201120_COVID-19 Press Briefing
9:40PM Nov 20, 2020
Governor Asa Hutchinson
Governor Asa Hutchinson
Dr. Jose Romero
Andrew DeMillo - AP
Alex Burch - KATV
Mike McNeil - MagnoliaReporter.com
Leslie Peacock - Ark Times
Josh White - KAIT
Dr. Cam Patterson - UAMS
Larry Shackelford - WRMC
Thank you for joining me this afternoon I'm pleased to be joined by Dr. Jose Romero with the Department of Health, as well as Dr. Cam Patterson, Chancellor of UAMS, but also on the Winter COVID Task Force. Mr. Larry Shackelford, CEO of Washington Regional Hospital is by Zoom with us. And we'll have some comments a little bit later. He's also serves on the task force. I'm also pleased to be joined by Sue Tedford
Sue, there's Sue Tedford, who is the director of the Arkansas Nursing Board and have a relevant announcement to make in that regard. So thank you for being here. First, I want to go through some of the cases and this is going to be abbreviated but it it sets the stage for where we are right now. And let's go to the first today's update, we're going to do it in this fashion, which you're accustomed to seen. And you can see in terms of our total cases that have increased from yesterday is 2061. Our active cases are up 362. Our deaths, very regrettably, are at 24 increase. If you look at our hospitalizations, it reflects the challenge that we face, which is an increase of looks like 36 from yesterday adding to our hospitalizations, that brings us to 935. We have additional ones on ventilators. And then you can see the top counties there as well. plasti County 209, Washington County 162 new cases, it is significant to look at the testing because of the PCR test. Just the last 24 hours we have done 15,095 PCR tests, which is a record in a 24 hour period, and the antigen test are equally high at 3383. So testing it a record amount. That's a total of over 19,000 excuse me, 18,000 tests in 124 hour period that have come in the cases of 2061 new for today are part of our confirmed cases and are probable cases. With that. Let me go to the next one because I want to focus on hospitalizations today. And the challenges that we face in space, as well as in medical staff. And we're looking at a number of items to the task force on this. But this gives you a perspective of confirmed covid 19 admissions by hospital region. And this gives you the trend line for November 7 to November 19. The red and the last one here is a southeast region. And then you see up the top the growth trend at the metro. And these are not the public health regions with your hospital region. So it's a little bit different usually see. But if you look by region, you can see the trend lines by region. The next one breaks it down in a different way. And these are percent of hospital resources used by COVID patients. And so it gives you a Wednesday and why Thursday and yellow and red is Friday. So a three day look at both hospital beds, ICU beds and ventilator state wide. And their modest increases, you know, slightly increased the number of hospital beds, which means that almost 90% of hospital beds are occupied by non covid patients, of course, you got ICU beds, it's jumped from 33 to 34% in a couple of days, ventilators 34% or 37%. It shows a trend line but it also shows the fact that we have a lot of other health needs in Arkansas besides COVID that we have to manage. But the COVID is what is occupying a significant percent of the of the metrics. And then this goes by hospital region, statewide Metro Northwest northeast, Southwest, Southeast North Central and Arkansas Valley. And these are hospital beds you can see the management challenge. And so northeast is 18% growth rate in our vets occupied by COVID patients. But that's down in the southeast to 5%. Statewide is 10% the next one, you'll see See it broken down. Additionally, for ICU beds, and here you can see the management challenge again, indoor Central, which I presume is Mountain Home and Harrison area, North Central 69% of our ICU beds are occupied by COVID patients. In contrast at 28%, in the northwest 24% in the Arkansas Valley, you go to the next one, and you will see ventilator usage. And again, the Northeast is at 62%, vent occupancy by COVID patients. And that varies down to 28% in the metro region. And so every region has a different look. And you cannot just simply look at it by region, you got to look at it by state wide when you're trying to manage all of these resources. And so with that, I think that's the last one there. Let me come back to turn this over to Dr. Patterson, to talk about what we're doing in terms of our central healthcare workers. And trying to standardize that with our quote our our taskforce that's been meeting on that topic. And I believe he also wants to set the stage for what we're trying to do to manage this statewide population. Dr. Patterson.
