On morning, we heard about the ground efforts of mitigation there. Was briefed by the hospital c. E. O. , the chief medical officer, the county Public Health officer and others. In taking necessary safety precautions we visited with aff at marius Medical Center and heritage assisted living center. We visited with them outside the facilities. I also had the opportunity meet with sheriff whit and the county commissioners. I also had the opportunity or chance to see the National Guards mission in action, both visiting with air guard members who are working at the heritage center, and also National Guard soldiers as theyre screening passengers disembark from the train station. Left with any number of observations from that trip, first, the recognition that in large communities and small that this impacts every facet of the community. And its also amazing the Community Support and ways the communities come together. And having the open forum with the hospital staff, of how appreciative they are of flowers being delivered. Of the recognition in windows all across the town. Of people in shelby recognizing that the Health Care Providers are working hard each and every day to keep not only those in need of health care safe but indeed the entire community. Also underscored continued concerns about the needs for supplies. And the challenge of that and those are things well continue o work on chear day. The topic of modeling and as people are looking at various models from around the country and trying to say, this is exactly whats happening in montana, certainly has been a conversation in recent days and weeks. Ive asked dr. Greg holdsman, the states chief medical officer, to share with you today how we use modeling to guide us in our work and in our decision making, but importantly, why we dont rely solely on modeling. This is a stand that time of uncertainty particularly for families across our state whose lives look different than they did a month ago. I understand that many are experiencing economic and financial hardship, particularly those who have been laid off or had to take leaves of absence from their jobs. I understand its easy to turn to modeling, especially the ones that give us the most optimistic look, as we all search for answers to better understand and better understanding of this virus, how long it may last and how much worse it could get. I certainly want to open back up nonessential businesses and operations as soon as we can. I want us to be able to celebrate the lives that weve saved together. With our Health Care Workers rather than just howling for our Health Care Workers from our doorstep each night. I want to return as much normalcy as possible, as much as you all do as well. Thats why were taking steps now so we can make this a reality as soon as we can. Modelings are predictions on what we do now. Our modelings are predictions on what we do now, but its what we do now that will make the real difference on what actually happens. With that, i turn it over to the doctor. Thank you, governor. Two major points i want to get across on modeling. The strength of ones model is dependent on the understanding of the science of the current situation, and with covid19 a lot is still unknown or only partially known. The second part of modeling is that modeling does not predict the future. It helps us describe possibilities of what could happen depending on what interventions we implement today. Covid19 modeling are based on many assumptions. We do not know all the science and we are learning more and more each day. For example, how transmittable is this virus . What is the severity or virulence of the virus . How does it affect different populations . And we can go on and on and on. This information is very important. And when we dont know all the facts we try to use our best scientific assumptions with that data that we do have. Let me give you an example. You may have herd the term rnouth. The basic definition of rin and ut is the number of cases rnought is the number of other cases an infectious person infect. A virus may be very infectious ke measles, which has a high rnoughht. Or lower like influenza. But the rnought doesnt describe the whole thing. It also describes the population its spreading. In measles is infectious buzz in the vites most in the United States most individuals are vaccinated decreasing decreasing the spread of this disease. There are other issues arn measles but thats a discussion for another time. Flu is not as infectious as measles but we see more spread in the United States because one, fewer people are vaccinated against the flu and this virus can easily mutate, thus allowing another way for the virus to kind of dodge our immune system. The point here is the rnought is not a stable number, it depends on many factors. So returning to the discussion of modeling, once we make guesstimate ops the variables, such as the r0. With models we need to make assumptions here also. For example, we might want one possible outcome is if social distancing is in play. And we look at another one as if social distancing is not in place. Or if its partially in place. This gives us data and ideas of what could happen. From the states perspective, with many different assumptions being put in place on the different covid19 models, it is important that we do not rely on one model. As no one model is complete completely correct. We look at many different mod el8s. We also look at our own epidemiological data that is coming in new each and every day and we talk to providers on the front line. We use all this information and more to help us make short term and longer term plans. And we continue to modify these plans as we learn more about the virus and the success of different preventive measures. It is important to acknowledge there are variablesed a modeling that we cannot control. The virulence or the severity