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roughly 30 minutes from now new york governor andrew cuomo will give us that daily briefing, governor cuomo announcing that new york and six other states are grouping together to buy tests, ppe and other medical equipment as well. and as always, we have our doctor on duty here all hour, dr. steve cor win back with us, dr. corwin is the president and ceo of new york presbyterian hospitals, also this hour we are going to put a spotlight on iowa, a key part of our nation's food supply chain. and that is where we find nbc's dasha burns, at a tyson plant in waterloo. walk us through the things that community is facing as they try to figure out what to do next. >> reporter: as the majority of counties in iowa are reopening right now, here in black hawk county the number of cases keeps rising, it's above 1,500 now as of sunday and public health officials here say about 90% of that can be linked to what happened at this tyson plant before they shut down on april 22nd. it's one of the largest pork processing facilities in the country. and county officials here spent weeks pressuring the plant to shut down because of unsafe work conditions. after they did, just days later, president trump ordered meat plants to remain open, which caused a lot of confusion here, both among county officials and among the 2,700 employees at this plant. many of whom, craig, are minorities and refugees, black hawk county is one of the most diverse counties in iowa. and these workers, they want to earn that paycheck but they don't want to risk their lives and their families' lives. i spoke to one employee this morning who himself tested positive for covid-19, and he saw firsthand the cost of all of this. take a listen to what he told us this morning. >> it's heartbreaking for one because there's a person that you work with, that you knew personally, that won't be there no more, you know, because of this disease. and then it kind of makes you upset because we don't know if it could have been anything done that could have prevented it. >> reporter: and, craig, he saw firsthand one of his co-workers did pass away. he's concerned about this plant reopening. he wants to make sure that they can go back and feel safe and comfortable at work. i did speak to sheriff tony thompson here who told me they've been in close talks with tyson. and they are not planning to reopen until they can guarantee safety of workers and until county officials here agree. the sheriff said he takes them at his word. what happens here over the next week or so is critical, craig. >> dasha, stand by for me if you can. i want to come back to you in a moment. i want to go to florida for a moment, though, where the beaches in clearwater beach are opening back up. governor ron desantis never formally closed the beaches in the sunshine state, he left it up to local governments to decide when and how to reopen, to a certain extent. if clearwater beach rings a bell, you may remember it was back in march when beaches there were packed, spring breakers put that community in the spotlight for all the wrong reasons. nbc's sam brock is in clearwater beach this morning, and, sam, how is clearwater hoping to avoid a repeat of what we all saw back in early march? >> well, it's quite a contrast from what we saw in march. there's 213 different access points to this beach. 35 miles of sand up and down here. and you'll see behind me it's not throngs of people like what we remembered. that's because the enforcement has been seriously ratcheted up from several hundred law enforcement officials, sheriff's deputies and police officers patrolling the beach, to people in helicopters on atv, watching for a couple of things to make sure families and groups of people are not getting more than ten or more in a particular situation or setting, and also that they're staying six feet away. check this out right here, you see these cones, this is to create a clear pathway for all sorts of police vehicles coming through here, whether it's an atv or cruiser, i've watched them come every minute or so, in some cases they are talking to people and saying you need to keep more distance, you don't have to wear a mask. i might be one of the only people on this beach wearing a mask. but the key is, you have to be safe. there are particular warnings in place right now, and people here don't want to lose the privilege of what they've been given. if you go backward six weeks from here, the images were, in many cases, shocking what we were seeing in the middle of this coronavirus breaking out. here's what one beach goer told me about why she's being as careful as she can. >> it is the right timing, everyone are being responsible, and they are going to continue being responsible and following the guidelines because, as i said, we don't want to lose this privilege. no one does. we don't want to stay home anymore. >> reporter: now, in panelis, the vote was 6-1 to reopen the beaches. one commissioner felt there's not enough testing going on here right now to be able to take these steps. but if you look at broad brush stroke numbers, craig, several hundred cases in this particular county, a fraction of what the state is looking at. 36,000 plus cases across florida, and 1,300 or 1,400 at the times. given the circumstances here, being able to flatten the curve in this area it was a safe move to go forward and do it. we'll see how it plays out. time will tell. craig? >> all right, sam brock there in clearwater beach where lots of folks are