Virginia Governor Ralph Northam Coronavirus Briefing Transcript March 27

Henry: (01:18) Governor, how realistic is federalized testing for the area? But then also is it frustrating that the Trump administration is saying this is basically a state's problem and the governors are all saying, "We need more help and we're losing valuable time now here each day this keeps going." Ralph Northam: (01:33) I think that the question is how realistic is federal testing in the greater Washington area? I think it's very realistic, Henry, and one of the challenges that we've had is in the supply chain. Not only enough reagent, but also the swabs that are being used. And so, the testing currently is through our state lab and it's also through healthcare systems. Sentara is close to being up and running. UVA, VCU have their testing that they can do locally and they're expanding that around the state, but certainly in that greater Washington area where there's a density of population, where there are vital individuals that need to be at work every day, one of many challenges with testing is the turnaround time. Ralph Northam: (02:28) And at the state lab, we're doing the best we can to get the turnaround at one to two days. Some of the private labs, because they are not in Virginia, the turnaround can be five to seven days. So, imagine when there's a central personnel that may have symptoms and you say, "Well, let's do a test and make sure that you don't have COVID-19 but by the way, it's going to take five to seven days." So, that person's at home being quarantined for that time. So, it's not a very effective, efficient system. And so, that's why the governors collectively around the country have asked for some leadership, for some direction at the national level, to really help make that testing more efficient. And the same is with the equipment, the inventory of the equipment, the ability to disperse that, deliver that equipment. We really need a national system. We need direction from Washington because as I said in my comments, States, healthcare systems, we here in Richmond, we are all competing for the same equipment and it's not as efficient and as effective as it should be. Speaker 3: (03:42) Governor, Democrats this year passed [inaudible 00:03:48] also increase teacher pay. Where do those priorities stand now with this completely changed economics department? And then also, why are ABC stores considered essential [inaudible 00:00:04:03]? Ralph Northam: (04:00) Two questions. The first question is I think dealing with our budget pay raises for state employees, for teachers, for the state police, new spending. We're looking at that on a day to day basis with secretary Lane who is with us today. We're looking at the Care Act, how much funding, how much resources will come into Virginia. So, we are assessing that every day and we will make decisions between now and reconvene session, which is April 22nd, as to what we need to do with our budget moving forward. And the second question was why are ABC stores... Speaker 3: (04:43) Considered essential. Henry: (04:45) Brian, you want to take that. Brian: (04:50) Question being ABC stores are considered essential. They are essential under the existing emergency operations plan and really we're able to achieve social distancing in the ABC store environment. No more than 10 customers can be in the store at any one time and so that's social distancing, which is so important and has been the underlying message throughout this, can be achieved with respect to an ABC store purchase. Speaker 5: (05:25) For secretary Lane. I know when you spoke with us a few days ago, you said you were still looking through the stimulus package to see how much Virginia would be getting. It's now past the House ann the Senate. Can you tell us more in terms of what Virginia looks to receive from this? Speaker 6: (05:39) Yeah, so the question is how much might Virginia expect to get from the recent stimulus package passed by the Congress? And I can report that right before we came in, the house did pass it, so now it'll be going to the president's desk for signature. Under the preliminary payments to us, it's about $4. 3 billion between now and December 31st. $1.8 billion would come directly to the state. Now those monies can't be used to offset revenue loss or can't be used for other expenditures other than those directly dealing with the COVID virus and public health. The additional $1.5 billion would go to cities and localities in the Commonwealth and any locality over 550,000, I think at least Fairfax qualifies for that, they will be able to access additional monies through this act. So, about #3.3 billion and just one thing to add to the previous question regarding about raises. There is a provision in the current budget that they are conditioned on the revenues generated at the state level. So, a lot of that will depend on the revenue and as the governor mentioned, we're looking through those projections and how this is going to impact us going forward. Thank you. Speaker 7: (06:58) We're now going to turn to the phones for a second. Speaker 8: (07:04) The conference is now in talk mode. Speaker 7: (07:08) We're going to take our first question from David McGee with the Bristol Herald Courier. David McGee: (07:14) Yes. Thank you all. I want to follow up on the testing issue. The number of cases here in far Southwest Virginia is very low and there are concerns here that that's reflective of insufficient testing and I wonder if governor, if you could or someone on your staff could maybe speak to