West Virginia Governor Jim Justice COVID-19 Briefing Transcript April 6

Jim Justice: (04:50) Hello everyone, this is our April 6th briefing. I'd like to start off today, and I don't know of anything that could be more important, but I've just been notified of an additional death, but we have our third and fourth deaths in West Virginia now, and while they're pacing significantly below all the other states and it's surely significantly below the national average, it's sad and it's not good enough, but we just have to deal with it. We know that this pandemic is really rough stuff, and that's why we urge all of you in every way to stay the course, because it is truly devastating. So for those families and those individuals, I again ask all of us, as West Virginians, to join Cathy and I as we think about them in prayer, and know that we just hate it and we miss them, and so, but I really don't know what else to say about that. Jim Justice: (06:16) Over the weekend, we did do two more executive orders, emergency orders. The last time I spoke with you, on Friday, we had a clustering that we, basically a hotspot in Berkeley and Jefferson County primarily, but Morgan County was right on the tips of this and really asked to join those two counties. Since that time, we also had more hotspots that came to our attention over the weekend and on Saturday night, I mean throughout today, on Saturday we discussed what was going on, we evaluated over and over and over with our medical experts, with the National Guard and with all the people that are involved from our side. At 9:30 on Saturday night or 9:45 on Saturday night I issued another executive order that was basically bringing the counties of Monogalia, Harrison and Kanawha County into the fold with Berkeley, Jefferson and Morgan County. Those counties, we are limiting, and I'm going to read this to you, we are limiting groups to a maximum of five people, we're directing all businesses to require employees to work from home to the maximum extent possible, we're directing the local health departments to establish the maximum occupancy of and proper social distancing within essential businesses, and taking action to, and this is really important, and taking action to enforce these health regulations. I'm directing the West Virginia National Guard to provide logistical support and services to assist county agencies. The National Guard is not to do law enforcement, the National Guard is to assist, and by assist I mean everything that they can possibly do to help in every way, all of our county agencies, all the way from going to get groceries for people or whatever it may be, and I am directing the West Virginia State Police to assist with enforcement of local county orders. Jim Justice: (08:42) We've got to stay at home, we've got to listen and we've got to take heed to everything we're doing. It's working, and it's working fabulously in the state of West Virginia, but we've got to know, over and over I say the same thing, we're the most elderly state, we're the mostly chronic illness state, we're the highest risk state of all and we're within a rocks throw of all these populations where people are dying like flies. You've go to listen and we've got to stay the course. This storm is either close upon us, or in some places it's even looking like it's fading away. We're close. We're close. Please, stay the course. Also, we have an issue, we've had an issue, it came to me in two different questions, one on Thursday and one on Friday, and to just tell it like it is, I went immediately to my people and I said "Listen, I'm sick and tired of hearing about this," because I don't know how, any other way to say it. We were not processing or answer the phone as prudently with all of our unemployment claims that are coming in. Our people are doing great work. They've overcome by the number of claims, just like is happening all across our nation. There's a federal website or whatever that we've got to go through that mechanism to get everything plugged in, that was the bottleneck, but what I did is I basically, Brian Abraham was there, and Brian that day, being a guardsman, he was dressed in his uniform, and I said "I want you to tell General Hoyer that whatever we think is adequate that WorkForce is soliciting from the guard, do three times, because we've got to get these unemployment claims out and we got to get people that are looking to find a way to pay their utility bills or whatever, we've go to get them satisfied and we've got to get them taken care of, because they've got enough on their mind, scared to death about the health of them, or their families, or their grandparents or whatever it may be." Jim Justice: (11:08) So, I am happy to report right now that we now at WorkForce West Virginia have had the equivalency of, we are moving toward having the equivalency of three call centers, and by that we're spread out, we're not going to all cluster together, but we now have the operating capability of doing going 24/7, so we should get these claims taken care of, and the phones answered and your questions taken care of as well. Now, also yet on Friday about, I don't know, probably two or three or four o'clock in the day, we got our Federal Disaster Declaration from the federal government, which was a really good thing, and I thank president Trump and his whole team. We had made the request and it became, it got out in an expedited fashion, and this basically triggers the release of Fed funds to help our communities recover from this virus and this terrible pandemic. Jim Justice: (12:17) I'd also like to report at this time that we have had a positive, a person test positive that was an employee of WorkForce West Virginia. The DHHR and the National Guard are staying in close communication with the Kanawha-Charleston Health Department in this, in their investigation. The employee is isolated now at home. The call center has not been impacted by this situation, and General Hoyer will give you more details on this measure in just a few minutes. I've got just a couple more things. At the Eastbrook Center Nursing Home there was an individual that just tested positive there and the Charleston Area Medical Center has agreed to administer all the tests to all the patients and employees at Eastbrook, and they'll do that beginning today. And the last thing I would tell you is just this, and I want to go over this for just one second with you, and that is that take heed again, and again, and again to everything everybody's saying. Wash your hands. I've got a little bit of a running nose and everything, and you see me with a handkerchief and everything, and I've washed my hands 18 thousand times today and I'm going to keep on doing exactly that, and I'm only exaggerating to make a point, but with all that being said, please keep your social distancing. Jim Justice: (14:08) For those six counties that I mentioned, and they were Jefferson, Berkeley, Morgan, Monongalia, Harrison and Kanawha counties, just stay with me on this just for second, they represent right at 60% of the total positive cases that we have in this state. They are true hotspots and we need to stay right dead on top of this, and that's what we're trying to do. I will promise you that overreaction will never hurt us. It may inconvenience us, but it will never hurt us, and the ability to save one line, one life is wroth every bit of overreacting and going at this as aggressively as we possibly can, and that's what we're trying to do. When we get a hotspot we're going to stay right on it and we're going to act