Good morning. Today we are going to provide an update on covid19 testing, personal protective equipment, Hospital Capacity, and a rundown on the approach we have taken to supporting our nursing home community. Worked towe have dramatically scale up our testing capacity. Thats because we believe testing is crucial not only to our current efforts to understand the spread of this disease but because it will play a Critical Role over the longterm term as we work through decisions around reopening parts of our community. We are continuing to make progress. As of yesterday we conducted a , total of 126,551 tests. Testsncludes a new 4500 conducted yesterday which were conducted at 28 sites across the mouth across the commonwealth. This makes massachusetts one of the leading states in the country with respect to testing. We are grateful to our colleagues in the medical community. These laboratories are a big part of massachusetts progress on this front. That includes quest diagnostics, the broad institute, and many other public and private sector hospitals. Their contributions and partnerships are another example of how massachusetts nation leading healthcare and innovation leaders are helping us respond to this unprecedented outbreak. In massachusetts, we launched initiatives to test the most vulnerable residents like seniors in longterm care facilities and individuals with develop mental disabilities. Testing is crucial for a number of reasons, but most of all it gives us the opportunity to identify and isolate people who have tested positive and to make sure they get treatment. It helps us understand where the outbreaks are added to key and to keep people informed with respect to infection. Even if they do not have symptoms, to slow the spread in the short term. The state will be crucial to plug into Contact Tracing which is ultimately the infrastructure that we believe we need to build in the commonwealth alongside our colleagues and partners in health to ensure we can do Everything Possible to identify and isolate people who are dealing with covid19 after the surge and beyond. We are working around the clock to obtain and distribute large quantities of personal protective equipment for frontline workers. We are working with partners to help distribute over 3. 7 million pieces of ppe to hospitals, Nursing Homes, Community Health centers, Public Safety personnel, local boards of health and state , agencies. This includes over 2 million gloves, 820,000 masks, 370,000 masks from aircraft delivery and. Ver 170,000 gallons gowns late last night another shipment arrived in massachusetts. Fema notified us this morning we will be receiving one million pieces of personal protective equipment including 650,000 masks and 260,000 suits. Officials are in the process of inspecting and counting this inventory and will work but we could attribute this gear to frontline workers once the inventory count and inspection is completed. As i said many times before, i am incredibly grateful for the generosity and support of the craft family who helped us bring that shipment home. Getting enough gear not just here in massachusetts, across the country has been a challenge and it will continue to be until supply chains adjust to the new normal. As we announced yesterday, we are posting a daily summary of personal protective equipment distribution which is available at mass. Gov covid19. For several weeks you have heard us talk about the work that has been done with our command center to determine exactly what the plan and the bed capacity that we need here in massachusetts to manage our way through the surge. That plan includes an entirely new system for bed capacity on a daily basis. Those steps are posted publicly. As of the end of the day on monday, there were 17,500 beds statewide in massachusetts that were suitable for covid19 treatment. That includes just under 6000 acute care beds, 2500 icu beds, and another 750 beds available in the Field Hospitals that we have put up for patients if needed. The last number will increase as we bring more Field Hospitals online. Yesterday the Lieutenant Governor and i visited the new Field Hospital at joint base cape cod that will formally launch on monday. Additional sites are being launched and done on the south coast to ensure we sustain a regional approach to these Field Hospitals. Those three sites join the two that are already open, one in worchester and the other in boston. The beds in these facilities will serve as alternative care options for medical professionals to treat patients especially those who need less , intensive care. They also leverage partnerships with local Healthcare Providers who know their communities and their populations well. These sites would not be possible without the coordination between the National Guard, our command center, and many of our colleagues in the Healthcare Community who have stepped up in a big way to make this possible and to get it done in a very short period of time. Right now the number of patients at the two sites open is relatively low, just a handful. These sites are being built to augment assisting hospital to augment existing Hospital Capacity and we hope the surge in cases is not significant enough that we need to rely heavily on those beds. We think it is important that they be there and that we have them because all along, the goal has been to plan for the worst and that is what we have been doing. Weould also like to are intensely focused on mitigating the spread of illness in our Senior Living facilities. In total, there are 300 83 Nursing Homes in massachusetts, 255 assistedliving residences and 93 rest homes. There are approximately 38,000 residents in Nursing Homes, 16,500 in assistedliving facilities and 3000 residents in rest homes. As we