They are expected to continue their testimony on the federal response to the spread of covid19 before the House Oversight and Reform Committee. This hearing began this morning at 9 30. Theyve been in recess since 11 40 this morning so the witnesses could attend meetings at the white house. Live coverage of this hearing when it resumes here on cspan3. Also, Vice President mike pence was expected to meet with Hospital Executives this afternoon at 1 00 to talk about the federal response to the coronavirus. That meeting, we understand, has not yet gotten under way. We will be taping it and bringing it to you on the cspan networks. The hearing with ken cuccinelli, the acting deputy Homeland Security secretary will be Available Online at cspan. Org. Hes testifying before the house Homeland Security committee on how his department is responding to the coronavirus. That hearing online live now at it started at 2 00 p. M. Eastern. You can see it at cspan. Org. Until this hearing, before the House Oversight and Reform Committee gets under way, remarks this morning from dr. David gifford of the American HealthCare Association on how coronavirus is affecting those in assisted living facilities. Dr. David gifford joins us now. How many Nursing Homes and assisted living facilities do you represent and what are they telling you right now that they need to deal with coronavirus . About a fifth of the assisted living in the country. Theyre concerned and the family members are concerned because what were seeing is that this virus really acts differently in the elderly. It can be quite dire and so theres a mixed message i think out there, both are true. This is like the flu and so dont worry for the general population. But for the elderly, its a different story. I think thats the message and i think people are getting that. We just had a congresswoman from washington on that king county, washington, nursing home was the epicenter of the early outbreak. So far, what happened there and whats being done to keep what happened there from happening at other Nursing Homes . I think what happened there was the virus was in the community and it got introduced into the nursing home. Our concern is how to prevent that from happening. And so we have made recommendations the government has made recommendations not to visit Nursing Homes. Not just for family members, but for everyone. So really seriously look at whether you need to be in there. Weve been talking to vendors whether they need to go in for the sales force and theyre thinking of staying out. We want to keep people from bringing the virus into the nursing home. A headline from todays New York Times and one of the executives from your group quoted in this story, new guidelines as virus devastates Nursing Homes. No more visitors. Explain how those guidelines are enforced. Can the government mandate that nobody can visit or is this made on an individual basis for the Nursing Homes . I think right now the guidelines are, its not a ban. Some governors in some areas where the virus is spreading, they are making bans. But generally, no ban. But, we really want you to ask yourself, should you be going in there . Because right now the consequences of going in there and introducing the virus as weve seen in washington is that there are a lot of people dying. If youre trying to balance the risk like the representative talked before and youre worried about your family member, i would not go in. I want to go to the phone calls. Dr. Gifford is with us until the bottom of the hour. If youre in the mountain or pacific time zones, a special line for those with experience with assisted living, whether its yourself or a family member, do want to hearing about your experiences, what youre seeing right now in Nursing Homes. 2027488002 is that number. As folks are calling in, i want to come back to the New York Times story and a quote that stood out from that story. This from one of those interviewed, her name is melissa west whose motherinlaw is living in a nursing home. She said im concerned that the loneliness and helplessness will kill her quicker than the virus. I think about her sitting in the wheelchair all day being trapped and waiting. I think, you know, that is certainly a concern. I would have that concern if it was my mom in a facility. One thing were recommending is making sure that family members have the Contact Information and were asking everyone to figure out how to have alternative ways to communicate. Were recommending facilities and family members explore video conferencing. Is that something that theres funding for. We saw an emergency funding bill passed last week. Does any of that go to these private Nursing Homes and care facilities. Im not aware of that. But there are current things available out there, regular phones, tablets and exploring those options now. We have a lot of family members who are distant anyway and that will help with some of that loneliness that was described. Does that funding go to anything else that impacts your industry . I have not gone through all the details. I know theres money in there for Small Business loans and supplies. How it gets distributed were waiting to see. How bad are the supply issues right now in Nursing Homes . I think were concerned about the supplies because a lot of them are manufactured in china. Were been monitoring those closely. We have issues and concerns about that. But right now, theyre getting some supplies out there. George is up first out of philly. Good morning to you. George, are you with us this morning . Caller hello . Go ahead, george. Caller i would like what youre going to do about