Louisiana is backed in Phase 2 (modified) LINKS TO WATCH This conference was announced last Thursday
Pre-Conference Question - What do you think he'll announce?
- A harsher lecture on being a GOOD NEIGHBOR?
- Modified Phase 3 ala New Orleans?
- Moving back to Phase 2 or 1?
- Or will it be an unexpected Stay At Home order?
- Some other option?
Summary NOTE: The summary of this press conference is transcribed LIVE. The summary may contain spelling and grammatical errors which until it is able to be corrected once the conference concludes. NOTE: The summary may contain spelling and grammatical errors. Gov JBE
- Anyone who has been paying attention to the news whether internationally, nationally, or state you know COVID-19 is going in the wrong direction unmoving very fast in the wrong direction.
- Louisiana is experiencing the third surge of COVID-19.
- Nov alone the US has had more new cases than in any other months and hospitalizations are at a record high nationally. Higher than other surges.
- Yesterday the US added more than 169,000 new cases in one day and 898 deaths.
- This week's WH Coronavirus Taskforce Report shows 474 new cases per 100,000 people last week we had 172 new cases per 100,000 people. The national average is 356 cases per 100,000.
- So this is the first week in many weeks that LA has had more new cases than the national average.
- Today we report ___ new cases and sadly 39 additional people have lost their lives to the virus for a Toal amount of ___ deaths. Reporting 1,052 hospitalizations, not the first of the month we had less than 600. Today we are up 40 than yesterday with more than 350+ net new COVID19 hospitalizations. 113 patients on mechanical ventilators.
- When we see what's happening in state and across all regions we have to be very cautious about hospitalizations and maintain the capacity to give life-saving care to covid and non-covid patients.
- Trajectory we are on it is imperative we take action now.
- If we could flip a switch and get 100% adherence to mitigation measures to all measures we are still 2 weeks from seeing changes.
- We are in for a rough patch, and the degree we flatten the curve and are successful will depend on eery Louisianan.
- We are stepping a step back to a revised Phase 2. So Phase 2 with some modifications.
- We got out of the prior surge by moving to Phase 2.
- What does that mean?
- Will get into that later...
- Wants to get ahead of the Thanksgiving Holiday and the extended holiday season.
- Data includes info thru Friday, Nov 20.
- Thanks National Guard, GOSHEP, and the LDH for working very hard and working over the holiday.
- Gating Criteria Slides:
- What we are seeing is as concerning as it has ever been. We were lucky to have a reprieve from the rest of the countries rise in cases for a few weeks we are now where a large portion of the country is.
- Top left shows % of patients coming into ER departments across the state with symptoms suggestive of COVID-19 you can see the prior spikes and now it is increasing again.
- Top right show new cases on a rolling 7-day average you can see the first and second spikes and now the increase we are on which is almost identical to where we were going up in the second spike and clearly we have not hit the top yet.
- Bottom left you can see the % positivity dated back to the date of collection and that is increasing as well up to 8.1% now will be posted on the dashboard tomorrow. You will see testing volume is also increasing. There is more COVID so more people are getting tested due to more exposure plus the increase around testing around the holiday. An increase in testing volume has no bearing on testing positivity. An increase in positivity and testing volume is a strong signal we are experiencing a lot of COVID.
- Bottom right is the amount of hospitalized patients with COVID19 you can see the two spikes and now a sharp increase. It is a rate of increase that our hospitals cannot stand for very much longer.
- Region analysis - every region across the state are seeing similar increases.
- Region 1 Orleans - increase across the board.
- Region 2 EBR - increase across the board.
- Region 3 River parishes - increase across the board.
- Region 4 - increases across the board.
- Region 5 Lake Charles - increases across the board.
- Region 6 Can LA - increases across the board with a very sharp increase in new cases and hosp.
- Region 7 - increase across the board.
- Region 8 - increase across the board.
- Region 9 - increases across the board.
- A month ago it was a mixed bag with some areas plateauing or increasing.
- Now the entire state for all gating criteria is increasing, (only Can LA is plateauing for COVID-like illness reports).
- Still have capacity across the state but this is a lagging indicator so if you act when hospitals are at capacity it is too late.
- People waiting a long time to get a bed. One ER had to use recliners in the ER while people waited for a bed to open up.
- Rural/smaller hospitals are having a difficult time transferring patients to other locations. Not every ICU bed is equal and some conditions require more expertise from an advanced center. Only a handful exist across the state. Even if a rural hospital has an ICU available if a patient presents with needing an advanced team and there are none available they may have to wait a couple of days before they get transferred in. That's a delay of care and has consequences.