Thank you, Governor Hutchinson. So I wanted to give everyone a little bit of insight about the winner COVID task force them what the task force is working on. What we've been up to over the past week, Governor Hutchinson has convened two meetings of the winner COVID Task Force. The task force has also been divided up into specific subcommittees, I chaired the resources. So committee, our subcommittee has met two additional times. So this is a subcommittee that's been asked to do work and the work is getting done. There are good news as we scan the state and many areas as we've looked at resources, for example, peepee, through the work of the Department of Emergency Management, we have over 60 days, statewide supply, a PPA, and all hospitals are reporting that supply chains are moving well. You saw today almost a record number of tests being done. So the testing resources are not perfect, but but they are certainly considerably better than we have been able to talk about previously. And you'll hear some very good news that has come out of work of the subcommittee in a second related to how we're improving human resources, having people at the bedside able to take care of patients. In addition to that, this week, two other important objectives have been met by the task force. One is to provide consistent guidelines across the state for how we bring caregivers back to the bad side, in the event that they've either contracted COVID-19 or have been exposed to COVID-19. And to give you an sense of the magnitude of this problem, just that you a ms alone, we have almost 400 employees who are currently under quarantine. So there's our 400 employees who cannot be at the bedside to manage patients. And that creates all kinds of challenges for us as we are constrained by increasing numbers of patients and in our hospitals. So through the assistance of the Arkansas Department of Health, and I particularly want to give a shout out to Navin Patil. for his work on this, we create a guidelines for essential hospital workers and how we quarantine them and when we decide to bring them back. So for anybody in the population who's been infected with COVID-19, the typical protocol is for those individuals to remain at home and in isolation for 10 days after diagnosis of COVID-19. And for those who have been exposed to COVID-19. The current guidelines are to remain quarantine for 14 days for essential health care workers. The guidelines under current circumstances, as enumerated in these guidelines, which will be released this afternoon, are that for essential health care workers who have been exposed, they may be tested by PCR, five to seven days after exposure, and if that test is negative, those individuals can return to the workforce with enhanced precautions. In addition, we provide guidelines in the instance in which a hospital is in desperate need of bedside caregivers. And those extreme conditions don't currently exist, we hope that they never exist. But under those extreme conditions, if an essential health care worker has been infected with COVID-19, they may return to work if they are asymptomatic if they are only treating patients who are COVID-19 infected, and if they are segregated from from employees who are not COVID-19 positive. So as I said, Well, we get we'll be pushing these guidelines out to the healthcare community across the state this afternoon. In addition to that, we've been looking at whether we can apply our trauma comm system to assist us in managing health care resources across the state. We have not implemented the utilization of trauma calm yet, under these present circumstances, but it may provide us with an enhanced resource to manage COVID-19 patience, because as governor Hutchinson just demonstrated to you, the problem is not spread evenly across the state. So what is trauma calm trauma calm is a system that set up is housed in the Department of Health. It's statutory, it was created by the legislature in 2009. And trauma con does two things. One is it assesses the resources that are available for pay for individuals who have been subjected to trauma. So what resources does a hospital currently have to manage those patients, and it provides communication to transfer patients from one facility to another, in order to make sure that they have they get the resources that they need. So imagine applying the same principle to patients with COVID-19 for patient is in a facility that doesn't have the ability to provide Intensive Care Unit management of that patients, this system would know where those resources would exist, would coordinate with emergency medical systems, to an inactive transfer of the patient bring the patient to a facility that would have those resources, either because the facility was a higher order facility or facility happen to have an empty bed that was available that wasn't available in the local community. So like I said, this has not been implemented yet. We're looking at the resources that would be necessary to do this. But it is, I think, a great example of what the winner COVID-19 task force can do to enhance our ability under constrained conditions to make sure that our healthcare system in the state is not overly burdened and overly stressed. And I'd like to finish by saying what I'm sure everybody else is going to say, as we head into the Thanksgiving holiday. This is the time when we really need to double down on wearing masks on good hand hygiene, and on maintaining social distancing. And especially at a time when we otherwise would want to be around all of our family members. This is a thanksgiving for a nuclear family turkey dinner. So thank you, Governor Hutchinson.
