Oregon Governor Kate Brown COVID-19 Press Conference Transcript November 13: Announces "Two-Week Freeze"

Dr. Dean Sidelinger: (00:00) The opportunity to talk about the logistics for today's press conference. As many of you know, OHA recommends that when indoors with people who are not members of your household that you should wear a face covering. However, today we are taking off our face coverings when speaking so we can communicate with people who do not speak sign language and depend on seeing a speaker's mouth and lips. The speakers are nine feet apart. The ASL interpreters are seven feet from the speakers and 11 feet apart from each other. We have also recently upgraded the air filtration system in the building, and we have limited the number of people in this room. Thank you, Governor Brown. Kate Brown: (00:39) Thank you, Dr. Sidelinger. Good afternoon, and thank you all for joining us today. We're here to give you an urgent update on the COVID-19 crisis sweeping the entire state of Oregon. I'm joined by Dr. Dean Sidelinger, our state epidemiologist; Dr. Dana Hargunani, the chief medical officer from the Oregon Health Authority; Dr. Renee Edwards, the chief medical officer at Oregon Health Sciences University; and Dr. Esther Choo, emergency physician and professor at OHSU. Kate Brown: (01:14) One week ago, I announced a two-week pause on social activities to slow the spread of COVID-19 in several of our counties across the state. Unfortunately, since then, we've seen an alarming spike in both cases and COVID-19 hospitalizations. Today, we topple 1,000 cases again. The majority of these cases stem from sporadic community spread, which means the virus is out there. It is out there lurking amongst us, both visible and not. Every day, it's infecting more and more Oregonians who think they are safely seeing their friends and their family members. It's a very dangerous situation. Kate Brown: (02:02) Our hospitals have been sounding the alarm. In the Portland metropolitan area, hospitals are expecting an influx of COVID-19 patients. Several hospitals across the state have voluntarily begun to reduce some surgeries, to preserve both hospital beds and staff capacity. However, this isn't just about COVID-19 patients. The next time you need medical care, the last thing you want to hear is that the ambulance has no place to go. It's certainly not happening just in Oregon. The dreaded winter surge is here. Infection records are being set in states across the entire country. This means we cannot look to other states to share their staffing and hospital beds because they, too, are experiencing the surge. Kate Brown: (02:59) Whether we like it or not, we're about to face what might be the roughest days of the pandemic. If we want to give Oregonians a fighting chance, we must take further measures to flatten the curve now. That's why I'm announcing a two-week freeze for the entire state beginning Wednesday, November 18th. The two-week freeze includes limiting restaurants to takeout-only; limiting retail, grocery stores, and pharmacies to 75% capacity, and strongly encouraging curbside pickup; closing gyms and fitness organizations, as well as venues that host either indoor or outdoor events; limiting churches and other faith venues to a maximum of 25 people indoors or 50 outdoors; and requiring remote work if at all possible for all businesses across the entire state. Kate Brown: (04:09) I'm also asking Oregonians to wear a mask at all times, except when eating and drinking, whether you are indoors or outdoors. The evidence is very, very clear that masks save lives. Kate Brown: (04:25) This is in addition to the travel advisory I issued this morning alongside California Governor Gavin Newsom and Washington Governor Jay Inslee. We recommend that those who have traveled out of state self-quarantine for 14 days upon return. Kate Brown: (04:47) One more key item for the two-week freeze. It's about social get-togethers, which are limited to two households or a maximum of six people. I know there's a lot of confusion on what this means, so let me be very, very clear. This means you should only socialize with one other household. For those of you who live alone, choose up to five people total to socialize with for the next two weeks, and that's it. Then when you are together, whether indoors or outdoors, you must still practice all the public health measures we've been drilling for the past eight months, physically distance, wear a mask, and wash your hands. Kate Brown: (05:39) Unfortunately, Thanksgiving is going to fall within this two-week freeze time frame, so let me give you an example about what an in-person holiday should look like under these guidelines. Dan, myself, and our new puppy, Jory, will invite over one other household. For us, that's Dan's daughter and her fiance. There, we'll have them come for dinner. Ideally, we'll eat outside, but obviously if our beautiful Oregon weather delivers its typical November weather, it's likely to be raining, so we may choose to eat inside. We will all physically distance and wear our masks, except when eating and drinking. Hopefully, we'll be able to Zoom with my mom and sisters and brothers, and Dan's mom and his family members too. I know it doesn't look like the Thanksgiving holiday we've all been planning for weeks, and I know it's really, really hard, but unfortunately it's a necessity right now. Kate Brown: (06:44) The freeze is for two weeks statewide, starting on Wednesday, November 18th, through Wednesday, December 2nd. Businesses should start to be in compliance by this coming Wednesday, and individuals should start to be in compliance right now. After the two weeks, we will reassess the progress we've made and what measures may still be necessary. Kate Brown: (07:14) Given the data and modeling we're seeing, my public health experts tell me that some counties will need longer to flatten the curve and slow the transmission of the virus. I want to be very clear that there are some COVID-19 hotspot counties that are likely to stay in the freeze for much longer than two weeks. Multnomah County, for example, will be in this freeze for at least four weeks. I want to be honest about that now. Be prepared. Kate Brown: (07:53) Our actions right now, no matter where in the state you live, are absolutely critical. If this all sounds familiar to our Stay Home, Save Lives order I issued back in March, that's because it is. The cycle of this virus is such that we are seeing case rates topping 1,000 per day now, and that means our hospitals are headed for some very dark days ahead. Actions taken now will prevent lives from being lost, not just from COVID-19, but frankly, from other diseases or accidents that lead people to get hospital-level care, which they won't be able to get if our beds are full of COVID-19 patients. Kate Brown: (08:43) But before you panic over the thoughts of another stay