49 Lab Confirmed cases. 1760 new cases reported today and a new high, 760 people in the hospital and sadly, 1092 deaths. Dying from covid19 or morning a loved one who right now can be isolating in difficultin and we are praying for all those who are suffering now. Today, our concern is growing about the increase in cases and hospitalizations in North Carolina. This is also happening in many states across the country. While our hospitals still have capacity wean know this can chae quickly so we are working with hospitals and tracking hospitalizations and icq beds closely. Today is North Carolina highest day of new cases since the pandemic started and it is also the highest day of testing that weve had with over 21000 test reported. But the high number of new caseh is not just related to more testing. These numbers show the disease is spreading, that more people need hospital care. This has to be taken seriously. In the last week we have done an average of over 15000 tests a day and this is a high number and is good but we know we still need to do more. Testing is available all over the state but we are specifically targetingai historically marginalized communities and other highrisk populations. The state is also working to surge testing to hotspots as those needs emerge. We also know that when you have been in a crowd your risk of contracting covid19 increases. This is particularly true when many are not wearing Face Coverings and theres little social distancing. We recommend that anyone who has been in a crowd get tested even if you have no symptoms. Oday we have an update on our key metrics from doctor mandy cohen, secretary of North Carolinas department of health and human services. I will hand it off to her now to make her presentation. Doctor cohen. Thank you, governor. It is daytoday for those of you who like crafts. We are now three weeks into phase two and as i said earlier in the week, i am concerned about our covid19 trends. North carolina is not alone. Many other states are seeing increases in covid19 cases as well and the virus is still a serious threat. We have seen in other states how a stable situation can quickly become anything but. As i walked through the data today you will see that unfortunately it has been another recordsetting day. As a reminder we look at a combination of trends that guide our decisionmaking and that will include covid like syndrome, cases, Lab Confirmed cases, positive test that the percentageli of those total tess and hospitalizations. These subsets of metrics are chosen based on Public Health data and white house guidance. We cant look at anyone of these metrics in isolation. We really need to look at them as a whole package when making decisions. Each one of them has limitations but let me go through them now. On its first graph we look at people who come into the Emergency Department with covid like symptoms. This metric serves as an Early Detection mechanism and looking at that yellow line you can see there is a small uptick at the right hand side of that graph which represents this past week. As we look to the next graph these are our Laboratory Confirmed tests. Again, i draw your attention to the yellow line. You can see there is a fairly sizable increase in new Lab Confirmed cases and as you heard from the governor today we have have seen the highest number of positive cases at 1768 new cases which you will see that top blue dot on the righthand side represents that high record number. We have now seen four days with cases above 1000 in just last week. We are also setting records on the testing side done each day as well. As a result of this record high amounts of testing we did expect this number to go up but is the pace of the increase that is concerning and shows us that this virus is still very much present in our communities across our state. We zoom in now, this next graph shows the exact same data on the last slide of Lab Confirmed cases but now again zooming in or slightly closer look. This graph shows data since may 1, not all the way back to march, you can see it in more detail. Looking at the yellow line again its a seven day rolling average in this metric is trending up. You can see its accelerating as the slope of that yellow line is becoming steeper in the last two weeks. Now, moving on to the of tests that are positive. This metric provides an important context for our cases. I want to draw your attention again to that yellow line and you can seese the of total tess that are positive have just been slightly increasing and today it is at c 10 . If you look at that 10 in the context of our nation our present positive is not one of the highest amongst states in the nation. We would like that number to be closer to 5 . Our next metric here is about day over day hospitalizations. Again, the yellow line shows that North Carolinas trajectory of hospitalizations is rising and yesterday was our highest day of hospitalizations with 812 but our hospital still have capacity as governor said to meet the increased demand if more people become seriously ill but this continued rise in this metric is concerning. Finally, an update on testing, looking at the yellow line. You can see that daily testing really is trending up and we continue to make significant progressne in expanding our testing. Over the past month we have tripled our testing from about 5000 tests on average a day to 15000 average tests per day right now. Testerday with our largest day of testing with more than 21000 test completed in one day. Alright, putting that altogether but where are we . First, Surveillance Data shows a slight uptick and its a yellow line, North Carolinas trajectory