the people from the military who is coming home . George, our focus right now is on assisted living facilities. Did you want to respond to that . Thats a good point. I think one of the things to remember is that theres a lot of unique situations, the military, people traveling for business, people traveling for vacation. This virus really does not discriminate the purpose of the travel or who the people are. And so certainly people coming back to other countries should really monitor their health and i would probably limit their interaction with other people. And then particularly, i would not go and visit assisted living or a nursing home. To jackie out of missouri. Good morning. Caller good morning. Thank you for taking my call. My mother is at a facility in illinois and they have started a procedure where they stop you at the door, 18 and younger is not allowed in the building. They have to leave. And my second thing is, people need to be more diligent about what theyre doing at home to keep it from being transferred. Wash your hands, disinfect your home, go to the Grocery Stores late at night when its not crowded. If you do your part, you can save a lot of livines in this country. I couldnt have said it better, jackie. Absolutely great advice. Cambridge, massachusetts, this is mary. Good morning. Caller hello. Well, im a senior who is at home. Im over 85, although i dont like to say it. But im going about my usual business and im not sure you know, i go to the store. I stay away from crowds. I went to church. Its not a big congregation. And i just kept sort of an arms length distance between myself and other people. They have crackers and things and i use tongs but then i forget using the tongs that everybody else is using the tongs. I forget about that part of it. So im wondering what are People Like Us supposed to do, getting close to 90, but getting out and doing what weve always done . Many people are like you. You should be proud that youre 85 and what youve done. Any parents are 87 and 88 and in the very same situation you are. And so ill tell you same thing i told them which is i think they should stay home as much as possible. They should avoid large crowds like youre doing. They like to go to the symphony and concerts and i said you should probably stop that and try to avoid. They cant seal themselves in their house. They need to get out and get food and buy other things as well. You need to do that. But i would take the precautions you did, washing your hands. I wouldnt shake other peoples hands. Try to use the alcohol hand gels in between actions. I think youre doing the right thing there. John is next out of louisiana. Good morning. Caller good morning. I was wondering, you know, they said that the young people, they could you know, have the disease and show no symptoms of it. At my age, ill be 72, that is there any kind of clean everything. But is any kind of vitamin b12 for people to build up their immune systems if case they do have it, that they have a better chance of surviving . I think the steps to take are to not get exposed to the virus. Thats the most helpful thing. Certainly limiting your interaction with other individuals, washing your hands, are probably the most productive way to do that. Eating healthy and resting and making sure youre drinking enough is another way to do that. In our family, we usually get together with family gatherings. My parents have sent out an email to all of us saying were not going to have family gatherings for this time period because we know, unfortunately, the history, every time weve gotten together at thanksgiving, other holidays, they end up getting sick afterwards because we bring our kids and grandkids over and they love to see them, but were really trying to figure out how to explore using video chat with them. Dr. David gifford is our guest, former director of the Rhode Island Department of health and a masters in Public Health taking your phone calls and we do have that special line for those who have experience in Nursing Homes and assisted living. 2027488002. I want to ask you about Kaiser Health news report. They know long before the coronavirus made its appearance, the nations Nursing Homes were struggling to obey basic infection proposals designed to halt the spread of viruses and bacteria. Government Health Inspectors have cited more Nursing Homes. That according to a Kaiser Health news analysis. 9,372 Nursing Homes or 61 of all were cited for one or more Infection Control deficiencies, according to their analysis. I think weve been trying to tackle that. We put an Infection Prevention program together to train everyone in the Nursing Homes. Weve supported the regulations that would require all the Nursing Homes to have an infecti infecti Infection Preventionist on board. There are some things that people can do. And i would recommend whether youre in a hospital, a nursing home or assisted living, when a Health Care Worker is coming into your home, you should see them washing their hands. If theyre not, you should ask them to wash their hands. That is completely okay. If they get upset with that, thats something wrong with them. You should not be embarrassed to ask people to wash their hands. Thats probably the single most important thing that people can be doing. Unfortunately we know in all settings, hospitals, Nursing Homes, everywhere, most of the citations are for not washing hands. Those regulations went into effect last fall just in time for this. Ron is next, out of indiana. Good morning. Caller hello. Thank you for taking my call. I was going to mention about the sustainability. Things are