home order, let me tell you what we're doing differently this time. Number one, personal service providers, including physical therapy, chiropractors, and medical spas, will remain open with the very strict guidelines that we have in place. This is an area where we've seen very limited spread of the virus, and it's often vital to our health needs. We strongly encourage outdoor recreation and camping; and as such, our parks and playgrounds are staying open. Breathing fresh, if not chilly, air will help every single one of us. Schools that meet the metrics will stay open. With much limited capacity, our faith-based gatherings may stay open as well. Childcare remains open. And with restaurants continuing takeout service and retail at 75% capacity, I can't underscore enough how important it is to continue to support our local businesses, whether it's Annie Bloom's Books or Thinker Toys. Not only will it help them, it helps us all remain a sense of normalcy. Kate Brown: (10:07) While the social get-togethers are limited to two households or six people, lean on those people you choose to intermingle with, and stay connected to your family and friends that you love via video conferencing or by phone. I know it's hard and I know everybody is weary, but we are trying to stop this ferocious virus from spreading even more quickly and far wide and to save lives. In Oregon, we can do this. We've done it before. We can do it again. With that, I'm going to turn it over to Dr. Dean's Sidelinger. Dr. Dean Sidelinger: (10:47) Thank you, Governor Brown. As the state's health officer, I'm here to deliver a simple message. COVID-19 is raging across Oregon. The virus is spreading fast and threatens to overwhelm our hospitals across the state with severely ill patients if we all don't act now. Dr. Dean Sidelinger: (11:07) The two-week freeze Governor Brown just announced will put an urgently needed brake on COVID-19's accelerating momentum and help us bring the virus back under control. These actions can work if we all follow them. Think of the freeze like a firebreak that crews dig to slow a wildfire. These temporary limitations on our normal social, commercial, and recreational activities deprive COVID-19 of the needed fuel it needs to spread, people working, socializing, dining, and exercising indoors in close proximity to each other. Right now, the fire is all around us, and it threatens the people we hold most dear. In some places, the fire is burning even hotter, and we may need a wider firebreak, as Governor Brown said, maybe four weeks or longer. But no matter our location, we're all on the line fighting this fire together. Dr. Dean Sidelinger: (12:05) I know this brings hardship, isolation, and limitation at a time when we're looking forward to celebrations, but the risks are too high to shut our eyes to the escalating crisis, and so are the stakes for all Oregonians. So let me provide an update on the situation in Oregon and the latest projection of how the virus will spread if we leave it unchecked. Today, we're announcing 1,076 new cases of COVID-19 in Oregon and, sadly, seven additional deaths. That brings our cumulative total to 54,937 cases of COVID-19 across our state, with our death toll now at 753. Our deepest sympathy goes out to the families who've lost a loved one to the disease, the Oregonians who've lost their lives, our neighbors, colleagues, and friends. We note each death with sadness and a renewed effort to control this virus. The virus has impacted all of us, and we grieve together. Dr. Dean Sidelinger: (13:08) COVID-19 is spreading at an escalating and alarming rate. Last week, we saw 5,177 new cases of COVID-19, a 46% increase over the previous record high of just over 3,500 cases the week prior. I am also saddened to tell you that the virus claimed 42 lives last week, a record high for us here in Oregon, and we mourn every death. The percent of positive cases also jumped to a record high of 11.9%, more evidence that the virus is running rampant in our community. Dr. Dean Sidelinger: (13:44) So what's causing this spread? In two words, social gatherings. Our case investigations have linked a significant portion of cases to our social get-togethers where people spend time with each other, often without masks, often not keeping our distance or taking other precautions. Let me tell you about a couple recent examples, two Halloween parties. One party had over 50 people in attendance. 10 of those people have since been diagnosed with COVID-19, and we're still investigating whether more of the party attendees will turn up positive. Another Halloween party, smaller in scope, involved members of several different households, with six people subsequently testing positive who attended the party, and we're following up on an additional 25 cases that have arisen from this outbreak. So two social gatherings, one large, the other small, but the result of each was the same, a new round of infections in people's families and spread to other people, including their workplaces, once they've left the party. Dr. Dean Sidelinger: (14:47) These skyrocketing cases are even compromising our ability to conduct case investigations and contact tracing on the same level we were just a month ago. On a temporary basis, we've notified counties that can prioritize high-risk contacts and scale back the extent of the interviews and length of time they monitor people who have been exposed in response to the surge. If someone tells you you've been exposed, if you are waiting for the results of a test, or if you test positive, stay home so that you don't risk impacting others. Don't wait for a call from Public Health. Dr. Dean Sidelinger: (15:19) Our public health system in Oregon is strong, but it can't keep up with the huge increase in cases. It's not a failure of our public health workers. Public health investigation, contact tracing, isolation, and quarantine are only some of the tools that we have to use. These tools do not work as well when cases increase dramatically. They can't stop a virus when there are large numbers of people who don't have symptoms and never come to our attention. When people continue to get together in large groups with many people outside their households, that fuels the spread. That is why we use different tools to respond to COVID-19 in different situations. Governor Brown's announcement today gives us heavier and sharper tools to continue the fight. While it's true many people recover quickly, others, sadly, do not. Dr. Dean Sidelinger: (16:03) And while it's true many people recover quickly, others sadly do not and some will suffer with the symptoms of COVID-19 for weeks, if not months. Many people will wind up in the hospital. This in turn can overwhelm our healthcare system. Today, the situation facing Oregon hospitals is looking increasingly grim and COVID-19 hospitalizations have increased nearly 50% in the past week and