or harmfulness of the virus. However there is a lot we can control. Such as social distancing. Wearing your cloth mask. When social distancing might not be able to occur. Washing your hands frequently. Trying not to touch your face. Thats one i find difficult to do at times and have to keep reminding myself. Cleaning commontouched service surfaces and others that we have talked about. While we are all doing our best to prevent the spread of the virus and protech ourselves and our neighbors from covid19, medical providers and local and state Public Health are also helping us control the virus. Providers in the state lab are notifying local Public Health partners regarding individuals who are sick with covid19. So we can move quickly to make sure those individuals who are sick are isolated and those who have been exposed are quarantined. We want to stop the spread of the virus before we they have exponential growth of the virus within one community. Where the pandemic goes in montana is dependent on us. I would like to emphasize once again, modeling does not predict the future. It helps explain possibilities of what could happen, depending on what we do or dont do today. Id like to hand over the microphone to jim murphy, the chief of the Communicable Disease and control and Prevention Bureau here at the state, and he can describe how it works on the ground and how the epidemiologist and state and local health are working together to try to stop the sprofede the virus and protect montanans, especially those at higher risk for bad outcomes. Thank you. Thanks, greg. I would like to explain how the local process works after a case of covid19 gets reported. I think its important to act ng that covid19 is something thats new but it is a reportable disease in montana. As soon as the disease report comes in, to a local or state Health Department, it gets immediately evaluated to figure out a few things. One is, the local Public Health nurses are really the folks on the ground that do a lot of the hard work to try to find out where this infection came frfment so each case gets investigated to find out three things. One is, where do we think this person acquired the infection. For instance, we know a lot of our early cases were travel associated. Imported into the state of montana. The second thing that the Public Health nurses try to find out is when that person interfaced with the medical systems in montana, was anybody in the medical systems placed at risk . Thats a very important step to help break the chain of transmission. The third thing and probably the most laborintensive part of this investigation is to try to figure out who are the close contacts that may have been placed at risk if the person that we are investigating. All of that gets rolled up in the local Health Department then goes out and works with the close cabots involved and the case to control the in the case to ro control the spread of the disease. The case is put in isolation. If were fortunate theyll be isolated in their home until theyre deemed no longer a hell risk to anybody and then theyre released after recovery and they can go about their business without any worry of spread. We have some people isolated in the hospital because of their requirements for hospitalization. Fortunately, weve been able to avoid that in almost every case. The next thing well do is work with close contacts. These are people who we think spent enough time or in close enough proximity to the person diagnosed that they are at risk. Those close contacts are then quarantined. Quarantine right now lasts for 14 days after your last exposure. During that time, those people are asked to remain alone, not go to work, not place other people at risk. During that entire period theyre monitored for any change in signs or symptoms. Any change many signs or symptoms will immediately lead to a medical evaluation that might include covid19 testing. Thats the only way were going to be able to break the chain of transmission is by identifying people who are cases, looking at the epeople they placed at risk, then identifying those people that they if they convert to cases. Thats the work going on at the will call level. In some cases we get very fortunate and a case might have literally zero to two or three contacts. That have to be followed up at the local level. The case of somebody returning from International Travel that gets back to montana, not feeling good, stays home, they might literally have zero close contacts for us to follow up after we investigate that case. More extreme cases we might end up with somebody that has 30 close contacts that we need to follow up with monitoring. Thats where the steps can get really intense for the local Health Department to keep up with that. These steps, though, are important for people to be able to be assured that that were not putting other people at risk and that local and state Health Departments are doing everything they can to protect the yen public out there its important to remind Health Care Providers who we work with that we are interested in testing anybody that has signs or simptosms covid19 infection. The state Public Health laboratory has resources to test anybody that a clinician feels is at risk and looks like they have clinically compatible illness. Again this is the only way were going to be able to interrupt the chain of transmission. Were making a lot of progress on that. We have the local Public Health departments out there and the clinicians to thank for that thank you. Gov. Bullock thanks, dr. Holtzman and thank you, jim. Before i open up for questions of either me or dr. Holtzman or jim murphy, i want to acknowledge again, this is a really difficult time for families. And right now, parents are having to explain the many recent changes and challenges in their childrens lives. I certainly understand that. As a father of