North Carolina Governor Roy Cooper Briefing Transcript April 28

Roy Cooper: (00:02) We're seeing some leveling and I hope to see more. We know what helps push down these numbers. Social distancing, careful cleaning, and staying home. If we keep working at these, we'll get to where we need to be. Last week, I told you about the budget proposal that we made to the legislature. Today the session starts and they'll work on ways to direct federal dollars to help North Carolina. If done right, we can get more testing, increase healthcare equipment, assistance to those out of work, and other vital things to help our state. Roy Cooper: (00:45) We are enacting our battle plan. Just yesterday, you heard Dr. Cohen talk about the Department of Health and Human Services. They signed a key partnership that advances our efforts to fight COVID-19. The Carolina Community Tracing Collaborative brings two trusted groups in North Carolina that we have a longstanding experience in healthcare, to bring on more contact tracers. Now, contact tracing is critical to our ability to safely ease these restrictions. Think of it like detective work, helping to track down anybody who may have been exposed to a person who tests positive. That's an essential step to containing and isolating those who may carry the disease. The Collaborative has already started recruiting for the 250 positions they will need to fill, and time is of the essence. I appreciate their quick work to stand up this partnership. Roy Cooper: (01:46) I also want to thank another of our key partners today for all of their work, the North Carolina National Guard. Without missing a beat, these 939 men and women that I've activated have been there when we need them, always ready, as their mission explains. Yesterday, our head of the National Guard, General Todd Hunt and I had a call with the United States Secretary of Defense, Mark Esper. We were able to thank him for the partnership we have in North Carolina and particularly for the essential work the National Guard is providing in food supply and logistics. We agreed to continue to work together to keep our military personnel battle ready. Roy Cooper: (02:34) One of the National Guard's first tasks is supporting warehouse logistics. Taking in the supplies when they arrive, and quickly getting them turned around and shipped out to our local partners. They've conducted 242 missions, traveling over 45,000 miles to 77 counties, delivering personal protective equipment to hospitals, medical sites, and other facilities, and we know how bad we need it. General Allen Boyette is leading our food supply chain work group, which meets daily. They're ensuring our grocery stores remain stocked and our food supply remains strong. They're also working with our food banks, delivering over 40,000 meals to school nutrition sites. And we have Army and Air Guard medical personnel ready to assist in the event we need to use the Sand Hills Regional Medical Center as an overflow medical facility. These are just some of the examples of the work of our National Guard. I'm proud of them. I'm grateful for them. And I can rest just a little bit easier knowing that they are always ready when we need them. Roy Cooper: (03:49) As we enter another week of staying at home, I want to think North Carolinians everywhere for following the restrictions, and I want to remind everyone that we can't let our guard down just yet. We grabbed hold of the opportunity to save lives in North Carolina. Every single one of us who's changed our daily life, we've done that together through our own actions. We continue to plan for the days ahead when we ease restrictions and work our way back to a new normal. But for now, stick with it. We can do this. I know it's hard, but it is saving lives. As one Charlotte teacher said that she would virtually write in her students' yearbooks, "Rise up. Move on. You can do it." We can do this, North Carolina. Roy Cooper: (04:47) With me today is our Secretary of Health and Human Services, Dr. Mandy Cohen, our Emergency Management Director, Mike Sprayberry, our Commissioner of Prisons, Todd Ishee, and Assistant Commissioner of Agriculture, Joe Reardon. Monica McGee and Cameron Larson are our sign language interpreters, and behind the scenes Jackie and Yasmin Metivier are our Spanish language interpreters. Dr. Cohen, we'll first recognize you. Dr. Cohen: (05:22) Thank you, sir. This crisis is magnifying cracks that have long existed in our healthcare system, and we ignore them now at our own risk. That is why I wrote a second letter to HHS Secretary Azar today, asking him to support the North Carolina healthcare providers, the doctors, the nurses, hospitals and other clinicians who serve the more than two million people our state covers with our Medicaid program, and the one million North Carolinians who don't have health insurance. Almost $100 billion from the first round of the CARES Act Provider Relief Fund has now been