over 100% in the last month with the Portland Metro area hospitals especially facing a constraint. As Governor Brown said, they began to take steps to limit elected procedures to try and spare capacity. As of 3:30 yesterday afternoon, there were only 15 staffed ICU beds available to accept any patients in the metro region, the lowest level we've seen in response to this pandemic. Dr. Dean Sidelinger: (16:46) Other regions are facing similar urgency, even if their capacities are not as high. And we expect that will change in the coming weeks with increased cases. Because hospitalizations are a lagging indicator, today's hospitalizations reflect the cases from one to two weeks ago when our case counts were significantly lower. So if the cases continue to rise, you will continue to see a rise in people needing to be hospitalized. Dr. Dean Sidelinger: (17:12) Between September and October, the rate of COVID-19 transmission in Oregon was less than one, meaning each person was infected gave it on average to less than one other person. But the situation has changed. Cases spiked at the national level and many Oregonians were displaced by wildfires and more people started gathering indoors as the weather changed. Now we estimate our infection rate is closer to 1.5, meaning that per each person infected, they infect more than one other person, thus allowing cases to surge as they are. At our present rate, we expect we would see over 1500 new confirmed cases per day within the next month. New cases would have terrible consequences. More would go to the hospital and more may even die. And these numbers are likely conservative because they're based on numbers that were pulled a week ago in our model. Dr. Dean Sidelinger: (18:02) But we can keep that forecast from becoming a reality. The model tells us we can bend the curve back down to where we were in mid-October where the virus spreads less to one person. And by mid-December, if we take all those precautions, we will be in a much better place. Dr. Dean Sidelinger: (18:19) Across Oregon, COVID is our common enemy. In communities across the state, it's stolen lives and livelihoods. It's closed businesses, schools, houses of worship. It's fragmented families and separated friends. It's disrupted every part of our lives and it's even disrupted our peace of mind. We fought COVID-19 early. We've had lower case rates and death rates than most other states. And maybe we thought the fight was over, but it's not. This is likely the most dangerous time here in Oregon. We have never faced the possibility that our hospitals could be overwhelmed across the state and that people might not be able to access high quality care that we all deserve. That's the grim prospect we're facing today. Dr. Dean Sidelinger: (19:06) I know we're all tired. We all want life to go back to normal. But we can't give in. We can't pretend that COVID-19 is going away on its own. We can't surrender the hopeless belief that we're helpless to stop it. We've beaten it back before and we will do it again if we work together, adhere to the freeze, and stay true to the basics of COVID-19 precautions. Keep your distance, wear your face covering, avoid groups and wash your hands. Dr. Dean Sidelinger: (19:36) And this time there's growing hope to help us hold out longer. We have new treatments that are increasing survival rates. The first vaccine has showed efficacy, meaning that it works, and it could be available for those at high risk by the end of the year. But we have to keep our guard up until safe and effective vaccines are widely distributed and enough Oregonians are protected so we don't have to continue to impose stringent physical distancing measures again. Dr. Dean Sidelinger: (20:01) So let me turn it back over to Governor Brown. Kate Brown: (20:04) Thank you. Dr. Edwards? Dr. Renee Edwards: (20:08) Good afternoon, everyone. I'm Dr. Renee Edwards and I'm the chief medical officer for OHSU Health. Thank you for the privilege of being with you again today. Dr. Renee Edwards: (20:18) Governor Brown has laid out a difficult to hear, but necessary, stay at home order for Oregonians today. OHSU strongly supports taking these actions to protect the health and safety of Oregonians, especially the patients who need the specialized care only available through our hospitals and intensive care units. Both Governor Brown and Dr. Sidelinger have laid out the record setting number of cases that we saw yesterday and again today. And we know that slightly less than 20% of these Oregonians diagnosed today with COVID-19 will become ill enough to require hospitalization in the next two to three weeks. Some will die, increasing the number of souls tragically lost because of this pandemic. Dr. Renee Edwards: (21:14) As a state, we are now on the exponential upward slope that has been seen in COVID-19 surges around the country and around the world. Unfortunately, some of the social gatherings that we most enjoy together, such as Halloween and birthday parties, group activities and meals, continue to be the greatest source of transmission. Our experts warned that we would see a fall or winter surge as we moved our outdoor activities indoors. And that's why it's imperative that everyone follows the governor's order to now stay home and save lives. Dr. Renee Edwards: (21:56) I want to with you what we are seeing as the current and very real effects of this surge of COVID-19 on Oregon's hospitals. We have four ICUs at OHSU and all are operating at greater than 90% capacity. This means that we have limited additional ICU beds available. You might be thinking that we don't have that many people with COVID-19 in the ICU in our state. But what we have to remember is that our medical and nursing teams care for many critically ill patients with conditions other than COVID-19, and it's imperative that we reduce the number of Oregonians falling ill with COVID-19 so that we can have sufficient beds, staffing, resources, and supplies to care for everyone who needs us. Dr. Renee Edwards: (22:54) OHSU is not alone in this struggle. Every intensive care unit in the Portland metro area is either full or nearly full, as Dr. Sidelinger noted. And the demand for additional staffing currently outweighs the supply. Hospitals and health systems statewide are seeing equal or greater number of patients sick with COVID-19 and facing similar capacity and workforce challenges. Dr. Renee Edwards: (23:23) At OHSU, we've spent a lot of time contingency planning for a large surge of patients with COVID-19, both in our inpatient and outpatient areas. But these plans were meant to be a last resort. Ultimately, we and every hospital and health system in the state are at risk of moving further through our surge plans in order to care for the many patients that are now coming through our doors. Our dedicated frontline healthcare workers continue to risk their lives to care for