three kids, simple things like watching our kids compete in sporting events can almost seem like we used to take it for granted. And i think even our younger kids who are trying to figure all this out are often that much harder hit. A parent relayed to me recently that their 10yearold, she asked the parents like, i cant believe my birthday was taken away by our governor. I think its really especially important in times like this that we do remember to try to find ways to bring joy and goodness into our homes. We have to look for that goodness that surrounds us in each day all throughout this. While we cant lift the shelter in place for a childs birthday party, know that if any parent nts to email in, governor mt. Gov, that the governor, i and the lieutenant governor, will send out a little video wishing your child a happy birthday. And in light of this weekend, im also issuing a directive providing that certain magical creatures may travel throughout montana to perform essential services. Magical entities certainly do perform services outside the scope of human ability. The tradition of Easter Egg Hunts is an example, its been celebrated by generations of montanan ofs. Of montanaians. I remember rushing to find the golden egg, and bringing my kids to the Easter Egg Hunt as well. I kay thi we can all recognize the easter bunny does perform essential services of hiding easter eggs, supporting the Chocolate Bunny industry, and further all dental services, including magical one are considered essential services, especially in a time of increased consumption of chocolate eggs, yellow peeps, other related spring treats. Uniquely fairy is alified to perform teeth gathering and submitting remitance for lost baby teeths. The easter bunny and tooth fairly may travel through montana and may leave behind a gift, for example eggs, chocolates, fair mark value of a baby tooth at every home they visit and must follow social distancing guidelines. Ive spoke within the easter bunny who agreed to ad here to social distancing requirements this weekend. Well be limiting the hiding of eggs and treats to within households. And immediate yards of households. I know ill be asked what type of authority i have to do this, its pretty simple,ester watkins arnold, tooth fairy from 1927, and the vell reteen rabbit from 1922. And all Montana Children young and young at heart. So for those of you young at heart tuning in today, i hope you do remember to find joy in each day. To try to look for the goodness around us even in these times. I now turn it over for questions. If yud like to ask a question you can press five star, not star five, phil drake. [laughter] youll be notified your hand is raised. When we unmute your phone youll be notified youve been called on to ask a question. Any questions . Reporter [inaudible] recognizing that this model is not set in stone does the leading model show that montana has hit a peak yet . If we look at the numbers coming from the state it looks like were stair steps down from a peak of march 26, do we believe were ahead or beat that model . Or is there potentially another ise . So i hope weve were ahead of it. But to be completely honest probably not. We need to follow out the numbers a little bit farther and see where things go. Theres also, while the lab data we get from our own lab here at the state is very quickly turned around, lab data that goes out or testing that goes out to some private labs, we may not get the results back as quickly. Hopefully they are getting to us as quickly as possible. So i think we need to follow it a little longer and see where things are going. We also need to, as jim murphy mentioned, really encourage our providers to continue to test. And this will allow us to do the Contact Tracing and hopefully we are beyond the curve. But i think we need to move forward as if were not. Gov. Bullock next question. Reporter im trying to imagine what it would look like when the economy starts to reawaken. Im wondering what are your [inaudible] gov. Bullock maybe ill turn it over to dr. Holtzman but i would also say, im both reading and looking into, as experts around the country say, how do we reopen this, its also based on your question assumptions of an antibody test. Being successful and being approved. I dont know if you have anything more to add to that . I agree with the governor, theres a lot of assumptions here. Theres even some places within montana that are looking at the Antibody Testing to see how effective it would be and trying to figure out the right test that could be used. The concept of the Antibody Testing is to show who has already been infected by this virus and thus might have immunity. So i think theres still a lot more to learn on that. It will be a great tool if we do have it available and we start to learn how long that immunity might be, how long an individual might have immunity after being infected with this virus. A lot still to learn. A lot of assumptions were taking on. Im glad the research folks are doing this and it would be a reat tool to have. Gov. Bullock another phone question. Reporter this is a question for the criteria for testing for covid19 is they the same criteria theyre supposed to have been using or has it changed . Blip jim can answer too, but what its been signs an symptoms of covid19 and either direct contact with covid positive or traveling of an area of concern. I think just to clarify, when testing first became available, because testing availability was an issue, the early recommendations for c. D. C. Were concentrating on hospitalized patients. It quickly evolved from that point to where we do have adequate testing now to test people who have symptoms of concern. If a clinician feels that they should be tested, we have the ability to do that. C. D. C. Does have some priorities for this, that if we have to prioritize because of volume, for