how the testing resources have been deployed statewide and efforts to expand testing in response? Ralph Northam: (07:38) Thank you for the question. I'm going to let the secretary of health answer that. Thanks, Dan. Dan: (07:43) Thank you. This has to do with testing and far Southwest Virginia. So, just the origin of the state lab. The state lab, we're so fortunate to have the state lab as a resource. They were the originator of the ability of doing in state testing and using the resources coming from the CDC to get that up and going and available to clinicians to help better serve patients in Virginia. So, we're so appreciative that the primary mission of the state lab is to support its public health mission and those referred by the health districts for testing, so that all 35 health districts around the state have the same criteria for testing, so that regionally all patients are treated with a similar set of criteria. So, that's first and foremost. And second, the question was again, the shortage of testing capability with six or seven each day. Dan: (08:49) We get reports to the Virginia Department of Health because it's a reportable disease. We get both the positive test numbers and the negative test numbers, but because as the governor indicated, the testing from the commercial laboratories can be six or seven or eight or even nine days, we know that there's thousands of tests out there that have not been resulted. That is, the results have not been reported. So, there is a lot of testing. Is it quick enough? No, we definitely need a point of care testing in the medium term that can be deployed not in the tens or the hundreds, but in the thousands and the tens of thousands to do the appropriate surveillance that our public health officials would use if it were available. In the meantime, we are getting volume from the commercial labs. We are hopeful that they will be able to improve their turnaround times. At the same time, as the governor mentioned, institutions and health systems like UVA and VCU, Sentara are standing up their own capabilities focused on inpatient testing. There really is a connection between preservation of personal protective equipment, the PPE- Dan: (10:03) ... Connection between preservation of personal protective equipment, the PPE, and the ability to find out if a patient indeed has that disease. The positive rate, both in the state lab and in the commercial lab, is only about seven to 8% so that that's good news, but it also means that for every patient that's admitted to the hospital awaiting testing, there are a lot of patients there that we don't know whether they're positive or negative, and therefore they're using the same isolation procedures. So testing availability, testing turnaround time is key, both to understand where the disease is in Virginia and how to prevent it. And secondly, how to make sure we preserve the amount of protective equipment that we have. So again, we need commercial labs to continue to work on their turnaround times, and we definitely appreciate the health systems and our academic centers that are increasing the availability of a rapid test similar to the state lab, and that it's available within 24 to 48 hours. So thank you. Speaker 12: (11:05) Max Thornberry with The Northern Virginia Daily. Max Thornberry: (11:10) Hi, thank you for taking our calls remotely. I've got a question about juvenile detention centers. We have one juvenile detention center out here, Bonaire where families of the children that are in these centers are paying child support to help cover the cost of education. In those centers, education has been cut in order to prevent people coming in and out of the facility, but those child support payments are court ordered. Is the governor going to suspend those payments for those families during this time where education isn't being provided? Ralph Northam: (11:46) Do you want to address that Brian? Brian: (11:50) Question with respect to our juvenile justice facilities and the subset of that with respect to the orders and that is something we will pursue because since the governor's order that closed schools, that did apply to our educational opportunities in our juvenile correctional centers, we have the Yvonne Miller named after Senator Miller. We have a wonderful education center at Bonaire facility, but that is now closed. So I'll have to address the order with respect to the payments. I will say, paramount with respect to ensuring the safety of those kids at our center and DJJ has implemented some most stringent of reviews in assessing each ... Every 72 hours, they are screening those kids to make sure that everyone is safe and sound. Brian: (12:43) So some extreme measures are being adopted, appropriate measures and that will continue throughout this. And of course we're, once again, with respect to the governor's recommendation trying to reduce, reduce the capacity in our, all of our detention centers, jails, prisons and our juvenile correctional facilities. We are indeed reducing that population. We're not accepting any further unless they're court ordered and that we cannot do anything about. So, again, the population is being reduced and being screened regularly. Thank you. Ralph Northam: (13:21) Thanks Brian. Speaker 12: (13:25) Roger Watson with the Farmville Herald. Roger Watson: (13:28) Thank you. We got news this morning that VCU Health is reopening a hospital that was previously closed in South Hills for COVID 19 patients. Are there any stats or models showing how much additional hospital capacity is needed in