every patient who needs them, but we are perilously close to overwhelming them. Like many of us, they're tired, frustrated, and grieving. And I want to thank each and every one of them for their dedicated work on behalf of all of us. They continue to do everything in their power to provide the best possible care amid tough circumstances. So please do everything in your power to slow the transmission of this virus by staying at home, to stay safe and prevent additional Oregonians from becoming ill. Dr. Renee Edwards: (24:36) This has been an extraordinarily difficult year, and we're all weary of the many demands that this pandemic has placed upon us. Many times I and other healthcare providers have stood here and thanked you for following the safety measures that have been laid out by our public health officials. I'm proud to live in a state that has been considered a high performer in combating COVID-19. As Oregonians demonstrated last spring, it's absolutely within our means to protect ourselves and others from becoming gravely ill with COVID-19. Dr. Renee Edwards: (25:16) People of all ages are at risk of COVID-19. No one is immune and there is currently no cure. Some of us will become sicker than others. And some of us have COVID-19 and don't even know it. That's why it's critically important that we all stay home and minimize activities. If we must go out, please practice the safety measures that have previously proven successful in protecting you and others. Wear a mask, stay six feet apart, and wash your hands frequently. Dr. Renee Edwards: (25:52) The pandemic has taught us that the safety and resilience of our community is reliant on the individual choices of its members. We all have an immense impact on one another and together we can flatten the curve again. Thank you for doing your part and allowing me to speak with you again today. And I am going to turn my spot over to Dr. Esther Choo. Dr. Esther Choo: (26:28) Thank you, Governor and Dr. Sidelinger and Dr. Edwards. My name is Esther Choo. I'm an emergency medicine physician and a professor at Oregon Health And Science University. I want to start by acknowledging that this has been such a hard year. Everyone is under strain from financial and housing and health and schooling stresses. It is so hard to ask all of you this again, and I sincerely wish that I didn't have to. But as an ER physician, I hope to provide at least some context for how your sacrifices directly save lives. And I think I can speak on behalf of the very large and dedicated group of doctors and nurses and advanced practice providers and respiratory therapists, and many other frontline healthcare workers who have tended to patients throughout the course of this pandemic. Dr. Esther Choo: (27:23) For healthcare workers on the front lines, staying home to save lives is much more than just a slogan. For me, it means safety for my colleagues in the hospital and for the families we go home to. In my case, my husband and our four young children. For my patients, it means high quality care in the controlled setting of a well supplied and fully staffed hospital, a resource that we've managed to maintain to this point in Oregon. The alternative and what we desperately want to avoid is the overcrowded and overwhelmed and under protected health systems that we've seen across the country and around the world. The difference between those two circumstances is quite literally life and death. Dr. Esther Choo: (28:11) We are so grateful for all of your personal and economic sacrifices across Oregon earlier this spring. I want to be really clear that your economic prosperity is a critical part of your health. They are part of our concern and our calculus as well. But by staying home in the spring, Oregonians slowed the virus and ensured that everyone who needed care received it. By staying home, Oregonians allowed me and healthcare workers across the state to conserve personal protective equipment, that PPE that's been in such maddeningly short supply, even now almost a year into the pandemic. By staying home, you kept Oregon's hospitals and clinics from being overwhelmed beyond our capacity to effectively treat all Oregonians who needed our care. You did this. Dr. Esther Choo: (29:05) Healthcare workers are so appreciative and we care deeply about the welfare of our patients and our communities. It's true that we're learning more about how to treat the disease. We're having a lot of successes. But we have also seen firsthand that failing to stay home continues to cost the lives of Oregonians, our neighbors, our friends, and our families. The really heartbreaking thing about the nature of this disease is that when people come into the hospital, they're isolated, right when they need support and company and love the most. It has been really hard for me to see people in the hospital isolated and alone like that. Dr. Esther Choo: (29:54) I'm sorry. Many of you cheered and rang bells and put up signs calling us heroes. And we're so grateful for that. Right now, we're asking you to be our heroes and to listen to our call for help again. We have the opportunity now to save hundreds or thousands of Oregon families from any more of these painful last goodbyes. The way that we will get through the winter is safe and healthy and strong is by pulling together and going all in against this virus right now. Now is the time to double down on the only, truly effective measures to stop this virus. Wear a mask, keep your physical distance, wash your hands. And for the next two weeks, please stay home. Stay home and save my life and the lives of our families, neighbors, friends, and essential workers across the state. Thank you. Kate Brown: (30:57) Thank you, Dr. Choo. And I think next up, we're going to welcome ... No. Okay. Dr. [inaudible 00:15:07], you're coming up? Okay, great. Okay. All right. With that, we're ready for questions. Speaker 1: (31:13) To the reports on the line, thank you for bearing with us through the technical difficulties. The conference line is working now. So please press zero to ask a question. We'll also take the questions you've sent in writing as well. But we'll start first with Erin Ross from OPB. Go ahead, Erin. Erin Ross: (31:31) Hi. So we've had experts saying for several months to expect to fall wave and that we did know this is coming. So why did we wait until hospital capacity was strained to enact new measures? Kate Brown: (31:43) Thank you, Erin, for the question. I have been telling and pleading with Oregonians for the last several weeks to substantially restrict, in particular, their informal social gatherings, their house parties. As you recall, over a week ago, I also issued a two week pause- Kate Brown: (32:03) ... recall over a week ago, I also issued a two week pause. What is really, really clear is that cases are rising exponentially and we need to take immediate action now. From my