State Health Officials are responding, from austin this is 50 minutes. I cannot tell if youre ready or not. Its good to go. All right, very good i want to thank everybody for being here today, we are here today to let texas know about the abundant Hospital Capacity that exist to treat texans who may test positive for covid19. Now understand the context that were dealing with, we are in the middle of a short period of time where all of us have to coexist with covid19 and the reality is, covid19 still exist in texas, it exists in the United States as well as across the entire world. This is going to continue to be the case for at least a few more months until we have medicines that are able to treat people who test positive for covid19 and until we have medicines that can prevent people from getting covid19. Remember this, go back to march and april earlier this year when there was a nationwide effort to slow the spread of covid19 so we would be able to prevent hospitals fr being overrun. Importantly, that goal has been achieved. Fewer texans test positive for covid19 the end residents of any large state in the United States. We have the Second Lowest death rate of the 25 most affected states in america. Only about 10 or less of texas who test positive for covid19, never even need to go to the hospital in the first place. When they do, there is a hospital bed available for them for them to be treated. As we continue the process of opening up texas, as we continue to have texans return to their jobs so they are able to earn a paycheck that will help them pay their bills or put food on the table, we at the state level as well as her peers across the entire state at the county and local level, we remain laser focused on maintaining abundant Hospital Capacity. Doctor will be providing a more detailed indepth update on Hospital Capacity in texas but first there are a few points i want to stress. First more important than the numbers that you may hear about on a daily basis are the reasons behind those numbers. Let me just give you one example. It goes back a few days ago to june the tenth, that was a day and time when we had the most number of texans who tested positive for covid19. The number was 2504. You hear that number and how large and salt was the highest number of people testing positive, that would be a big reason for concern, if however, you look behind the number and look into the reason why there was such a high number that day, then it provides a different level of context. Let me just mention to counties of the 254 in the state of texas the hud and outsized influence on the number that day. One is Jefferson County which is where beaumont is located and we have multiple state prisons in a federal prison located. Beaumont and Jefferson County average about 12 15 positive cases per day, on june the tenth they had 537 people who tested positive, about 520 of those came from a batch of positive tests that have been aggregated of inmates in the texas prison and federal prison system that all came back at once and as opposed to having it spread out over a number of days, elevated one single day from 12 15, we about 500. Another county, small little pecos county texas. They average less then two people testing positive each and every day. On june the tenth, there were 92 who tested positive that day, obviously a massive operation, we looked into it and we found there was a data error. As opposed to 92, the correct number was two. If we just look at only those two out of 254 counties, you can see that there were certain reasons why on june the tenth there happened to be a massive spike or increase in the number of people testing positive. I want you to know this is the same type of analysis that we use on the ongoing basis as we look into each and every county across his entire state of texas to figure out exactly what is going on, the reason why this is important is because knowing whats going on leads to an increase of the number of people testing positive and informs us how the state needs to go about responding to the challenges that may exist in any particular county and informs us about strategies that we may need to employ to make sure that we will maintain Hospital Capacity. That brings me too today, today there will be another new high, and the number of people who test positive. Todays number is going to be 2622. As we look at this number, we look at counties around the state and we look at information that we have been gathering for the past several days and there are explanations for why these numbers are so high. Let me give you a couple of examples. One county where they tested high is calling county, it has been averaging well below 50 per day, around 25 30 People Per Day testing positive, today calling county had 120 people test positive, one reason for that is because test came back from an assisted living facility which obviously is of concern but as we have proven in other regions across the entire state of texas, when we have a high level of positivity and like an assisted living facility, were able to search resources into the facility to get it contained and have a number reduced back down to 0. Some other counties. Hays county. Hays county as far as i can tell had the highest number of people testing positive today than ever before it had 265 but when you look back at the numbers, i see that yesterday the county had 0 test positive in the day before they had 0 test positive. Whereas before that they had something in the 30s or 40s tested positive, what this means for whatever reason, there was no report to the state of texas, will happen in the two priorities and it seems like these numbers were batched together, and averaged out a little bit above were hays county typically is. There is a reason why hays county as well as other counties have been testing positive at a higher rate. One of the reasons that we have learned for multiple reports across the state of texas, there are certain counties where the