Virginia to handle the crisis? Dan: (13:49) Well, thank you. The question has to do with the fact that been reported that VCU, and we can confirm it with VCU, is reopening a hospital with the intent of specializing either in the care of COVID 19 patients there or as an overflow for other groups of patients that can be taken out of other sites. And the question really was the model for the hospital beds. Now, we're ... I'm sure all your viewers have been aware there, there are curves and projections, and we are certainly aware of those. Our first and foremost goal is to encourage how to bend that curve so that those statistics and those potential realities don't come to pass. Our first thing, again, is to stay home, reduce social ... Maintain social distancing to decrease the frequency and the and the rapidity of transmitting this virus, and expansion of this disease. Dan: (14:58) So that's first and foremost. But at the same time we are looking at those models. We are very much involved with planning, along with our health systems and along with our emergency planners. And along, frankly, with the ... As the governor has mentioned today and previously with the Army Corps of Engineers and our national guard. So our plans really are around helping the health systems expand on their footprint. And they do, under their emergency operations plans, have those plans in place. And we are working on a daily basis, the Virginia Department of Health and Virginia Department of Emergency Management, how to support those plans with the regional coalitions. Secondly, we're also working with them on how might we use the resources of FEMA and the Army Corps of Engineers and the National Guard to build out that footprint to better meet the needs of Virginians as this crisis and as this disease continues. Dan: (15:54) So we're in the midst of that evaluation to see where the best locations are and we look forward, in the days ahead, of working through those plans. So again ... And again, I will also say that in our planning, we need to ... The biggest shortage is not just a place, there's material, PPE and then there's staff. So we're looking at all three. And what we've heard from our federal partners is that there's no reservoirs. We see reservoir of staff from other states or the federal level that we can count on. Dan: (16:29) We need to make sure through the current medical staffs and nursing and all their medical professionals that we support them in their continued work here in the commonwealth. And we also mobilize the medical professionals that we have in the commonwealth that could be called upon to serve. So there's where our efforts are, and those plans are ongoing, but our number one goal is to have those folks not needed because we've done the social distancing. We've stayed at home when it is appropriate. And that's for all of us, unless we're doing essential functions, we need to be at home and to decrease our ability to transmit the virus. So thank you for that question Speaker 12: (17:16) Bill Atkinson with The Progress Index. Bill Atkinson: (17:24) Oh, thank you very much, governor. This question is pertaining to the issue of the test that you were talking about earlier. Has a special emphasis been put on getting tests to military installations around the state. As you know, Fort Lee had a confirmed case this week that really threw this area into an uproar because it's so heavily needed ... Fort Lee is so heavily needed in this area. Access has been cut off to all but essential personnel, and it's just really a big business driver in this area. My question is, what, if any, reassurances or so can you give communities that are so heavily reliant on military installations that a special emphasis is being put to get tests to these ... All the necessary tests needed to these military installations? Ralph Northam: (18:27) The question is, I appreciate the question is, given priority to certain groups across the Commonwealth of Virginia and we have in fact done that. I think if you look at the levels of priority, starting with our healthcare providers, certainly our military personnel would be right there with them. Obviously they're vitally important for national security, being able to test individuals who are in our nursing homes where the most vulnerable patients are. So yes, we have a level of priority throughout the, the state as as to who's being tested, and we'll continue to do that. I would like to get to the point where we can get past where we are right now, where we need to do the screening. Looking at travel, looking at exposures, contacts, looking at symptoms before you get to the actual testing, making sure that individuals meet those criteria. As we have more tests available around the Commonwealth, we'll be able to loosen up some of that ... The screening versus the testing ratio. Bill Atkinson: (19:35) Can you talk about when we think that might be, and what is our capacity at the moment? Ralph Northam: (19:39) Dr. Tony, do you want to address ... The question is when that will be and what our capacity is. Thank you. Dr. Tony: (19:49) So I'll make a couple of comments with respect to the military question too. To follow up on what the governor said is that we, the state lab is in active communication with the military establishments within Virginia. And we do- Speaker 13: (20:03) [inaudible 00:20:00] within Virginia, and we do offer and partner with them to provide testing in the event that they need testing. The request is that they work through the Virginia Department of Health to meet the