perspective, this is a collective call for sacrifice. I know that Oregonians have been making tremendous sacrifices over the last nine months, but we are going to need to sacrifice further in order to preserve adequate hospital beds and preserve the capacity of our nurses' and our doctors' and our CNAs' and our physicians assistants' ability to not only care for COVID-19 patients, but to care for other patients with medical needs as well. Erin: (32:46) I understand all of those things that you've done, but I'm curious as to what the reasoning was for holding off. I'm sure that there were a lot of discussions going on about when the best time was to do a lockdown or something or weighing economic costs. But what were you considering at the time? What are the reasons? Kate Brown: (33:02) Dr. Sidelinger? Dr. Dean Sidelinger: (33:05) Thank you, Governor Brown, and thank you for the question. I think a lot goes into the decisions about the actions we're taking. The effects of COVID-19 are huge on our physical health, on our mental health, with Oregonians in the hospital and dying. But we know the actions we're taking today have tremendous impacts on our mental health, the isolation we see in some of our long-term care facility residents who've not seen family or loved ones in months and on the economy. That economic impact has real impacts on our health. We've been asking people to do some fairly simple things: wearing a mask and keeping your distance. We've asked them to make sacrifices like limiting the amount of people they see, their family and friends. When doing that. We've been able to overall keep the numbers down, but they have continued to rise this fall. Dr. Dean Sidelinger: (33:55) The timing of these interventions aren't perfect. If we had stayed locked down in our stay home, save lives orders and people actually stayed home, we wouldn't see the spread of disease in our community. But people can't tolerate that level of isolation for very long and people needed to come back out and need to have some level of return to socialization, return to being outside and getting exercise and return to other things that we did before this pandemic came. These conversations have happened since this virus was first identified and haven't just been happening in the uptick to the fall. These actions aren't taken lightly, and that's why they were step wise with that initial pause being announced last week and now some escalating actions being taken. We hope that these actions with the adherence from Oregonians will bend this curve over the next few weeks and that we can return some of these activities back because we know they have tremendous impacts. Dr. Edwards? Dr. Renee Edwards: (34:53) I also want to emphasize the exponential rise of this virus. Once it begins to taking off in a community, it increases rapidly. I've mentioned to Oregonians before that many of the chief medical officers, CEOs and COOs of our hospitals and healthcare systems across the state have been meeting on a regular basis discussing our hospitalization trends and the number of patients we see becoming ill with COVID-19. As recently as the beginning of last week, we were starting to cautiously pay attention, but we were still definitely managing within our normal hospital bed capacities and typical numbers that we see. Just in the last week, the number of COVID-19 patients that we are both hearing from through our clinics, through our call lines, seeing in our emergency rooms and requiring hospitalizations has shot up significantly. As mentioned, the need for some of the distancing, wearing masks, hand-washing has been present all along, but as this has taken off just in the last 10 days, it's really created an exponential rise that we've seen happen in other areas of the country and the world. Speaker 1: (36:15) Thank you, Erin. Our next question is a written question from Lisa Baylick of [inaudible 00:04:19]. Lisa asks, "Why not include personal services, which are often close up for contact? What's next if the numbers don't improve and what are college students supposed to do about coming home and possibly spreading the virus?" Kate Brown: (36:32) Okay. Holy smokes. That was a lot of questions. I'll start with personal services and hope I can get some help from my colleagues here. In terms of personal services, there are a couple of reasons why we chose to separate those out this time around. The reason being is, frankly, we're just not seeing extensive COVID spread amongst these businesses. The second piece is that many of these personal service businesses are important for individual health, for healthcare, whether it's a chiropractic visit or other. For those two reasons, we felt strongly about continuing to keep the very rigid and safe protocol in place to protect both the employers and the employees and of course the clients and the patients. Dr. Dean Sidelinger: (37:32) Thank you, Governor Brown. I can build on that a little bit. When we reopened in May, personal services were one of the things that we were very nervous about because of that close up contact, but what our safe reopening guidelines have shown us is that using masks, limiting the number of people in the business, can really prevent the spread. That's not just been demonstrated in our cases here in Oregon but across other states. You asked about next actions that could be taken and some of those were alluded to here, that some of the counties that are entering into these restrictive actions will likely stay in for longer than two weeks, some even longer than four weeks. But we'll continue to look at the data and adjust it as needed. As we come out of this freeze, we will have some refined guidance about reducing risk in all of these settings. Dr. Dean Sidelinger: (38:20) Lastly, you asked about college students returning home. This is an area where there's a tremendous need for personal responsibility as these students return home. We've seen spread on college campuses, whether it's from social gatherings or people who are just coming to campus who've tested positive. It's important for students before they return home, they should try and limit their activities as much as possible. Try not to socialize as much, especially if they're returning home to someone who's older or has underlying conditions. This will limit the chance that they may pick up COVID before they come home and spread it to their family. When they come home, keeping their distance, wearing their mask as much as possible when they're in the house and around others is also really important because we don't want to take a virus from one part of our state and spread it to communities in other parts of our state or other states. College students and their families should take these kinds of precautions as they return home. Speaker 1: (39:16) Thank you, Lisa. Our next question is from Brenna Kelly of KPTV. Go ahead, Brenna. Brenna