clearly enjoying the beach there, sam, thank you. let's head across the state line to georgia, where the warmer weather is also presenting a challenge. scenes like this. in atlanta's piedmont park, got a lot of attention over the weekend, there's the scene there, people there and across the state out in droves enjoying the fresh air in parks, rubbing elbows, crossing the street, many without the face masks. meanwhile, as businesses are slowly reopening, the risk of exposure to covid-19 still a major concern. the number of cases, and the death toll, still rising in georgia. i want to bring in sharon tranter, she owns a salon in atlanta, balancing the realities of reopening her business during this pandemic. and sharon, what's it been like to go back to work, to reopen your business, even as the cases continue to climb in your state? >> well, it's been, of course, very scary. it's -- we don't have enough testing. and quite honestly it's fearful. but being between a rock and a hard place is that if i don't open now, and someone else is going to take that business, maybe i'm not going to have a business to come back to. but it's very, very frightening to try and keep safe, to try and keep my guests safe, following all the science. i don't know. it's hard. >> sharon, the nature of your job, the nature of your work, it's person to person contact, what precautions have you been taking to ensure that you and your employees and the customers are safe? >> well, georgia, we all have to wear masks and clients have to wear masks. everything is sanitized. that should be anyway in between clients. temperature controls when people come in, social distancing, not having more than -- so we can have six foot apart from one another. but reality is, is that even with swapping out my capes all the time, i wear a mask, i wear a visor, the issue that we have is that we are within six feet of one another. and so therefore we're at extreme risk of any transfer rens, and in the area. i'm trying to do my best to follow all the science. and put all these precautions and protocols into place to be safe and to keep everyone safe. >> we just showed a picture of you donning your face shield there at the salon. how have your clients been reacting to seeing the precautions that you and your team have been taking? >> i would say this, that my clients have been absolutely fantastic with this. however, many people coming into the salon have made the comments of, i feel really strange coming in with a mask because i'm outside and absolutely no one has got them. so i think people are being very, very grateful of all the steps that we have taken, and to ensure that everybody's safety within this very, very close proximity of working with people. so it's a challenge, i'm not going to lie. it's a challenge. >> is it sustainable long term, sharon, the things you're doing at the salon, all of the precaution that precautions that you're taking, a year from now if you're still being asked to do this, can you? >> i think the concern is going to be for a lot of hair stylists is that if you on average took ten clients a day that you're now taking five clients a day because of the social distancing, and being -- everything implemented inside. so the question's going to be, now, is that are you having enough revenue being brought in to cover the overheads, the lease, and so on and so forth. i've had many people reach out to me saying that if they don't work on volume, which is like barbering, they are not going to be able to make this work due to the fact of the volume within the salon. so i think only time will tell. but it's certainly going to impact revenue for all stylists, and the ability to be able to pay their overheads. >> sharon tranter, thank you. and good luck to you and good luck to the salon as well. appreciate your time this morning. as more of the country starts to reopen president trump is now raising his estimate of how many americans could die from the coronavirus. the president now projecting the death toll could reach 100,000 people. just two weeks ago he suggested that the figure could be up to 60,000. let's bring in nbc's peter alexander at the white house, and peter, do we know what's behind the shift in the numbers? >> yeah, craig, it's a good question, it's not clear what the president has to gain politically by continuing to shift these numbers. it's obvious in the beginning he wanted to downplay it, suggesting they might be well below the threshold many people were expecting but he has now upgraded, in effect, revised upward his number, five times in 13 days, the latest example of this taking place last night, two weeks ago he said the number could be as low as 50,000, and then 60,000, and then 65,000. here was president trump last night during that fox news town hall. >> we're going to lose anywhere from 75,000 to 80,000, to 100,000. that's horrible. >> that number has changed, mr. president. >> it's gone up. i used to say 65,000. and now i'm saying up to 90,000. and it goes up, and rapidly. it's at the lower end of the plane if we did the shutdown. >> reporter: nonetheless the president is calling for states to try to get parks and beaches and some businesses open again, even if that town hall he said that he believed schools could reopen this fall. he did also offer a little bit of a note of caution saying that some older americans, those over the age of 60, he suggested, may be able to stay -- may need to stay put for their own safety during this time. craig? >> peter alexander from 1600 