to bring that number down, but it's very dependent upon the demand and where there might be peak loads in that demand. Speaker 7: (09:31) How much does it cost for you to develop the tests and how much are you charging for it? And for the governor or the secretary, today what's the capacity for it? What's the daily capacity? Speaker 1: (09:39) Yeah. Well, first of all we never ... Frankly we haven't added up what it costs us to develop it, but it was millions of dollars within a short period of time with our existing MD PhDs, which worked primarily in California for us. Second is, in terms of the cost issue to Americans, it's zero out of pocket costs, whether you're in commercial insurance systems or you're part of Medicare and Medicaid. Speaker 5: (10:04) What's the daily testing? Mary Lou Sudders: (10:09) Let me just ... So there is no charge, I'm going to look up that number for you. There is no charge for Medicaid recipients for testing. I want to be very clear about that. Medicaid pays. There's no charge to individuals who have Medicaid for testing. And as you know, the governor put out an executive order around copays and the like around testing for and treatment of COVID 19. So I remind people to go back to that bulletin we put out which covers commercial ... The group insurance in Massachusetts as well as Medicaid. But I want to be clear, there's no charge for testing for people who are on the Medicaid program, which is about 1.8 million people in Massachusetts. And I'm going to get you that number. Speaker 7: (10:51) Secretary, [inaudible 00:10:54] next week per day. If you combine that with other labs and what the state lab is doing. Do you have any idea of [inaudible 00:11:08]? Mary Lou Sudders: (11:07) So we're hoping by the beginning of the week that we would have capacity. So I didn't even count Steve's number. So we're hoping by the beginning of the week to have about 3,500, the ability to test 3,500 a day in Massachusetts. Between the state lab, commercial labs, Broad Institute coming online beginning of the week and others, which would be a good place ... Would be a good place to build from in our state. Speaker 5: (11:31) What's the overall goal, would you say? What's the overall goal of what you'd like to test per day? Mary Lou Sudders: (11:36) So honestly, as much testing as possible. If I go back to where we were in February and where we had only ... The day before, February 28th we only had the CDC. The fact that we have the CDC, the state lab has now doubled its capacity. Commercial labs available us, commercial lab now being able to test in Massachusetts, Broad Institute coming online Monday, Tuesday at the latest. A number of what I'd call smaller regional labs that would be like 200, 400 capacity. Honestly, my answer to you is as much testing capacity. So the ... I don't have a goal because I don't want to limit. Speaker 6: (12:14) How many [inaudible 00:12:14] per day? Do you know? Mary Lou Sudders: (12:19) So looking at what Korea did, and so I'm just using Korea as one benchmark. The minimal we'd want to be doing a day is 3,500 a day. If you just use their demographics, our demographics, which not the most precise estimate, but that would be a reasonable place to be. Speaker 6: (12:36) New York's tested 75,000 in the last 24 hours. Why is Massachusetts not operating at that level? When we had our first positive many days before them. Mary Lou Sudders: (12:47) So if you look ... So New York state had a ... The guidance that came out last Friday from the federal government might have been Thursday, Friday, that allows States to now basically take on some of the responsibility of the FDA for approval of labs. So in New York state, New York state had a special ... Their New York state lab was actually deemed, for a very long time, a special lab to CMS. So they had a very special status. They were actually able to basically do FDA approval of labs in Massachusetts that now we have the ability to do, so we ... New York, New York, New York. Speaker 7: (13:29) Some healthcare providers, [inaudible 00:00:13:32]. Charlie Baker: (13:38) You should speak to the quest piece. Speaker 1: (13:39) Yeah, sure. So, so we've actually shipped out, and this is Quest Diagnostics nationally, close to 300,000 supplies in the last couple of weeks. So a lot of supplies, more than the test has been done in this country. The issue we have is lining up those supplies and those inventories where the testing is happening. We're bringing in more of those supplies and so we are right in the middle of trying to make sure that when we hear the demand and the shortages, we can supply the supplies, and also considering moving, taking some of that inventory for existing physicians in hospital systems where they don't have the demand and moving into those hotspots. So we're real time managing that. Speaker 8: (14:26) [inaudible 00:14:26] that this was a really big deal, and the federal government didn't come out. Charlie Baker: (14:34) Okay. I'm not familiar ... I was walking around the lab here. So yeah, sometimes I do. Yeah. Speaker 5: (14:43) [inaudible 00:14:43] in which you told them big deal businesses will be shut down, essentially what is happening now. Three weeks ago, [inaudible 00:00:14:55]. Charlie Baker: (14:56) Look, I think the biggest problem we've got in dealing with all of this is getting far enough ahead to believe that we have the capacity to play a proactive game here. And a big part of the pivots that labs like Quest are