criteria that we establish for all citizens of the commonwealth, but if they need testing at the state level, we will provide them collection kits and access to state resources for testing if they needed it. Speaker 13: (20:27) The second question was what is our capacity? Currently the state lab has a capacity to test about 1,800 patients. That testing not only supports universities, but it supports anyone within the Commonwealth that works through the Health Department. It supports corrections, supports nursing homes, outbreaks that might occur in institutional settings, so we do provide a very broad distribution of testing support where it is critically needed in Virginia. We have procured and brought in high throughput instrumentation that we are evaluating at the current time and hope to be able to expand that testing in the next week or so. Speaker 14: (21:19) You said high throughput testing? What is that? Speaker 13: (21:24) Right now, the current testing that we are doing is the CDC test that has been approved under FDA emergency use authorization. That is a test that requires manual processing, which means there's no automation. There's no robotics that allows us to do high scale, high throughput testing. We've looked into instrumentation that will allow us to process larger batches of tests at a single time, which would increase our capacity. Again, I can't overemphasize the supply chain issues that are limiting our ability to do higher numbers of testing, so they are across every manufacturer, every platform, every test system. We are experiencing that, as our all state laboratories and university laboratories. That's something that we are all trying to navigate through and to have redundancy, so that when one supply chain runs out or becomes back ordered, we can reflex and use a different test system. Speaker 15: (22:32) Question from [inaudible 00:02:34]. Ralph Northam: (22:32) Thank you. Speaker 16: (22:37) Hi, thank you. We have a lot of road construction projects that continue in Northern Virginia. I'm curious if there's been some considerations for stopping work on road construction projects, or how the COVID crisis has impacted VDOT's ability to get these projects done? Ralph Northam: (22:55) Our secretary of transportation is here with us. Shannon Valentine. Shannon, thank you. Shannon Valentine: (23:03) Thank you for that question. The federal government and nearly every state in the country has determined that construction and maintenance of highways is an essential process. At VDOT, there are about 7,700 personnel, half of which are teleworking. The other half have been pre-positioned to work on critical projects all over Virginia. I will say that any of the work that's being done is being done under very strict guidelines for safety, social distancing, hygiene. We are working on delegating equipment, trucks, various staff positions so that there is separation. As we are moving forward with these critical projects, we are instituting safety at every step. Thank you. Speaker 15: (24:03) Sherry Hamilton. Sherry Hamilton: (24:08) Yes. Thank you for taking my question, Governor. Your Executive Order Number 53 orders the closure of recreational and entertainment businesses, and then it lists specific businesses, but while state parks are also listed in your closure, private campgrounds are not. In a small rural community, the opening up a campground and the sudden influx of people at entails can put a real strain on local government, and not to mention that the campground environment is one of close community interaction. Local governments are wondering what they should do. Speaker 17: (24:46) Good question with respect to parks and private camp grounds. There will be direction beginning, well, this evening, Friday. No overnight stays for our state parks, and that is the same guidance we would give for private campgrounds. Speaker 15: (25:03) Great. Tracy Agnew. Tracey Agnew: (25:06) Hello. Thank you for taking our questions on the phone. My question is are any more restrictive closures or shutdowns being considered at the time? Ralph Northam: (25:14) The question is are more shutdown or restrictions being considered? As I have said throughout this process, we are looking at this as a very dynamic situation. It changes literally hourly. We monitor that and make decisions that we think are appropriate. The guidelines that we have in place as of today will continue. If we need to make modifications we will, but as of today, nothing has changed. Kate: (25:47) But more specifically, if staying at home is the most important thing for Virginians, why not issue a stay at home order? Ralph Northam: (25:53) The question is why not issue a stay at home order? Kate, we're talking semantics here. We're talking about how to enforce this. I think if you go back and listen to my comments, not only from today but from previous days, I have said repeatedly stay at home unless it's essential that you get out. That's what we'll continue to say. That's what our guidelines will be. If you look at whether this is a shelter at home, if it's a shutdown, it's a lockdown, however you want to describe it, excuse me, all the states are giving the same direction, and that is to stay at home. Speaker 15: (26:36) Our last one from the phone is from John Engle. John Engle: (26:40) Yeah. Thank you. To the point about testing availability in far Southwest Virginia and rural communities, I'll present a similar question but in terms of PPE and medical supplies. While we know that there's that obvious and necessary emphasis on the