Thank you, Dr. Patterson. And that's a good lead into the comments of Dr. Romero in terms to have the new CDC guidelines.
Thank you, Governor. So before I talk about those guidelines, let me let me put it back to the bed status here in the state. We have beds at this time. But as you all know, in the previous holidays, that is the fourth of July and Labor Day, we've seen surges in the number of cases that occur afterwards. We are at a high level at this point of occupancy, we still have room. But that number can increase further. If we don't abide by the three W's which are wear your mask, wash your hands and watch your distance. So the CDC has new guidelines with regard to the holiday coming holiday. That is they're strongly discouraging a travel outside of the area. So you should not really be thinking of traveling a lot to go across the country to see your relatives and even within the state you should probably not engage in that. That as was mentioned by Dr. Patterson, a nuclear a nuclear Thanksgiving that is a family. Really Family Centered Thanksgiving less than 10 people certainly would be advisable and preferably just the people that are living in your home at that time. We the health department are currently discouraging individuals from bringing persons in nursing homes into the home environment because we know that they can become infected There are rules and now quarantine periods being placed on on persons in nursing homes before they can go back so that if you come to dinner for Thanksgiving, you may not be able to get back into that nursing home immediately, you will have to be quarantined. If there's no quarantine facility or room at that institution, you may need to spend time in your home until there is. So keep that in mind. Again, things like opening up windows in your in your home if you have the dinner are encouraged. And if you do decide to travel, if you do decide to travel, be tested before you go get a PCR test, get a test that can be rapidly interpreted. The local health units do that and can provide that for you. So let me move on to one other topic and then I'll turn it back over to the governor. Literally within the last hour. Pfizer which is one of the vaccine manufacturing companies submitted their paperwork to the FDA for EA approval from reading the the little blurb It will take about three weeks for the FDA to make an adjudication of the efficacy and safety of their of their vaccine, we hear that also there'll be a second vaccine entering into the EU a phase in the next week or two. So this is to let you know that we are moving forward on vaccine development and licensure. Those vaccines will be available next month, but they will only be available to a select group of individuals high risk individuals with with which is being determined this time by the CDC Advisory Committee on Immunization Practices, and also taking into account the National Academies of medicine and engineering recommendations. So I'll stop here and turn it back over to the governor.
Thank you. And then I appreciate Larry Shackelford, who has some comments from Northwest Arkansas, in terms of our public messaging and how we can do better. So Larry.
Yes, sir. Governor, thank you. Thank you for the opportunity to be able to join you on a remote basis and remain here in Northwest Arkansas where we're taking care of folks. I'm pleased as as Dr. Patterson shared to not only be working on the governor's winter Task Force, but to be leading a a subcommittee that is looking at what are ways that that we can reduce the current current rate of spread of COVID-19. We have have heard the importance of the the three W's wear your mask, wash your hands, wash your distance. But part of the recommendation that we're bringing is we need to also be very diligent about watching, gathering in groups. It's natural that at this time of year, it's dark earlier, we're spending more time inside where we're we're spending more time with with others. And being very mindful of not gathering in groups of 10 or more. Being mindful of limiting no more than two households at the time that that we do gather is I think an important part of our messaging as we go into this winter season. Just as the the graphs and the data show, we are seeing a rapid increase in patients that are needing inpatient care. We're certainly seeing that here in Northwest Arkansas, where in the last two weeks, we've had a 40% increase in number of patients that are COVID positive, needing inpatient care, it does give me pause and concern. And we look back at Fourth of July, we look back at Labor Day. And two weeks after those events, we see more patients needing and impatient here, I want you to understand that that where we are today, we do have capacity to not only take care of covid patients but to take care of other patients that that need care. But it's important that we act now. If we see two weeks from today, the kinds of increases that we've seen two weeks following other hospitals, then we are going to be at at the point that that it will be challenging to to meet those needs. Thank you, Governor.