Kelly: (39:26) Good afternoon, Governor. This is a two-part question. First, why are businesses being targeted here when there's no evidence for spread at places like bars and restaurants? OHA continued to call it the least cause in social gatherings. Do you not believe indoor gathering will continue to happen in this shutdown? In addition, what's your plan to help all of these people who will now have to file for unemployment? No six hundred dollars federal aid this time and Oregon's minority groups are going to be disproportionately affected by a shutdown. Kate Brown: (39:55) We're certainly aware that COVID-19 along with our wildfire emergencies have disproportionately impacted our historically underserved communities. I think what is most important at this point in our nation's history is frankly that Congress step up, that Democrats and Republicans put aside their political differences and deliver on a coronavirus relief package. I spoke to that last week. I think it's critically important that Congress continue the $600 a week pandemic unemployment assistance that has run out. Senator Wyden was the champion, the author, the creator of that effort. I know that he is working with his colleagues on both sides of the aisle to encourage them to move forward, but it's time for Congress to just do it and quit talking about it. Oregonians can't wait. Obviously the employment department is working hard every single day to get money out the door as quickly as possible, and they will continue to do so. Kate Brown: (41:01) In terms of businesses, the harsh reality is that the virus is widespread throughout Oregon. I have been telling and pleading Oregonians for the last several months to severely limit your social interactions, to limit the house parties, to limit the informal social gatherings. Unfortunately, at this point in time, we have no choice. I know that this is really hard on our businesses, particularly our iconic small businesses that have really come to define Oregon and create not only a national reputation, but an international reputation. But we have no choice. I'm asking everyone to take action now. It is not too late to make a difference. I'm asking everyone to make a collective sacrifice to preserve our hospitals' bed capacity, to ensure that our hospital and health care workers can continue to serve Oregonians that are in need of medical services and that we can substantially reduce the spread of the virus and flatten the curve. Speaker 1: (42:23) Thanks, Brenna. Our next question is a written question from Matt Rashmit with Oregonian. I believe this is for Dr. Sidelinger. Brad asks, "What specific thresholds would it take to go back into stay at home status or impose even stricter business restrictions? Then the state previously said Oregon could reach hospital capacity by mid to late December, a projection made before the recent surge. What specifically does the state now project reaching hospital capacity, when specifically, and what is the measurement that's being used? Is it 90, 95% or a hundred percent of staffed beds being full?" Dr. Dean Sidelinger: (42:58) Thank you for those questions. The first one on specific thresholds we're using. I think as we look at the cases as they increase as Dr. Edwards state, they increase exponentially. It's not a linear increase where we see this gradual increase. We've seen that in the past. What we saw is the slope of the increase really did change over the last week and a half with significantly more cases day-to-day and almost daily record breaking case counts. What comes with those is that a subsequent number of those people will require hospitalization. That doesn't happen immediately. Someone doesn't come down with the virus and require hospitalization immediately, but that can be one to two to three weeks later when we see those people seeking care. We also know that it's not just COVID patients who are in our hospitals, who are in our ICU beds. Dr. Dean Sidelinger: (43:51) It's people with flu, people who have had heart attacks, people after car crashes and many other things that cause people to seek hospitalization. In our latest modeling, our data was cut off a week ago to make the model work so that doesn't take into account the huge increase we've seen in the past week. Also we were unable to model hospitalizations. When we look at linear projections of our hospital cases based just on the number of cases, we do see that increase that happens sooner than the middle of December. We don't have a specific threshold across the state.. I'll tell you a little bit about how we work and then let Dr. Edwards give you some specifics for OSHU. Dr. Dean Sidelinger: (44:33) But each of our regions, we have a regional hospital leader who convenes the other hospitals in the area. They've come up with plans on how they will try to increase capacity with canceling elective procedures and other things. They will shift patients to get the most appropriate care within the region or out of the region if that's necessary, often to the Portland region where we have the most specialized care. Each regional hospital and coalition has worked on an individual plan, have set the thresholds for where they would start to do different activities, and that definitely started happening here in the Portland region over the last 10 days. I'd like to turn it over to Dr. Edwards to talk about how some of those things happened and what their cut offs were. Dr. Renee Edwards: (45:14) Thank you, Dr. Sidelinger. It is extraordinarily difficult to predict when we reach maximum hospital capacity. We do have the opportunity to slow or halt some of the otherwise elective activities that often occupy some of our procedure rooms, our operating rooms, our staffing needs, and our hospital beds. For example, in the Portland metropolitan area now, all of the major hospitals and health systems are intentionally limiting the number of elective surgical procedures we're doing for patients who require a hospital bed for their recovery. When we use the term elective surgery, it's often interpreted as an outpatient surgery or more minor surgery. But when we use the term elective surgery, we're really talking about any surgical cases that aren't required for emergent or urgent care. In this circumstance, the cases that we are limiting are the surgeries where the patient would otherwise need a hospital bed for one or two or three or more nights in order to recover. The elective surgeries that are done as an outpatient or when patients go home immediately after the procedure, we're allowed to continue doing because that doesn't limit the number of beds we would otherwise have available. Dr. Renee Edwards: (46:32) I want to say that specifically because I don't want Oregonians to have the impression that we're not able to deliver upon the care and the services that you need at this time for your health care. But we do