pennsylvania, peter, thank you. let's bring in our doctor on duty, dr. corwin is with us for the hour, president and ceo of new york presbyterian hospitals. dr. corwin, let's start with that warning from trump administration expert, dr. deborah birx, she was asked about those protests that have been popping up around the country, calling on governments to reopen. here's what she said. >> it's devastatingly worrisome to me personally. because if they go home and infect their grandmother or their grandfather who has a co-morbid condition and they have an unfortunate outcome they will feel guilty the rest of their lives. we need to protect each other at the same time we're voicing our discontent. >> dr. corwin, what kind of risks do these protests that we've been seeing, what kind of risks do they create, even for folks who might not be there? >> well, of course they create risks. the reality, the -- we know the epidemiology of this very well. if one person infects less than one person, you can see -- meaning an "r" value of less than one, you can see that the infection rates will go down. if that -- as that number goes up, a pandemic occurs, the more people you have congregated, the less social distancing you have, the more likely it is that the infection's going to spread. if you then couple that with inadequate testing then you don't know where you are. what we're titrating is the infection, versus the opening of the economy. that's why dr. birx was so concerned. we've made progress but we're not there yet. and until we get a vaccine, or an effective therapy, we're not going to get there this way. >> you mentioned a vaccine. british scientists are testing a possible vaccine. they say their tests could show signs that it works as early as next month. does that sound feasible? what are the safety concerns for doctors when a vaccine is developed that fast? >> the reality here is that to compress the vaccine development curve down to what we would hope would be 18 months, we're going to have to take some chances, one of the chances will be starting to manufacture multiple vaccines early, one of the chances will be one of the human volunteers to test the vaccine and test it vis-a-vis infection. so there's a lot to it in order to get all the trials down to a compressed time frame where we could potentially have a vaccine in 18 months. a lot of vaccine trials show promise, craig. and then the minute you put them into humans they don't work. think about all the vaccines we've had for hiv a.i.d.s. we've got to be very cautious about this, but hopefully we can compress the time frame. and look, the oxford results are encouraging. >> the fda, last hour, dr. corwin, we learned the food and drug administration has changed its policy for antibody tests. >> yes. >> makers of the test will now need to get emergency use authorization from the fda. how does that help increase the accuracy of the results? or does it? >> it will. let's remember three things about the antibody test. it needs to be sensitive, number one. does it pick up the fact that you've had the infection? you want that to be over 95%. is it specific? you want that to be over 95%. there are a lot of coronaviruses out there. you want to make sure it's picking up this coronavirus. and then the third thing is you want it to be quantitative. how much of the antibody did you produce? so those three things are necessary for an effective test. a lot of tests that have been out there are not sensitive, they're not specific, and quite frankly ta consequence of that they're not meaningful. >> dr. corwin, we just showed clearwater beach, a slew of folks on the beach there, we showed a bunch of folks in georgia, nice over the weekend, a lot of folks out and about, and i read over the weekend that there are two major studies now, two major studies, one out of taiwan, one out of seattle, this was the scene, by the way in new york city, just yesterday, and according to these studies, again confirming what we've talked about a number of times on this broadcast, there are a significant number of people who are walking around with this virus in their bodies who do not know that they have it. they're asymptomatic. if we know that to be true. why are so many people walking around like this? >> i wish i knew. what i've said publicly and privately is i want no part of this country to go through what new york city has gone through. and the minute the pressure starts to get relieved people feel less concerned about this. we should remain vigilant until we have an effective treatment or an effective vaccine. i've seen those social gatherings in new york. i worry about florida and georgia. we have to have, in my opinion, we have to have a campaign to get people to wear masks. i think it would help. the same way that we had campaigns on condom use during the a.i.d.s. epidemic and still do, i think it's really important. and i think this notion of liberty is a relative notion and i'm very, very concerned about some of the demonstrations that occurred in michigan and in other places because i think we're going to have a public health calamity if we follow some of those recommendations. >> dr. corwin, stand by for me if you can, sir, i want to come back to you later. dr. corwin, doctor on duty for the hour. less than an hour from now we expect to hear from iowa's governor, there's confusion in iowa about unemployment benefits specifically, the state initially warned that workers risked losing those benefit ifs they did not return to work when their company