of last confirmed lacases does continue to increae arand is accelerating against te yellow acts. North carolinas trajectory of tests returning positive has increased slightly over the last week and this gets a yellow line. North carolina trajectory of olhospitalizations also slightly on the rise and this trend gets a yellow line. We also track critical capabilities. When you look at the trend metrics, those i just shared, as well as our capability metrics meetingtr our ability to respond to this pandemic and our ability to respond is where we really see positive trends and a ton of work that has gone on. First, as i have said, testing has had an upper arrow as we have been averaging more than 15000 tests a g day and we are more than 450 sites listed on our website plus additional popup testing sites that folks can go to and our art as q additional test sites purchase 4from the State Government just closed so we will soon be able to served even more Rapid Response of testing where it is needed in the states. We have hired more than 250 contact tracers to bolster our efforts of our local Health Departments and are in the process of adding even another 200 to meet the ongoing need of our local Health Departments. These Covid Community teams, team members, reflect the diversity of the tracers and more than half are bilingual. More than 500 local Department Staff and Community Team members have completed state led training on Contact Tracing and our ppe supplies continues to be stable. We have critical supplies on hand to fill the next 30 days. Capacity is looking good. We have those tools to respond crisis and slow the spread of the virus but we all have to Work Together on this. We can protect our families and neighbors a and we can rebuild r economy and we can look forward to our children returning to school but we must all do our part to make these things happen. First, we must all practice the 3ws. Wearing a Face Covering, wait 6 feet apart and wash your hands frequently print these easy actions have huge impact but each person needs to do them for us all to benefit and do them consistently, every day, every time. This weekend if you are leavingd your house make sure to grab that Face Covering before you go. Wash your hands every chance you get and make sure to stay 60 apart from others. Second, if you think youve been exposed to covert 19 get tested. Even if you do not have symptoms you attended a mass gathering or protest get tested. If you work in a setting of high risk exposure such as a Grocery Store, Childcare Program or restaurant get tested. If you work at a high risk setting like a Food Processing facility, get tested. Third thing we can all do answer the call. The local health Department Staff and other Covid Community team and members are reaching out to people who may have come into close contact with someone who tests positive or covid19. The team will connect them with Important Information and support to make sure that they get through this time. We continue to do our part to respond to the crisis and we continue to strengthen our testing and Contact Tracing infrastructure because we were aggressive and took early action we bought ourselves valuable time to build that capability so that we would be in the best position to be able to responsibly use restrictions. We can now draw on these capabilities but if we all do our part we will not overwhelm them. Early on north carolinians came together improved we can flatten the curve and we can do it again. Remember, we are all in this together and the actions that we all take right now will help protect our friends, our families, our neighbors and will save lives. Thank you, governor. Thank you, doctor cohen. We want to thank you and your team for the hard work that goes into presenting these numbers to us, relying on the data in science is critical and i know that we came into this having or making it difficult to gather all this information from all over the state and you are doing an amazing job putting it together and synthesizing it. One thing i want to make sure that i know you know this but the trajectory of cases was a red mark just like the graph showed and i thank you said yellow, but i want to make sure they understand that the trajectory was a red x here today. I think as a state we have taken important steps to slow the virus. A e t those numbers and trends are sobering. I understand that people are anxious to get back to normal. I am too. Especially as school ends and the summer begins. More stores and restaurants and businesses open, people are leaving home more to get out. But everyone should remember that North Carolina is still under a safer athome recommendation and just because we cannot leave home does not mean we always should. The places that have opened with new safety rules, thank you for the extra work you are doing to clean and distance for your customers and wear Face Coverings and keep up that good work, it will be Good Business for you too. We will continue to use caution in our stages of using restrictions. Keeping our People Health foremost while also strengthening our States Economic health. Using restrictions gradually has kept theat disease from overwhelming our hospitals and we must keep that as a priority in our decisionmaking. This increase in cases that we have seen doesnt mean that we have made a decision about going into phase 2. 