allocated. A lot of money. But it was divided up in a way that greatly advantaged health providers who mostly see patients with private and employer-based health insurance or Medicare, those patients over 65. And it disadvantaged those health providers willing to serve the people most in need, those serving Medicaid and the uninsured. Dr. Cohen: (06:29) The federal government's allocation formula essentially had every patient a provider is seeing, if you see them with private, employer-based insurance, would count twice as much as a Medicaid patient. So, think about that. Twice as much counting for the private employer insurance than Medicaid. That means Medicaid providers will receive substantially less from this relief fund compared to others providing the exact same care to privately insured and Medicare patients. Our safety net providers already operate on the thinnest margins, so they are most at risk of closure due to lost revenue and new costs related to COVID-19. The last thing anyone wants during a public health crisis is fewer providers on the front lines. Dr. Cohen: (07:22) Our essential providers, they're our rural hospitals and other rural providers, they're our pediatricians who serve six out of 10 North Carolinian children who are enrolled in Medicaid or Health Choice. They're our obstetricians who deliver babies across the states. And they're our behavioral health providers. And these ongoing financial strains are exacerbated because North Carolina has not expanded Medicaid. That's the one thing our state could do right now to protect families and put our rural hospitals and provider on strong financial footing. At the federal level, we need to support these critical providers so that many North Carolinians who rely upon them for their health and well being are protected. Dr. Cohen: (08:06) There's still time to get this right. Congress just allocated another $75 billion to this Provider Relief Fund, bringing the total to 175 billion. 30% of those funds, $50 billion, should be targeted to our safety net healthcare providers, who disproportionately serve Medicaid and the uninsured. In addition to requesting this money from the CARES Provider Relief Fund be directed to Medicaid and uninsured providers, I've also asked Secretary Azar to approve our emergency 1115 Medicaid waiver. Such waivers have been approved in prior disasters, and COVID-19 is certainly a disaster. While it would be more fiscally prudent for the state to just expand Medicaid, in its absence we are asking for the federal government to approve a temporary change to- Dr. Cohen: (09:03) ... cover prevention, testing and treatment related to COVID-19 and for the flexibility to create our own provider relief fund to further assist providers in weathering the COVID-19 storm. These actions from the federal government will assist North Carolina in its response to this crisis and I urge federal action quickly. Thank you, governor. Roy Cooper: (09:31) Thank you, Dr. Cohen. And I know a lot of other health and human service secretaries and governors across the country who feel the same way about that, and we'll push it and see what we can get done. We'll now recognize Emergency Management Director, Mike Sprayberry. Mike. Mike Sprayberry: (09:49) Thank you governor and thank you for your leadership. Today is day 50 of the COVID-19 response at the state Emergency Operations center. Under the direction of the White House, coronavirus taskforce, FEMA will begin sending shipments of personal protective equipment to more than 15,000 Medicaid and Medicare certified nursing homes across the nation, including more than 430 in North Carolina. These shipments are intended to supplement the regular supply of personal protective equipment to these facilities. Shipments are expected to begin next week and be completed in mid June. Each facility will receive an allotment of gloves, gowns, eye protection, and surgical masks based on the size of the facility. Mike Sprayberry: (10:41) We're also continuing our procurement of PPE equipment with another $8.2 million in orders yesterday. So far the total of supplies and equipment ordered for the COVID-19 response is about $335 million. Among yesterday's items that we received were several shipments of face shields, along with face masks and soap. We shipped supplies to 14 locations and we received 40 requests for PPE just yesterday. We've received 45 requests for PPE so far today. This week, the human services section here at the state Emergency Operation Center started holding regular county feeding coordinator calls three times per week. These calls are intended to provide feeding strategy support to our local partners to ensure that no one in North Carolina is going hungry. Sharing information and best practices and learning from the experiences of others helps everyone out. Mike Sprayberry: (11:43) Today, the state Emergency Response team is also working at the Sandhills regional medical