- Hospitals are stretched and already at staffing capacity. A nurse may typically care for 4-5 patients may now be caring for 6-7.
- These things have consequences and it is just the beginning because we haven't hit capacity yet. This is a warning we have to act now. There are things we are working to preserve in the state and the ability to access normal hospital care is one of those priorities. We do not want to have to delay scheduled procedures.
- The path ahead is dangerous. This is a dangerous time for Louisiana.
- The trajectory we are on is dangerous. We are on a similar trajectory as before.
- Now it is flu season so we have extra patients in the hospital.
- Weather turning cold so more people indoors = more transmission.
- Peak of the holiday season coming up so there's a temptation to gather. Gathering = more transmission.
- Previous increases we were not in lockstep with the rest of the country. Every other state is seeing runs on hospital care and demands of their hospital staff at the same time we are. If we need to ask for help, it may not be there this time. In fact, we don't think they will be available because they will be caring for their own state's patients.
Questions for Dr Kanter about data Related to Halloween? Seems people are willing to gather for Thanksgiving. Are we going to see a worsening 2 weeks after Thanksgiving
We are already seeing just about as steep of an increase as we can get it really can't get much steeper than that. I don't know, looking back to Halloween, it was part of it. I think increases from other states was bleeding over into our particularly in Northern LA. Plus we are tired, COVID fatigue is real, and it's easy to get complacent. Even without Thanksgiving coming ahead we will continue to get worse. I don't know how much worse it gets with Thanksgiving. I cannot emphasize this more than enough if you need to make a decision for your family talk to someone who has had it, experiencing the disease, or someone who has worked in the affected healthcare facilities during those two surges. How much is being driven by small gatherings indoors and if so it doesn't seem restrictions matter than much
Small gatherings have been a larger component than months ago, there is no question about that but that is just one slice. We continue to see a lot of cases tied to bars, restaurants, events, and churches as well. Mitigation measures are going to be significant in their effect but not absolute. The other side is that people really need to make responsible decisions when no one is looking. No one will police who parities but I want families to take it seriously and know what the real risks are and make an informed decision. The more families are informed the more they will be likely to say for this year, for my family, it is just not worth it. Gov. JBE
- We have already been told that for example if we will request help from he Fed gov in respect to medical care to Louisiana there are 12 individual and discrete things we have done first before we can be considered.
- Strong indication we cannot count on that.
- Difference between Spring and Summer surges when we did have medical personnel available from requests to the Federal government at that time.
- Partially important for Northern and Central LA. I do not know how hard it will be to go back in the gating criteria for those regions but if you go to Region 6. If you look right at the summer surge we never got those numbers as far down as we wanted to we never got those numbers down to where we wanted to. So the baseline of going into the third surge is much higher relatively speaking to the state as a whole. So we are already in a much more difficult place.
- Statewide the non-COVID patient population is higher now than it was in the Spring or the Summer.
- Region 7 you will see the right of the summer surge the numbers did not come down to be even close to where they were before the summer surge started. So they have a very high baseline of cases.
- Region 8 the same thing.
- Our numbers are worse and they are getting worse everywhere so I hesitate to bring up regions 6,7, and 8 because people might think that's the only places we need to be focused on. That is not true, but I will tell you its a particular concern if you are in Central or Northern LA because you have such a high baseline going into this.
- While we need adherence to restrictions everywhere it is particularly acute in Regions 6,7, and 8.
- Breakdown of Phase 2 (modified) will become effective tomorrow and last 28 days (4 weeks) expiring on Dec 23:
- Statewide surge requiring a statewide effort.
- Follows the White House Coronavirus Task Force recommendations.
- Last time we had such a large single-day increase was in July -- which is when we took action through implementing Phase 2 and the mask mandate -- and collectively the people across Louisiana responded and we bent the curve.
- Time for us to rise again and meet the challenge before us.
- With the Holiday season before us we really gotta pay attention to this now so we do not overburden our hospitals to not deliver care. I do not want to have hospitals have to cancel elective surgeries or medical procedures want. Delayed non-emergency procedures and surges often transmit into emergencies later on. Do not want doctors to have to make crisis care decisions pitting cases against one another due to a lack of resources.
- We have avoided crisis care during our previous waves because we worked together to flatten the curve.
- If there was ever a time to step up and be a good neighbor, whether it is to your actual neighbor or to someone in LA you have never met, that time is now.
- People do not stop having car accidents because of a pandemic. There are still critical care needs apart from COVID.
- Do it for the medical professionals as well who have been overworked since March.
- To keep schools open.
- Encouraging all employers public and private to maximize the use of telework where possible.