5 or three but insisting on the strategies that reduce transmission like washing hands, wearing Face Coverings, waiting 6 feet apart from other people and tracing the virus to its sources, those are the things we want you to do so that we can make these decisions in a positive way. The most important reopening is our schools. Even as we celebrate graduates this week, i expect to have our children back in the classroom in just a few months. The hard work that we do now will make that happen safely. I know people are tired of the virus and its been hard on everybody. But it is still deadlyrk and we cannot let our guard down. Slowing the spread is up to every one of us, every time we leave home soow practice those 3ws. Our numbers arent where we want them to be but it does not have to stay that way. It will take all of us doing our part but north carolinians no that we will Work Together and how to defeat it. Along with doctor cohen with me today is Emergency Management director [inaudible] and nicole fox for our sign language interpreters. Behindthescenes josiah and jasmine are our Spanish Language interpreters and i seen out we also are joined with our secretary of the department of public safety, eric cooks. We will not take your questions andd if you can identify yoursf and your organization we would appreciate it. Thank you. Our first question is from michael hyland, w ncn. Hello, governor print this is michael hyland, i wanted to ask you first with the numbers you laid out could you go into more detail about how this is influencing about moving the state into phase 2. 5 and even into phase three, is anything off the table at this point based on what we saw and how does this impact your decision about what we will assign the that the General Assembly passed to partially reopen bars . And cute for that question. We are looking at all the science and data to make decisions about a potential 2. 5 or a phase three and we are looking at it over a period of time and we are looking at the trends. There has not been the decision made about even one of those at this point. Neither one of those phases is off the table here. We will review that legislation and obviously, we would rather do it through executive order but, as i think, that legislation makes the process much more clumsy and more difficult to change in the event that we would need to reinstate it and an executive order. W we will review that bill and let you know what we do with it when we make that decision. Thanks. Our next question from Vanessa Rufus with w ncn c. Hello there, vanessa, thank you so much for taking my questions. I have three and they are related to metrics. I wanted to know how reflective is the current testing and resents positives we are seeing of the general population so are we seeing these higher rates as a result of targeted testing in communities or is this reflective of the general population of the state . My second question is the other day and also today you mentioned doctor cohen, that the state has one of the highest present positives in the u. S. And we know that North Carolina has not opened as quickly as other states so why do you think that metric is so high and then finally, hospitalizations we know is the concerning metric as well and we also know hospital beds can be used to meet the needs what is the threshold for this call to surge or further action to be taken with hospitals . I will let doctor cohen give her analysis on that in those questions. Sure, thank you for that thoughtful question. It is questions we ask of the data as well. We have been searching our testing and we continue to have testing criteria that is focused on people with symptoms but also with exposures. This week in particular we have been sharing with you that we want folks to get tested who have been at a mass gathering or protest or some of the higher risks jobsites and as i mentioned in my remarks. I think what we are seen in our testing is a combination ofen those symptoms and exposure the people have. That is a good thing and it means we are targeting our testing to people who are more likely to be positive. When i see that present positive i think that we are targeting two groupsen of folks that are more likely to be positive however, we know we want to get to a level of testing that does drive that present positive lower so that we make sure that not just that we are targeting those specific people who might be positive but we are really casting a wide enough net. That is why we are going to continue to ramp up our testing even further so were not done here. In particular we will be focusing, as i have mentioned earlier remarks this week, on some counties where we are seen a more rapid increase in the number of cases where we want to have Surge Capacity in those counties as well. We know there is more work to do on the testing side there. As far as hospitalizations, those are trending up and it is something we want to very much keep our eye on but you can also see from ourth dashboard we do have capacity in our Hospital Systems. I think i see you beds is the thing we watch most closely and we know that that is a smaller resource for us as a state through the smaller number of icu beds total than there are in other hospital beds. We watch that closely. Im in close contact with the leaders of our large Hospital Systems that have the majority of those icu beds there were just on a phone call with them earlier today to get there input on where they see or how they see things close to the ground and obviously they are seeing those trends as well but what i would say is they have said we feel that these months in which we have been able to build our capabilities that i talked about earlier, by building our ability to have ppe, building our capacity around testing, building our plan to preserve, that puts us in a better position to respond. Again, these are concerning trends and they are things we can do to continue to slow the spread of the virus but we need to make sure were doing those actions now. That the actions have to come now in order to avoid overwhelming our Hospital Systems three, four weeks to incalm in the future. That is why we are raising our concern level now to make sure that we take all the actions we need and the individuals out there again, these coverings, washing hands, waiting 6 feet apart, those will be the individual actions and actions businesses can take right now vtoday that will help us slow e spread of the virus and not overwhelm the Healthcare Systems so we see that hospitals rise and we hopeal to see that level out. Thank you. Thank you. Next question please. Our next question is from don with [inaudible] hello, don von [inaudible] i want to find out about any decisions on phase 2. 