facility on refining our concept of operations and our patient flow planning. While we may not need to operate this facility, it's important that we have a medical surge contingency plan in place in the event that we need space for non-COVID-19 patients. Sandhills needs to be ramped up and ready to go. We really appreciate our partners in Richmond County, in Hamlet, North Carolina and at FirstHealth for the outstanding support they provided from day one as we've worked to bring the Sandhills facility to the necessary level of operational readiness. Mike Sprayberry: (12:27) In closing, it's important that we all continue to stay at home and practice social distancing per Governor Cooper's executive order. You as an individual have the power to flatten the curve that will enable our state to move ahead with easing restrictions. Always remember to look out for your family, friends and neighbors and to call your loved ones daily. With your help, we will get through this together as one team, one mission and one family. Thank you, governor. Roy Cooper: (13:02) Thank you, Director Sprayberry. We'll now take media questions. If you can state your name and the organization that you represent, we would appreciate it. We'll take our first question. Speaker 1: (13:13) Our first question is from Brian Murphy, News Observer and Charlotte Observer. Brian Murphy: (13:23) Governor, two questions, among the criteria for reopening is extending the testing or the number of tests that are being performed in North Carolina. Can you explain what the current bottleneck or roadblock to getting more testing done in North Carolina is? Is it PPE or sample collection test kits, reagents, the number of people requesting the test? What is stopping us from getting to that number? And then secondly, you had mentioned talking with NASCAR last week and the teams, have you made any decisions about the Coca-Cola 600? Roy Cooper: (13:56) As to the first question, we believe that we're going to reach our goal in the number of tests that we need for the indicators. We're getting more and more testing capability every day, we're getting more and more personal protective equipment, getting more testing capacity with our private labs. Yesterday, I was on a conference call with the governors and the president, and the federal government is going to help us some with testing. I think we realized about a month ago that the states were going to be responsible for getting us where we needed to get and we realized that and have been working on it since that time. We'll take as much federal help as we can possibly get. We want to get our testing up to the point where we can go in and test at job site where an employee is tested positive to go in and test everybody, we want to be able to go in and test everybody at a nursing home when there's a outbreak there and we want to increase the testing all around. It's one of the reasons why we have put up a testing surge group and why we've also set up this collaboration in order to increase the tracing because the testing is important, but we also want to trace people and find out whether they've been in contact with someone who's tested positive to be able to protect people further and allow us to ease restrictions. Roy Cooper: (15:33) Secretary Cohen, would you want to answer any ... On the second part, I have had conversations with NASCAR officials and officials at the Charlotte motor Speedway, and they have submitted plans that involve social distancing. Our public health officials, Secretary Cohen and the state Health Director, Betsy Tilson, have looked at them and made some suggestions, but we'll approve those. And we believe that unless health conditions go down that we can have the Coca Cola 600 on Memorial Day in Charlotte. I think that in Concord is where it would be. I think that NASCAR will be making that announcement, but we believe that's what will happen. Next question please. Speaker 1: (16:35) Olivia Neely, The Wilson Times. Olivia Neely: (16:41) This is Olivia at The Wilson Times. Just following up with the testing, this might be for Dr. Cohen to answer, but the Durham VA team members were out here in Wilson at the state-owned nursing facility here that has the outbreak and they said that they had tested 180 employees today. Is this a part of an ongoing effort? Can you explain maybe why they were there? Roy Cooper: (17:06) Whenever there is an outbreak or whenever there's a positive, we want to get into the nursing homes or any of these congregate care facilities to provide testing to determine what the extent of the problem is and then to be able to separate people who have tested positive from those who haven't, have separate staff looking after people who have tested positive than people who haven't. Dr. Cohen, you may want to talk specifically about that. Dr. Cohen: (17:38) Sure, that was exactly right, governor. And in this case, we have partnered with the VA medical