convenient too. I was concerned about oversterilization. It sounds kind of odd. Theres a lot of good bacteria out there too and it seems like we might be killing a lot of that too. Using antiseptics. Theres an herb called goldenseal. You can only use it for three or four days and you have to stop for a day or two because it throws so many toxins into your body that you can actually get sick for that. Oversterilization . A lot of people ask how we should clean everything. I think that the guidelines and what we know about this virus is that the normal cleaning and wiping things down make sense. We also do know while the majority of the time the way this is transmitted, people cough and sneeze, droplets go out in the air or people are touching their noise or face or they shake your hands. Not shaking hands is a key aspect now. But wiping down hightouch surfaces. The way you would normally do. You dont need special cleaning agents or anything for this. As more people are being tested and confirmed around the country, weve seen a doubling of the numbers just since 48 hours ago. What are the rules when it comes to transferring a person from a hospital who may be there with coronavirus to a longterm care facility and a nursing home . Is that allowed and how do nursing facilities deal with that . So certainly i think the testing results are going to show a lot of increase over time and thats partly because i think the virus is out there but we havent had the tests available. Thats i think for people to be lulled into wait for the test results might be a big mistake. For the issue about how to move people back and forth, thats going to change depending on whats going on. In washington, youre going to have to change the guidance from somewhere elsewhere there isnt a lot out there. But i certainly am concerned about how to not introduce it. I know that the centers for Disease Control and cms are trying to look at this question about what it is and our members are anxious about that. What is the guidance youre giving them . Should they allow those sort of transfers . Right now the guidance is if youre going to accept someone in normally, you should accept them in if they dont have it. If they have it, thats where the controversy is. Right now theres not a lot. Were trying to learn about whats going on in washington. Everywhere else in the country it should be okay. Just because someone has Covid Infection does not mean they have to go to the hospital. Certainly for a lot of young people, they can stay at home. It will be like the common cold. They should call and check to see what they need and so were following that same guidance within the nursing home, if they dont need to go to the hospital, were not sending them. That could spread it to the hospital. If theyre coming from the hospital, we are asking what the issue is and if they are covid possible, right now theres a lot of concern of how to do that. Theres evolving guidance how to keep them separate from the rest of the residents. Fred is next from new york city. Youre on with dr. David gifford. Go ahead. Caller good morning, thank you for taking my call. Thank you for cspan. I had my mother in a nursing home and i was there quite often because thats the way Nursing Homes are. If you dont visit, your loved ones are not going to be taken care of as well. And what i observed is a lot of good people working in the nursing home, but the nursing home is absolutely understaffed and i would say that i spoke to one nurse and she told me she had a patient ratio of 40to1. Thats ridiculous. Some of them cant walk. Some of them have big medical issues. And these people have to handle all of these medications and everything. I see these people running and sweating, trying to do everything. What is going on in our country . We neglect our citizens so bad. Youre worried abiliout coronavirus, doctors kill 300,000 people by accident. Theres too many people in positions that dont have what i would call foot on the ground experience. They have a lot of education and a lot of accomplishments in the academic world and everything, but somehow, its not able to get this stuff done. You bring up a couple good points. Certainly the workforce in the Nursing Homes and assisted living is unbelievably committed to the elderly. They put their own families and their own health at risk every day. Weve seen up in seattle those who have been asked to stay at home wanting to come back in because theyre worried about their residents there. I think you also are pointing out that there are some broad system issues that we need to grapple with in in country. Right now during this crisis, were not going to be able to do that. I learned earlier on in my medical career when im taking care of someone with a heart attack, i cant talk to them about stopping smoking and exercising better. Im going to talk about it later. But i got to manage the heart attack. Right now were having a heart attack with the virus out there, but we need to have that discussion and i think you raised many good points and theres a lot of other good points that were going to need to look at after this happen. Thats how it is at Nursing Homes if you dont visit your loved one, they dont get taken care of as well. If you can visit an individual, to the earlier caller, a lot of people are lonely. Its an important aspect of that. Right now the risk of introducing as i said, this is not like the flu. The risk of introducing this virus in there is really very serious. And so we dont want to have that risk. If you really care about your family member, going in there is the way to introduce it. Out of an abundance