we are here to make a very exciting announcement about a clinical trial we are eager to partner with the state on, to get up and running effective today to help with the covid-19 spread. i think what you will hear and is a great sign that health care is alive and well in the dakotas. i want to thank the governor for her support, the secretary for inrything that she has done getting us the drugs necessary to pursue the trials you will fromabout today, and there, i will introduce the governor to make a couple of comments. about thee will talk trial specifically. >> good morning, everyone. we are continuing every single of along -- across the state south dakota to allow facts and science to drive our decision-making. fortunately, thanks to all of the people who live in this state, we are doing well. the spread has slowed down. had we taken no action whatsoever, the original modeling had us peeking in the middle of april. what we have been able to do by putting in mitigation efforts, limiting group sizes old to stay home, focusing on hygiene and sizes, limiting group telling people to stay home, focusing on hygiene and washing peak early. we are going to be the first state in the nation to run a statewide clinical on hydrochloric when. fightl be used to covid-19 and the team behind me will help leave -- lead this effort. i have spoken with the white house and president trump's team , vice president pence and many within the task force to make sure they were on board with what we wanted to do here in south dakota. not only will sanford be leading the effort, but avira and monument will be participating as well. this will be the first ever state endorsed, state backed, statewide clinical trial in the united states to help take care of our people here that would not only treat patients, but also give us the data we need to be prepared to fight this virus long into the future. over the weekend, we received the initial first doses of the drug. we will get the trial up and running. my understanding is some patients may already be receiving this today. thanks to the leadership of sanford health and the medical teams at avera and monument being willing to partner with us, i am excited about what is ahead. there are so many things today that can get discouraging. we see increasing positive cases in the state of south dakota. beenow all of this has expected. we have been talking for weeks about seeing this virus come. science tells us we cannot stop it, but we can slow it down. we can take care of people while we are dealing with it, and this announcement will make sure we can do that in the best way possible. our leaders here have collaborated with my administration, and i'm so proud that they are willing to respond in this unprecedented manner, leading national research efforts as well. i am going to let dr. suttle go into the details of this trial and how many people will be impacted and who will benefit. >> thank you, governor. like to thank the governor and secretary. this is an excellent opportunity and a fabulous day. it is an unprecedented time that we face, and it calls for unprecedented measures. getting all of the health systems in one state to come together with the support of the health department and the state, we really have options and we have hope for south dakota. it shows how public health and the state and community health systems can really come together , that when there is a pandemic when there is an emergency, that we really come together to help the communities we serve. it is not often that a physician faces an unknown illness. it doesn't come around very much. we know how to treat pneumonia. we know how to treat sepsis. we know how to treat influenza. this is a new disease that our physicians have no treatment options for. and ittakes research, takes a lot of information and data to determine what is a successful treatment? what is a therapy we can use for a patient with covid-19? i using research and doing clinical trials, we can if medications like hydroxychloroquine can have an impact on the disease progression. and it brings hope. as a physician, i want to know that what i am prescribing is going to make a difference for that patient, not do harm. going to be two different components to the clinical trials. the first is a registry for patients who have covid-19. they are positive. patients will be inpatient or outpatient and have the option to receive hydroxychloroquine. setting, -- now that the state has been able to get enough samples and medication, every south dakota and -- every person in south dakota who has covid-19 can have that discussion with their physician. mia candidate to receive hydroxychloroquine to help fight this disease? the second side of the clinical trial is for patients that have ,een exposed to covid-19 health-care workers that could either receive the placebo or receive hydroxychloroquine. the second part is high risk individuals we have all been those over 60, those with chronic medical conditions. if they have been exposed -- let's say they live in a household with someone with covid-19 -- they could receive hydroxychloroquine or the placebo. the way the hydroxychloroquine works, you take it similar to a cpac. you take a loading dose and then you take it for four or five days, but it stays in your body for up to 50 days, anywhere from 30-50. it will help the individuals who might be exposed to potentially fight the illness. we know that hydroxychloroquine has the potential to work by preventing the virus from entering athat prevents the virm spreading. the only way the virus works is if it can infect another person. if we prevent the virus from entering the human cell, we can stop the virus from spreading. we also think the hydroxychloroquine might work i preventing an inflammatory response. what we hope to do today by having these pinnacle trials, by offering this medication to all who might be impacted by covid, is to provide a treatment, provide hope, increase the information that we know about medication and learn what works. this virus will be with us for a while. if we can learn today what works and what doesn't, we will have a treatment in the future. thank you. >> let's open it up for questions. dr. archer, sorry about that. would you like to make a few comments? that would be great. >> we are very appreciative to the governor and the state department of health for this opportunity. we are hopeful -- allison and i share the hope. there is only a couple of trials currently in the u.s., so this chance to participate is potentially groundbreaking. our clinical research department at monument health will lead with the state, stanford, and avera, and we look forward to this opportunity. gov. noem: dr. erickson, would you like to share as well? >> thank you, governor. i would like to share my thanks to the governor and secretary for the work they have done and i appreciate the opportunity to join virtually, as dr. archer and i are attending virtually. i would like to thank my colleagues dr. archer and dr. suttle for the work they have done on this. we are very supportive of this clinical trial and it is a great opportunity to do statewide research. we have much to learn about the virus and the various treatments. the fact can put this in a clinical trial and do research will help move some of this forward. i think we also need to practice, governor, all the things you share every day. social distancing, physical distancing, hand hygiene, clean surfaces and devices because we don't have a vaccine or a clear treatment. i receive questions asking about zinc and vitamin c and antiviral convalescent plasma and ventilators. the opportunity to continue with research, clinical trials to follow the science and data forwards is a huge win for us. my thanks to you, governor, and to the secretary and my colleagues. gov. noem: thank you very much to dr. erickson and dr. archer for your partnership. i know your systems have been partners with us since we started talking about this virus , even several months ago. just want to thank you for taking care of the people of south dakota, along with sanford health. this is an exciting day because it is unprecedented in the fact it will be the first ever statewide finical trial in the united states to deal with covid-19 in the future. we are months, if not over a year away from a vaccine coming to fruition. we are using every tool available to us. the people of south dakota are looking for answers and our mitigation efforts, along with developments in technology and using the care 19 app to help with contact tracing, and now this clinical trial is going to help us get through this together. we will come through the other side strong. let's open it up to any questions you may have. how do patients become part of the finical trial? gov. noem: i will let dr. suttle talk to that. dr. suttle: if a patient is admitted and has covid-19, there is a conversation between the physician and the patient. patients can bring up if you want to be a part of the trial. they can ask their care provider, but it is a conversation between the physician. outpatient, same thing. they would talk to their physician when i get -- when they get their test results. can i be part of the trial and get the hydroxychloroquine? gov. noem: the important thing to note is -- dr. suttle can give more details -- a clinical trial starts with about 2000 people. we can treat up to 100,000 people with the amount of doses in south dakota. that number is very significant for the amount of drugs we have been able to secure with partnership from the health systems, but also the federal government stepped up to get us the doses they need. my initial request was $1.2 million and they will be supplying that for us. the 100,000 patients that can be treated should let south dakota and snow -- south dakotans know that those who have high risk writers -- conditions, their providers can protect them because they are exposed to individuals dealing with the virus and we also have a balance of individuals who will receive it who are struggling to get better. >> i am not sure how clinical trials work, but does your health insurance coverage or is it free? >> clinical trials are funded by the organization area -- organization. it is not a cost to the patient to be enrolled. the outpatient clinical trial with the placebo and the prophylaxis for those exposed, that is the 2000 we want to treat. the inpatients and outpatients that have covid, we can treat as many patients as needed in that registry trial. there is no limitation to how many who are positive with the disease that we can treat. what we want to find out is, does this medication work? we are contributing to the science to know long-term if it works. sanford is not stopping there. we have a lot of other clinical trials, using convalescent plasma, other antivirals, things that work with the immune system. gov. noem: and the state will be supporting those efforts as well. yes, question on the phone? >> this is carol hart with the red river farm radio network. , butis still covid related more focused on the agriculture side. on saturday you send a letter to smithfield asking them to take care of the coronavirus concerns. on sunday, as you know, smithfield decided to close the sioux falls plant. is there anything else you would like to say about smithfield's closure on sunday? have you talked to them since they have closed? gov. noem: i talked to ken sullivan this morning. we are going to talk later this afternoon or tomorrow morning and discuss the future of when they can get back up and running. i think the letter and the request made to them, they are looking at. but also knowing they give their employees time to go home to heal, to visit with their families, and make sure we are taking good action to protect the community. smithfield has done incredible work inside the facility for mitigation efforts, putting an infrastructure to protect employees, and also what they did to make sure they identified those who may be struggling with the virus or exposed to it. we will get them up online as soon as it is appropriate for public health reasons. chance -- have you had a chance to talk to the mayor about his shelter-in-place? gov. noem: i talked to the mayor on sunday afternoon that he would be requesting that. i understand he was still considering that. my team is evaluating it. i will go back to what i have been saying for weeks. this is something to look at, but you need to consider that at the appropriate time to make the biggest difference on when we could see people search into the health care system. to in south agreed dakota was planning and preparation for how many people we could handle on hospital beds, icu beds, and ventilators at peak time. that is 5000 hospital beds. sanford,he plan that of the rock, monument