majority of the people who tested positive are in the county are under the age of 30, this result from people going to bar type settings, i can tell you the case in lovett county, bear county, cameron county, there were news reports in each of those three week counties that the majority of the people who tested positive since beginning of june have been the people under the age of 30, its hard to tell exactly where those people contracted covid, it could be a memorial day celebration, a bar setting, it could be a similar topic gathering, all we know because these people are testing positive at a higher rate age 30 and younger informed us about certain strategies to take to make sure were able to reduce the number of people testing positive. An example of that, what you saw announced yesterday by the ta bc. The ta bc issued a warning to bars and restaurants across the state of texas that serve alcohol, if there are any violations of what the orders are, then there will be a 30 day suspension of the Liquor License for the next violation, the violation after that will be a 60 day suspension of the Liquor License, this is necessary to make sure that all of these businesses are following the protocols and standards that have been established with the standards that were established by doctors knowing if the standards were followed, there should not be an increase in the spread of covid19. Because there had been pictures that i had seen another sensing about the bar type settings where the centers are not being followed, i think enforcement by ta bc should bring these types of things more into line to being safer standards. I will also tell you today there is a oneoff in rusk county like there had been an pecos county before or Jefferson County before. In county texas, their tapered not that many the test positive prethere was a reporter 104 people testing positive today and its my understanding a majority of those that came back positive were a batch return from test that have been conducted and imprisoned in rusk county. To go back so you will know, texas was very aggressive over the past several weeks to make sure that we test congregate settings. One is Nursing Homes were retested 100 of the nursing home to make sure those facilities will be as safe as possible, another congregate setting is jail or prison setting. We have completed testing well over the majority of those congregate settings. Know that jail and prison setting times returned the highest Positivity Rate that we have seen in the state of texas, now that we have gone through, most of those congregate settings, various reasons to believe that those testing positive, the number of those testing positive should begin to decline a little bit. Another thing that we see with regards to numbers. I am still continuing the process of talking about the importance of whats behind the numbers. One thing about the numbers, in addition to the testing positive, are these numbers that you been seeing about an increase in the number of people who are hospitalized because of covid19. Let me share context that the doctor will be elaborating on in far greater detail. These are numbers from today they give you an explanation, today it will be recorded the third 2518 people who tested positive who are hospitalized in the state of texas. The doctor will explain this, a small percentage a small percentage of all the beds that are available. Looking at the sheet that i have about the major metro areas, there is only one county or region in the state of texas where Covid Patients represent more than 10 of the hospital beds that are available. That would be dallas county. It looks like on average it is about five or 63 of the hospital beds that are occupied in the state of texas arbeit coaCovid Patients meaning percentage wise and numerically, there is an abundant supply of beds that are available. Let me mention two counties to show you how this works. Today there were 64 people who tested positive in the dallasfort worth area who were oheaded hospital beds. That said, separate from that there were 308 hospital beds in the fort worth area that become available. Even though there was more people hospitalized because of covid19, it turned out there were about 250 beds more available in the region. The same is true for houston. In houston there are 65 more people that tested positive for covid19 that are hospitalized. That said, there were 183 beds more than became available hints even though more people testing positive for covid19 were hospitalized in houston, there was more than 100 additional beds that became available. The second thing that i want to emphasize. As we gather today, we are better prepared to deal with covid19 today then we were back in march and april. There are new medical strategies as well as new treatments are available today, one is the hospitals have more ppp available then they did a couple months ago. Two they have new drugs like remdesivir, theyre able to treat patients or hospitalized and get them out of the hospital bed sooner than before. The third strategy is a process learned as doctors and hospitals have dealt with the patient and that is appose to treating a patient laying on their back they will treat a patient laying on their stomach. In to understand the positive benefit, it makes it less likely that the patient will need to go on to a ventilator. The third thing i want to emphasize, unlike back in march, today everyone now knows how to make safe decisions to prevent contracting covid19 and to prevent the spread of covid19, the first and most obvious is to stay at home, if you do not need to get out, the best advice is to still stay at home, this is especially true for those who are age 65 and older and those of the age group who have some other health based condition. We know that 75 of the deaths of covid19 result from ages 65 and older with another type of health condition. Unless youre in the age group and need to go out for some reason, my