reopened. now it does seem to be making some exceptions. i want to bring nbc's dasha burns back, in iowa, in waterloo today for us. dasha, bottom line, people in the hawkeye state are confused. what's the plan? >> reporter: craig, concern and confusion for residents of iowa, and employees like those, the 2,700 employees at this tyson plant behind me who don't know what exactly they're supposed to do after the head of the iowa workforce development issued that warning, essentially, to employees. i'm going to -- just to clarify, read a little bit directly from the faq page recently updated on the iowa workforce development page. on that question of if someone has fear of work, fear of doing their job because of covid-19, the answer is, should you choose not to attend work or return to work? this would be considered a voluntary quit job, abandonment or refusal to work and you would not receive unemployment benefits. there are exceptions, and that includes those diagnosed with covid-19, and those caring for, or living with a household member with covid-19, also those who have recovered, but are suffering medical complications, those who are having issues with child care or transportation, and finally there is some flexibility, craig, for folks who are in those high risk categories and people living with people in higher risk categories. but bottom line, people are worried that their hands might be essentially tied and they won't have a whole lot of options should these companies reopen. >> it's quite the predicament, for sure. dasha burns there in waterloo, iowa. an army of seamstresses answering the call to help medical workers all over this country. a rare glimpse inside a secluded amish community and how its putting traditional skills to work. we're waiting for an update from governor andrew cuomo, saying the state will face more than a $10 billion shortfall if the federal government doesn't step in. the state, of course, lost tax revenue when businesses shut down. one nurse on long island says she and her colleagues have already suffered enough, can't take a potential financial hit on top of everything else, they face. >> at the place where i work the doctors, the nurses, the respiratory therapists, the nursing assistants, the pharmacists, et cetera, will all have to take a pay cut because people aren't doing what's right and the people that aren't doing things that are right all work in washington. we've suffered enough. our lives are totally closed down. people that we know have died. the loss and the suffering that the staff has to deal with, that they'll take with them, there's no reason that we should also suffer financial blow because someone needs to be right. aboutr customers, patients, and employees safe. fastsigns understands. helping you solve your communication challenges so you can run your organization smoothly is our commitment. with locally-owned fastsigns centers operating as essential businesses, we're in this together. neutrogena® rapid wrinkle repair®. we've got the retinol that gives you results in one week. not just any retinol. accelerated retinol sa. for not only smoother skin in one day, but younger-looking skin in just one week. and that's clinically proven. results that fast or your money back. unless you're attached to your wrinkles. one week is all it takes. neutrogena®. o♪we ain't stoppin' believe me♪ ♪go straight till the morning look like we♪ ♪won't wait,♪ ♪we're taking everything we wanted♪ ♪we can do it ♪all strength, no sweat it's ohioans who have said, yeah, we're going to stay home, or we're not going to be mixing with a big group of people. we just have to continue to do that distancing, to be careful, we're not requiring it, but we're urging everyone who goes out into retail, wear a mask. that is for -- that's not for you, that's for someone else. >> that was ohio's governor mike dewine there on "morning joe," stressing the steps he hopes people in his state are taking to stay safe. there's still a struggle to get the protective gear, like face masks to hospitals and to the general public as well. so one community in the buckeye state has mobilized to help fill the void. msnbc's chris jansing is live in cleveland. she made a trip about 80 miles south to holmes county to get an up close look at what the amish community is doing there. this is a state you know very well, it's your state. why did this particular community in ohio jump in to help? >> reporter: yeah, craig, i grew up not far from an ammish community, it's a core part of their belief, if someone needs help, you come together as a community and offer it. when folks here at the cleveland clinic said they needed help the amish were very quick to raise their hands. it's a remarkable story we're only able to tell because of a very rare interview we were able to get with one member of that amish community. take a listen. this isn't the first place you think to go when tackling a global pandemic but that's exactly what happened. the cleveland clinic as 55,000 employees plus visitors and they needed masks. >> we couldn't get them anywhere so the solutions had to be local. >> reporter: they turned to nearby holmes county, and the country's largest amish community. and while the amish reject most modern technology, including tv, one man agreed to this rare interview. >> a request was made, and just that fast the amish community responded. >> we do try if there's a need somewhere, maybe an example would be a fire, or a sickness in the family, we do try to get together and we try to