center. They've been terrific partners and are the ones that are helping us surge our testing ability. I think it goes back to the earlier question to say, how can you ramp up testing? It's going to take effort along many, many fronts, not just from getting the right supplies, but also getting the right people in the right place so that we can respond to these kinds of things, like an outbreak- Mandy Cohen: (18:03) ... at a nursing home. This one happens to be us wanting to test at one of our state operated facilities, and we have partners from the VA who are helping us ramp up our ability to do it. In other places, we partner with FQHCs and others. It's the hospital system and others. It's our outpatient provider. So, it's a huge team effort across North Carolina to make sure we have the appropriate testing. That's exactly the work that governor was describing related to the testing work group is to really get that coordination across our state, so we can all partner together to make sure the testing gets done for those who need it. Thank you. Roy Cooper: (18:43) Next question, please. Speaker 3: (18:47) Tresia Bowles, WITN. Tresia Bowles: (18:52) Hi. My question is as far as when it comes to contact tracing, how... Excuse me, is that hiring process going, and basically with the contact tracing, how do we choose these people, and how will this kind of supplement what the health departments are already doing? Roy Cooper: (19:13) Already, there are about 250 people across our states at our health departments that are already in the trenches doing great work on contact tracing, and they've spent a lot of time doing this since this virus has hit North Carolina. This collaboration is going to add 250 people more, and already the word is out that these jobs are open, and we're hoping that they can get on the job very soon, because time is of the essence, and we hope that that process can begin very, very soon, that the additional people can get to work very soon. Would you want to add to that, Dr. Cohen? Mandy Cohen: (20:01) Sure. Thank you. Other than to say that recruiting has already begun, if anyone is interested, they can visit the Community Care of North Carolina site, which is our partner in this contact tracing collaborative. We've already heard from more than a thousand people who've already submitted interest in it, so we're thankful to our North Carolinians who just even in the last 24 hours have already raised their hand to say they wanted to help. Again, we had said yesterday we're going to be prioritizing folks who have become unemployed because of COVID-19 and do have experience working in the field with communities, so Community are of North Carolina is going to be working on vetting and then actually hiring on those folks and then to begin training them and then deploying them out to our local health departments. Thank you. Roy Cooper: (20:52) When we get this going well, that's going to allow us to ease these restriction, because we get this testing and tracing humming along, which is what we want to do. Then that means we can be better protected as we ease restrictions across the state and go through these phases. Next question please. Speaker 3: (21:14) Travis Fain, WRAL. Travis Fain: (21:18) Thank you. This is Travis Fang with WRAL. I wondered, the modeling that [inaudible 00:21:23] and some other entities put out through the state a few weeks ago. Has that been updated, and if so, when will we see that new modeling? And what exactly will it be based on? Roy Cooper: (21:36) One of the things about modeling that I think is important is that we can affect what the modeling shows by obeying these restrictions and social distancing and staying home, so that's an important part of showing us what's coming. Another important thing is that the indicators that we have put forth, I think, are very specific and those are real numbers on a day to day basis, like numbers of cases, like percentage of positive cases, like hospitalizations, like pre COVID symptoms. Those kinds of things are solid numbers that we are looking at, and those are the things we're looking at regarding making decisions about going into next phases, but I'll let Dr. Cohen address that as well. Mandy Cohen: (22:32) Thank you. Thanks, Travis, for the question and yes, this independent group of modelers has been working, again, in coordination with us, but they had been working independently. My understanding is they're going to be putting out another brief even as of today, possibly this afternoon or first thing tomorrow. And again, just to reiterate where the governor was, that modeling is not some of the information that we are using in terms of moving to reopening. It does help us for planning purposes, and I think has been helpful as we think about the kinds of things that our hospitals need to do, in particular in thinking about our surge planning. Luckily, we haven't needed to use those plans, but I think it's been