eastern region and DC, Maryland, that whole area, what assurances can you give rural Virginians like the ones here that they too are a priority of this administration? Dr. Carey: (27:08) Thank you, Governor. The question really is about our rural areas, of which many areas of Virginia obviously are rural, and we have very urban areas as well and suburban areas. How can we make sure that they're not left out in the allocation of personal protective equipment? The way by which, under emergency situations, that PPE is allocated, it is done through the local health districts so that they know the needs of, whether it's post-acute and in nursing homes or it's first responders or it's the social service workers that need to go for adult protective and child welfare cases, they have to go into the home to keep our seniors and our children's safe. Those local districts are allocated a large portion of any supplies that we get from the state to make sure that those needs are being addressed. Now, there's a shortage nationally, so that shortage will be experienced in Virginia and its locations in localities, but that voice of each health district is very much a part of our allocation. Speaker 15: (28:24) Then last question, Laura. Laura: (28:25) Two-parter for Dr. Carey. Sorry. You were talking about capacity of testing earlier. Can you speak to the capacity of beds, ventilators and staff. I know you said earlier the main thing is for people to stay home and not push the capacity, but can you speak to, say, over the next few days, do you know, off the top of your head, how many beds are available or how many ventilators. The second half was governor, you said something about previously licensed medical professionals. Are you allowing folks to come back through this volunteer capacity to practice, to help out? Dr. Carey: (29:17) The questions were, first ... The second question was with the governor's call for the Virginia Medical Volunteer Corps to come back into service. We've got, under emergency conditions, the Department of Health Professions has the ability to adjust. We're assessing our needs on how that might be changed. We have already allowed reciprocal practice from neighboring states, so that those who are practicing in good standing in various health professions have the ability to come into Virginia to serve, as long as they're in good standing in their States, for example. We are assessing how to meet that need. The first ... Dr. Carey: (30:03) ... assessing how to meet that need. The first question really was, what are the actual number of beds? We do work closely with the Virginia Hospital and Healthcare Association and we can get you those exact numbers. ICU beds I think we've mentioned at previous press conferences is in the 2000 range. So, at any one time, whether it's ventilators or those beds, are not fully utilized, especially ventilator, less than half of those are being used at any one time. So we are assessing the total number that we have there. We know what those are and there are roughly 2000 ICU beds and there's about a ventilator in Virginia for every ICU bed. And at the same time, we are also surveying our ambulatory surgery centers and all of the areas that have breathing equipment, anesthesia machines, that under certain circumstances could be employed in the Commonwealth for ventilatory and respiratory support. Dr. Carey: (31:09) So we are monitoring those. And in terms of the time course that we're looking, again, we're looking ahead every day, we're looking at our numbers and we're really again encouraged by the Governor's actions and what we're going to see in 7 and 10 and 12 days around reducing the likely peak and shifting the curve to the right. At the same time, as we mentioned earlier, we are looking at those projections and making sure that we're making the necessary plan. Hence, working with our hospital systems for expansion onsite, near site, and also working with the Army Corps of Engineers to see how we might increase that supply further. Thank you. Ralph Northam: (31:58) Yes. As we approach the weekend, I just wanted to remind Virginians to be vigilant, to follow the guidelines of social distancing, washing your hands, et cetera. And I appreciate all of us working together. We will get through this. I want to also take this opportunity. You see a lot of individual standing to my left and my right. They are working very hard every day. They're professionals. They do everything that they can to keep you safe. And so I wanted to take this opportunity to thank all of them. And in light of that I thought maybe if it's okay, this is a very serious situation, but perhaps going into the weekend we could bring a little bit of levity to the situation. And so I have had some comments. Ralph Northam: (32:50) They say, "Governor, you and your staff are looking kind of casual. What about the neck ties?" And this is little bit of medical trivia for you and certainly nothing against our retail stores that sell clothing and especially neckties. But neckties actually harbor contagious pathogens. And a study was done in 2004, at a fairly large hospital in this country and they collected the neck ties and cultured them, and close to 50% of them had infectious pathogens on them. So in light of protecting my staff, keeping them healthy and also you may say being comfortable, I've asked them to keep their neck ties in their closets. So I ask you all to stay strong out there. We're going to get through this and have a great weekend. Thank you so much. Speaker 19: (33:44) [inaudible 00:36:35].