Epidemiology, complex systems, and math in the school of Public Health of michigan. Professor andiate epidemiologist at the university of michigan. I want to start by thanking those of you who have attended these press conferences to get the facts and stay tuned what happening in our state and what we are thinking and sharing information with you. It is crucial to stay informed during this time. Im so proud we live in a state where so many people are choosing to do that and taking the precautions that are contributing to the flattening of the curve and saving lives. I want to thank the members of the press who have been reporting on this pandemic for over six weeks. It is a relentless job. Absolutely critical to keeping people informed. Ive held more than a dozen press conferences on this issue alone. Issued more than 50 executive orders to protect people from the virus. This is truly for an unprecedented time. Are dedicated reporters in michigan to make sure they get the information they need. Todays update on our cases. Have 33,966 positive cases. That is up 999 since yesterday. Michiganders2813 to covid19. That is up 113 since yesterday. Numbers are hard to look at and hard to take, but what they represent is a sign for cautious optimism. They show a vast majority in our state are doing their part. Andal distancing is working michiganders are doing well compared to other states. This is a map based on public data that shows how we are doing with regard to social distancing. We are taking this seriously. The vast majority of people in our state are doing their part. I know it has not been easy, i know it has been difficult for folks in our state, but we are getting through this. We will get through it together. Thank you for doing your part. We have good news. We are testing more people every day. The number of new cases is starting to go down as a percentage of that. We could do twice as much testing as we are currently doing, knowing we have that capacity is heartening. Making sure we have the supplies we need to execute is our challenge. All of the new testing sites i mentioned on monday are opening and ready to test people. Is now in south gate doing business as a testing site. Walgreens has opened a new detroit site. Cvs has opened a dearborn site. I want to thank congresswoman debby dingle for her help and commitment to expanding testing for citizens in dearborn. There are sites open in macomb, shorts creek, kentwood, and saginaw. I encourage you to go to test. Gan. Gov coronavirus more people need to get tested. Eithere have to have prioritize who has tested in the early phases, we want to make sure we are getting more people tested in michigan. Testing is the only way we will know where the virus is so we can appropriately deploy our resources to slow the spread. If you have symptoms and believe you came in contact with somebody who tested positive, find your nearest testing site and get tested. Covid19 symptoms include fever, cough, and shortness of breath. If you have any of these symptoms, call your health care visiter or visit get michigan. Gov coronavirustest to get a testing say near you. If you are an essential worker reporting to work in person, whether you have symptoms or not, get tested. Call your Health Care Provider or visit im doing it for a reason, michigan. Gov coronavirustest to contact a testing site near you. You dont need a prescription to get tested. You dont need a Health Care Provider to refer you. Supplies are still a constraint, all over the country, and we are working to ensure those labs and Health Care Providers have sufficient supplies of Staff Support to support the testing effort. We will continue to need help from the federal government to ensure we have and maintain and continue to have robust testing in place. An update on ppe, the personal protection equipment. A couple of weeks ago, we had less than a days worth in our hospital. With the help of large and Small Businesses in michigan, the federal government and our procurement office, we have secured enough ppe to last hospitals over a week. Even several weeks, in some cases. Dozens of businesses have stepped up. We are really grateful. Businesses like stormy in the Upper Peninsula who produces those phenomenal hats. They are making masks. They are making gowns. The victory automakers making ventilators and face shields. Whiskey,er brewery, tc mammoth distillery, all of whom are helping us produce more hand sanitizer. This has been an all hands on deck effort and it is working. We are rising to this challenge together. We still anticipate more deliveries of ppe and we will continue working until every hospital in michigan has the supplies they need. I want to thank our hospitals and Health Care Workers for doing your best to use ppe efficiently and safely. We appreciate it, and it has helped us get into this position where we are stronger today than we were a couple of weeks ago. The number of patients in the hospital with suspected or of about 10vid19 days ago. We have seen a 15 reduction. In the top no longer five states when it comes to positive cases. We dropped behind other states. Its because of our aggressive actions and measures. States without stayathome orders have seen an increase in cases recently. Shows our order is working. We are still in the top 10. We are still in the top five, in terms of number of deaths. It shows what we are doing is working, but we must keep staying safe if we will keep dropping numbers and saving lives. On mondayore graphs to where we are versus where we could have been. Hadnt taken aggressive action to fight this virus. Their partare doing in making an impact. Youre the reason we have enough ppe for our First Responders. Ourare the reason hospitalization rate is decreasing. In the end, you will be the reason we can safely begin to phase back in to our new normal. I want to highlight the hard work of our brothers and sisters in labor and what they have done through