as aggressively as possible to make sure that we save as many lives as we possibly can. Jim Justice: (15:08) Now, in conclusion I want to just, I just want to bring up something that has come either through our DHHR or it's come to us from the federal government, but listen, just listen to this. For those out there that were concerned about "Are we taking enough tests? Are we testing enough?" And this is all prorated on your population, your total population versus your total population in the other states, it's the only way that it can be done in an appropriate manner, but West Virginia, per its population has tested point, well, and I want to get this straight, it's tested .049 of its population. Virginia has tested .274. West Virginia, remember it's 49, that's the easiest way because I may be off a digit on what I'm reporting to you, but West Virginia is at 49 on the testing, Virginia's at 27, Pennsylvania's at 60, Ohio's at 37, Maryland is at 46 and Kentucky at 41. So basically, the bottom line of the whole thing is per the population percentage of those states that I read, Kentucky, Maryland, Ohio, Pennsylvania, Virginia and West Virginia, we are second in those states as far as the number tested to the population percentage. Jim Justice: (16:56) Now with that, Kentucky's positive percentage is 21% or 21, Maryland was 59, Ohio 34, Pennsylvania 90, Virginia 31 and West Virginia 18, so the number of tested, we're the second highest of all those states, and for the number of positive per tested we're first, the lowest. And so, I commend all West Virginians again and again. You're doing great stuff. We're staying ahead. We're staying ahead with a population that you know is the highest risk. We're staying ahead. Stay the course. Please, stay the course. If we stay the course, we hope and pray we don't have long to go, and if we can stay the course good things will happen, so I commend you and I thank you in every way. God bless. Moderator: (18:03) Thank you, Governor. We're now going to take comments from a few of our panel members. Up first, Dr. Clay Marsh, our coronavirus czar. Dr. Clay Marsh: (18:12) Well, thank you, and it's great to be with everybody this afternoon, the governor has shared a lot of the good news that we have received here over the last few days, but I think that, let me take pause for just a second to talk about the prediction ratings, the numbers that we're getting back from the University of Washington's Prediction Model, and also about the work of our citizens. Dr. Clay Marsh: (18:39) So, we know that prediction models have many limitations. They are only as good as the information that's fed to them, and they're very dynamic, so as the information changes that is fed to them, so do the models. In fact, little differences in what is put in can lead to big differences on the other side of the models, and what we know about fighting this COVID-19 and winning is the fact that our power is to starve this virus. The virus really lives and thrives on person to person contact, and there's a measure called the R-0 or R naught, which basically reflects how infective the virus is. So, the influenza virus, every person that's infected infects about 1.2 to 1.6 people, so the R naught is about 1.6. The COVID virus infects, one person infected infects about 2.5 to three people, so the R naught is much higher, which means that the COVID virus can amplify very quickly, and we've talked about that, that in two months one person with the appropriate doubling time of the COVID virus can infect 1000 people, and ... Dr. Marsh: (20:03) ... of the COVID virus can infect a thousand people, in four months one person can infect a million people, in six months a person can infect a billion people, so that's the compounding benefit to the virus, but we also have a compounding benefit that allows us to fight the virus, and that is doing exactly what most of our citizens are doing, staying at home, staying apart, protecting yourself, because it's not just you protecting yourself, it's you protecting your family members, your vulnerable people in your community, our health care workers, our first responders, and we are doing a great job at that, so by reducing that infectivity ratio from 2.5 to three down below one which is what I believe that these activities will allow us to do then we starve off the virus, and the virus goes away, and we win. Dr. Marsh: (20:54) And so, the model that the University of Washington has published and updated recently suggest that we're doing a good job. The max time that we will see a little surge, it looks like by this model, has moved up from May 4th to April 15th. The number of people they project will die in West Virginia has gone down from about 500 to around 150, 170 as I remember, and a number of our parameters around critical care beds, and that kind of thing looks really good, but this model is only as good as the information that is currently being fed into it, and so, that means that we are doing a great job as a state, and people should feel good about that, and for us we are incredibly grateful and indebted to each person who is doing this to protect themselves, and their family, and their community, and our state. Dr. Marsh: (21:54) But, it's not time to become complacent, it's not time to turn back and say, "Oh, we're good." In fact, this is a time that we know doubling down really helps, and as we learned from California and New York, on March 16th New York and California had the same number of COVID positive people. California went on a stay at home, very strict. New York didn't, and eight days, New York had 15,000 people that were positive. San Francisco had a thousand, and we also know from the China experience, a single day of really doubling down can reduce the number of COVID positive people by 40% in 12 days, so West Virginia, we are doing great. It's time to do even better. Dr. Marsh: (22:44) The governor has talked about the executive orders, and those are important, but let's just say that the really important thing is the personal responsibility of every person in our state to do the right thing, and to do the right thing not just for themselves, but do the right thing for their family members, for their community first, their state, for our first responders, and I think the way that we're going, and the community that we have around social distancing, six feet away, staying at home, protecting yourself, don't put your hands to your mouth, or your face, or your eyes. Wash your hands frequently is making a huge difference. You've heard that from the governor, but I would implore you not to be satisfied with this, because things could change very quickly. Dr. Marsh: (23:33) And, if we stay together, and we stay connected spiritually, morally, socially, but not physically in the state of West Virginia around this particular issue, then we absolutely will be the beacon for the rest of the country, and we're doing it, and we're winning, and it's time for us to continue that commitment. Thank you very much for everything you're doing, and I will turn it back over to other people on the panel to comment. Thank you. Speaker 1: (24:05) Thank you Dr. Marsh. Next we'll go to Major General Hoyer with the West Virginia National Guard. General Hoyer: (24:14) Good afternoon. Today we have 493 National Guard personnel on duty just to highlight some of the key components of what the governor has tasked us to do today at Eastbrook Center along with CAMC, Kanawha-Charleston Health Department, and Charleston Ambulance Authority. Over 125 personnel, and staff