Thank you, Larry and also thanks for your support recommendations in regards to the 11 o'clock limitation for our restaurants and bars to ease that burden as well. With that, I want to make this final announcement. In the coming weeks, we will have 1104 nursing students that will graduate from nursing schools across Arkansas. It is Sue Tet, Tedford is here as worked hard on this. And the nursing licensing board will expedite the licensure of those 1104 nursing students, that will provide a 24 hour turnaround for their licensure. And I'll also ask the board to waive the application fee, which is 100 to $125. We need to get those nurses on board quickly. We need them to help relieve some of the challenges that we face, they will still have the background check, which is a $30 fee, that cannot be waived. But the fact that we will expedite that will make it easier for those nurses to enter the profession and go to work at a time that their talents, their heart is critically needed. And so I hope that word gets out, and that those nursing students will graduate. And they will go to work here in Arkansas. We want them here. We need their talent and their convictions and their heart. With that will turn over any questions. All right. So at the table first, Leslie, they will go remotely. But Leslie, your you started
talking about the trauma system that was mentioned about that it might be this might be implemented? Are you talking about the trauma system might gather data on on patients with COVID and direct them to...
Let me let me answer that question. And this is something that the task force is working on. The the exact application of it has not been determined in terms of resources, training protocols. But yes, just like we guide trauma patients to the right hospitals, we want to be able to guide COVID patients to where we have the best resources and the best treatment. And so we want to incorporate that into trauma con, our trauma system. But that is as far as we can go today in terms of where we are, and hopefully, this kind of statewide coordination that will be useful and helpful.
have shown up at a hospital and be in the regular Toma dashboard. They would just be
separately treated under under under coordination system. Remotely, was at Andrew I heard
no, I got
Hey governor. The head had a couple of questions for you regarding your announcement yesterday on the earlier closing time for bars, bars and restaurants and clubs. First of all, I just wanted to see if you are some of the taskforce members could elaborate on elaborate on what why 11 o'clock, you know what it was there some research that that back this up or gives you some confidence that this this time would make make some impact in terms of curbing case cases here? And the second question I had was just wondering, is this as far as you think the state can go in terms of additional restrictions on businesses? Or are there? Are there other restrictions that still are on the table? And if so, what's kind of the what's what's the number you're watching for to revisit, revisit whether there needs to be more restrictions beyond in early closing time.
In terms of why 11pm was selected, in talking with our Director of enforcement with our Department of Health compliance officials, that led to this discussion. Of course, our ABC agents are, are there, they understand the atmosphere they understand where the compliance is likely to take place where it might get a little bit less than that. And so, you know, whenever we're trying to minimize undisciplined gatherings of people that are not in compliance with public health guidelines. This was a recommendation that came Larry shackleford might have additional comment on that. Larry, did you want to say anything more on that?
Yes. So that was very, very much as as we talked through that recommendation, that was the the guidance from our facade apartment help. And we certainly are looking at at what we would consider to be high risk activities and things that that that can be done now to, to help that those that risk moving forward.
Thank you, Larry. And on the other part of the question, I've been asked a lot. Are we going to put further restrictions on Are we going to get nervous about our businesses? And the answer is, our businesses are working very hard on compliance. And I've indicated on numerous occasions, that we want to keep our businesses going, we don't want to slow them down. We don't want to put undue hardship on it, we want our decisions to be based upon good facts and analysis. And, and so we don't see a justification for any further economic restrictions, that there's not any way to compensate for the losses. And so that's an important part of the equation, we want everybody to be disciplined to follow the guidelines, we want to be able to insist upon compliance. And that's why they're working hard in that area. But we want our businesses to do well, and particularly to reward those that have done well. And not to just across the board say, we need to close gyms, for example, the gyms that I know, are working hard to comply with the public health guidelines. And we're not seeing a repercussion from that, as Larry and others have mentioned, it is the social gatherings. That has been a challenge. And this is an unregulated area. We can't go into homes, we're not going to be doing that we're not going to have a social police, but we can educate and we can try to make sure that those smaller groups are discouraged, or those larger groups are discouraged. Next question.