help. and here we're in need for our neighbors. >> reporter: with the amish could raise a barn in a day, surely they could mobilize to make masks. >> we have four girls in our house and they can all sew. >> did you ask them to be a part of this? >> they are part of it. three of the girls and mom. >> so four? >> not myself. >> in this 20-mile radius there are 5,400 amish households. so boxes of supplies were quickly assembled and distributed. operation stop covid-19 was in full swing. in 48 hours the cleveland clinic had 12,000 masks, eventually 150,000 of them. then companies where the amish work stepped up, dutchman hospitality offered to launder masks, berlin gardens switched from making lawn furniture to as many as 150,000 face shields a day. and keim lumber store is handling logistics. >> the amish care deeply about other people and are very giving. this is a very natural way they want to give back. >> now the english have masks and gowns and shields that global supply chains simply couldn't provide. community is what you're about. >> we are a tight knit community, and i guess we were taught that from our youth. helping each other out. and we try to continue and plant that in the next generation and continue helping each other. >> reporter: so obviously we respected his wish not to be identified. here at the cleveland clinic they said they were so impressed with the sheer speed and the quality with which they went to work. and we should point out that they are paid. these folks are also out of work, like a million other folks here in ohio. but they don't take any sort of government help. they didn't take unemployment. they would not take one of those $1,200 checks and i was thinking as i was there, craig, about you reporting from central park, a lot of the amish are wood workers and they built the infrastructure for those tents that became remote hospitals all throughout new york, craig. >> wow, how cool is that? chris jansing, what a fascinating story, thank you, thank you so much for that. chris jansing there in cleveland, ohio. no one knows the buckeye state like our senior correspondent there, chris jansing, chris, thank you. from ohio to new york, there's the scene, rochester, new york, governor andrew qcuom, set to bring us that daily update. when it starts we will bring it to you live. meanwhile, overseas, europe's longest lockdown, coming to an end, life restarting in italy. but it is far from normal there. first, here at home, though, a heartfelt sendoff, over the weekend emergency squads from the new york and new jersey area paid tribute to their out of state allies who helped offset the spike in calls and filled in when local first responders got sick themselves. 122 fema response teams answered 10,000 emergency calls while they were here. now, they're heading back home. courtney rumbauch posted the video, she's a kansas state student who traveled 1,500 miles to lend her emt skills while still working with professors to finish the semester. our sincere thanks to courtney and all of her colleagues. 1, featuring the emmy award-winning voice remote. access to your favorite apps, including netflix, prime video, youtube and hulu. all without changing passwords and inputs. the most 4k content and movies and shows on any screen. the best entertainment experience all in one place. this virus is testing all of us. and it's testing the people on the front lines of this fight most of all. so abbott is getting new tests into their hands, delivering the critical results they need. and until this fight is over, we...will...never...quit. because they never quit. >> governor andrew cuomo is set to sit down in a moment. we'll take you there when he starts. for the first time, eight weeks, italy is tarting to reopen. it means lifestyle changes for millions of italian people. experts are worried are these changes are coming too soon. nbc's matt bradley is live for us at a newly opened park in rome. and, matt, you've been in italy for a number of weeks now, i remember seeing you when it was completely empty on the streets. quite desolate. it looks like things are starting to slowly get back to normal there. >> we've been here, craig, my crew and i, for eight weeks, since the very beginning of the lockdown. we were here just when they locked down this whole country. this is the worst afflicted country in europe. it's got nearly 28,000 people dead of the coronavirus. so just walking through a park like this for me and my crew it's been really emotional. we feel like we've been on lockdown with italians, we've been here since the beginning and that's why you're seeing everybody coming out and taking advantage of this. but really, you know, craig, this is a lockdown in name only. most businesses, most restaurants, we're all going to be waiting a few more weeks for them to open up. craig? >> all right, matt bradley there in rome, matt, thank you. governor cuomo is starting his briefing in rochester. we expect he's going to smile, that big smile again, it's a pleasure to be in rochester with so many of my friends who have done such great work for the state. former lieutenant governor bob duffy who worked with me when we first got started and has done great work for the entire state of new york. danny wegman, pleasure to be with you, danny is a great civic leader. they've been very helpful through this situation. also, thank you for allowing us to do the antibody testing at wegman's, that's been very, very helpful. we thank you for everything you've done. and nicole wegman, thank