- Ask families to engage in safe holiday-related activities. When you gather with those outsides from your household the more times you do it the more you roll the dice and the more likely it is that you or multiple people get sick. With community spread the dice are loaded against you. I ask you not to do this, especially during the holidays. It is what the CDC and LDH recommend.
- Start planning now for a safe Christmas and Hanukkah.
- Reduction in gathering sizes for businesses & houses of worship
- 50% for occupancy with social distancing and masks for restaurants, coffee shops, cafes, gyms, casinos, and video poker, and non-essential retail businesses.**
- Essential is determined by the Dept. of Homeland Security.
- 75% for occupancy with social distancing and masks for churches and places of worship.**
- Reduction in gathering sizes at bars other restrictions remain in place.
- Bars in parishes with greater than 5% must close to indoors consumption can have outdoor seating of up to 50 people, seated and spaced out, and masks mandated.
- Bars in parishes with less than 5% can allow indoor consumption up to 25% occupancy seated and spaced out; outdoor consumption encouraged and masks mandated.
- Reduction in gathering sizes at event centers
- Indoors limited to 25% occupancy, make required up to 75.
- Outdoors limited to 25% occupancy, masks required, up to 150 where social distancing is not possible.
- Reduction of sporting event occupancy
- Limited to 25% occupancy.
- When LDH updates the two-week case incidence numbers tomorrow there will be some parishes where bars close, that were going to happen regardless of these changes because those parishes would have exceeded the 10% that was previously required.
- Now allowing outdoor seating.
- Statewide mask mandate remains in effect
- It was a critical part of slowing the spread in the summer and is a critical part now.
- Now we know wearing a mask also reduces transmission to you as well as those around you.
- Doing everything we can to keep schools open.
- Local decision how schools do this.. if they are in person, vertical, or hybrid.
- Do not have an expectation that by Dec 23rd we will reduce restrictions a couple of days ahead of Christmas.
- All data indicates we in for a couple of rough months.
- No one should believe we will relax restrictions around that time.
- I hope and pray, and believe, we will not have to put more restrictions in place before then.
- Will be dependent on if the people of Louisiana embrace the mitigation measures and flatten that curve again. If we stay on the current trajectory we will be forced to put more restrictions in place.
- Everyday households need to stick together and reduce interaction with those outside of their household.
- Any activities that do take place should take place outside rather than inside.
- Odds are 20x higher to catch the virus indoors than outdoors when the same activity takes place.
- We are expecting rain this week perhaps staying with us through Thanksgiving and after.
- Even if you planned the safest possible event with it intended to be outdoors there is a good chance you will not be able to do that.
- Now is your opportunity to adjust your Thanksgiving plans.
- Do not have people from different households come indoors together. The virus doesn't care if you are a relative.
- If you want a Christmas without loved ones in the hospital, or worse, you need to be extremely careful on Thanksgiving and every day.
- Next few weeks would normally be holiday party time - office, block, family, etc.
- Holiday parties are a recipe for disaster now. Asking people to forgo those parties.
- There is a light at the end of the tunnel, it is not a high-speed train heading in our direction, I believe in a few months we will be able to put the pandemic behind us. Next month we can start vaccinating in small numbers and will take some time to get to the general population. Do not get in your mind we will have to mask up and physically distance forever. There is an excellent chance that next Thanksgiving will be the best one ever. While there is COVID fatigue and I know it is real, it is also real that we are looking for renewed interest and compliance for a finite amount of time. I hope it inspires people to do what is required and know they won't have to do it forever. The next few months are critical. We need everyone to be on the same page.
- Holidays are about showing your love for those you care about. The best way to love someone right now is to give them COVID. So like it says, "pass the pie and not COVID" that is our mission. That is the mission for everybody in Louisiana.
- Follow the commonsense public health measures, the restrictions, and mitigation measures.
- They work and have worked before.
- Mitigation measures: wear a mask, stay 6ft apart from that outside of your household, wash your hands for 20 seconds, stay home when sick, and protect the most vulnerable from this disease (65+ in age and those with co-morbidities).
- Thanks to all public health workers.
- Owe a debt of gratitude for those who have worked so hard for months now. We should not make it harder than it needs to be. We should all do our part.