have discussed before, these facilities not just here in massachusetts, but everywhere are highly vulnerable settings for our bricks of covid19. Outbreaks of covid19. That is why we were among the first states in the country to implement screening guidelines for patients and staff. To protect the health and safety of our most vulnerable seniors and the dedicated staff to support their daily needs, we continue a multipronged approach to respond to covid19 at these facilities. Our strategy includes expanded mobile testing. We are one of a very small number of states that have brought testing to our senior care facilities so that that work can be done on site. Personal protective equipment distribution. Rapid response clinical teams and other staff resources, Crisis Management support, 130 million in new funding and an a nursing home Family Resource line. Secretary sutters will talk more about that in a minute. We talked before about expanding our mobile Testing Program, working with colleagues at the department of Public Health and the National Guard to support longterm care facilities here in massachusetts. How this works is rather than having people make a trip to the hospital or to a medical center, the department of Public Health brings the test to them at their facility. This proactive onsite testing also heightens our visibility into how the virus is impacting these facilities even before facilities in some cases realized that residents are infected. With the data, residents can be quarantined and monitored to slow the spread is much as possible. On april 13, we updated guidance to encourage longterm facilities to conduct widespread testing for residents even if they have no symptoms with residents or with their staff. Facilities can either get tested through the mobile Testing Program or they can conduct their own onsite testing using kits we are making available as of april 14, or than 4500 tests have been collected at Senior Living facilities. As of yesterday, another 77 facilities have requested more than 8600 test kits and the institute will process those tests on behalf of those facilities. Nursing facilities have received a significant distribution of personal protective equipment. Since the beginning of march, we have provided nearly 1. 3 million mask, almost gowns. 200,000and over 2 million gloves. We are also providing shortterm support to facilities with a high count of cases. These teams are made up of ems technicians, nurses, and other healthcare professionals. Having these Resources Available for Rapid Deployment makes a big difference in the longterm care facility system and it is something we have already gotten positive feedback from a number of Community Providers as a result. The covid19 outbreak is undoubtedly has undoubtedly put a strain on the dedicated workers who take care of our most vulnerable seniors. Staff shortages are likely to occur in facilities as more employees test positive for covid19. To meet staffing needs, the administration has stood up the longterm care portal to match individuals that have registered through the portal that the staffing request submitted by facilities. We have announced a 1000 signing bonus for all individuals registering through that portal and we have tapped into the volunteer portal. For Crisis Management support, we have contacted a firm that specializes in Crisis Management. They will be available to provide facilities with onsite Operational Support to assist with staffing, vendors, implementing Infection Control measures, and other key elements of appropriate operation and design during this time. The firm will also support efforts to stand up dedicated covid19 wings and units in existing nursing facilities. I would also like to say a quick word about nursing facility capacity. We pursued three options for expanding covid19 dedicated nursing facility capacity here in massachusetts. First of all, converting existing facilities to fully dedicated covid19 facilities. One example of this would be the beaumont facility in worchester. Second, a new covid19 nursing facility. One example of this would be the Pioneer Valley Recovery Center in east longmeadow. And third, creating dedicated covid19 wings within a broader nursing facility. We built this approach to make sure we have needed capacity for seniors and to adapt to the realities of covid19 infections that have impacted several facilities. The goal is to be nimble and smart in our approach and we believe that these different build outs provide the appropriate settings for seniors staff to provide the appropriate care. In addition to the beaumont facility, the commonwealth currently has five dedicated covid19 facilities opening within the next seven to 10 days in new bedford, east longmeadow, and Great Barrington with others in planning stages. No one has ever done this before. The command center pulled this together using every available resource and we will continue to adapt and respond to the situation as it requires. Before i close, i want to point out that this would normally be tax day which i think most people know it has been moved to july 15. It is also the seventh anniversary of the 2013 Boston Marathon bombings. April 15, 2013 was a dark day for the city of boston and the commonwealth of massachusetts and our country. The lives taken and changed forever our never very far from our thoughts. There was a lot of sadness that day but there was also bravery, compassion, and strength. First responders, healthcare workers, and bystanders rushed in to help, putting their lives on the line in the process. Neighbors, friends, and strangers held each other up with acts of kindness. The city and the commonwealth rallied, rose to the occasion, and turned tragedy into strength. Now as we all endure the , worldwide pandemic, we are rising to the task to meet it again. Every day, nurses, doctors, Public Safety personnel and countless others in the public and private sectors are rushing to the front lines. Millions of massachusetts residents are sacrificing, upending their lives to protect one another from further spread. There is no doubt we have tremendous challenges ahead. The one thing i am absolutely sure about and it is never in doubt is the remarkable people of massachusetts. We will get through this. We will get through it together just like we have so many times before. I would like to turn the podium secretary for some secretary sutters for some updates from the command center. Thank you, governor. Thank you, Lieutenant Governor. As the governor said, it is important to remember that we are strong and resilient in the commonwealth of massachusetts. There is one other group the governor references, one of the groups of folks that comes to work every single day despite how the media presents things are in fact our nursing home workers. Each and every day despite what sometimes you read in the papers, nursing home cnas, workers and staff come to work to take care of some of the most vulnerable older adults and i do not want people to forget that. We often talk about First Responders and healthcare workers but there is a whole other group of people who are Human Services workers who help people with disabilities stay at home and our nursing home workers and Home Health Aides as well. On Nursing Homes, we are working with longterm care facilities to mitigate and manage the outbreak of covid19 throughout the state. We are intensely focused on the spread of illness and making certain that our nursing home residents are receiving the care that they need during this unprecedented Public Health emergency. As part of the multipronged strategy the governor enumerated, we have committed 130 million in stabilization and support funding. In early april, we announced an acrosstheboard 10 rate increase which is worth 50 million for all nursing facilities effective april 1 as part of that early stabilization package. Additionally facilities that , create dedicated covid19 wings or units and who follow necessary safety protocol will be eligible for an additional 15 rate increase or a net increase of 25 10 that i mentioned plus an additional 15 . That is worth approximately 50 million. Now we are up to 100 million. We are assuming that two thirds of the industry of that 398 facilities the governor mentioned will be able to provide these units. Those funds support additional staffing, Infection Control, dedicated staffing unit so that the staff are not migrating from noncovid to covid units and the additional cost of supplies throughout the state of emergency. The balance of 30 million is our estimate for standing up fully dedicated Skilled Nursing facilities such as beaumont, east longmeadow, and the others. Within our rate increase is an expectation that we will see increased salaries for our frontline nursing home staff as well as expenses related to supply and others. Additionally in addition to the 130 million not included is a 10 rate increase for rest homes which is a different funding formula. We do not want to forget the funding for rest homes. It is 130 million for Nursing Homes and a 10 rate increase for rest homes across the commonwealth. A couple of other updates around our ability to try to keep the residents and citizens of the commonwealth informed. As the governor said, we end we instituted a nursing home Family Resource line. We have had more than 1100 individuals contact our nursing Home Resource line which is a dedicated line to connect family members who are anxious about what is happening in their nursing home for their loved one. Additionally, an update about boy health, only announced it a few weeks ago, more than 70 thousand people have used the online tool. The health tool is free and live residentsssachusetts connecting , you to the next appropriate healthcare resource and staying in touch with you. It is not to be used in place of Emergency Medical Care but for those who may be worried about their symptoms which is true for many in our state. Finally just an update on , reporting. As the governor has noted, it is our commitment to continue to improve our reporting. For the first Time Starting today, we will release coronavirus cases by cities and towns as the state takes additional steps to report the burden of infection across the state. This new reporting which will be updated weekly each wednesday marks the latest in a series of new data points and information recently they publicly available in addition to the data on the daily covid19 dashboard. Our testing efforts have increased. We know every community has experienced the impact of coronavirus. Many cities and towns report this information directly to the residents. As a standard Public Health practice, we will not release the number of positive cases if there are fewer than five in a municipality of 50,000 or less in order to protect privacy. Having the ability to look at this virus through the lens of its impact on specific cities and towns will help us identify potential hotspots, inform the Public Health response, assist cities and towns working to slow the spread, and help the state appropriately deploy resources. In recent weeks we have provided data on by race and ethnicity so that the public can see for themselves the impact of the illness and death on communities of color. We have acknowledged that this information is not nearly as complete as we want it to be. I do notice progress every day, but it could occur faster and the Public Health commissioner has issued an order mandating enhanced report of demographic data. We also now report