you, pleasure, thank you for being on our new york forward advisory board to help us going forward and find our way through this. let's give you an update on where we are today. the total number of hospitalizations is down. you see that curve coming down. you see that mountain that we went up. now we're on the other side of the mountain. you start to see the shape of the mountain. unfortunately the decline from the mountain is not as steep as the incline, right? and the big question for us in new york and every state across the nation has been how fast and how low does that decline go? right? how fast does the decline actually happen? and what is the lowest level that the decline will reach? unfortunately you see that we were shape -- we were hoping for a quick up, plateau, at the top, which is what they talked about. but a fast decline. you see the decline is, again, not as steep as the incline. but it is a decline, and that's good news. changing total hospitalizations is down, net change in intubations is down, and that's always good news. when a person is intubated, 80% of the time there's not a good outcome. the fact that intubations is down is good news. the other end is how many new cases are coming in the door every day? how many new diagnoses in covid cases? and that number is also declining. not only are the number of people in hospitals coming down, but the number of new cases coming in the door is down. and that's good news because it had plateaued at about 900 statewide. for a few days. but this number is down at 700, and that's a good number. i would take this with a grain of salt as they say because this is reporting from yesterday, which was a sunday, and sometimes we get different results on the weekend. remember, this whole reporting system is just been put in place. this never happened before. this is now every hospital in the state reporting, every day, for the first time. so it's a plus or minus across the board. this is the number that haunts me every day, and this number is not declining anywhere nearly as fast as we would like to see it decline. still 226 new yorkers who passed away. and so we don't become immune. we talk about these numbers. 226 families, right, that's 226 wives or brothers or sisters or children that are now suffering the loss of a loved one. so we remember them in our thoughts and our prayers. people are all talking about reopening. which we should be talking about. this is not a sustainable situation. close down everything. close down the economy. lock yourself in the home. you can do it for a short period of time but you can't do it forever. but, reopening is more difficult than the closedown. the closedown was relatively simple, right, you're going to the basement, you throw the big power switch, and everything just goes down. close the businesses. stay at home. it was a blunt operation. and when that was done all across the country, just stop everything now. when you go to restart, the reopening, now knowing what we know, it's more nuanced. you have to be more careful. and again, no one has done this before, and no one has been here before. so, first, start by learning the lessons that we did learn through this experience. and second, let's be smart about what we do. and i get the emotion, and i get the impatience, and i get the anxiety. we all feel it. when i say the situation was unsustainable, it's unsustainable on many levels. it's unsustainable economically, it's unsustainable personally. a lot of anxiety is now all through our community. we see it in increased alcoholism, increased substance abuse, increased domestic violence. so this is a very, very difficult period, and people want to move on. yes. but let's be smart about what we do. and let's learn the lessons. one of the lessons is, we have never been here before, and we didn't really know what was going on. cdc releases a report, end of last week, that says the virus was actually coming to the east coast from europe. everybody was looking at china for all those months. china, china, china, china, china, yeah, china was, last november/december. the virus migrated from china, while we were all staring at china, and went to europe. and the strain that came to the united states came from europe. we had people in the airports stopping people from china, testing people from china, the federal government did a lot of testing, a lot of screening, people getting off planes, from china. yeah. but meanwhile the people from europe were walking right past them. and that's where the strain came from that was infecting this area. and that's what the cdc just learned last week. and this is going back to february, right, one of the most studied topics ever. again, just learned the lessons of what happened. you now add that piece of information on the europe trips, and then you see the number of flights that came from europe during that time, where they landed, and now you -- it explains why you've seen the outbreak in chicago that you've seen, why you've seen the number of cases in new york. because, yes, the flights were landing here, people were coming from italy, and uk, and from european countries, and nobody thought to screen them. nobody was on guard. and you add that to the density of new york, especially in new york city. and that virus just took off, okay. we didn't know. we didn't know. now we do. we also can look back in history and look at that 1918 flu pandemic they talk about. the places that opened too soon saw that flu come right back. and by the way, that flu was not one