of caution they shouldnt go in there. John in maryland with a text question, should testing for covid in Nursing Homes be a high priority. I would add, should it be mandated . Excellent question. We actually have been advocating that both the residents as well as the Health Care Workers are on a priority for getting testing. We need to have people come in or we further create this Workforce Shortage that were seeing across the country thats out there. Absolutely. You dont need to test everyone because if you dont have symptoms, doing the testing is going to take the testing away from other more important individuals that are out there and its not going to be beneficial for them. Certainly, the earlier part is absolutely right. About ten minutes left or so with dr. David gifford, the chief medical officer at the medical health Care Association. Anna from new york. Caller good morning. I am an resign and i worked for two years in two different longterm care settings and i can tell you that the staffing issue is decades old. I didnt happen just now. And as an example, one unit i worked on as an resign, on the night shift, there was one nurse and two nursing assistants for a 48bed unit of which a handful were selfambulatory. Most longterm care facilities have or quite a few, ill not say most. In my experience, two residents to a room and policies and procedures and training can happen from now until the cows come home. But if staff do not have the time to be able to implement these policies and procedures, washing your hands between care of individual residents, you know, this chronic infection rate of multiple diseases will continue in longterm care settings. This is a cry that has been made for as i said, for decades. Thanks for the call. I couldnt agree with you more. First off, thank you for working in the longterm care setting. I think we need more people like you coming in and we hear from our members in Nursing Homes around the country that they cannot find individuals like you. We would love to hire more nurses, more aides to come in and we really would like to move that. And i think thats a discussion were going to have to have and grapple with the country particularly as more and more people reach 80 and over. There are going to be more people needing it. We need more workforce to come in and help there. Thats something well have to have a discussion once this coronavirus quiets down. In general, when you have that discussion, what is the pay difference between being a nurse in a longterm care facility or a nursing home versus a hospital . It varies all over the country, whether its an urban or rural area. Generally hospitals pay higher with that. But theres a lot of other policy issues and payment issues that really make the difference. Again, i dont think its the right time to get into that discussion now because really thats not going to prevent the virus from getting in. And i think the messaging right now, the governors are sending, the government is sending, the providers are sending, please dont bring the virus in. Ask yourself, do i need to go in and risk the possibility of introducing the virus. Whether thats a family members, contractor, employee, whoever it is. Glen here in washington, d. C. , good morning. Caller hi. I was wondering, i heard on cnn that fecal material contains the virus. I was wondering, because my grandma and grandpa live in an assisted facility, when you flush the toilet an aerosol is created. Can that transmit the virus . Have there been any studying on that . Theres been some learning that the virus is in your nose and mouth and coughing and sneezing but it can also be in your stool. That is why for all the other reasons with back tibacteria an everything else, you need to take the right precautions. The main way this gets transmitted is through the droplets. Being its not like some of the other viruses like measles or chickenpox and its in the air. Certainly, if youre doing certain procedures where your aerosolizing things and people who have certain respiratory problems, then it can get finer. Its usually very close to the individual. Thats why we recommend Health Care Workers to wear the mask. For people at home, theres not a big risk for that certainly through the stool. Just a few minutes left with dr. David gifford this morning. This is rich out of marion, ohio. Good morning. Caller good morning. Great questions. Curious about different ways we can close the barn door. It seems like waiting rooms have a lot of people in there. If we could cut the waiting time. One thing is, if people get tested, if they could do it from their car which some countries are doing, could cut that waiting where people have to interact in waiting rooms. That could make a big difference of the whole hospital not being not being infected. The other thing is, we should keep a chart for a lot of different categories of best of class. Whats the best of class here and it can change. And also someone has the authority to pull those things in really fast as you see a good solution come up here. The other one is in the restaurants, theres a possibility that minimizing economic damage of people not going to a restaurant, having carry outs and things like that and delivered to their home, restaurants could do better. Ill hang up and listen to your answers. You raise good points there. If people arent really sick that you normally would go to the doctor, you shouldnt be going to the doctor. You can spread the virus, whether it be the covid or coronavirus or influenza or any other virus. You should be calling ahead. Call ahead so they know youre coming in so they