Governor Mike McNeil at Magnolia Reporter.com, even before the COVID crisis, rural hospitals in Arkansas, were having difficulty recruiting nurses, signing bonuses are common $5,000 signing bonuses are common now. Are you concerned that a bidding war might break out for nurses and other medical professionals? And if so, what steps might be taken to make sure this resources spread barely across the rural areas, Arkansas?
Well, there is a bidding war. And that's a much greater very much a challenge for our hospitals, not just rule but urban as well. And, you know, bonuses or profit, profit, promised, you know, they they become traveling, and we have to recruit others, healthcare professionals, and so it is a challenge. All I can say is our task force myself, we're looking at that to see if there's any relief that can be provided. But we don't have any specific solution right now. That's something we're continuing to look at.
This is Alex with CHANNEL SEVEN, regarding the latest directive, what is it about January 3, why was that date chosen?
I believe we picked 45 days out if I remember. That's and so, but also clearly, you know, whenever you look at how long and we're going to have this, you've got Thanksgiving, you've got Christmas, and you've got New Year's. And all of those are where we have an atmosphere that is just real tempting for everybody to get together. And so to me, it made sense based upon the advice that I receive that we continue that through January 3, you know if our cases zip out the window, if they go down dramatically if our hospitalizations go down. Hopefully we can lift that before then. But I think it's safe to say on the trajectory we're on that. It needs to be January 3 at this time, hopefully won't have to be extended beyond that.
This is Josh White at KAIT . I've got a question for you. Gentlemen from Washington, from Northwest Arkansas product point that the 11pm curfew was to try to curb some of the numbers. Was there any given thoughts? That getting thousands of students together after the two after the Thanksgiving holiday, that that could curb the numbers as well, especially since half the schools are seeing at least five or more cases in them now statewide.
You're talking about K through 12. Schools?
Yes, sir. Well,
I will certainly invite Larry to comment on that. As I think the question I would ask is, where were those K through 12 students go and congregate. If they're not going into an environment of the school, I don't think they're going to stop congregating necessarily and just be in a much less disciplined fashion, perhaps, but Larry, do you have a comment on that?
No, sir, you know, you know, we, we talked about, you know, numbers in terms of getting that that message of, of what we as as individuals or or, or families are choosing, so when we talked about not numbers of not gathering in groups, that was that was where it was where that was coming from? So
Next question. Yes, right here.
Any trends of the surgeon cases? Where are we seeing these cases come from?
So thank you for that question. We are constantly looking at our contacts and seeing where that we could be finding this. We have not found any single point source. We continue to believe that this spread is coming primarily from small gatherings in our communities. But we've not identified a specific source that we can put our finger on.
Is it rampant at this point?
don't say that it's rampant. I think that there's widespread, widespread communication of the disease in our communicate in our state. But But you know, this can still be controlled. And we need to try to control this. And we can do so by means we've talked about before.
We have time for one more question.
Governor. Good afternoon. It's Neal Gladner in Hot Springs. With regards to the testing big testing numbers. Could you or Dr. Romero update us, please on what's the turnaround time, like there have been some people who haven't taken tests because they didn't want to stay home that long? What's the turnaround on both the health department and on the commercial labs has that improved, Dr. Patterson.
So the turnaround time depends on sorry, the turnaround time depends on whether the facility that you go to has the ability to do tests themselves, or whether the test can be sent out. If you come to a facility, like us, or Washington regional or other big medical centers, the turnaround time is going to be usually less than 24 hours that you a mess, depending on our platform. It's anywhere between three hours, and a little bit less than 24 hour turnaround time. If the requirement is to send out to a regional center, then turnaround time is typically less than 48 hours. If you have to send out your test to a national center such as quest. Recall that at our worst it was taking a week or more to get tests back on if you look back in time, three or four weeks ago, it was taking only about a day to get tests back from quest. Now because of the fact that the numbers have gone up so dramatically nationally, the turnaround time for quest or other national centers is creeping up to three or four days again. So it really depends on where you're getting your test done and whether that test is getting done at the site of care or whether it is having to be sent out.
Thank you, Dr. Patterson. I know our experts here will be available for questions afterwards. I have a commitment I've got to go to thank you very much for being here on a Friday. Have a good weekend.