wave. that was three waves. first wave, second wave, third wave. second wave was worse than the first wave. and you see, watch the other countries that went through this before us, right, we're not the first one down the chute. there were other countries that went down before us. you see they wanted to reopen also. they were feeling the pressure on reopening, and you study those cases and you see that you reopen too soon or you reopen unintelligently and you can then have an immediate backlash. and that's not speculation. that is looking at other countries, and look at what has happened around the world. and then you talk to the experts who know, listen to what they're saying. dr. fauci, who i think is one of the best voices and minds on this, dr. fauci's been through this in denvifferent iterationse was one of the pioneers on the hiv virus and a.i.d.s. and he says we could be in for a bad fall and a bad winter. could be. why? because he doesn't know. he's not sure. but could be for a bad fall or bad winter. okay, so put all of this in the -- in the equation. and then also acknowledge and actualize that the truth is that nobody knows what happens next, and when it happens. well, how can that be that nobody knows? we're so sophisticated. we have so much intelligence. we have so many experts. this is the united states of america. how can it be that no one knows? because no one knows. i speak to the best experts globally, globally, and nobody can tell you for sure. now, experts we look to experts, and we expect them to know so we push them to know. answer the question. tell me when. what's going to happen in september? what's going to happen in december? sometimes the answer is i don't know. sometimes that's the honest answer. i was talking to my daughters last night, and they said, you know, you say at your briefings i don't know. how can you say that? first, i'm not really sure they watch my briefings. but they're right. sometimes i say i don't know. why? because i don't know. and if you don't know, say you don't know. and i speak, again, to the best minds in this country, the best minds around the globe, and they don't know. so if you don't know, say you don't know. it doesn't mean you're not smart, no reason to defensive. i don't know. when you know what you don't know, and add it it, it will actually keep you safe. my daughters don't quite agree with this yet, but i haven't given up on the concept. know what you don't know. know when you don't know what the future holds, you can be safe because then you can prepare for different possibilities. and that's where we are. we don't know. but we will be prepared for all possibilities. so reopening. chart a course. with the best information you have. learning from the lessons you have. but be able to correct that course depending on what happens. which means, don't act emotionally. don't act because i feel this, i feel that. because someone said, well other states are opening, so you must be able to open, if other states are opening. forget the anecdotal, forget the atmospheric, forget the environmental, forget the emotional. look at the data. look at the measurements. look at the science. follow the facts. that's what we've done here from day one. this is no gut instinct. this is at the data, look at the science, look at the metrics. move forward measuring what you can and what you know, and then be prepared to adjust. well, i want specificity. i want to know for sure. you don't. but there's liberation in knowing that. so let's do this intelligently, based on metrics, and we'll see what happens and we'll adjust to whatever happens. well, what does that mean on metrics? you can measure this. and we have to measure this. you look at that percentage and the rate of hospitalizations, which we have, right? that's the chart that goes up and down. you watch that hospitalization rate. do your diagnostic testing so you know how many people are testing positive and you can watch that rate going up or down or flat. do the contact tracing, so after the testing, you follow up and you do that contact tracing. and you are then reducing the infection spread by isolating the positives. if you do those things, you will control the rate of transmission of the virus, which is everything. nobody says you're going to eliminate the virus in the short term. nobody. but you can control the rate of transmission. and if you can control the rate of transmission, you can control the rate of transmission from becoming an outbreak or an epidemic or overwhelming your public health system. that is the best you can do. so, control the rate of transmission to what they call 1.1 or less. 1.1 is every person infects 1.1 other people, more than one other person. if you're doing that, that is an outbreak. that means it's going to increase exponentially and it's going to be out of control. as long as your rate of transmission is manageable and low, then reopen your businesses and reopen the businesses in phases so you're increasing that activity level while you're watching the rate of transmission. the rate of transmission goes up, stop the reopening, close the valve. close the valve right away. so, reopen businesses. do it in phases. and watch that rate of transmission. it gets over 1.1, stop everything immediately. that's where the other countries wound up. they started to reopen. they ceded the 1.1. it became an outbreak again. they had to slow down. rather than starting and stopping, you'd rather have a controlled start so you don't have to stop, right? and that's