helpful for us to do the kinds of surge planning that our hospitals have been able to do, and now we are going to keep those plans activated, so as we move through these phases, we can make sure that we have the medical capacity we need. Thank you. Roy Cooper: (23:31) Thanks. Next question, please. Speaker 3: (23:35) Jonathan Drew, Associated Press. Jonathan Drew: (23:40) Hi, this is Jonathan Drew with the Associated Press. Governor Cooper, the Reopen NC protesters were out there again today. What's your reaction to their notion that your reopening plan isn't moving fast enough? Thank you. Roy Cooper: (23:54) I understand that people are eager to ease these restrictions. I know it's frustrating to be at home so much. I also know and have talked to many business owners and people who are out of work. A lot of families are hanging by a thread, and this is one of the reasons that we're pushing out unemployment payments and pushing out stimulus money, trying to get money to small businesses because the thing we have to put first and foremost is the public health and safety of North Carolinians, and we have to make sure that things are safe. I'm very eager to move into our phases of reopening, and we have a way to look at the indicators to tell us how fast we're going to get there. And I hope that we move through these as quickly as possible, but we're going to rely on the science. We're going to rely on the data and we're going to rely on the facts in order to make decisions about moving forward, and we're going to involve our business community in helping us make decisions about how we do that so that they can be the most effective while we can also be effective at keeping people safe. Thanks. Next question, please. Speaker 3: (25:18) Elizabeth Anne Brown, Asheville Citizen Times. Elizabeth Anne Brown: (25:24) Hello, Governor. Elizabeth Anne Brown from the Asheville Citizen Times newspaper. I am hoping to get some clarity about the deaths that are reported every day. What are the requirements? Since there have been some persistent rumors on social media that these are suspected deaths. They're not confirmed related to COVID-19. What is required to add a death to that tally, and are y'all considering adding the dates the deaths occurred to the state tally? Mandy Cohen: (25:55) Thanks for that question, and I just want to triple confirm with our team to make sure I get this right, but those deaths are determined by our medical examiners. Most of them are folks who had been found to be COVID-19 positive before their passing. But let us get back to you with the specifics of how are our deaths are recorded and are attributed to COVID-19 versus not. We've got that question a couple of times, and I don't want to get that wrong for you, so we'll follow back up. Thank you. Roy Cooper: (26:28) Thank you. Next question, please. Speaker 3: (26:33) Matt Debnam, Washington Daily News. Matt Debnam: (26:37) Good afternoon, Governor. My question for you today is what are your thoughts on potentially granting local governments additional flexibility to safely ease some restrictions at their own pace? Thank you. Roy Cooper: (26:49) Thanks. We know that this virus does not respect county lines. There are people who live in one county, work in another county, shop in yet another county, and when that happens, the virus- Roy Cooper: (27:03) ... can spread from county to county. We know that there have been some hotspots, for lack of a better word, in our state and some local governments have wanted to go further than the orders that I put in place on a statewide basis, but we're going to continue with having the state have a floor with some counties and some cities being able to have more restrictions than that. We'll still leave open the potential of looking at regional reopening if the data shows us that going forward. Right now we're not there yet. Hopefully by May 8th we can begin going into phase one if the numbers tell us that we can do that, but we'll continue to look at the potential of regional phases and we've gotten some input on that from across the state. Thanks. Next question please. Speaker 4: (28:11) Ginger Livingston, The Daily Reflector. Ginger Livingston: (28:15) Hi governor, this is Ginger Livingston with daily reflector. I would like to get your reaction to Cartaret County, Atlantic Beach making decisions to start opening their beaches to the public before May 8th. Roy Cooper: (28:34) I think that local governments do have the authority to do that. It's my understanding that some of these local communities are opening beaches more than they were, but are putting some restrictions and the people who can be on the beach and the kinds of things that they can do. We would encourage these local communities to do things that encourage people to keep moving, encourage people to be socially distant, and we have been on the phone with a lot of our municipalities and our public health people work with