cumulative data on positive cases and deaths at Nursing Homes and other longterm care facilities and a number of facilities with positive covid19 cases. We have also started to report the daily number of covid19 inpatient cases by hospital and the number of coronavirus patients in icu by hospital. Every day we continue to report on the total number of covid19 tests, the number of tests that were positive, the number of deaths, and of those deaths i8 those deaths by age group condo by age group, gender, and county of residence. We are providing a summary of the distribution of personal protective equipment by type of facility, entity, and region of the state so the public knows where the supplies are going. Governor . [inaudible] gov. Baker we said all along that we thought the surge would start between the seventh and 10th of april. Based on the conversations we are having everyday with our colleagues in the Hospital Committee that we are in the surge, yes. Is there anything else you would like people to do . Gov. Baker we spent a lot of time talking about three things with the Health Care Community and the Public Health community. One was doing everything we possibly could through orders and guidance and instructions and public commentary to stop the spread and to do what we could with regard to social distancing, essential businesses, and all the rest. Stay at home advisories and the like. Number two was to work with our colleagues in the Healthcare Community and the Public Health world to figure out what we thought the timing would look like with respect to the surge here and what kind of capacity we would need to have in place to make sure we would be able to meet it. That led to a variety of things. For example we were one of the , first states to cancel elective surgeries so that we could free up gear and people and space to manage covid19 when we had the surge. We will also were also one of the first states in the country to put a series of orders in place with respect to making it possible for retired folks to come back, outofstate folks to get licensed to practice in massachusetts, accelerate the graduation of medical school students, nurses, and others and as long as they were working alongside of a licensed practitioner that they will be able to participate. We put 800 million into our Provider Community to be able to deal with the fact that in a covid19 world, their revenue just literally fell because a lot of people were not going anywhere near Healthcare Organizations generally and by cutting off elective surgeries, we took away one of the most important revenue generators a lot of the providers have and to we were one of the first states in the country to issue an order around telehealth so that we could create distance between people who were concerned about the state of affairs and their symptoms and a clinician so that they could engage and get reimbursed whether it was a phone call or a video chat. The secretary mentioned, we were the first state in the country to what an online tool for people to do self diagnostics to determine if they needed to reach out to their provider. The third piece was to use the models to try and figure out how much capacity we needed. I would say at this point in time, with the addition with of some of the other stuff that is coming online over the course of the next five to seven days, we are wellpositioned to deal with this. [indiscernible] when do you expect a fema shipment . Gov. Baker the fema shipment i just talked about, i will not count that one until he gets here. But i expect it to be in the next few days. On the patriot one, it is being inspected and inventoried. Maybe tomorrow we will have more to say about that. There were no significant issues or challenges associated with getting it up here. [inaudible] gov. Baker do you want to speak to this . I meant we were stabilizing, not a stabilization fund. It is meant to stabilize Nursing Homes. We have approximately 982 million on the gross basis. It is just under 400 million on a net basis in the mass Health Budget that has not been used for elective surgeries and elective procedures. It is reallocating within the base budget. It really is one long day. I just have to tell you. It is really taking funds we already had received in the budget and reallocating it to stabilize healthcare, Nursing Homes, Home Health Agencies and the like through primarily rate increases. I will take them both. One at a time. She was halfway through her question. You said there was an expectation that there would be an increase in salaries for dedicated nursing home employees. We heard from some of the unions that the temp workers are getting brought in at higher salaries and those that have been there, their pay has been frozen and they are not getting the increase. If you think about these rate increases, one was 10 acrosstheboard and 15 if you create these covid wings within facilities and we know 85 of costs are people costs. There will be an a test station tion in terms of how cost are being spent. Publicly we expect that the staff are coming to work each day deserve to have recognition in their salaries. I have heard those concerns and it is important that we support our line workers. The other thing the governor mentioned is through our longterm care portal is a signing bonus which is often used during times when people try to recruit. If individuals work for a certain period of time and we are trying to work out the best number of hours, individuals would get a bonus at the end of that period of time. And that is bringing in employees and not staffing. Like a Staffing Agency again, trying to increase the staff. [indiscernible] where can people find information . It will be posted on the website. It will probably be later today. 