this crisis. Being able to speak with a number of our dedicated Union Members over the phone, i know the heart you are putting in on our behalf. I want to thank the teamsters for delivering ppe and supplies for healthcare workers, First Responders, and family. Uaw for faceank the shields and more. I want to thank the alternate care facilities. And for working on roads projects during this crisis to keep our roads safe for drivers and First Responders. I want to think the ame mie and aft members for educating our students from a distance over zoom, over the phone, through the mail. Ufcw workersnk the making sure the shelves are stocked at our Grocery Stores and helping michiganders put food on the table. To think the Michigan Nurses association for providing Critical Health care and Janitorial Services to protect our families. Healtha you members, care profession, department of corrections, and those working aroundtheclock to process unemployment claims. The frontline workers from the michigan professional firefighters union, the association of police, and all of our incredible First Responders working to keep our families safe. And the laborers working with the Air National Guard and servicing vehicles to keep up the supply chain. The list goes on. Working people built this state. Im proud to have them in our corner protecting families and helping us heal. Today, i outlined several things michigan is doing in our battle against covid19. There are reasons for cautious optimism. We need to keep it up. Im hoping to say more when we can start loosening restrictions as soon as friday of this week. I will continue this conversation and share more information. We will likely need another shortterm extension of the stayathome stay safe order. When we do reengage, it will have to be very thoughtful and precise mitigating risk to all and risk of a second wave. We will start to reengage. We will have a plan, and we will start to share that in more depth as we get closer to next week. Michiganders will still need to stay home unless they are doing things permitted by the order. We have to get this right. Thats the most important thing. As i have talked to business leaders, families, those who have lost a loved one to covid19, we all recognize, even if we might disagree on the we all and the timeline, recognize a second wave would be devastating to our state, to our people, and our economy. We have seen proof loosening restrictions too fast can lead to a second peak. It happened during the flu pandemic of 1918, and its happening in some countries around the world today. As hard as this is, a second wave would be devastating. When i say i am hoping to loosen some restrictions, i mean i will only loosen them based on what the facts and data are telling us when and how it is safe to do so. I will work with the best experts, like the ones we had from the university of michigan and our epidemiologists to make sure we get this right. The data we have seen in the past week has led me to believe it is time to reevaluate the stay home, stay safe order. Directly to speak those who serve our state every single day. They have hard jobs and to show up, and they serve the public. They have a special place in my heart. I had the privilege of serving with the thousands of state employees. I am proud to serve alongside our state employees now as the governor and as we navigate this crisis. You are a crucial part of this team and you have done your part to help protect families in the wake of covid19. Weeks, we have faced an unprecedented challenge that has led to serious budget implications for our state. In order to ensure the essential services we provide every day to the people of michigan continue, i have made the difficult choice to approve a temporary layoff in departments across state government. Employees who have been laid off will retain their Health Insurance and other benefits and will be automatically enrolled into the unemployment process to help ensure they have the help they need during this challenging time. These layoffs will last for 10 workdays. I have made a lot of hard choices in the past six weeks. This was one of the hardest. This is the right thing to do to ensure we can continue providing Critical Services to the people of michigan. I know how important it is for leaders to lead by example, which is why announced i would a pay cut and am telling my executive team to take one, as well. The actions we have taken in the past six weeks are working. Because of the hard work of our state employees, we see the curve start to fly and and we are saving lives. To my fellow state employees, i am proud to serve the state of michigan alongside each of you every day. I monitored to be amongst your ranks. I will do everything i can to make sure you get the support you need during this challenging time. In the coming days, i will share to discuss plans to phase in sectors of our economy. I will work with a Bipartisan Group of midwestern governors to make sure we get this right and avoid a second wave, like we have seen in other countries around the world. You will hear more on this in the coming weeks. Today, you will hear from experts from the university of michigan who have been helping me ensure we take a fact based approach to fighting this virus and saving lives. First, im going to pass it off to my partner, dr. Jenae calderon, our chief medical exec it of. Executive. 