Continuing every single day across the state of south dakota to allow facts and science to drive our decisionmaking. I think that what youre going to hear and see today is a great demonstration that the entrepreneurial and Pioneering Spirit is alive and well within health care in the could in the dakotas. Are goinger way, we on offense against the virus. I want to thank the governor for her support. And everything the secretary has done. Their theroduce from governor to make a couple of comments. Will talkysicians about trial specifics. Good morning, everyone. We continue every day across the state of south dakota to allow facts and science to drive our decisionmaking. 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 limiting group sizes, telling people to stay home, focusing on hygiene and washing hands, we have been able to push that peak off. Today, we have an announcement about going on the offense against covid19 in our state. We are going to be the first state in the nation to run a statewide clinical on oquine. Loric w it will be used to fight covid19 and the team behind me will help lead this effort. I have spoken with the white house and president trumps 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. We see new people and families being impacted. We know all of this has been expected. For weeks 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. We are going on offense to help every Single Person deal with this virus, fight it, get better , and go home to their families. Our leaders here have collaborated with my administration, and im 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. Not just for our state but also the country. Thank you, governor. I would like to thank the governor and the 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 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. So, it takes research, and it 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 covid19 . I using research and doing Clinical Trials, we can determine 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. There are going to be two different components to the Clinical Trials. The first is a registry for patients who have covid19. They are positive. Those patients will be inpatient or outpatient and have the option to receive hydroxychloroquine. In the inpatient 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 covid19 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 been exposed to covid19, healthcare workers that could either receive the placebo or receive hydroxychloroquine. The second part is high risk individuals we have all been talking about, those over 60, those with chronic medical conditions. If they have been exposed lets say they live in a household with someone with covid19 they could receive hydroxychloroquine or the placebo. The way the hydroxychloroquine works, you take it similar to a z pak. 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 3050. 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 a cell. That prevents the virus from spreading. The only way a virus works is if it affects another person. It will help those individuals that might be exposed to potentially fight the illness. We know hydroxychloroquine has the potential to work area we are learning it has the potential to work by preventing the virus from entering the cell. That prevents the virus from 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 doesnt, we will have a treatment in the future. Thank you. Lets 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 dont 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 covid19 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. Lets 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 covid19, 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 longterm 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. This is still covid related, but 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 smithfields 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. I want a chance have you had a chance to talk to the mayor about his shelterinplace . 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. The model we agreed to in south 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. That is the plan that sanford, 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. Do doctors 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 stayathome orders. Can you speak to if that is your strategy Going Forward . How do you see your strategy 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 stayathome for weeks has been greater than some states that issued shelterinplace 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 shelterinplace 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 africanamericans 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 cant 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 dont 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