were tested in a couple hour period to address the issue at that location. In addition, as was pointed out by the governor, we had one potential positive at the workforce office with Kanawha-Charleston Health Department, and our epidemiology teams at the state supporting the Kanawha-Charleston Health department. It was determined that one individual would need to be isolated. General Hoyer: (25:09) We've also put in some preventive measures to help ensure the safety of all staff and personnel. That includes taking temperatures as well as surveillance questions. In addition to the activities there for workforce as was pointed out by the governor [inaudible 00:25:27] National Guard personnel are supporting the efforts at workforce along with other agencies to go to a 24/7 call center, and then, also over this week also improve the number of personnel who will be able to process claims. Those are all working effectively at this time, and our citizens should start to see improvements over the next couple of days. General Hoyer: (25:54) In addition, as the governor pointed out on Saturday in consultation with his leadership team, we provided additional surge capacity to Kanawha county, and are prepared to provide additional surge capacity to Mon county as well as to Berkeley county. That comes in the form of additional training for businesses and retail establishments that are considered critical as well as providing support to additional epidemiology assistance to the county health department as well as logistic support where it may be needed. Again, it's important to point out that increased staffing is supporting those locations as well as workforce West Virginia to address the directives that the governor's laid out for us. General Hoyer: (26:45) In addition, I think it's important for us to understand that we continue to work methods to help improve our PPE posture. One of the things that started today at Charleston Area Medical Center is a method being used to sanitize N95 mask. We have another method that we're awaiting final FDA approval on, and in the case of these methods it would allow us to sanitize over 20 different times N95 masks to approve our availability of PPE for our frontline workers. All things that are being done to help innovate, and make sure that we meet the demands that we may have over the next several days. Thank you. Speaker 1: (27:30) Thank you general. Up next we'll go to the West Virginia DHHR with Secretary Bill Crouch and our state health officer, Dr. Cathy Slemp. Sec. Bill Crouch: (27:43) Good afternoon. As Clay mentioned, we're doing the right things. Our citizens out in our communities are doing what needs to be done to slow the spread of this virus, and as the governor said, we must keep the course. We must stay the course. I want to remind everyone that as they social distance to protect your physical health, take care of your mental health as well. On our www.coronavirus.wv.gov website, we've added some additional tabs. We've added under the Behavioral Health tab guidance on stress and coping, providing tips there for reducing stress for parents and caregivers, children, and our responders. We've also added a tab, updated guidance under the Public tab. We have information for non-healthcare settings on that tab Sec. Bill Crouch: (28:46) We've added under the Travel tab some guidance for hotels, motels, and other lodging facilities in the state. Preventative actions there for hotel workers, and information on out-of-state travelers and more. DHHR is a large agency. We have a lot of services that we are continuing. Even though we're in the middle of a pandemic, we have our folks working from home where possible. We want to be available, we want to be accessible to anyone who needs us in the community, so I want to mention again that if you need services, almost all of the services provided at DHHR can be accessed under wvpath. org. That's wvpath.org. Sec. Bill Crouch: (29:35) And also, again, your family resource network, and in counties that is at wvfrn.com so either one of those websites can lead you to individuals that can help you with questions. Our local offices are trying to work from home as well, but contact numbers should still be available there, so be safe, take care of your families, and thank you all for what you're doing to help. Dr. Cathy Slemp: (30:07) Thanks. I was asked to speak a little more for the data, especially the data that's on our dashboard now, the updated dashboard, and so, I wanted to kind of talk to that, and then, I think we're going to go through some slides to look at that. I think first it's important to note that there are a couple of priorities with data. There's the priority both of accuracy and the priority of speed, and they are important at different levels in different ways, so at the state level, DHHR is the official reporting agency for COVID-19 which in turn we provide that data not only for our own use in the state, but also, for the U.S Centers For Disease Control and Prevention all of our national numbers. Dr. Cathy Slemp: (30:48) So, at the state level, accuracy is really the absolute priority. It's important to note that data is informed by the local investigations that occur. You may see that the data that comes in shifts slightly. For example, laboratories may come in or a hospital may report an individual coming from one county, but the investigation shows that they actually reside in a different county, so that gets updated and corrected each time that the data gets resubmitted from the local to the state. I think that's just important to know that the data at the state level continues to get more and more accurate each time that it is updated, but there's often a day or two lag time between when that occurs at the local level, and when it gets to the state level. Dr. Cathy Slemp: (31:39) At the local level, speed is more important, and so, that's where you often will see local reports being publicly available before the state, and the state will actually, you'll find the same, that the data will be updated before the national data for West Virginia is updated, so this is just part of the routine system to be aware of that, and know that. We also think hospitalizations are a piece that we'd like to be reporting on as well shortly, and so, we are working with a variety of folks on how to do that. I want to make sure that people realize that every data point we collect takes time, and effort of someone on the front lines, and so, we want to really thank all those healthcare workers, hospitals, local health departments that collect this data, and put it into the systems that we can then report it out. Dr. Cathy Slemp: (32:26) We do have some of that data. We are working to make sure it's provided to you in a clear and understandable way with that. Let's walk through the actual dashboard. Here you see the front of the dashboard, and it has the same numbers you've been seeing. On the left is the 345 laboratory confirmed positive cases that we've been reported to at the state. Then you have the number of deaths that we've seen, the number of total individuals that we have received, or the number of reports that we've received from laboratory results, and then, the cumulative percent positive, which is what we are following that people have talked about that three to 4%. It really varies over time. We want to keep that steady. Dr. Cathy Slemp: (33:16) On each of these numbers you've got some information below that you can click to get more information on. If we click on that one on the left, the 345, we'll