5 and three, june 26 is that still the planned datend even if specifics arent ready yet . On a different topic, the budget was 2. 5 million last year for the africanamericans monuments on the Capitol Grounds and now that the money isnt in the budget is there money somewhere else or another agency that could from that and should the process stay as it is or removing confederate monuments [inaudible] . The first question iat think had to do with phase 2. 5 and phase three and we have not made the decisions on that and neither of those are off the table, nor is it off the table that we might go into phase three as scheduled. We will look at the trends in the data in order to make that decisions and we will let you soon as those decisions are made. Secondly, my position is or has been clear on confederate monuments that we should move them to a place with more Historical Context and moving them off the Capitol Grounds into one of the civil war battlefields. I do believe that that monument is a that the budget had as a positive thing for our state. We will want to help to try to find the money for such a thing and we will continue to work with the legislator to see if that can happen thanks, next question pleased. Our next question is jonah from abc 11. Good afternoon. This is jonah with abc 11, what is the threshold for stain in phase two or pivoting back to stay phase one . Is it too thousand cases a day, 50 increase in cases, and doctor cohen, the National Headlines that included North Carolina this week is the huge increase in cases each day. We today is no exception but by our map we seen cases of [inaudible] but weve also seen tests of 24 in the last week. Hospitalizations up only up 10 so clearly we want cases to go the other direction but is this increase in cases really that unexpected seen how we are doing so many more test . Thank you. I will let doctor cohen address that because they are looking at y all of these trends and indicators, all seven of them in combination in order to make decisions about moving forward into a phase. I will let doctor cohen address that along with the second part of your question. Hello, jonah. The governor is exactly right. That is why we have said all along it cant be one metric in isolation. We can move forward but we cant go forward. They all interplay with each other. You rightly, i think, or giving an analysis that we have ramped up testing a lot which is good news and so we are seeing more cases. The question is are we just seen those cases for the more testing or are we also seen a lot more viral spread . I think what we can see is when he put together note number of cases that are increasing with the percent positive which is also increasing makes me have the conclusion that we are not just picking up cases because of increasing testing but also because we are seen more viral spread. Points hospitalizationssi us to that conclusion as well and we have been very stable of the hospitalizations around 550 ish people in hospital stay over day for many weeks and we were very stable and really in the last two, three weeks weve seen that go from the mid five hundreds to now over 800 and not as a significant change and again, tells me that people that the virus is spreading more because we know that there will be a percentage of people who will become more seriously ill so as more people become ill that percentage of people who will need hospitalizations goes up. I think all of those in commendation more cases that we are finding through testing, positive going up, hospitalizations coming up and i think those tell us in commendation that we are seen more virus in our communities. I thank you can see by the graphs i went to today that that timing is very much linked to the last two, three weeks. It is very much linked to when we started reopening and i think we knew that when you reopen and you move around more that the virus will move around more as well. Now it is upon us, every one of us in North Carolina to say how can i help keep the virus level low and i have outlined those three things we need to do but one is the 3ws wearing the facemask everything a time when youre out and about, waiting 6 feet apart, washing hands but the second is getting tested. If you avenge those iris places where you might have an exposure and the third is s picking up te phone to our local Health Departments in case you have been exposed and they want to tell you about the next step in terms of isolation and getting tested. Those are the things we can do right now so we want to see those trends and we are increasing but the question is how fast and we have the ability to change the trajectory of those trends so that it doesnt go as fast and we can flatten the curve. Again, it is always that action to how can we flatten the curve as we go forward. We have done it before and we can do it again. Thank you. Thank you. Next question please. Followup from jonah, abc 11. Hello again thank you for taking this question. Doctor cohen, to followup the second time you mentioned we have flatten the curve and we can do it again good does that mean the curve has not been flattened right now and we are going towards the peak that you said be avoided and for governor cooper, phase 2. 