can take the right precautions. Not Everyone Needs to run to the doctor. Really, you know, follow the guidance of your physicians and the Health Professionals that are out there. I think the other question about, you know, whether you need testing or not, again, it really should be guidance from your doctor. For certain people who are healthy and have mild symptoms, whether you test positive or not isnt going to change whether theyre going to do any treatment with you on that. Thats a key aspect. I think the messaging again, you dont want to overwhelm the Health Care System for the people who are really sick. We dont want people coming in and introducing it and overwhelming that. The other thing is, people have to wear gowns and gloves and that contributes to the shortage we talked about earlier. Weve been getting updates from the Coronavirus Task force, is that group specifically communicating with you or the assisted living industries, giving their advice to you . Yeah, actually the Vice President called us in a week ago and gave us some advice that we need to do better social distancing and looking at how we control these issues. Weve been talking regularly with people from hhs and the center for Disease Control. The other challenge the previous caller identified is this is changing rapidly as we learn things. The government within the center for medicare and Medicaid Services have come out with new regulations every two or three days. I applaud them for that. Ive never seen them move that fast. Theyre trying to stay ahead of that. I think if you look behind all the details, the main message is, lets keep the virus from preventing it from coming in and how do we keep people out. Thats why you hear everyone, governors, us, government officials saying please dont visit these facilities. Try to get one more call. Doug, thanks for holding. Caller im from well, ive heard i hear it i pay for tv like a lot of people. Im 74, 75. And this i think we need to trust our doctors. I think maybe take it off tv for about 30 days because people its scaring the nation. A whole lot more people are dying from the flu and abortion clinics. I think we need to stop trust the doctors. I went to the doctor yesterday for my physical. And i trust the doctors. We trust our doctors. We need to turn it over to them, let them take care of it, take got your point, doug. Well give the doctor the final minute. Trust your doctor. I think a couple points that doug made is a good one, theres still influenza out there. These recommendations would apply to that as well. The point is that for a lot of the younger individuals, this is not as serious as in the elderly. What were seeing is that most of the deaths are in the elderly, both of the deaths are in people who are over 80 who have other chronic diseases and thats who lives in assisted living and Nursing Homes and thats why were taking this dramatic step of trying to prevent people from coming in where that may not apply in other settings. We want to prevent that from coming into this group because thats who is getting it. Its more serious than the flu and the common cold from what were seeing so far. Dr. David gifford. Appreciate your time this morning. Thank you very much for having me. The House Oversight and Reform Committee is set to hear again from the cdcs dr. Robert redfield and dr. Anthony fauci this afternoon. Live picture here from the Office Building on capitol hill where they will continue their testimony shortly. Theyre expected to return this afternoon to continue talking about the federal response to the coronavirus pandemic. We will have it live when it resumes shortly here on cspan3. While we wait for the hearing to assume, cspan has a one on one with Vice President mike pence. He talked about the coronavirus pandemic and how it is affecting the u. S. Economy. Mr. Vice president , dr. Anthony fauci saying the coronavirus is going to continue to spread. Angela merkel saying 70 of the germans could be affected. Were seeing the lockdown in italy. What worries you personally the most . The American People can be confident that this president , our administration, leadership at every state in the country have no higher priority than the health and safety of the people of this nation. Its one of the reasons why President Trump took unprecedented action in january, declared it a Public Health emergency, established the white house Coronavirus Task force, but also suspended all travel from china and then quarantined all americans that were coming back from china to essentially do everything we could to prevent the spread of the disease in the united states. Weve also issued travel advisories for portions of italy, portions of south korea, and were now screening 100 of all passengers from all airports in italy or south korea into the united states. But the truth is that the coronavirus is here and now we have more than 1,000 cases in this country. As dr. Fauci said, there will be many more in the days ahead. The good news is that most people that contract the coronavirus will have flulike symptoms ranging from mild to more serious flulike symptoms. But President Trump has made it clear to us that we are to focus on our efforts to mitigate the spread but also ensure so we will leave this conversation with the Vice President and return live to capitol hill now. We are in the rayburn house Office Building awaiting conversation with the cdcs dr. Robert redfield and dr. Anthony fauci. Theyll be talking about the federal response to the coronavirus pandemic. We see that the chair is in the room. Were expecting it to resume shortly. Live coverage on cspan3