have the opportunity to delay or postpone the surgical procedures that would otherwise require that bed capacity. That's one example of why it's difficult to predict when we might hit a maximum hospital capacity in this state because we're actively managing some of those levers that we have in order to balance the number of patients who are being admitted to our hospitals, with the patients who are being discharged and maintain a measure of capacity that's required for Oregonians' care. Speaker 1: (47:18) Thanks, Brad. Our next question is from Pat Dooris with KGW. Go ahead, Pat. Pat Dooris: (47:29) Three questions, one just basically technical. Wondering if you could update us on the capacity for testing. What's the statewide test capacity per day? Also, wondering why implement the freeze on the 18th? Why not sooner? Then finally on the travel advisory, why not make that mandatory? Why not require people flying into Portland, for example, to have positive tests or else required quarantine? That's a lot. Thanks for taking it on. Kate Brown: (47:58) Thank you. In terms of why not make the travel advisory mandatory, that- Kate Brown: (48:03) In terms of why not make the travel advisory mandatory that may be something that we are forced to do if cases continue to rise. At this point in time we're working with our partners on the West coast, governor Jay Inslee of Washington and governor of California, Gavin Newsome to do this in such a way that the entire region is using the same metrics. So that's the reason for that. In terms of starting the freeze on Wednesday, November 18th, the reason for doing that is that our businesses need some time to be prepared. They need to obviously restaurants for example buy food ahead of time. The last time we went into shutdown mode it was on very short notice and I wanted to make sure that they had an opportunity to use up their supplies and get prepared. Kate Brown: (48:55) I'm asking all of our businesses that fall under this order to start their preparations immediately and be in full compliance by next Wednesday. In terms of individuals, I am not asking you I am telling you to stop your social gatherings, your informal social gatherings and your house parties, and to limit your social interactions to six and under not more than one household. And I'm asking that immediately. I will take a stronger legal action as appropriate. I've already directed the superintendent of state police to begin to work with local law enforcement to legally enforce the informal social gathering orders. Oh, and Dr. Sidelinger do you want to talk about testing capacity? Dr. Dean Sidelinger: (49:51) Thank you for that question. We continue to see kind of more robust testing here in Oregon than we have earlier in the pandemic with almost 35,000 new Oregonians being tested last week. That is not the absolute number of tests as many people have multiple tests, and there are also tests that lag in their reporting time. Some of our point of care tests where we focus on reporting the positive tests and the negative test may result. So testing capacity is robust. We have testing available through most of our healthcare systems with community based testing and drive up testing available throughout much of Oregon. Speaker 1: (50:28) Thanks Pat. We have time for just a few more questions so I'm going to go ask Sarah Klein of the Associated press. Go ahead, Sarah. Sarah: (50:37) Hi. Yes I just wanted to make sure I just heard you clearly governor. Did you say that you are working with local law enforcement to enforce the six limit get togethers? Kate Brown: (50:49) What I said was and I'm very clear about that is that I have directed our Oregon superintendent of police, Terry Davey, to begin working with local law enforcement. I will be issuing an executive order regarding these restrictions. And as before as always, these are enforceable by law. And I will be asking our Oregon state police to work collaboratively with local law enforcement to enforce the limits on social gatherings. Sarah: (51:26) Okay. And for that will people be fined if they're found not listening to your order? Kate Brown: (51:34) That's a great question. The question was whether or not people are fined. Law enforcement has the discretion to enforce these. They are class C misdemeanors and they can be enforced through a citation, a fine or through an arrest. Obviously for the last eight months I have been asking Oregonians to follow the letter and the spirit of the law, and we have not chosen to engage law enforcement. At this point in time unfortunately we have no other option. Sarah: (52:12) Okay. Thank you. Speaker 1: (52:13) Thanks, Sarah. Our next question is from Wright Gazaway from KATU. Go ahead Wright. Wright Gazaway: (52:21) Governor I've spoken to many restaurants in the past couple of weeks and none of them want to open wide open, but they do feel like they have a controlled environment where they can force mass wearing and social distancing. A lot of them have said they will not survive on takeout only. What benefit does further economic stress on them do for our state? Kate Brown: (52:39) Look, this is definitely a challenging situation. I like many other Oregonians absolutely love, love, love going to my favorite local restaurants. It's a part of our culture, it's part of who we are as a people. Oregon was from my perspective the creator of the farm to table movement. So it's a really important part of the heart and soul of Oregon. Unfortunately, the virus is too widespread and we need to substantially reduce social interactions amongst people. And this is one of the tools that we have. Dr. Sidelinger or Dr. Renee Edwards do you want to fill in? Dr. Dean Sidelinger: (53:25) Thank you, governor Brown. This is Dean Sidelinger. I think what we know about bars and restaurants shows us that they can contribute to the spread. So people need to remove their mask when they're eating or drinking. What we've seen across other communities is that we've seen significant spread from parties and restaurants. What the Oregon data tells us is that we have had outbreaks in restaurants primarily among employees. We've seen limited spread amongst parties that we can prove. But we know is those people who are getting together in social get togethers in homes are also reporting going to bars and restaurants at a much higher rate than others. So this is a setting that with indoors where the air circulation isn't as good as outdoors with needing to remove your mask to eat or drink, because that's why you're at a bar or restaurant and with social gatherings happening there and in other places that it does promote the spread. Dr. Dean Sidelinger: (54:19) So the unique situation of that not being able to keep your mask on means we lose one of those powerful tools we have. So we hope it is a very difficult decision. The economic impact is huge and many of our small