theirs and we'll continue to talk about that, but that is something that they can do and some of them have done, but they're doing that on a gradual basis. Thanks. Next question please. Speaker 4: (29:31) Kate Martin, Carolina Public Press. Kate Martin: (29:35) Good afternoon governor. This is Kate Martin with Carolina Public Press. I'm wondering which areas of the state are most in need of contact tracers? I know some counties are saying that they've got enough for the effort up ahead, but I'm wondering if there's anything like an urban or rural divide and that sort of thing. Thank you. Mandy Cohen: (29:54) Hi Kate. It's Mandy Cohen. Thanks for that question. It's a mix. There are certain that are our smaller counties but may have a hotspot due to either a nursing home outbreak or other that they're responding to so it stretches their resource and then they need some extra help. Or in some of our urban centers there's just more people more work. Mandy Cohen: (30:13) So it's a bit of a mix. We have surveyed our public health leadership and ask them and the good news is most of them have said they're doing quite well to handle what the work that there is. But we know that things are going to ramp up because as we know, if we loosen things, we may have more spread of the virus and we want to make sure that we're able to jump on that very quickly as the governor mentioned. Mandy Cohen: (30:36) So that's why we're bringing on this new additional workforce that the local health departments can request. We can deploy it and then they can work side by side with folks who have been doing the contact tracing in these communities. And again, it helps us build up that workforce over a period of time. Thank you. Roy Cooper: (30:57) Thank you. Next question please. Speaker 4: (31:01) This will be our final question. Cole Delcharco, WUNC. Cole Delcharco: (31:08) Hi, thanks for taking my question. I'd like to direct this question to Director Sprayberry. Despite the tallies you keep giving us on PPE numbers that the state continues to get and that we're getting more and more PPE, we still don't have information on who's requesting the PPE and who's getting it from the state. I wonder if you could share a little bit about that. Director Sprayberry: (31:34) So the way that it's been working is we get requests from our eight healthcare preparedness coalitions which make up our 124 hospitals. We also get requests for PPE from our counties and it goes two different directions. The ones going from the healthcare preparedness coalitions and the longterm care facilities come up through our office of emergency medical services that's co-located with us here at the EOC, and the request for PPE coming in from the counties comes to us right here at emergency management. Director Sprayberry: (32:15) So what we do is we have a prioritization list and of course we're going to prioritize PPE going out to the more acute patients at the hospitals in the longterm care facilities. But we are also able to provide some PPE to our county partners as we get more and more and the supply lines are loosening up. We've also been receiving information that our private sector partners are providing some level of support of PPE to our counties and hospitals as well. So it's hard to get oversight of all of that, but we know that that's coming in as well in some pretty good quantities. And so between the amount that we're getting, purchasing, and between what the local partners at the hospitals and at the county level are purchasing, we're beginning to make somewhat of a dent in our need, but we still have a long way to go. Thank you. Roy Cooper: (33:20) Thanks everybody for tuning in today. Please stay safe. Stay at home if you can and I will see you next time. Speaker 5: (33:30) You've been listening live to Governor Cooper there and state emergency officials on COVID-19 response in North Carolina. Today we have 9,568 positive cases in 96 of 100 counties, 342 deaths and 463 are hospitalized today. The governor there talking a lot about the budget that he proposed last week. This as state legislators returned to work today and they are debating that 1.4 billion dollars in emergency spending plan to help small businesses and expand COVID-19 testing and contact tracing. So the governor did talk about the importance of those contact tracers in North Carolina and how they are going to be critical to easing restrictions across the state. Speaker 5: (34:14) Of course, yesterday they announced the Carolina community collaborative with 250 new contact tracers that they are looking to hire to get that in motion. The governor said that we are seeing some leveling. We continue to see some leveling, but we need to see more to continue to work to open up, and we should not let our guard down. We of course will have a full wrap up of all the day's news today, including some of those folks who were protesting again for reopen NC, they encountered counter-