all agreed to with us. whatever mitigation plans we put into place, we need to be able to sustain them. we are evaluating all that. we are still within our models with the positive rates in sioux falls. as far as the statewide model, that has not changed, but we are looking at what has gone on in sioux falls to see what the appropriate action might be. need patient and family consent for this treatment? what side effects should people know about? for patients needing it for proven treatments, like lupus, will we have enough for those patients? dr. suttle: the first question was informed consent. yes, we do informed consent for the clinical trial with the randomized controlled trial as well as the registry trial. with regards to side effects, many of the common side effects you can find with a lot of medication. some nausea, fatigue, those sorts of things. there are some contraindications , so there are individuals who are not candidates. this ensures we have adequate medication for those with metroid arthritis and other illnesses that use the medication so we will not dip into their supply. >> it seems like you are being aggressive on the treatment and medication side. the first state to have a statewide clinical trial. but less aggressive on the stay-at-home orders. can you speak to if that is your strategy going forward? strategyu see your different from efforts in other states? gov. noem: i would disagree with that, stephen. the response we have gotten out of the people of south dakota to my calling to them to stay-at-home for weeks has been greater than some states that issued shelter-in-place orders. the people of south dakota have been phenomenal. they have stepped up. they have dramatically decreased leaving their homes. i understand it is taking days to get their online orders of groceries picked up on time because so many people are doing that. traffic counts have been down across the state. overwhelmingly people have responded. i have been proud of their recognition of personal responsibility. when i look at other states that do have shelter-in-place orders and people are not complying and we are getting better results, i would say south dakota once again has proven me right. we are a fantastic state with people that understand their role in making sure we are protecting our communities. >> this is ariel with the rapid city journal. can you hear me? gov. noem: i can. >> this is for you or the health secretary. are we able to get data that other states have been sharing? other states are sharing racial data. arizona just released data showing african-americans -- they are breaking it down by zip code. also there state department of corrections is breaking it down by not just positive tests but in each person, how many people who have been tested and pending. there is a lot of concern and rumors going around from lot lines of people in prison and they want to know what is going on. >> thank you for those questions. if you look at how we have been able to provide data around positive and negative covid cases, that has continued to evolve. we have more data. that will continue to evolve and we will provide more. we need to ensure that any data can't lead to the identification of specific individuals. that is a core function in public health reporting. that is part of what we have to deal with as we are releasing that data. speaking to the racial disparity, we do not have that data available. we are not seeing large racial disparity, i can tell you that. as we get more cases and are able to break out data into finer detail, we will do that. regarding your question around cases in the correctional system, we have been open with the status of that. we have had one total positive case of anybody in our state correctional institutions. that remains the same today. that person has recovered and we don't have other positive cases. we will continue to update as any of those situations change. >> no plans to share how many people are being tested in the prisons, as other states are? just like we have pending cases in each county. >> right. some challenges with reporting testing, as you know, is our ability to test people has greatly increased. not long ago the only option was the state public health lab. that has quadrupled with the advent of commercial lab capacity with folks like sanford being able to test, and avera and monument. machines being deployed to ihs facilities across the state. our ability to track what is going on with all of that testing is not going to let us report all the details about who is being tested. you can be sure we will report aggregate numbers when we have them and certainly details around positive cases. >> regarding the trial test, how soon do you believe we can start seeing results on whether this drug is effective against covid-19? >> the trial can go out up to five years, but we will start getting results -- the more patience and role, the more results we will get. there are some short-term wins we can get from the results, and we will also be evaluating long-term. i don't know that i can give you a specific month or day, but we will share as soon as we know more. we have already been treating patients on the registry and have a paper coming out later this week or next week with regards to that. >> a viewer just sent me a question. be part of the clinical trials as well? >> i am in discussions with the v.a. to incorporate them. there is working through irb's and different things, but we will offer it to the v.a. of possible. >> and the ihs? >> yes, and the ihs. good question, thank you. >> over the weekend you said the virus is going to infect everyone, it is only a matter of when. my question is, at what point does the value of delaying the inevitable, delaying the peak, is outweighed by the economic devastation we are seeing now? especially with hospitals in wide swaths of the country with underutilized, empty beds. shouldn't you give instructions now to open up, at least for the relatively young and healthy, who we have seen our coping very well with the virus? gov. noem: to clarify, what i have consistently said in january and february is that 30 to 70% of the population we could expect would contract the virus at some point. south dakota's peak would be showing still to be in mid june for the peak infection rates. that does not mean different parts of the state will not peak sooner. we are continuing to