5 and phase three could mean bigger crowds andnd the rnc is moving to jacksonville, florida and the president also saying he wants to hold a rally here in North Carolina. Have you had any contact with the President Campaign about North Carolina hosting events . Let me take your first question. I think we saw in the data i presented today we saw the slope of that line and it tells you how fast are we accelerating and that does contribute to this flatten the curve. I do see a quickening of the pace or the steepness of that curve which tells us we have work to do to flatten that curve out. Like i said we have done that before and there were actions we take to do it an alternate back over the governor. We are concerned when there are Mass Gatherings and large crowds because we see more viral spread when that occurs. I have not heard anything from the President Campaign about any rally in North Carolina and we will check to see if any of our other agencies have heard anything about that but i have not. Thanks. Next question please. Our next question is from boian anderson with the associated press. Hello, governor. Brian anderson with the associated press. Thank you for taking my ve htions. I had one for the governor and one for doctor cohen. Wfor the governor you talked about phase 2. 5 and acknowledge that theres a possibility that s e current second phase would need to be scaled back. I was hoping you could give me a straight answer on whether or on which direction you are leaning towards right now and do you generally feel that things should be more open or more closed right now because it sounds like youre saying you no intention of going backwards so i wanted a general direction of where you are going and for doctor cohen we have a pending request with your office for daily case data so by county and i was curious if you had an eye deal of where dr. Birx was flagged and if you could follow up with your staff get back to us on that wed appreciate it. I want to ask are we in the middle of a second wave yet . Over the past week have your fears of the second wave escalated and those are my main questions are now and i see on your dashboard that the icu beds, the way its represented, has changed 13 22 so if you could follow up on that as well that would be great. So we are going to rely on our Health Experts who are reviewing this data. All seven of these trends and indicators making recommendations to us about whether we have movedin to a 2. 5483, no decisions have been made about that yet. These trends that we have been seen over the past week are concerning and we wanted or we think the public, the people of North Carolina can play a significant role in our ability to get these numbers headed in the right direction. If people are careful and wear their clothde Face Coverings and keep their social distance and wash her hands and if our leaders across the state and people that others look up to will do those things in the same things by example it will help us a lot because i will say right now the priority is getting our children in school in august and we want to do that. We also want to continue taking steps to ease restrictions to reignite the economy but we will not do that until our trends and indicators tell us that it is time to do that. I will turn it over to doctor cohen. Thanks. There are a number of data questions in there and we will followupur on each one of them but in terms of case counts by county those are on our dashboard right now and we have them by county and zip code and per capita so we also just this week posted line level data as well. Piey are now spreadsheets of data if you want to look through them so there is a lot of new information up on our dashboard. Again, trying to be as transparent as we can and how we are looking at these numbers across our state and so today i try to synthesize that together for you to paint a picture of where i think our trends are going and as the governor said, how we canre impact them because nothing is set in stone. These trends dont mean our [inaudible] but that we have the ability to do actions ourselves right now that can change the trajectory of these curves and that is what we want to make sure that we are doing. We are warning everyone that the trends are headed in the wrong direction but thereha are things we can done now to make sure we can get our kids back to school in august and do other things. Thanks. Thank you. Next question please t. Followup from brian Anderson Associated press. Sorry, just really quick for doctor cohen. Do believe we are in the middle of a second wave right now . Over the past week have your fears of the second wave escalated . Im sorry, so, i think this is our first wave. When i look at the numbers we took early and aggressive action to flatten the curve and we did that but we did it very successfully and as i said that was important and critical time that allowed us to build our capacity here in the state to respond to this crisis but we did not see an early spike or search. Ed that was a good thing in our state. I think this is our First Experience at an increase. In the beginning of that increase and so that is why we all want to really Pay Attention here because i dont want to see a spike or a search. There are things we