go to the next slide, and here you actually have some more information related to the confirmed cases in West Virginia. You have the map on the left, and if you hover over each of those counties you can see that the number of cases that are in that county, and then, the counties with a gray are ones where we have not yet identified a positive case. That does not mean that the virus may not be there. People need to be doing all the same precaution measures. They're just as they have anywhere else across the state, but has not identified a positive case and a resident from that jurisdiction. Dr. Cathy Slemp: (34:10) But, we have well over half of our counties, I think 30 some counties now that we have identified positive cases in, so that's the map, and it gives you the sense of where numbers are and by county. Some of those may be related to outbreaks and facilities, some may be related to community level on transmission. On the right hand side you see on the top, this is the kind of the in... cumulative number of laboratory confirmed cases, and you can see that that is increasing over time as each time we report out more cases that column goes up, it's by day. Dr. Cathy Slemp: (34:50) And, we were actually tracking those by the data specimen collection, because that actually gives us the most accurate timeframe which they are diagnosed there. You will notice that it levels off, at the very end, those last few, and that is because some laboratories take longer than others to get the results back, and so, those numbers increase in completeness based on when the laboratory gets their numbers back to us, and how what their turnaround time is. Everybody is working very hard to make sure as fast as possible those labs get things done. It is a challenge across the nation with that. The bottom, you see two different charts. The one on the left. actually looks at the age distribution, so what age are people that are laboratory confirmed cases? You will see on the right hand side, those last two bars, that actually reflects our 60 to 69 year olds, and our 70 plus year olds, so about 34% today. A third essentially of our cases, our confirmed cases are over the age of 60. In the middle you see that by age, by decade, the percent of our cases that are in each of those categories. So, if you look at our combined there are 20, so 59 year olds, 62% of our confirmed cases are in that age group there, and then, if you could look at under 20 which is the left two columns. Those that actually reflects that only about 3% of our cases are under the age of 20 so this mirrors the national data that this is really an illness that is occurring mostly in adults, and that it is across that adult lifespan. Dr. Cathy Slemp: (36:47) We know that those that have higher risk factors, or are older are at higher risk of poor outcomes with that. On the right hand side there, the circle, that's the breakdown by gender, and so, we have about 53% of our cases reported to date are female, and 45% or so, 46% are male with that, and so, that's the breakdown by gender, so this is the page that looks at our confirmed cases, and what the demographics of those are. If we go to the next slide, this is the third page on the dashboard, and this is actually looking at the test results that we have received, and before we even jump into this, we were looking at it, as you can see, we've received test results on, essentially almost 10,000 test results. Dr. Cathy Slemp: (37:45) This actually is under-reported in terms of there are more tests that have been done. We get the positives of those, but not every laboratory can report them to us electronically, and so, of the negatives, and so, this is actually an under-reporting of the test results that have been done through the system, through the state, but it is what we can track electronically with that. On the left hand side, what you see is the age breakdown of individuals tested, those test results. What you see essentially there is that testing is being done across the adult lifespan, and then, you've got some testing done at the younger ages as well, but that's about 8% of an under 20, and those would be based on the symptoms, and those types of things for the testing. Dr. Cathy Slemp: (38:38) The right hand graph there looks at the cumulative number of laboratory results reported to DHHR, and so, you see, it's showing that we have a increasing numbers of testing going on, and you see a leveling off at the end of that, those last few bars, and that again is, because there're some labs that have longer turnaround times than others, and so, we might have a few more days before some labs get their tests done, and get the reports sent to us. Once they get the tests done, they report to them to us very quickly, but that leveling off is just reflecting the lag time of some labs being a longer turnaround times than others. Dr. Cathy Slemp: (39:28) And then, the last slide here is looking at the cumulative percent of positive lab results to date, and this is the number that Dr. Marsh, and the governor, and others have been tracking, and that we compare it to some other jurisdictions as well, and this simply reflects the percent of all the tests done cumulatively, what percent are positive, and we map this actually out... Dr. Cathy Slemp: (40:03) ... what percent are positive? We map this actually out by the date of specimen collection here, so that it's clear. This is the number that we keep following with that as well. We also look at the daily rate. That is actually quite variable because it's a smaller number, but we look at that for trends as well. But the one that we can look at systematically across is this cumulative percent of positive lab results to date, and that's what we're all watching carefully there. Dr. Cathy Slemp: (40:28) The last area that I would speak to is just I think to reiterate the importance of the measures that people are putting in place. As you heard, the projections are actually improving in terms of what our peak might look like. Although, it may come sooner than we originally were thinking, the projections are now suggesting that it will not be quite as severe. That being said, it will get worse before it gets better, so we would expect to continue to see rises in cases and rises in deaths, sadly. Dr. Cathy Slemp: (41:06) This just reiterates the importance, the critical importance of the social distancing, the being physically distant from each other, that frequent hand washing, the surface cleaning and then now we've added the use of cloth face coverings in many settings. I think that is just important that we keep doing that. We can give some practical examples of that. I mean, the one I'll share today in terms of simple things that make a difference is, for instance, with your grocery shopping, if you can limit that to say once a week to minimize the times you need to leave the house. You could limit that to one family member. Think about using online ordering and pickup if that's available or delivery if that's available in your community. Those are a key kind of simple tip with those. Dr. Cathy Slemp: (41:59) Many of us I think want to kind of loosen those social distancing restrictions a little bit because it's difficult especially now that weather is nice. We'd ask you, please do not. We've got to have every one really stay strong and keep doing your part to flatten that curve. It's okay to do things like if you are going to go out, take a walk with your dog and you're on your own and you do that physical distancing, that's absolutely fine. It's okay to do