recommendation that you still remain home, however, you dont need to be in the age group to understand that staying at home does more to ensure that you will not come into contact with somebody who has covid19. It is just a mathematical result if you stay at home the likelihood of spreading covid19 decreases. As opposed to increases. And in addition to that, one thing weve all learned in the past few months, there are three strategies that everyone can u use, they will go a long way to slowing and reducing the spread of covid19, one is to wear a mask, two is to use frequent Hand Sanitizer and three is to maintain the safety since he practices. You cannot get covid by Walking Around somewhere, covid will be exchanged by getting up close to somebody where it can be transmitted. If you wear the mask and sanitize your hands, maintain your distance when you go shopping, whatever the case may be, you will do the things that ensure you do not get covid and you will not be spreading covid to somebody else. The reason why i make the last point is this, you may think if i have covid im not going to go out. Remember there is asymptomatic covid cases. Meaning that you may not have any symptoms, you may not know that you have covid and you may still be going out. Because you may have it and not know it, that is why its so important for you to wear a facemask when he got to make sure if you happen to be in asymptomatic covid19 person that you are doing the right thing by wearing a facemask so youre not spreading covid19 to somebody else. The strategies that we have learned to reduce the spread of covid19, they also pertain to businesses in the state of texas. Businesses have learned say strategies for their employees as well as their customers to make sure they are preventing the spread of covid19. So much so that some businesses have recognized that even though they are able to open for business, they have realized it is simply not safe to do so at this time. The last point i want to make. That is we are now in a situation where we are coexisting with covid19 where we do not have to choose between either returning to jobs or protecting healthcare. We do have the tools and the strategies in place where we can achieve both of those, jobs can be maintained without jeopardizing the health of the community. If everyone follows the say strategies to prevent the spread of covid19, the more the texans protect their own health, the safer our state will be in the more we will be able to open up texas for doing business. Listen, i know an issue on the minds of a lot of people on the state, is the issue about Hospital Capacity and our ability to make sure that we are going to be able to treat anybody the test positive for covid19. The good news is, i have good news for you, there will be explained to you by doctor john. Thank you governor, thank you for the opportunity about Hospital Capacity. Im going to do this largely through a slideshow and ill move into the first slide that talks about total beds available in texas and it starts back where we were in midmarch before we had a prohibition on elective surgeries being done we had about 8000 beds available at the time and with the imposition of a prohibition, that rose to almost 22000 beds and since that time on april 22 and we lifted the prohibition by your order, we are now at about 15000 beds available. Still nearly 20 twice the number of beds available now that were available back in midmarch that could be available for Covid Patients. This represents about 78 increase in all of her patients. Oliver beds out there. Statewide and the next slide is a total beds available, nearly 15000, the total beds reported in our Healthcare System is almost 55000, some of the beds are 27 , the total number of icu beds available is 1675 and ill just mention the ventilators, you can see we have nearly 6000 classic or conventional ventilators if you will that are available. What i would like to do is touch on a slide that the department of state Health Services worked on very hard and allowed me too be a part of the conversation where we divided the various levels of Surge Capacity into five different levels, level five being what you typically see in the maintenance of staff beds, currently right now day in and day out, that is the bed that the hospital would typically run, level four would be how many places can research into, how can we increase bed capacity into a hospital and perhaps there is space for an beds and there were no staff and so forth. The third level would be surging into less conventional areas of the hospital, example i would like to give that is close to my heart as an anesthesiologist, is not a typical to use the Recovery Room area after surgery as an icu because all the equipment that you need in order to take care of an intensive care patient can be handled in the Recovery Room type setting. All three of those levels are levels within the walls of a hospital in the numbers i will subsequently run through in nine different areas of the state will speak to that. Double two and level one is where we get outside the hospital. These are ambulatory surgery centers, these are Nursing Homes that might be available, longterm, acute care hospitals, might even be buildings of opportunity where you set up an arena hospital similar at in rg or the Freeman Auditorium or the Freeman Center in san antonio. Let me run through about nine different areas with you here, is going to be a bit repetitive and i apologize for that and ill pick the speed up as they go through. If we look at the dallasfort worth area, let me just say tsa refers to Trauma Service area, thats the way the state is broken up in various ways of managing emergencies and crises and things like that, they are managed by a Regional Advisory Council in tsa e is one of the largest ones, dallasfort worth area obviously, the total reported beds is over 14000 in that particular area. What we know is there about 3400 beds, total icu beds available, these