businesses have already closed and more might close as well. So if you have the means and can do takeout and support the businesses and coffee shops, retail stores in your neighborhood, I would urge you to do so. They need our help now more than ever so that when we fight this virus which I know we will, they'll be there as a partner. Kate Brown: (54:53) Right. I just want to add one more thing. Congressman Earl Blumenauer has been fighting in Congress for the last several months for Congress to pass a financial aid package specifically for our restaurants. I applaud him for those efforts. And in my letter to Congress this morning to our congressional leadership, I added that our businesses across the state need additional financial assistance, including an extension and addition to the PPP program. As well as specific financial assistance to our restaurants. Speaker 1: (55:32) Thanks Wright. We have time for just one more question. So we're about to go to Gary Warner with EO media. Go ahead, Gary. Gary Warner: (55:38) Hi sorry, I tried to take the mute off there. If these numbers come back as some projections show with a rise after Thanksgiving, will you do something more drastic and earlier to curtail what would certainly be a massive problem at this time? Kate Brown: (56:01) So Gary we're instituting a statewide two week freeze in order to give Oregon a fighting chance to stop COVID-19 across the state and prevent hospitalizations from spiking. That goes from November 18th to December 2nd. I am fully expecting certain counties that are hotspots like Multnomah County to continue to stay in this freeze for longer than that two week period. But we will use all tools that we have available to continue to keep Oregonian safe. That is my top priority, is keeping Oregonian safe and keeping Oregonians alive. So we'll use all the tools that we have available. Gary Warner: (56:52) Can you tell me what some of those tools might be? I'll be the devil's advocate, but say we come back from Thanksgiving and the numbers are still high as they've been high after other holidays. And we've got another big holiday coming up in which travel plans are often made well in advance. What can you do? What are some of these tools that are on the table that you're not using now that you might be able to use? Kate Brown: (57:12) Dr. Edwards. Dr. Renee Edwards: (57:13) I think I can comment on a portion of that. We have to remember that with this the virus is setting the timeline. We are reacting to the needs on behalf of Oregonians and trying to manage the exponential spread of the virus in our community. But ultimately it is the virus that sets the timeline. This stay at home, this two week pause gives us the opportunity to trim the numbers, flatten the curve, and understand what the next steps can and should be. We all have a desire and a preference to know the answer to things. We'd like to know exactly when something's going to happen, when a deadline is going to end, the details of how to manage a circumstance. And I think that one of the things that's particularly difficult about this virus is that we don't at any one moment have all the answers. Dr. Renee Edwards: (58:12) We know that it's important to wear a mask, to physically distance, to wash our hands and to limit social gatherings. Those are tried and true measures that we know will assist us in this moment. But as we watch what happens with flattening the curve as Oregonians stay home through these next few weeks, we'll better understand what happens and what additional measures need to happen after that time. We also need to remember that this virus takes time once it infects someone to actually understand the degree of symptoms they'll have or whether or not they'll require hospitalization. So we're always trying to manage around these two or three week leading and lagging indicators of infections, hospitalizations and tragically deaths to help us understand what next steps will be. But the virus sets the timeline. Dr. Dean Sidelinger: (59:09) Can I add to Dr. Edwards? Thank you very much for that and governor Brown. The actions we're taking today don't have immediate impact. So if everyone listened to us and stayed home for the weekend we're not going to see case drop on Monday. This will be weeks before we see that impact, but we need to take this action now because the consequences could be dire, especially on the needed stuffed ICU capacity that those who are most seriously ill may need in the coming weeks. So we're taking all the steps we can be. We will look at Thanksgiving and we hope people heed the advice and stay small. Learn how to cook their grandmother's stuffing using Zoom rather than kind of looking over her shoulder and take this advice because we need you to. Dr. Dean Sidelinger: (59:54) We know what the holidays have done before and we know Thanksgiving is extremely important to everyone, but this is not the Thanksgiving to have like last Thanksgiving. Let's celebrate this Thanksgiving with members of our household. So that next year in 2021 we can look back and say, "Do you remember how awful Thanksgiving was in 2020? It's so good that we get to get together now because we did such a good job fighting the virus." So as we learn to live with this virus, it's going to look very different in the fall and winter than it did in the summer. We have less opportunities for outdoor recreation and spreading people out in the beautiful Oregon countryside. And so we're working on what does it look like for disease spread in the community and what risk messaging will we give to people and businesses to help control the spread of that disease? Dr. Dean Sidelinger: (01:00:40) How do people manage the risk? People can't stay home with the people in their household and not see anyone else. So how do we tell them how to look at the risk, how many friends they're getting together with in a week, how many activities are doing and how that risk adds up and how they can safely connect with family, friends and loved ones and not stay isolated at home. So we've been working on that through the spring, summer and fall, and we'll find those messages and those approaches to combating this virus in the coming weeks. Kate Brown: (01:01:10) And Gary just to close, I know that Oregon can do this because we've done it before. Throughout this entire pandemic Oregonians have made incredible sacrifices to protect themselves, their family members and their community members, their vulnerable neighbors. We throughout the pandemic have had one of the lowest infection rates. So I know we can deal with this again. As this virus has really taught us we are truly all in this together. So please stay safe out there, maintain your physical distance, wear your face covering, wash your hands, stay home, stay home from work if you are sick and get your flu shot, take good care. Speaker 1: (01:02:18) Thanks governor.