those things outside without masks, without other kinds of things, but we just wanted to make sure that people truly do adhere to those recommendations that are being made by your local health departments, that businesses really do operate along these lines, that maintained physical distance with individuals and that everyone respects that. Dr. Cathy Slemp: (42:44) If you do have any symptoms, cold-like symptoms or illness, please do stay home. Do not go out. People who have symptoms do not always need to be tested, but you do need to take those precautions to stay home and manage your illness and then call your healthcare provider if you are needing to get some assistance with that. Please do call first before you visit a healthcare provider. Dr. Cathy Slemp: (43:11) I'm going to stop there and we will go to questions. Speaker 2: (43:17) Okay. Thank you Dr. Slemp. Once again, we are holding today's briefing with media members joining us virtually to practice good social distancing. To media members, when we call on you, please remember to unmute the microphone on your end before asking your question, please confirm your name and affiliation as well. The first questioner today will be Taylor. Jim Justice: (43:37) Second. Bring it back to me, just one second. Before we go to the media and the questions, I'd like to just, Dr. Slemp's given us a lot of information and I want to, I want to kind of concise it. One thing I'd like to show you is, Jordan, if you could put up, I don't think you can put this up. I'm sorry. But put up the dashboard as of today, please. Jim Justice: (44:19) If if you'll notice on the dashboard today we have 345 positives, 9,940 tests taken and a 3.47 positive per test taken. Okay, if you could take that down now, Jordan. This morning at 10:00, and that's after 10 o'clock, that's today's results, but as of 10:00 this morning, we had 324 positive and 8,838 total tests for a 3.67 positive per total test. Now, the shockingly bad thing is just this is one death is too many and we have four now and we don't want to overlook that in any way, but what we have dropped from 3.67 to 3.45. Of those, the increase from 324 positives as of yesterday to 345 as of today is an increase in positives, about 21 with slightly over 1,100 tests taken. If you equate that into a percentage, that equates to right at 2%. If we're tracking at 3.47 now versus 3.67 yesterday and the number of tests we took in today was at 2%, that's good stuff. It's showing a lot of hope. Jim Justice: (46:09) Now I continue to stress that the hope can turn ugly really, really quickly now. But on a national basis, the other states are tracking at a level of about 8 to 10% and we're still tracking now at 3.47, with the results that came in today at right at 2%. We're tracking significantly below most all the rest of the states. If you think about New York, which is the epicenter of the whole, of everything right now, they're still tracking at 30 to 50% of test taken to positives. The net of the whole thing is we're tracking well and that's why I said over and over and over to all West Virginians. Jim Justice: (47:08) I've got one more graph that I want to show you, and I won't bore you with a whole lot of stuff, but if Jordan, if you could put this graph up real quick. Basically what this graph is is the states, and I guess it's the 14 States that are 37th to 51st and that's basically it, a territory I guess beyond the 50th state, but those states ranked from 37th to 51st, and you want to be last in this deal and everything, but we are almost tracking just exactly with Montana. Montana came in 51st and we came in 50th. Again, we're holding the numbers and we are holding where we want to. If you'll look at that curve that shoots straight up, that curve that shoots straight up is New Jersey. All of those states that are down on the lower level are the states that were from 37th to 51st. I may have misspoke when I said Montana because that state that is slightly higher than us is Minnesota not Montana. I mean slightly. They're 51st and we're 50th. Jim Justice: (48:39) But the only reason I wanted to go through that is Dr. Slemp is giving you tons of information. Their dashboard is phenomenal now. She's doing great, great work as well as secretary Crouch. They've put it out now to where it's really easy to track and it's easy to see. But, for me, as she was saying that, I just thought I could bring a little more clarity to that. Speaker 2: (49:04) Okay. Thank you, Governor. The first media questioner today will be Taylor Stuck with The Herald Dispatch. Taylor, are you with us? Taylor Stuck: (49:14) Hi. Yeah, It's Taylor with The Herald Dispatch. I was wondering if you could tell me, if someone could tell me, what the surge will look like in real time. What will that look like for West Virginians, do you think? What would be the indication that we're moving out of that surge? What will be the indication that we can maybe start going back to some normalcy? Dr. Clay Marsh: (49:38) Governor, okay if I take the first shot at that? Jim Justice: (49:40) Absolutely. No, Clay, that's good. Dr. Clay Marsh: (49:42) Thank you. I think that, Taylor, it's a great question. We're hoping to avoid a real surge. What we would look at would be an increased number of emergency room visits. We would look at a uptick in the number of positive tests, which is the reason why I think the governor acted very decisively in executing the further executive orders for the three areas of our state, because it starts in the community, it goes to the emergency rooms and then it goes into the ICU. We are tracking very carefully emergency room visits and looking at those for increases in particularly the areas of our state that we see the increased amount of positive testing. Then, of course, we look at intensive care unit capacity, look at how busy they are, how many people are on ventilators. We're doing that in a way to keep track of the part of our system that fails fastest if we get the surge. Dr. Clay Marsh: (50:44) We hope and we believe that because of the good work of our citizens and some of the decisions that the governor's made and that that local health officials as well as DHR's made, that we are able to prevent us from having that surge, which really is the overtaking of the capacity of the health system. We believe then that if we can get through this first part, which the Washington model predicts will happen mid-April, then we will start to see an opportunity for us to understand then what are those next phases; because if we get through this effectively, which we believe that we will with the good work of our citizens and their commitment, but then a lot of people will still not be immune to this virus and then we'll have to figure out what the next phase looks like. Jim Justice: (51:38) Let me follow up. I want to say one thing real quick. The surge, and God forbid, we saw what the surge could do in Italy. We've seen what the surge can do in New York and other places across this country. Whether big or small, the surge can be devastating beyond all comprehension. It's my job. It's my job to try with all in me to see that we're either ready or we some way, somehow prevent that from happening. Jim Justice: (52:16) You saw over and over bodies being loaded onto freezer trucks in New York City. It's bad stuff. You saw last night our president come out and give us what he said was just a glimpse of light of hope that this thing was beginning to turn. You've seen us shrink down when we thought really the surge was going to come till April 15th