take a targeted approach in how we look at our state and our population and what mitigation efforts might need to be put into place. there is a lot of elements to this virus. public health is extremely important and we are looking at that as paramount every day. we are also looking at the stress on families, the need to put food on their tables, a roof over their heads, and the mental health aspect. those are things that our state government departments and agencies are dealing with in making sure we are preparing people, helping not just families get through this, but keep small-town businesses open, keep larger employers doing well. it is a balance. to number one goal is remember and keep perspective that we can't stop the virus. we know that. we can slow it down. how we do that needs to be very specific and targeted and make sure we are protecting the most vulnerable, which is why people have seen me take the efforts i have. and make sure we are dealing with this and are able to get back to what we love, our south dakota way of life. the latest covid-19 numbers have been released by the state health department. i was wondering, have we got anymore numbers as to the numbers of people who work at smith yield who are infected -- at midfield who are infected -- at midfield who are infected? >> i will let the secretary of health talk about those numbers. -- excuse a total of me, i am checking my notes. we have 138 new cases today. 57 of those are with smithfield employees. so far we have had 10 individuals from smithfield hospitalized out of a total of 44 people in the state hospitalized. are there other questions i can answer about the numbers today? >> just wondering if you can tell us anything about what contract tracing can show about how the virus got into the smithfield population in the first place, if you know anything about that. >> since we investigate every positive case in the state, when we started seeing cases of different employees at smithfield, we did contact tracing there to better understand for the people that work together, did they work in the same shift, in the same environment? that is part of the investigation we have been working on. this is a disease that spreads through personal contact. any time you have a place, whether an employer or any other place, where there is a large number of people coming into contact with each other, that is how we know the virus spreads. each individual investigation includes where they work and who they come into contact with. defined ascts are being within six feet of another person for some period of time. they are not casual contacts. these are all part of the contact tracing we do. we let those individuals know they have been identified and should take precautions. they should be monitoring themselves, doing good social distancing, which we encourage of everybody. in the event they are infected, we want to make sure they are not spreading it to other people. does that answer the question? >> specifically i was curious, do you have any information on was there some kind of travel that brought this to smithfield was it -- smithfield? was it community spread? >> i am not sure we can definitively pinpoint the exact cause of the cases at smithfield. haveounty did already substantial community spread at the time we saw the first case in a smithfield employee. >> the day that you just updated, do you have -- the data you just updated, do you have how many recoveries? >> we have 10 new individuals who have recovered area that is part of our 207 people statewide who have recovered. i do think it is important, certainly not to minimize the gravity, but most people recover. 80% of people have mild symptoms. as the governor said, we have to keep these numbers in perspective. we expect thousands of cases of covid before we are done with this in south dakota and we are going to see a lot more people hospitalized. the thing we are announcing today with clinical trials, better access to drugs, those are encouraging. with black hills pioneer. with this weekend's announcement andesting for sioux falls ,eople around smithfield plant are you sticking to the strategy of more aggressive testing in that area? gov. noem: what we are announcing today is a nickel , aal for a therapeutic treatment for those who are covid positive and need some assistance to help recover quicker. in regards to testing, we are testing more aggressive. we have gotten more labs up and running, which allows us to do that. i was on the phone last night with jared kushner talking about our need for more testing supplies, especially the avid id machines that we did get from the federal government. we need supplies to run those. hotspots, those in like we are seeing in sioux falls. that will be helpful for us to get aggressive in slowing down the spread, identifying people, getting them isolated from other vulnerable people sooner. the more we get, it comes online in private suppliers or through the federal government or any other mechanisms we are going after, will help us be more aggressive. one model that worked pretty well, we saw earlier in south dakota, was what happened in huron. it was a county that flared up and had some positive cases that had some exposure to other folks. we talked to the mayor. i spoke to the mayor there, gave him direction on what he can do in this community. he pulled his county commissioners together. they formed a task force and implemented the guidance we gave them. now if you look at beetle county , they are doing much better. they were able to slow down the spread. i think they have two or three positive cases today, which is wonderful. with that kind of partnership around community leaders putting into action the guidance the state will give them, you can make a big difference in sioux falls. that is the guidance we are giving to your mayor, health department, city council, and county commissioners. form a group, get to work. we will be good partners. but that was effective in beetle county and that can happen in many lincoln counties as well. expectrnor, you said you some parts of the state to cap earlier than the mid june projection. do you expect sioux falls to peek earlier? gov. noem: it looks like sioux falls could peek earlier than the rest of the state, so we are continuing to monitor that. as i have said many times, remember these models are projections and we are reevaluating them daily, if not