4 00 is a good time to start checking the website for data. I know sometimes a little later than 4 00. 4 00 is a good time to start checking for the data. Make sure you get the link. So what changed. Public health folks are trying to balance privacy and the release of data. We have so many cases in massachusetts that as long as we stay true to serve the principal of not less than five in a municipality of 50 that this is important data for the public to identify hotspots. We have always ensured the data was local municipalities. They have always had the right an opportunity to share that data with their community. [inaudible] across the state, we continue to emphasize the need for individuals that all of us have obligations and responsibilities around social distancing, wearing face coverings if you are in places where you cannot have social distancing and personal hygiene. What we do not want is to raise such a level of fear and anxiety but information to help us plan as we are in the surge and at some point think about life post surge. For me it is around , identification of potential hotspots. [inaudible] it starts today effective going forward. It is every week, every wednesday you will see this data publicly reported. Cumulative, but it will not be every week going back. [inaudible] gov. Baker what i would say is i will never be satisfied that massachusetts has what it needs with respect to gear generally because one of the biggest lessons i hope that we and others have learned through this whole experience is you have enough gear until you dont and once you dont, finding it and acquiring it becomes enormously difficult. From my point of view, whether you are talking about traditional ppe or you are talking about test kits or a lot of the other elements of how this game will need to be played to manage this virus through the surge and beyond, we will keep chasing all elements of that stuff because i am never going to be comfortable that we have enough. I hope this is a real learning experience for Public Health folks, government officials at every level, and people in healthcare that justintime which is the inventory model that everyone has used for a long time to avoid putting working capital in place and not just using it, which i understand, is a perfectly appropriate way to manage a lot of things. I dont think it is an appropriate way to manage this stuff. I hope one of the big lessons the country and folks like me and other folks in the healthcare world learned from this is having a big gigantic stash of gear is not a bad thing when it comes to stuff that you absolutely have to have when you need it to keep people safe. [inaudible] gov. Baker it was not a kraft plane that came back. I think it was a commercial. I am not sure about the nature of the plane. They just drove down to pick the stuff up in new york. Why was it in new york . Gov. Baker some of the stuff that comes from china or other places lands in different places. We had a shipment of stuff that came into logan the other night that came through alaska. The bottom line on this is you work through the logistics associated with the airport you are flying in and out of, the rules of engagement associated with getting out of the u. S. And into whatever country you are flying to and then the rules of engagement associated with getting back. They depend. Some of the stuff comes back into california and comes from california to new york or to boston. It is driven by capacity, rules, International Guidelines and protocols and it is a little bit of a game of hopscotch. It is a really big game of hopscotch. There is a lot of stuff that comes in through a variety of different routes and processes. [inaudible] gov. Baker i listened to one of the nations world leading Infectious Disease specialists talk about this decontamination process. The Lieutenant Governor and i both did. I would not pretend to say that i understood a lot of what he said. I understood the part he said at the end which was the masks that come out of this facility are every bit as clean and decontaminated as one that comes out of a factory. Having a guy like that say that is good enough for me. The other thing i would say here is the whole point behind this exercise was to create capacity with respect to what everyone has said is one of the most important elements of keeping frontline healthcare workers safe which is access to , respirator masks. [inaudible] gov. Baker do you want to speak to that . I am assuming you were talking about the tracing collaborative with partners in health. That is in the process of ramping up. We have been doing a soft launch in eight communities north of the city. It is associated with the Rapid Testing we are doing. We have hired 250 individuals to work with them. They are working with local boards of health on Contact Tracing. One of the interesting things is the soft launch, initially the model was based on for every individual who is covid19 positive, we have 10 very close contacts and in the soft launch, it seems to be six. I guess that is good news. Obviously, we are still rolling it out in multiple languages. I believe the number of applicants they had was 15,000 individuals. They are in the process of hiring and are contracting with Community Health centers for local health work, and other clinical supportive services. Thats why we are collaborative, thats why partners and health will be the lead on tracing and data analytics. We have to have strong local Community Partnerships and Health Centers and Community Health centers have signed up to collaborate. [inaudible] we will have a more robust briefing in a week or so. [inaudible] you look for a number of factors. Obviously, if you saw from one week to the next week, a significant increase in number of