can do to prevent this. This is t not just a second way but this is a first. It reminds us that the virus is here and we have to learn to live with this virus because we dont have a vaccine and we dont have a cure and so this is a matter of how can we live with this virus so we dont see any spikes and that we can keep the virus level low enough that we can go about doing things like opening our schools back up so again i dont think this is our second wave but i think this is our first and it is a matter on us to make sure that we can live with the virus to make sure we dont overwhelm our Healthcare System and we save lives. Thank you. Thank you question please. Our next question is from bret [inaudible] with box 46. Hello, governor. No nod from fox 46 charlotte. South carolina has been opening at a much faster pace than North Carolina and we here in charlotte are right on the border and are seen cases of spiking. Do you believe the case count in charlotte is rising because of what happened in South Carolina . We know people are traveling down there and be to do other things. Also, second question, did you ever have a conversation a month ago when editing was reopening with Henry Mcmaster about having carolinas open together rather than having two Different Things . I will let doctor cohen address that in a minute but we know the virus does not respect state boundaries. We know that when you have an area where people traveled back and forth that there is potential to spread the virus and South Carolina took a somewhat different approach from North Carolina and did ease restrictions more quickly. He and i discussed it and we did not discuss coordinating those effortsoa but we did talk to eah other about what each one of us was doing and we remain concerned as these numbers go up. Im not sure that i can tell you particularly where that Charlotte Mecklenburg increase comes from. I do know Charlotte Mecklenburg has been a place of concern since almost the beginning and i will let doctor cohen address that point as well. Thank you, sir. Yes, i would say all of our three urban areas, the triad, the triangle in the charlotte area continue to be areas of focus for us and it means that when people live closer together and is more densely populated there is more mass transit and means theres more opportunities to spread the virus. As the governor said, charlottes always been an area a focus but i do think that as we are reopening and we know folks move around more the virus will move around more. There are a number of things that drive our trends and in fact, frankly, the increase testing we need to do helps us identify where the virus is and tries to understand how we can isolate it and make sure that folks who are sick and have covid19 to stay home. It is a number of the things that we have been talking about that drive viral spread and whether it is someone whos is n a high risk exposure through their job like a Grocery Store or Childcare Center or have attended a mass gathering. Those are the things where we want folks to get testing. This is driven by a number of different factors and in our urban areas because of their density are certainly going to be more challenged. Thanks. Next question please. Ourti next question is from Rebecca Martinez with w unc. Hello, governor and secretary. Thank you for taking my question. And Rebecca Martinez from w unc, my question is for doctor cohen. Where is the dhs and its planned taste test every nursing home resident and what reeses services are being provided to bring about that testing . Thanks for the cost of it we known Nursing Homes have been an incredible challenge through this pandemic. We know once the virus is in our Nursing Homes its incredibly hard to contain and it is why we have taken early and aggressive action to do a number of things across the board from decreased visitation to make sure that we are having folks if they see even one case of covid19 to test everyone but we wanted to go further but we know we test when there is a case but we want to state we need to take some proactive work to testte everyoe in longterm Nursing Homes. We are working with the Nursing Home Association and those folks that runn each of those Nursing Homes and how do we make that happen. It is a big challenge to test everyone and we are working through those challenges. We know that testing the residents of Nursing Homes is more simple because they have insurance, both in the Nursing Homes are either covered by medicare or medicaid and having insurance access really does help when we think about testing but we know unfortunately to folks that work in our longterm care settings are more likely to be uninsured. We know that our state is only one of a dozen or so states that have not expanded medicaid andy have a high uninsured rate here and so it presents a significant challenge, not just logistically like how do we get everyone tested, thats a big challenge and my team is working on that with the Nursing Homes but also how do we make sure that folks get that coveragewo of their tet so we are working through all those challenges and we want to make sure we are getting as much testing in the Long Term Care space as we can. Again, because of the risk to the medically frail folks who live in our Nursing Homes. Thank you a. Thank you. Next question please. Fo followup, Rebecca Martinez, w unc. Thank you, secretary. To clarify, what resources are being provided to the facilities to carrysa out testing . Are youin sending teams or if ty are responsible to do the testing on their own . My followup question is, what infrastructure is in place for residents who do test positive, especially