now and you've seen us reduce down from what looked like 500 people could die in West Virginia to 150 or 175, I can't recall exactly the number. Jim Justice: (52:57) Can you just imagine? Can you just imagine 150 or 175 West Virginians dying? If we can avoid that and it could have been way, way, way more catastrophic than that. Four is too many. 150 or 175 would be just terrible. Let's please just stay the course. We're going the right way here. Speaker 2: (53:21) Thank you. Up next, let's go to Charles Young with WV News. Charles Young: (53:27) Hi, this is Charles with WV News. My question is for Dr. Marsh and probably General Hoyer. Could you talk about what the updated modeling means for our preparedness in terms of supplies, PPE, that sort of thing? It sounds like we're going to need less than we had anticipated up until recently, but we're going to need it sooner. Could you guys address that for me? Dr. Clay Marsh: (53:53) Sure. Jim, do you mind if I start? Jim Justice: (53:55) No. Sure. I mean, you and General Hoyer handle it. You know about the supplies we got over the weekend and all that stuff. Dr. Clay Marsh: (54:02) Great. Thank you, Governor. Dr. Clay Marsh: (54:05) Charles, good question. We have been able to create some more time, that has really been through the actions of our policies and our citizens. We have been planning and I'm confident that we are ready for any surge that happens. Certainly we have tried to become self-sufficient as well as working with the federal government and having sufficient personal protective equipment and also come up with ways to produce our own personal protective equipment and decontaminate that that we're using. We also have a very novel plan for PPE that we will announce soon, which I think will be very exciting. Dr. Clay Marsh: (54:58) When it comes to having other supplies and availability of capacity, we have been working closely with the hospital associations, with the hospitals, with the extended-care groups so that we can can release bottlenecks and hospitals and also with some approaches to be able to help people stay in their homes if indeed they do get sick with the COVID virus. Dr. Clay Marsh: (55:24) I think that we are in relatively good shape. You can never be completely prepared for something that you don't exactly know what's going to follow, but we have paid strict attention to the models. We have done I think a really good job internally together in creating the best plans for capacity and for resourcing so that we are acting as a state, not a separate set of hospitals and entities. Dr. Clay Marsh: (55:53) Jim? Maj. Gen. Jim Hoyer: (55:55) Yeah, Charles, just to highlight a couple of things. Dr. Marsh and the governor talked about. One of the things we did early on is the governor authorized us to buy the reusable PPE, the system we refer to as the Papper system. Also in our hospitals, they have a little bit different system called the Capper system. That's also a reusable system and those are working with that. We work towards what we call the sanitation or decontamination of critical mass, like the n95 and work in multiple sources. Maj. Gen. Jim Hoyer: (56:30) Then the other key point is the governor directed us early on to stand up a task force to look for multiple sources of supply. This is just like a military operation overseas. You don't rely on one supply stream, you work on multiple sources of supply, so a number of different private supply chains as well as the system that is out there with FEMA to be able to manage that. We also now look at the proposed burn rate per day in our state versus the models. As we continue to do the things that we do. Maj. Gen. Jim Hoyer: (57:06) I guess the last thing I'd reinforce again, from the 6,400 guardsman, those on the front lines, our medical folks, our first responders, law enforcement, if we can double down now and we can double down in those counties of Kanawha, Monongalia, and Berkeley County where we have our highest numbers, we have a great opportunity to really even flatten this curve even more, which will be great for us as the state of West Virginia. Maj. Gen. Jim Hoyer: (57:34) We've got to space out in these stores. We've got to do those things that we're asking because that's the equivalent of PPE and reducing our burn rate on those things we need for the surge. Speaker 2: (57:46) Okay. Thank you, Charles. Up next, we'll go to WVVA. I believe Jackie is with us. Jackie Swaggert: (57:53) Yeah. Jackie Swaggert, WVVA here. Hey, y'all. I think this question would be best for Dr. Marsh and Secretary Crouch. What is the process for contact tracing positive patients in West Virginia? Jim Justice: (58:09) Hear the question, if it was coming to me. I'm sorry? Jackie Swaggert: (58:15) What's the process for contact tracing positive patients? Jim Justice: (58:21) I could not hear. Dr. Cathy Slemp: (58:24) To that. [inaudible 00:58:26] Speaker 2: (58:27) I believe her question was, what is the process for contact tracing in West Virginia? Jim Justice: (58:33) Kathy, maybe you could ... Dr. Cathy Slemp: (58:36) I'd be happy to. Dr. Cathy Slemp: (58:38) When a case is positive, is recorded, that goes to the local health department immediately and they began a case investigation. They have the support of both the regional epidemiologist and some National Guard that have also been trained in this process to support them as needed with that. Dr. Cathy Slemp: (58:58) They do an initial interview, getting everything they can gather around the individual person who is positive. They then identify and talk to them, or whoever they can speak to, the family and others, to identify who they would have been in close contact with from 48 hours before their illness began up until the present or when they would have been self-isolating or whatever the issue was. They identify the individuals who would be in close contact, and that really means living in the same household, being within six feet for more than 10 minutes with someone, sharing utensils, those kinds of very close contact. Identify those individuals and then they go to those individuals and work with each of them to determine who else needs to be tested, does anybody have symptoms, who needs to be isolating themselves. Actually, to explain some language, the person that is sick, anyone who is sick, isolates themselves. Those who are well- Dr. Cathy Slemp: (01:00:03) ... sick. Anyone who is sick isolates themselves. Those who are well, but have been exposed, do a self-imposed quarantine. And that's the 14 days. So they work with each case to work through that. To figure out what contacts need, what kind of follow up. And that's all part of that investigation. Jordan: (01:00:21) Okay. Thank you. Up next, let's go to Caity Coyne with the Charleston Gazette Mail. Caity Coyne: (01:00:29) Hi, Caity Coyne, Gazette Mail. Governor, can you speak a little bit looking at the enforcement piece of these extended orders, what are state police officers allowed to do? What are they not allowed to do and what's being done to ensure that there aren't abuses of power with these broad new responsibilities? Jim Justice: (01:00:49) I'm really sorry. I can't hear. General, can you hear? I mean, maybe ... General Hoyer: (01:01:02) Yes, sir. Governor, the question was what is being done related to the enforcement issues and the use of the State Police to help with the enforcement powers of the executive order and the ability of the local Health Departments to take action. Jim Justice: (01:01:19) Okay. I got it now. The bottom line is just this, the Health