hourly, on what we are seeing for where we get hotspots, where we get different infections spread, and how that is handled at the local level. local actions make a big difference. it looks like sioux falls could peek a couple weeks earlier, and we will be paired for that -- will be prepared for that. >> could you tell me what went into your decision to ask for field to close for 14 days -- to ask smithfield to close for 14 days? gov. noem: we were looking at the case rates that were coming back, doing contact tracing. the department of health has tripled the amount of staff doing contact tracing. this week we will triple that staff again. when positive cases come forward, it takes more staff to follow up with each of those individuals, find out who they were with, what locations, who could have been exposed, and follow up with those individuals. we are continuously making sure we have the capacity to do a good job of that. one of the technologies we rolled out last week that i want toencourage south dakotans do is to download the care 19 app on your phone. we have about 8000 people who have done it. we need many more, because when to havehat, you opt in it use your location services to track where you have gone. if you test positive, all you have to do is refer back to that app. we have all the information of who could have an exposed and it saves us dozens of hours. that means our staff can do other things to take care of people rather than do investigative work when people can't remember where they have been. please push out to all your folks how important it is to download that app. it is voluntary, information is anonymous, and will be destroyed when this event is over. we need you to do that to save our staff sometime so they can take care of people. >> when will that be available for android phones? gov. noem: this week. they are going to have it by the end of the week, which will be great. it is for apple phones today. they are going to continue to build out more features. some features we cannot build in, such as letting you know if you have been near someone who tested positive, until more people participate. we can add more features when more people downloaded and opt in. that would be incredibly help will. state inly the second the nation to be utilizing this kind of technology. the north dakota governor and i talked about it for a couple of weeks. he used his connections to get it built and north dakota went online and we went online the next day. >> governor, why is south dakota the first to take on this clinical trial? is it something you took the initiative to do? did the feds think south dakota was a good spot? gov. noem: there were several factors. i noticed how people took seriously the virus and what a big difference our mitigation efforts made right away. just by our first -- by my first executive order we caught our hospitalization rate in fact -- in half. then i looked at our health systems. we have sanford health that has a research component already and their ability to stand it up. and the outstanding partners of avira and monument. population, being smaller compared to other states. it is a perfect fit. started talking to the administration about it a couple of weeks ago and said i would be willing to partner and financially back a clinical trial like this, which other states have not done, makes it an incredible partnership that is a model for how things can be done in the future. this is one of the things i talked about in south dakota for years. we can do things other states can't because of the people. people who have made investments here for decades that give us the health care institutions we have. people that are willing to think outside the box and approach things in a different way. this is one area where we are seeing we can fill a role, not just for south dakota, but for our country, doing research that our country and the world needs, is incredibly special. further questions? speak toor, can you what this trial would cost the state, if anything? gov. noem: we are talking about that, but i have agreed to financially help support that. obviously some of the dollars from covid response we are receiving from the federal government could be a part of that funding source as well. so we will stop with questions. i did want to as dr. erickson if he had any final words he wanted to share. i know it was tough to go to questions for them because they are remote. dr. erickson, do you have any closing words from a vera -- from avera? >> certainly want to appreciate your leadership, the secretaries, and my colleagues for their work on this. it is a wonderful opportunity for south dakota, the clinical trials and research. we are glad to be part of this. gov. noem: dr. archer from monument health, would you like to share a few words? >> i would echo dr. erickson. efforts. systems we are excited to be part of this. us as wewill see from learn more about the trial, our research department will put out a statement about how to participate. we look forward to that in the near future and look forward to working with you all. gov. noem: great, thank you. i appreciate you all being here today. if you have any further follow-up actions -- questions, reach out to my office. i would like to have mike close with a few words from sanford health. >> i will wrap up by once again offering our gratitude to the state, governor, and secretary for their support and assistance. i would be remiss if i did not draw attention to the researchers in the back of the room. they like to maintain a low profile. it is times like these that you validate the investments that have been made over time. they stand game-ready to do what we believe in the integrated health system is truly meaningful, which is to take research from bench to bedside as quickly as possible. the investments that have been made over time in the work david and his team have done uniquely position our organization, in partnership with the state and the other institutions, to make a meaningful impact. it feels great to get on offense against this virus and we look forward to the success that is going to come. >> a live look at the white house briefing room, where in just a few minutes president trump will brief reporters on the coronavirus response. we expect vice president pence and members of the task worse to join the president

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