covid positive cases, and if you did not have a robust thing like drivethrough testing, for example, patriots place. If you have drivethrough testing you might see increase numbers of cases. Does notcommunity that have onsite testing capability, all of a sudden you saw a number of positive cases, you would want to start to ask questions. If you did not have that would be one. The second one would be the age of individuals. We would have access to simple data. If you saw younger individuals or areted positive, testing positive because of the vulnerabilities, those things you would look at. Its what i see a rapid increase in the number in a community or surrounding communities, that would suggest a hotspot. It is important for local boards to help. If you think about what the roles that local boards have. Are wedistancing, ensuring that our Grocery Stores are maintaining the limitations in terms of what they have, in terms of capacity coming in and out of your Grocery Stores. At the local level, its very helpful for restrictions and social distancing. From a Public Health perspective we have seen increases in a particular part of the state, thats an obvious thing you would want to look at. One more point to your question about the medicaid funding. The feds changed the match, they isreased it by 2. 65 , which i think that was in the second stimulus. It does not get a lot of attention, but it was a big deal. Not just for us, but for every state. What kind of sectors and industries [inaudible] i thought those checks were going to individuals. [inaudible] thing i worry the most about these days, and it gets back to a curveball on bruces question, is food. If we think about the conversations we have with folks about all kinds of things, one of the biggest things we have heard about his issues around access to food, food banks, and the draw and demand on many of our Food Bank Operations around the commonwealth, which is a clear indicator that you have a bunch of people who are struggling. Anticipate that one of the things that would come with a lot of those direct checks to people, is folks who are struggling with decisions about food, pharmacy, rent, and whatever else, can apply that in a way that makes it possible for them to sustain themselves. Thats a big part of why we are getting as many people as we can through the existing unemployment system, and why we are working hard how to figure out how to make the pandemic unemployment piecework. We know there are a lot of people that need help. [inaudible] i said this before. I Pay Attention to the numbers. What i really think about mostly are the stories, and people behind the stories. I think i said this when we put the original limit on gatherings in place. The first thing Lieutenant Governor i heard when we did was from the funeral home folks who basically said we were stealing the opportunity that families and friends would have to say thank you and goodbye to family members and friends. Honestly, that was one of the more brutal consequences, just psychologically, of this whole thing. When people talk about the numbers, the first thing i think ut is all those people who in some cases, my best friend. Ost his mom to covid and his mom had a great relationship he and his mom had a great relationship. Because they had a great relationship they never left anything unsaid. Be a situation where they would say, i wish i had the chance to tell my son whatever. That never happened with them. That did not make the fact that it was an extraordinarily painful process for their family loss of augh this that peopleual for thein and hold onto chance to say goodbye. When you talk about where the numbers are going, i am thinking about all the people who wont have a chance to say goodbye. I really hope people have a that theymake sure dont leave anything off the table, with respect to their loved ones. Is, my wifetion gives me a hard time all the time about the fact that baker men never say what they think to anybody. When it comes to personal things. And even on these goofy phone calls i have with my dad i tried more, more try to say because you just dont know anymore what the future will hold. I really hope that people will understand that their Health Care Community, and the folks who will be responsible for helping us work our way through this surge will do everything they can to save as many people as we possibly can. So that they dont have to deal with the situation, and family and friends dont have to deal with it. Those numbers are about lost opportunities. And the significance and the puttingce of loved ones it all out there and making sure they dont leave anything unsaid. Sorry. Thanks. I am smiling a little bit because she and i had our first facetoface socially distant meeting yesterday. She has been cleared to come back to work. Thank you for asking. Honorable] [inaudible] friendse heard from my with visual impairments, so people who are blind or visually impaired. We are licking out what the other states have done in terms of the ability to do online ordering. What other states have done as a possibility for massachusetts. Can we just get back to i do have that answer for you. Its not at the top of my head at the moment, but i can tell you how many people have come through the longterm portal. Journal prime a special evening edition on the federal response to the coronavirus pandemic. Our guest is the university of houston professor, an expert on chinese politics and animals. Talking about the suspected role in the virus. Also robin kelly on the impact of the virus on her district. Join the conversation tonight at 8 00 eastern on cspan. From chicago we are joined by the editor chief of journal of american medical association
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