what you learn from the other countries. you reopen too fast, then you have to stop, and nobody wants to have gone through all of this and then start just to stop again. well, how does that happen? first of all, it's not going to happen statewide. this state has different regions which are in much different situations than other regions in this state. and rather than wait for the whole state to be ready, reopen on a regional basis. if upstate has to wait for downstate to be ready, they're going to be waiting a long time. so, analyze the situation on a regional basis, okay? and you look at a region on four measures -- the number of new infections, your health care capacity. if the infections goes too high, you overwhelm your health system. now you're italy with people on gurneys in a hallway because your hospital system can't handle it. do your diagnostic testing so you're seeing how the infection is increasing or decreasing. and do the contact tracing, have that system in place so when you're testing, you find a positive, you trace the contacts from that positive person and you're isolating them to bring down the rate. and you do that on a regional basis. that system has to be in place for a regional basis. how do you start? when can i start reopening? you look at guidelines from the cdc, which say a region has to have at least 14 days of decline in total hospitalizations and death on a three-day rolling average. so you take a three-day average. you have to have 14 days of decline. you can't have more than 15 new total cases or five new deaths on a three-day rolling average. this is telling you that you're basically at a plateau level that you can actually start to reopen. then you're watching the rate of infection and the spread of the infection, and the benchmark there is fewer than two new covid patients per 100,000 residents, right? it's based on your population to account for the variance in the different sizes of regions across the state. then, anticipate, protect yourself from all possibilities. well, what if we have a surge again? never fill your hospitals to more than 70% capacity. leave 30%, in case you have a surge. remember, this virus is tricky. the rate of infection -- a person who gets infected today shows up in the hospital ten days from today or two weeks from today. so, that infection rate goes up. you don't feel it for two weeks. there's a lag to it. you want to make sure you have 30% of the hospital beds available in case you have that surge. also, learn the lessons from before. every hospital has to have 90 days of ppe for that hospital, at the rate that they have been using it during covid. we cannot have another mad scramble where nurses and doctors don't have gowns and masks, et cetera, because the hospitals don't have the necessary stockpile. so make sure every hospital has the stockpile. on the testing, we have done really remarkable work on testing. one million new yorkers have now been tested, believe it or not. and the cdc coronavirus task force for the white house recommends that for a region to reopen, you have 30 tests for every 1,000 residents ready to go. so, what testing capacity do we need for a region to reopen? you have to be prepared to do 30 tests for every 1,000 residents. new york is doing more tests than any country in the state so far. new york is doing more tests than any country on the globe per capita. so, we're way ahead in testing, but it doesn't matter what we're doing statewide. to open a region, that region has to have a testing capacity of 30 per 1,000. the national guard has been doing a great job for us in putting together testing kits and distributing testing kits, and we want to thank them very much, but we have to have those tests, and we have to have what they call tracers, contact tracers, in place. and mayor bloomberg has been very helpful, former mayor of new york city, in putting together this tracing system. this has never existed before on this scale. a group of people who literally trace contacts from a person who's positive. who did you have dinner with last night? who did you have dinner with two nights ago? who might you have been in contact with? and then contacting those people to say, do you have any symptoms? if you do, you should know you were with john smith. john smith tested positive. he said he went to dinner with you. you should be on alert. that whole tracing system has never been done, not only in this state, but in this country. so, that all has to be set up, and it has to be done. once that is all done, then you can talk about reopening businesses. well, which businesses do we open first? you open businesses first that are most essential and pose the lowest risk, okay? most essential and the lowest risk. phase one, we're talking about construction, manufacturing, and select retail with curbside pickup. they are the most essential with the lowest risk. second phase -- professional services, retail, administrative support, real estate. third phase -- restaurant, food services, accommodation. fourth -- arts, entertainment, recreation, education. remember, density is not your friend here. large gatherings are not your friend. that's where the virus tends to spread. that's why those situations would be down at the end. and then we need businesses to also reimagine how they're going to do business and get ready to protect their workforce, to change their physical environment to the extent they need to and to change their processes to make sure
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