Department people are urged to call if they see someone, if they see people that are gathering in a crowd, and they see things that are going on as far that is adverse to our social distancing, we're encouraging them or empowering them and encouraging them to call their local officials as well as the State Police and then the State Police or the local authorities are going to come and they're going to tell these people that they've got to disperse, they have to social distance and if they refuse to do so, they could charge them with obstruction. Jordan: (01:02:12) Okay. Thanks. Up next, let's go to Amanda Barren with WSAZ. Looks like Amanda. Amanda Barren: (01:02:33) Hi, there. Amanda Barren, WSAZ. Can you hear me? Jordan: (01:02:33) Yes, we got you. Go ahead. We have you, Amanda. Go ahead. Amanda Barren: (01:02:34) Jordan, can you hear me? Okay, cool. I wanted to ask, Governor, about the unemployment benefits. I know that obviously today is the first day that the National Guard is participating and helping getting the systems running 24/7, but there are so many people out there right now who are panicked about paying their bills. What is your plan? Is there any kind of a plan to help people in the short term? Also, Delegate Andrew Robinson sent a letter I know to you today about potentially differing weekly benefit calculations and determining chargeability back to specific employers. I know that's a lot at once, but there are a lot of people wondering what they're going to do as far as bills are concerned. Jim Justice: (01:03:17) Okay. Amanda, I think we've already done exactly what the delegate was requesting, but I'd like for Brian Abraham, if he could just step up here, maybe with that mic you could ... maybe Brian could add a little color to that. Brian Abraham: (01:03:42) So Amanda, last week, the governor, or two weeks ago actually as we began to stand this up, the governor had already ordered that every impediment to unemployment insurance be waived. So employers are not going to be charged their normal experience factor. The employees would not have to wait the week to get their unemployment, so everything that could be waived and still comply with federal law, the governor directed that. And he signed that into an order for the director to do. Jim Justice: (01:04:09) And Amanda, I think another part of your question was with manning workforce 24/7 and doing all the things we're doing to try to process the claims as expediently as we possibly, possibly can, and get everybody, be able to get everybody their dollars in as quickly as possible. And we've amped that up in a great big way, and we're going to get that done. But Brian, hold on just one second. There was another part of the question is, can we as a state step in and do something about the backlog or reinforce the backlog? And maybe you could comment on it. Brian Abraham: (01:04:51) The way to fix the backlog is to add the manpower the governor's directed. We have that operation going, we're going to be going 24/7. We've added staff. We're going to add processors to it, not just those that answer the phone calls. So we're reducing the backlog day-by-day. We're in constant contact with the Director of Workforce to ensure that they have all the resources they need. The governor is constantly contacting us and making sure we're pushing them in every way shape we can. We are bringing in the staff, the National Guard, some other agencies to supplement those call centers so we're putting every resource we can to it. The only issue that we're still trying to find a technology fix on and that is the federal portal for which we have to push all the claims through. The governor mentioned that earlier, but we continue to have our OT work on that as well. Jordan: (01:05:40) Okay. Thank you. Up next, let's get a Casey Gentile with WVNS. Casey Gentile: (01:05:50) Hi, this is Casey Gentile from WVNS. I'm just curious if there are any plans in the future to add recoveries to the DHHR website? Jim Justice: (01:06:01) Okay. Bill, maybe you could do that. Bill Crouch: (01:06:05) I couldn't quite understand the question, Governor. Casey Gentile: (01:06:07) Adding recoveries to the website. Bill Crouch: (01:06:10) We are looking at adding a variety of components there as we move forward. As you've seen what's been done over the past week, just week or so. The website is much improved. We're looking at those metrics that might be important for the public. It might be important for others to see. So it will change over time. Jordan: (01:06:34) Okay, thank you. Next, let's go to Brad McElhinny with West Virginia Metro News. Brad McElhinny: (01:06:41) Hi, Governor and everyone. We've talked about the people at Workforce West Virginia helping people process their unemployment claims, but this presumed positive test of an employee of workforce makes me wonder what the work conditions are there, with such urgency to process those claims, are the employees able to social distance the way the rest of us are trying to do? General Hoyer: (01:07:09) Governor, if you want, I can take that and Dr. Slemp could help. So Brad, they already were practicing the appropriate social distancing. That was one of the reasons that the Kanawha-Charleston Health Department Director decided that only one individual needed to be isolated, in the event that you just described. There is also separation by floors and part of the plan that the governor's directed that the National Guard and other agencies help with both the call center and the processing is a distributed system across the state. General Hoyer: (01:07:45) As Brian Abraham mentioned, one of the issues that we've got to manage with that is the technology to distribute and roll phone numbers and things of that nature, but I think the good news is that because of what was being done, it limited the exposure with the one individual. This morning, National Guard medical personnel also added an extra layer with taking temperatures as well as doing some surveillance questions. And I think Dr. Slemp may be able to speak to how all those things come into play to help us keep our workforce safe. Dr. Cathy Slemp: (01:08:23) Sure. My understanding actually is that they were doing a great job. The call center had really taken very seriously this issue. Their leadership had really taken seriously keeping their staff safe so they had spaced their employees, they had taken lots of good precautions to protect them and that actually that was a real benefit in the investigation because it really, it was clear that the work that they had done had limited any kind of exposures in the work setting. The close contact that you heard referenced, it was not a work setting contact. And so, they've done well with this. Jordan: (01:09:02) Okay. Thank you. Up next, let's go to Steven Alan Adams with Ogden. Steven Alan Adams: (01:09:10) Yeah. Steven Adams, Ogden Newspapers here, and my question is a little bit related to the unemployment issues with Workforce West Virginia. I've been asked about the pandemic unemployment assistance, the program for the self-employed. I understand that the workforce website basically kind of has a ... we'll let you know when it's ready type of webpage landing page, but when exact, do we even have a timeline for when that's going to be made available for self-employed? Jim Justice: (01:09:41) Yeah, I can take that. Steven, as I understand it right now, I think we're still waiting on the guidelines from the federal government in regard to that. I think what they have promised is they're trying to roll that out