making, the approval processes that we've been able to get out of the feds with respect to our own state lab and academic medical center labs here in places like the Broad are part of what we need to do to get to the point where we're doing, as as the secretary said, if you think about this on a per capita basis and you try and compare what South Korea has been up to, we need to get to at least 3,500 a day. But even once you get to 3,500 a day, you have a whole series of other issues you have to start to deal with and respond to. Charlie Baker: (15:47) Some of which have to do with PPE, personal protective equipment. I think every governor in the United States has been banging on the door of the federal government with respect to the stockpile. We certainly have, and we're going to continue to. Getting the supply chain running with respect to that, so that we have the ability to be sure that even once the stockpile is dealt with, there's a supply chain there with a regular distribution of additional gear is going to be critically important, not just for Massachusetts providers, but for providers all over the country and for first responders and others. Putting together the bed capacity that's going to be necessary to deal with the increase in what we all believe will be people who need to be hospitalized associated with this. I mean, these are all the things that we stood the command center up to chase and try and compress the timeframes around. Look, I fully believe that we in Massachusetts are doing the things we need to do to catch up, but there's no question that the federal government has a lot of catching up to do as well. Speaker 9: (16:55) Last question. Speaker 10: (16:56) [inaudible 00:16:56] have that personal protection equipment. The CDC is advising people to use scarves or bandanas as a last resort. Is that something that- Charlie Baker: (17:08) For practitioners or for individuals like? Speaker 10: (17:09) Anything treating COVID 19. Is that something that we have here in Massachusetts, or- Charlie Baker: (17:14) I haven't had that conversation with you, so not at this time. No. Speaker 6: (17:25) [inaudible 00:17:25] if the Celtics were able to be tested and there's been such a shortage of test, who's being prioritized for tests? Charlie Baker: (17:30) Well, I can't speak to the Celtics issue, but I can tell you that the prioritization ... Well, you should tell him what the prioritization is. Mary Lou Sudders: (17:38) so the prioritization is frontline healthcare workers and first responders are obviously the very first individuals. Then it's individuals who are hospitalized and sick, to determine whether they have upper respiratory illness COVID 19. Those are really like our priority ... As we prioritize, those are the prioritization Speaker 9: (17:59) Thanks everyone. Speaker 5: (18:01) What's your daily capacity today in [inaudible 00:18:03? Mary Lou Sudders: (18:03) I'm looking them up. Speaker 5: (18:22) Governor, I just have a non-testing question. We've heard from a lot of people who are [inaudible 00:18:23] elderly relatives in their own homes and they can't visit them. Is there anything that your administration is telling nursing homes and elder care facilities that can help with that or any advice for them? Charlie Baker: (18:28) Look, I haven't seen my father in a month. I can't remember the last time I went a month without seeing my dad. But I absolutely believe it is in his best interest for me to give him space. I mean, I'm in my 60s, but I'm a healthy person, and if I were to end up contracting this, I really do believe for me it would be like the flu. But my dad's 91 years old, and the people that he spends most of his days with are, generally speaking, in the same age category that he is in. They are among the most vulnerable people, clearly with respect to this issue, not just here but everywhere. And I think the thing that I've been doing is ... I mean, my dad is not a phone guy and neither am I, but that's become our new ... We're just not. I mean, our typical phone conversation lasts about 30 seconds. I'll be there at five o'clock. Good. See you then. Charlie Baker: (19:31) So we are becoming better at talking to each other and engaging using a device that historically wasn't our preferred way of communicating. I think for ... I mean, my message to anybody who's got family in a longterm care facility, you should know that in Massachusetts people have been incredibly aggressive about putting protocols, policies, and procedures in place to keep those people safe, and it has to be the way it is for their sake. And I get the fact that that means for, for those of us who want to hug our mom or our dad or a family member who's in an assisted living facility or a longterm care facility, that there's a certain anguish during a time like this to not be able to have that physical presence. Charlie Baker: (20:28) But that physical presence for them at this point in time is exactly the wrong thing to do. And I think we just all have to come up with alternative ways of trying to create the connectivity that, for all of us when it comes to our parents and our grandparents, that's so fundamental. And whether it's FaceTime or Skype or phone calls or whatever it might be, we need to give those people space. Because for them, this is a very different issue medically and clinically than it is for most of the rest of us. Speaker 9: (21:10) Thanks everyone. Mary Lou Sudders: (21:10) I will get you. I will [crosstalk 00:21:20].