instance, at the state laboratory, we would concentrate on the higher risk patients or hospitalized patients, but fortunately, the state lab has been able to keep up with demand and we havent had to make the difficult decisions right now. So a clinician who wants to test somebody who is symptomatic canned orer that test. E encourage them to do so. Eporter so currently symptoms alone are enough regardless of if theres been travel or documented contact . Correct. Simp tops are enough to warrant testing because we have transmission in many communities in montana so this would be the prudent thing to do so we can interrupt the chain of ransmission. Gov. Bullock next question. To rter governor, adjacent this, letter from the montana , your Association Reaction or response to that gov. Bullock i did just get the letter and look, we have to make sure that people are sheltered at home, that they have a place to be in their home. And to be clear, even when we made that directive, this doesnt excuse anyone from paying. And there should be an expectation that everyone does pay their rent and pays their rent on time. Well continue to have discussions with folks in the landlord side. We know that businesses, affected businesses including andlords could be eligible for s. B. A. Relief, also with federally backed mortgages may be eligible for relief under the cares act but well continue to talk to landlords. Nyone that is a tenant, during this time, its the directive says you cannot be evicted, that doesnt relieve you if you have the ability to pay your rent. Theres another phone read can you hear me . Gov. Bullock i can. I wanted to ask about testing capacity. [indiscernible] [indiscernible] gov. Bullock i do have concerns that someone who is symptomatic wherever they are may not get tested. The question underscores some of the challenge if you look at the county by county data. County, someone from Broadwater County might be tested here. We do encourage all avenues for individuals that are symptomatic to actually reach out to a Health Care Provider and try to arrange that test. Another phone question. [indiscernible] gov. Bullock yes, so a couple things, chris. Montana now is to get or just testtly received 15 abbott machines. Recognizing that these machines can get a result in literally like five minutes, the whole scale could go up to 15 minutes. At it is also one where it is lower volume test. Where we can batch test literally hundreds at the state lab, that ends up with the ability to only do effectively one of the time. We also have a good number of machines in montana that in many hospitalse both and some clinics that can be upgraded to run the health care. So, we want to figure out the best way to deploy those tests, but also i was in a call with governors jess yesterday governors just yesterday. Machines,ave these theres no expectation of any significant amount of the testing kits until the end of the year. Each one of these machines until the end of the month each one of these machines were shipped with 24 tests and with those 24 tests, good handful of them needed to calibrate the machines. So, we dropped off one of the abbott fast test machines up and shall be today. It will still be several weeks before we get sufficient numbers of the testing kits, so that these could be meaningfully utilized. Another phone question. [indiscernible] gov. Bullock sure, nikki. [indiscernible] gov. Bullock do you want to talk about the contracts with Indian Health service . Or jim . I think it is a very good question. We work closely with our partners at the tribal Health Departments and with Indian Health service. A lot ofeen doing testing on behalf of Indian Health service at the state laboratory. I think weve got a pretty representative sample of what is going on in all owners of montana, including indian country. Right now, we have seen a lower impact in indian country. We are watching that really closely, try to make sure they have access to other resources we can give them for testing as well as ppe or personal protective equipment. So far, things look pretty good, but it is something we continue to have to watch close and make sure services are offered in those settings. [indiscernible] we dont have that specific information. It gets a little bit challenging to look at that because people can get the test elsewhere, but live in a different county. Governor bullock explained this really well. With helena being situated close to jefferson and Broadwater County, this is where you would see some of our numbers go out wrong the first time where we have set a case was in one county, but found out it was in another. The test happened in lewis and clark possibly and the person was living in a different county. We dont have the specific numbers that are reliable for putting out at this time. Another phone question. [indiscernible] gov. Bullock yes, we will talk to landlords to try to figure out the best solution along the way as we do in every step. Taxes, comes to property the vast majority, over 80 of it goes to the local level, local jurisdictions have the ability to waive any penalties for late payment, but that is up to the local jurisdictions. Another phone question. [indiscernible] gov. Bullock they are not adjoining facilities, but there are facilities that end up in one silly or another. A directive that this was the individual or where it exactly started. There are separate facilities in different areas, but there is patients between one and the others. Other questions. Yes, sir. [indiscernible] gov. Bullock i would love for the ability the more testing we can receive, even if it ends up increasing the numbers, the better we have our hands around the impact of this virus and also the potential that this virus is being spread by Community Acquisition as the local Health Departments do their job, so i, like every member of the