on Wednesday or Thursday of this week. In regard to the independent contractors and the self employed. But, I think that's who we're waiting on, on that. Jordan: (01:10:10) Okay. Thanks, Steven. Up next, let's go to Kinney Bass with WCHS. Kenny Bass: (01:10:17) Hi, this is Kenny Bass from Channel Eight, Fox 11 in Charleston. I have a question for a Secretary Crouch. Specifically, we've gotten several calls from state institutions from across West Virginia focusing on the William R. Sharpe, Jr. Hospital reports that the screening process for patients and for workers has changed multiple times in the past several days, that people on the floor are working with fevers or others are symptomatic. And also that Sharpe is not getting the PPE equipment like some other places are not. Is it possible, I know that you guys have said you have policies and procedures in place, but is that possible that with the policies and procedures in place, there's some type of noise between you and the people on the front lines, the supervisors, either they're not getting the proper instruction or they're not paying attention to the proper instruction because maybe they're shorthanded or maybe they're used to doing things a certain way? Jim Justice: (01:11:15) Wait a minute, Bill, before you answer, let me do this, Kenny. Let me defend the great work that Secretary Crouch and Dr. Slemp, and The National Guard, all the people that are underpinning this whole effort are doing, because let me just tell you this, that we are screaming from the hilltops to have people follow guidelines. And those guidelines are the safest guidelines that we know about today. But you and I both know, you've seen people go into Walmart or you see people doing this and everything. We absolutely have to have people on the honor system and people following the guidelines. I'm sure now, Bill, you can take it from there, but I do want to speak up for the great work and the tireless work that these people are doing. It's not good enough. Don't get me wrong, we don't rest until it's over, but at the same time people got to listen. People got to listen on the other end too. Bill Crouch: (01:12:23) Thank you, Governor. Kenny, we have a process where we take everyone's temperature before they enter the building. There's actually a questionnaire that we ask daily when folks come in, if they've been in contact with someone who's COVID positive, whether they've been in an area that has a cluster. The temperatures that we use are actually a little more restrictive than CDC guidelines. So we follow CDC guidelines, and then take that a little step further. So we certainly don't want anyone in our buildings who have a fever and who have symptoms. Bill Crouch: (01:13:01) We ask them to go home immediately and a self quarantine, if that happens. We test folks that come through our facilities, so we're very serious about this. Obviously, we're not going to be successful at this if we allow folks who might be positive or might have symptoms to be in our buildings taking care of other folks. So we take this very seriously. We've heard the same rumors in the private sector. I've had hospital administrators contact me with the exact same complaint. So, I'm not sure where this is coming from, but again, we're very careful about that and we're serious about it. Jordan: (01:13:40) Okay, thank you. Up next, let's go to Mark Curtis with WOWK. Mark Curtis: (01:13:47) A couple of things here. First of all, the governor, I guess you tweeted over the weekend, something about changing or relaxing nursing requirements being adjusted, some appeal you made to the nursing board. If you could address that. And also of the 345 cases so far, how many of them are considered to have been recovered now? The people recovered. Jim Justice: (01:14:07) Okay. I got, I mean, the last half of the question, Mark, we're definitely going to have to go to Bill Crouch and Dr. Slemp. The first half of the question, I couldn't quite hear it, but it was something in regard to the nursing board and maybe Bill you can just take them both. Bill Crouch: (01:14:26) I'm sorry, Governor. I couldn't hear the first part or the second part. Cathy, did you hear that? We've got very poor audio reception here. Sorry. Can somebody repeat the question to us? Clay: (01:14:38) This is clay. So I think the two questions were that the governor tweeted over the weekend about relaxing some of the restrictions from the Nursing Board for surge issues. And then also, the second part, I'm actually forgetting, unfortunately. Dr. Cathy Slemp: (01:14:58) Recovery. Clay: (01:15:00) Recovery. That's it. Jim Justice: (01:15:01) The 345, how many are recovered? Bill Crouch: (01:15:06) Well, there are a lot of boards and a lot of federal requirements and regulations that are being relaxed in this pandemic. And the reason for that is simply that it's a pandemic. We have a serious situation in which we need to have all hands on deck. We're looking at utilizing nursing students in some cases, medical students from WVU to assist in investigations. So we're really looking hard here at all of the resources on the table that we need to make sure we get through this as unscathed as possible. Bill Crouch: (01:15:44) The governor's set us up by making everything, making all of these decisions early on, in some instances before we even had a positive case. So the federal government has come along and said they're going to relax some of the requirements as well. So, those are temporary. Those are during the emergency period only. But, you will see a lot of those that are relaxed. In terms of the recovery, Cathy, do you want to address that? Dr. Cathy Slemp: (01:16:08) Sure. This is a really fascinating question actually and a challenging one. We have to recognize that there is a wide array of duration and timeframes that people have before they are recovered from this disease, depending on their own conditions, et cetera. And exactly what is the definition of recovery. And so if someone who has minimal to no symptoms, it may be a few days, they may not ever even realize they had the disease. For several folks it will be a week or two. And then you've got individuals who are really have the longterm ongoing both challenges and disease and complications from that. Dr. Cathy Slemp: (01:16:53) There are some models that look at that and many of the projections on Hopkins and other sites are based on some of the modeling kind of things. We're looking at what we can do to do that and estimate here, but you would have to actually do a call down of every individual person and define exactly what's meant by recovered to get an actual percent exactly of these. So we're looking at what we can do in the interim to get a sense of that. But it is not as straightforward a question as one would like to think. And it really does have to look at how this disease takes part across population and how we can best project that. Jordan: (01:17:31) Okay. Thank you. Governor, I'll turn it back to you. Jim Justice: (01:17:35) Well, I'll just end real quickly and just say just this, that it is natural, it is natural for all of us that have never seen anything like this pandemic to think, well, it can't happen to me. This isn't going to happen to me. But in that, that makes us lackadaisical in heeding the advice of the medical community and the medical experts as well as our National Guard. Please, please keep the faith and stay the course and keep doing the things that we're trying to tell you to do. It's working, but we still got a long ways to go. Thank you so much.