33,966y, we announced cases and 2813 deaths. We are proactively fighting this disease using the best Public Health tools we have. Distancing is the most important thing we can do to stop the spread of this disease. It means people not coming out of the house unless they have to. Food, medicine, Critical Infrastructure work. It is working. Cases,r rise in new hospitals who felt the biggest burden and a surge are now leveling off. Discharging more covid19 patients than they are admitting. There are fewer people in intensive care in our hospitals. State mayparts of the see cases of covid19 rise at different times. We are not yet out of the woods. Were closely monitoring the entire state, making sure we are ready for any surge in cases and getting ready to support our hospitals, particularly the ones in rural areas, so they have capacity to be able to care for people if they need to. We have also heard some people are not seeking care for very important medical concerns, such as severe chest pain or difficulty breathing, or delaying diagnostic and treatment procedures for cancer. It is really important that everyone knows they should still seek care if they need it. If you think you are having a medical emergency, please do not delay seeking treatment. Testing and treatment for things like advance Heart Disease and cancer should still move forward. Andt wait for treatment, talk to your doctor about how you can get testing and treatment in the safest way possible. We have also focused a lot on expanding access to testing again, a very important part of our Public Health strategy. We have announced over 21 new cases over the past two weeks. We continue to see arise in the number of tests that are done. We have also expanded our testing criteria. Right now, anyone who has symptoms can get a test. Anyone who is a health care worker, first responder, or needing to come out of their home to do any work during this crisis, can get a test done at a testing site that has the supplies. We are encouraging everyone who should get a test to get one. You can go to our website, www. Tohigan. Gov coronavirustest find the site nearest you. We have to protect our most vulnerable, especially those who are elderly and living in nursing facilities across the state. Monday, we announced Skilled Nursing facilities are required to report any case of covid19 to the Michigan Department of health and Human Services. We are analyzing and collecting that data now. We expect to share that information with the public on our website in the coming days. Monday, we also announced the creation of new teams that will work with local Health Department staff, epidemiologists, and clinicians, longterm care facilities, making sure they are following the best prevention protocols and testing residents appropriately for the disease. Im pleased to announce we can provide a total of 3. 8 million to our local Health Department across the state to be able to do this important work. We are all doing the right thing. We are seeing a slowing in cases, testing is increasing, and people are recovering from the disease. We can beat this virus. Life is not going to go back to exactly the way it was before for a while. We will have to be patient and cautious. I encourage everyone to stay the course. We can do it together. I will turn it over to dr. Eisenberg and dr. Martin. Thank you. Id like to start by introducing myself. I am an associate professor of epidemiology, complex systems in math at the school of Public Health university of michigan. Im here with dr. Martin, an assistant professor of epidemiology. Our Modeling Team is a combination of researchers in Public Health, medicine, math, and other folks, other departments. I wanted to talk about some of the modeling we have in working on. Looking at different scenarios for resurgence, if social distancing is lifted. We have developed this model based on regional and statewide data from michigan to help with forecasting, planning, and scenarios. I wanted to start a little bit by saying all models have limitations. Nd models are a very useful tool for reasoning and planning, but they are not crystal balls. I want to note and acknowledge at the forefront that there is a lot of uncertainty that goes into these models, both in the data and the parameters and how they are built. I wanted to mention that briefly. With that, i wanted to show a couple of things. Heres some hypothetical scenarios where social distancing is lifted over a two week period starting may 1. This scenario is lifted completely by the time that two weeks is up. There are a wide range of outcomes. Going from a very small or even no resurgence up to quite a large second peak in transmission. While we cant say from the model which of this shaded range of scenarios might happen, it just means a secondit means thaa real possibility that we need to consider if social distancing is lifted. This range of outcomes really comes from the fact that theres a lot of uncertainty right now in terms of the proportion of the population that is susceptible or immune to the disease. So that ends up meaning that a wide range of potential scenarios for a second peak are consistent with the data we have seen so far. Note for important to these simulations that, while i showed the graphic for all of michigan, if you run the models for different regional areas, you get a lot of different potential second peaks or resurgence is that you can see region by region. In southeast michigan, and places that have seen more cases, we have more data and it lets us do better at restricting the range of what could happen. In areas that have not seen as many cases so far or where the epidemic started later and may still be increasing, we have less data. It ends up meaning that the range of potential second peaks is wider. That is just something to be aware of. It means that those regions may be more careful monitoring. Theres a lot of uncertainty in terms of what could happen. The other thing i want to note about these simulations is that we are running the models where you relax social distancing entirely and leave it off. That means that the simulations that we are showing, the second peaks are in the circumstance where you dont intervene further. Of course in reality, if you started to see Something Like that, people would take action and intervene. Im not saying that that is what we would actually see. Thats just what the model projects forward if you were to release social distancing and let it go. That is one t