if they dont have acute symptoms, do they get sent to the hospital or covid specific facility . The way we do testing is that in some cases the nursing home is able to, on their own, contract with a company that will come in and do all the testing for them and in other cases that is not possible. Nt we work with local Health Department to deploy teams so that is how we been doing it for the last number of months. When we hear about even just one case again, an outbreak of two or more cases but we set even one case we send or make sure that teams go from the local Health Department to work withke them, not just on testing but on the infection protocol that are necessary for folks to make sure that they are working through this. If someone does test positive for covid19 and they have no symptoms they should stay in the nursing home. In the nursing home you have nursing care and that is a good thing that they have some medical support at the nursing home. We only want folks going to the hospital if they need hospital level care. We want folks to find folks who are positive and to know to what we want those that are positive to Stay Together and those that are negative to be separate from them so the virus doesnt spread. Make sure the staff, who help those with covid, does not also work with the residents who dont have covid. There are a number of Infection Control procedures and we have many guidelines on our website with teams of folks who been working on this for quite and extensively for a long time. There is quite a lot of work that goesho into what is happenw in our Nursing Homes and we have reflected our payment levels in medicaid to these Nursing Homes to reflect the fact that this work is hard and it takes resources so there is a lot going on in the Long Term Care space we have been working aggressively on, thanks. You might have said this, doctor cohen but we have been sending personal protective equipment to all our Nursing Homes in rest homes to help them out with this situation because you do need that to do testing as well. Next question please. Our final question today will be from laura leslie with w url. Hello there governor. Can you hear me . Smacked yes. This is laura leslie, thank you for letting me ask of the. A couple of things. Number one, what percentage since we are testing more, what percentage of cases are coming of people who are in turn could get living settings, present, nursing him, what percentage of those cases overall or perhaps doctor cohen can speak to that . Number two, known what county had a rising caseload so what guidance, if any, are you offering to counties for measures that additional measures they might need to plummet to try to control outbreaks on a county or local level . I will let doctor cohen take that. Hello, laura. I dont have the percentage on the top of my head so let me get back to you on the percentage that are related to longterm care. There is a lot of information on our dashboard about the outbreaks and we track every day and how that relates to our cases. As far as what we advise with that county, we worked closely with a number of counties that we mentioned earlier that we are seen faster increases in cases so our state teams, local Health Departments within [inaudible] county andth a number of partnes are putting our Heads Together about how do we help make sure that we are getting ahead of things as much as possible. The key to that strategy is ramping up testing. Testing helps us and if folks know they are positive even when they dont have symptoms. Ramping up testing is critical. As well as ramping up tracing capacities so we have been deploying additional tracers from our contracts to our local Health Departments bid i know wade county has requested support from that purpose so we work with them to say how can we help you. Sometimes it is with testing and sometimes tracing and sometimes it is what we are just digging into the numbers. Our local Health Departments are the tip of the spear in doing this work and it is hard work. Thats why we are trying to pull in as many partners Piedmont Health systems involved, other doctors and it will take a ton of partners and an all hands on deck approach to really get our arms around this and make sure we stay ahead of it. We are sharing early warnings with you today about the trends we areke seen and if we can take an all hands on deck approach we just cant be from local but has to be everyone working together whether individual action, business action, testing action, tracing, all of that is going to matter and it is no one thing, they all have to be layered together and use all the tools but were working with [inaudible] county and many others on how to layer those together and try to be as coordinated as possible and when resources are needed from the state we want to come in behind the local efforts to see where we can fill in gaps. Thank you. Did that do it . We thank you all for joining us today. Stay safe and try to be careful this weekend. Use the 3ws. Thank you. Today marks the 57th anniversary of the assassination of civil rights leader, medgar evers and jackson, mississippi. Cspan traveled to jackson to tour his house and to learn more about the tragic event of 1953. Now, for many of us who have gone overseas, fought for this country, fought for mississippi and we fought for alabama and we fought for North Carolina and we fought for illinois and we fought for every state in this union, now we will stay here and see the things that the mayor has said become a reality. Fifteen minutes past midnight adverse got out of his car in the negro residential area. About 40 yards away they fired a