Questions Epidemiologists in Louisiana say we may be getting diminishing returns on our introduction of restrictions than what we previously saw. Are you concerned that the impact of the introduction of these restrictions will be more gradual and the implications that may have
I am concerned about an awful lot as it is related to COVID19 and this pandemic. There is not one easy decision I have made nor one that has brought me joy. I am convinced that if the people of Louisiana will embrace these mitigation measures and restrictions, be patient and selfless, and ensure compliance that we will flatten the curve again. That is what I know. There are no magic tricks to be worked here. The only way to stop a surge is with restrictions and mitigation measures. So with the numbers increases here and around the country as they are the sense of urgency that you see coming out of leaders in Washington right now, as seen with Vice President Pence and the Coronavirus Task Force the other day, everyone should understand that this a very very serious situation. We have to do our part in order to slow the spread. It has to be a collective effort. No one should say is 99% of the people do it that's good enough I don't have to personally do it... that doesn't work. We all have to see it as a common effort that we all play our part. If someone would have presented a better option to flatten the curve I would have taken it. I know we have COVID fatigue here and around the country. If there was something other than wearing masks, washing your hands and staying home when you are sick, and so forth I would embrace it. It doesn't exist. That is why you hear this coming out of Washington and all the other healthcare workers how important these are. So let's do it. Let's flatten the curve again. I feel very comfortable that in several months, not sure when we will have enough of our population vaccinated that I believe we can start putting in the rear view mirror. Until now and then we have to do what is necessary. I do not know if there is another surge after this one, I pray not, but we know we are surging now. Are you trying to change the way enforcement has been handled on these public health issues. Obviously the problem is people aren't following previous guidelines.. so are you making changes to enforcement?
We will continue to work with businesses of all types and venues to ensure that they understand that the restrictions are what rules they have to abide by. Individuals and businesses can get more information at opensafely.la.gov
and you will get more information. Will there be enforcement? Yes, there will be, but I am going to say what I've said back in March and every time since then, if the people in Louisiana insist we enforce our way through this we are doomed to failure
. There are 4.66 million Louisianas and 10s of thousands of business and quite frankly we cannot enforce our way through this. We are going to be asking people to comply, do compliance visits, respond to complaints, and where people refuse to come int o compliance you can expect enforcement. That will not get us through this surge. That will not protect the health of our fellow Louisianans, it is better than not doing any enforcement. We need to have people doin this because it is the right thing to do. They need to embrace it, not because it is pleasant but at the end of the day this about people's lives are talking about. We are doing our very best to strike the balance between lives on one hand and livelihoods on the other. When it comes to economy, to business, to employers, to livelihoods, the best thing we can do is put this virus behind us. Are the rules for temporary conditional permits allowing bars to operate as restaurants remain in effect?
Yes and we currently have 372 bars using conditional permits to operate as restaurants. They are not a hybrid, they are not part bar or part bar. They operate as restaurants if they are operating properly and they follow all rules for restaurants. For other establishment that continue to operate as bars they need to follow the way we outlined bars operate today. What are you doing for your Thanksgiving celebration. You have a son who is coming home from college because LSU is going virtual for Thanksgiving
Yeah I have a son who actually lives here in Baton Rogue and he will likely be coming home to spend some time with us. I will tell you we will stay in baton Rogue at the mansion and have a Thanksgiving meal that consists of the immediate household. We will gives thanks because even during this pandemic which has been so tough on people, even after the 3 hurricanes that hit this year, we have so much to be thankful for. God has truly blessed us. Thanksgiving is a day to give thanks and that is important to me and my family and we are going to do it, but last year I remember my 84 year old mother came, my 6 siblings all came with their spouses and children and grandchildren. We had 80 or 90 people. You will not be seeing that this year and you will not see it at Christmas either. I hope and pray that if you are with me on Thanksgiving Day of 2021 you will see that. I believe that you will, but between now and then we all have to do our part. Did you tell Legislative leaders about these new restrictions before you came out here today? What was their response?