media, like every montana and or many montanans look at those numbers of covid19 positives each and every day. Minds, to our own ascertain the trends. We also recognize it was one of the reasons why have someone is symptomatic, they should go to a Health Care Provider to get tested. The greater information we have about this, the sooner we are going to make sure, first of all , the sooner we are really going to get our arms around it. Also recognizing that one of the challenges of this when you see, here are the numbers that could be a transmission that had happened 10 days ago every at we are always sort of chasing yesterdays action. It is sogain why important from my perspective to adhere to the social distancing guidelines directives. It is so important also, so we can do the Contact Tracing of individuals that are positive to work our way backward, if you are symptomatic, that you should seek out a test. Another phone question. [indiscernible] gov. Bullock hi, kathy. [indiscernible] gov. Bullock i know there were 24,000 payments between march 29 and april 5 and 20,000 , so weyment insurance have brought additional staff and where department of labor and we are doing Everything Possible that we can to meet without significant pans. [indiscernible] gov. Bullock i certainly hope not that it does not happen there or anywhere else. Again to sort of underscore some of the reasons why we need to do everything we can. And if you are symptomatic if you are feeling symptomatic to selfquarantine until you can. Estate a state where at least before this be a lot ofre would interaction between individuals, not just at assisted living facilities, but any number of areas, but certainly there is nothing we have seen out of there to date to suggest that that concern is for every Single Community across the state. [indiscernible] gov. Bullock i think from my perspective, the Unemployment Insurance payments, that was one of the first things we did. My principal concern right now is making sure that if someone has got furloughed, to make sure we can get them those payments. Having looked at as far as duration of the pandemic and longterm economic impacts, but it also underscores one of the reasons why trying to take in consultation with Health Care Professionals and others, a measured approach of saying we are only going to be doing our statewide directives in two week periods, because i would love to open up our state and free our economy as soon as we can. Yes, sir. [indiscernible] so, yeah, so the that theon is now 80,000, there are about 70,000 from fema5 face masks or the strategic no National Stockpile and they will be coming. Some may even becoming this week. Earlier that they arrived. That was near the end of march. I heard from the administrator today and hes doing a great job in a challenging situation and we should get the additional 70,000 soon. Note that just by serving hospitals and des out there right now that the request from them to us is about 490,000. We certainly appreciate the per shiftust like my at the efforts of the red cross come in the American Red Cross to get us 10,000 masks. We are working each and every day to try to get the medical supplies that individuals need. , up at theres to me shelby hospital, speaking to the supplies even things like the basic toilet paper, some of those supply chains have broken down for the hospitals, so we are in constant discussion with the hospital providers for what they need and working to try to figure out distribution chain to work through what is a somewhat broken system. [indiscernible] gov. Bullock yeah. From the perspective the only way that we know someone is covid positive is you get a test that is confirmed. I also recognize that for the , how many tests that we run . 8000 . Yes, i would be presently surprised and be astonished that if at the end of today, that the 436 tests that we run, if all of them were negative. We will continue to see covid19 positive tests and it underscores the reasons again why we need to take all of these actions to minimize them and flatten the curve. [indiscernible] gov. Bullock we just extended it as of yesterday. They were set to expire on friday. Have not done anything since yesterday. Gov. Bullock its a consistent time and time again, listening to Public Health officials to assess what steps should be taken. Thank you very much. [captions Copyright National cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] cspan has roundtheclock coverage of the federal response to the coronavirus crisis. Briefings, house updates from governors and state officials, track the spread through the u. S. And the world with interactive maps, watch ondemand anytime, unfiltered at cspan. Org coronavirus. Bloomberg reporting on congressional efforts to provide more Financial Relief during the coronavirus pandemic. Democrats blocked mcconnell push to boost smallbusiness aid. The story comes after maryland senator ben cardin objected to majority leader Mitch Mcconnells unanimous consent request to provide additional funding to the paycheck protection loan program. Almost lawmakers away detriment way from capitol hill. Senate democratic leader Chuck Schumer and House Speaker nancy pelosi want to double the 250 billion aid request including more help for state and local governments and funding for hospitals. Heres a look at leader mcconnells request from earlier on the senate floor. Ll our nation continues to battle the coronavirus pandemic. More than 400,000 americans have tested positive. Nearly 15,000 have lost their lives. Nurses, doctors, and e. M. T. s are fighting this disease literally day and night. An important public and important Public Health measures are creating an economic catastrophe. This morning, we learned that 6. 6 million more americans filed for unemployment in just the last week
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