Yes, I did. You need to know that I routinely send data and information to the Speaker and to the President. We have complete transparency on the data we are relying on because we update it every day aside for Saturday. We also have sent Legislative leadership, and I believe every member of the Legislature, every White House Coronavirus Task Force report whenever we get them. This morning in a addition to those things we presented all gating criteria slides to the Speaker and the President. We talked about where we were especially in light of our hospital capacity and our need to go back to a modified Phase 2 in order to flatten the curve again. They asked some questions, expressed concerns to makes sure whether the Fire Marshall or ATC will work with proprietors and bar owners to maximum extend possible so they can know hat is expected of them and be given an opportunity, if they are operation in good faith -- of which the overwhelming majority of businesses are -- to come into compliance. That has been our approach throughout the pandemic. We have always bent over backwards to make sure individuals know what the rules give them every opportunity to come into compliance and only after persistent shortcomings/refusal to do any real enforcement actions like citations take place. I assured him our approach would not change. Does the influx of new vaccines change our prognosis at all
We have a draft plan in Louisiana that we continue to update and revise daily. The reason it is a draft plan is that we still don't know the day that we will get the first vaccines nor the number of doses that will be there. I have every expectation that around mid-December we should receive some doses of the Pfizer vaccines first. We don't know how many it could be as few as 30,000 or might be 60,000 we do not know for sure. We think the first doses of the Moderna vaccines would come weeks later, perhaps with a smaller number available initially. We continue to work with our federal partners. We were on the phone with Azar yesterday and talked about the logistical aspects of Project Warpspeed. Once the vaccine gets the EUA from the FDA we will have the vaccine in route to our location(s) of choice in 24 hours. The first shipment will be prioritized to healthcare workers, then high-risk groups (nursing homes, assisted living centers, congregated shelters), then the list expands from there out. Ultimately we want to get to a place where we put a call out to the general population they can go to their health unit (hospital, doctor's office, or pharmacy) and get the vaccine. This is not a one and one vaccine, it requires a second dose, depending on the manufacturer that could be between 21-28 days later. More vaccines may come only over time and some of these things may change. I do not want talk of the vaccine, it is critically important and no one is more excited than I am, but I do not want the talk of the vaccine to cause people to not pay attention to what is imperative right now. That is why you hear Dr. Birx, Dr. Fauci, Azar, talking about the term of bridging to the vaccine and needing to double-down on measures until the vaccine is widely available. The vaccine will not be here in the numbers we need soon enough to reverse the trajectory and numbers we went over today.
I do want to mention I have every confidence that when the FDA issues that EUA that that vaccine will be safe and effective. I hope my fellow Louisiana will embrace the vaccine. A vaccine saves 0 lives but vaccination can save a lot of lives. The vaccination requires the vaccines and
an individual to receive that vaccine in two injections. So please understand the FDA has not cut out any steps required to evaluate the safety and efficacy of these vaccines. In fact, the trial sizes were 5x-6x more than one would normally see in a trial. They took steps consecutively instead of sequentially to make this vaccine thereby shortening its time for production. They started the mass production while trials were still happening. So if that authorization comes they have the vaccine to distribute and more to be distributed and you don't have to start that manufacturing process up from the beginning. So I really want people to embrace this and understand they will be safe and effective once the call goes out to start vaccination. Does the state have enough cold storage for the vaccines or does the state have to put in some money for that?
We've identified the cold storage capacity that we need pursuant to our plan to administer the Pfizer vaccine. Its a combination of cold storage capacity and dry ice. We will be in good shape there. This is why you have to have really good hard work going on hard in advance. That way working with hospitals and universities you are able to identify all the cold storage you have, where is available for these vaccines and then you plug that into your plan. That will not be a limiting factor in terms of receiving the vaccine. Logistically it makes it more complicated because you have to receive it at those sites and distribute it from there. They are still evaluating how long the vaccines remain stable once they thaw out. We will be all over that so we will make sure if that vial falls out it will be administered while it is stable and making sure that people come and get the second dose as well.
- Thank you for continuing to cover this. We do not anticipate another press conference until next week, date unknown.
- As I mentioned awhile ago, despite how difficult this year has been for all of us both individually and as a state, there is a lot for us to be thankful for. That is always the case. So Thanksgiving is about giving thanks for the blessing we enjoy and I would encourage people to find ways to have a celebration that is safe so we can be thankful for the blessings we have while being mindful of the dangers of this pandemic. There are dangers if we insists on celebrating the holidays as we have in past. I cannot strongly encourage people to be patient. I know you are tired of this but be patient and love your loved ones by making sure you do not expose them to unnecessary risk. We close to them through the phone, FaceTime, and other ways. Let's look forward to getting together without restrictions and mitigation measures. Unless between now and then we are too risky with our behaviors and we'll be lamenting the fact that we didn't do what we were asked to do. That some of our loved ones won't be with us when the time comes to celebrate in person. When that next birthday, Thanksgiving, or Christmas happens. I encourage everyone to do their part. You've done it before. We can do it again. I am not asking for you to do this forever. There is finite time I am asking for. I cannot tell you when, but I believe in several months we will be putting this in our rearview mirror, but it is not today. In fact, it is not in our rear-view mirror it is in our grill and it is a nasty nasty situation here in Louisiana like it is around the country. We do not have a moment to waste. Everyone has to do their part. If we do, and I'm sure we will, we will get through this. I have every confidence of the people in Louisiana. They have always inspired by their kindness, goodness, and generosity and I believe they will do it again. So let's work together. Let's save lives. God bless and thank you.