We now leave this program to get you alive briefing of 40 governor ron desantis. Good afternoon i want to think Carlos Mcguire for hosting us in jackson and thank you to mayor carlos and manus to all the work he has done over many months working closely with us in the state government. We came to jackson and i think early march when this pandemic was really starting to pick up steam, at that point i dont know if miamidade had a case, positive, maybe a couple but it was obviously much different than what were finding here. [shouting] over 4000 people have died, you have no plans and youre doing nothing. Shame on you. At that time when we had when we were here we had a whole bunch of concerns about what would end up happening in the next few weeks and months craig we had concerns about testing, we were able to get test, we were not able to get test for all the people who needed them at the time, in fact there were probably hundreds of tests being conducted today statewide and nationally just thousands of tests that we would be doing, that was a huge concern, how do you get testing going and there was a big concern about a lack of personal protective equipment for the hospital employees and people who are working and treatment was a big issue because quite frankly hello new how to handle the virus and whether they would receive treatment that would work and we were monitoring under monitoring Hospital Capacity making sure Hospital Systems would be able to handle what the clinical consequences of the virus, we went into that. With a lot of uncertainties, florida was able to get through march and april wave but we knew with regards to the virus, that. Was not the end or really the beginning of the end but really the end of the beginning. Throughout may in the beginning part of june we were fortunate to be able to have a very low rate of people testing positive, the cases were low, the hospital census was low and that was a good trend that was happening. Then as you got into midjune, you started to see the cases rise and the testing was rising to but the percentage of people who were testing positive instead of being three, four, 5 instead of may or early june was now going up to where it ended up hitting 15 last week. You also saw an increasing amount of traffic starting in the third week of june for people visiting the Emergency Department with covid like illnesses throughout may an early june, it was very low and steady, same thing like influenza illnesses, we see more admissions for coronavirus into a hospital system, particularly here in Miamidade County. I know many floridians are filled with apprehension as they wonder, what does this mean, what are these trends for our health, our families, and for our jobs, how long is this going to go on for, what will happen with things like like kids being in school. I hear you and i along with our federal partners, or local leaders integrate medical community, we are working nonstop to be able to respond to this crisis, we have to address the virus with study results, we cannot get swept away in fear, we have to understand what is going on and understand that we have a long road ahead but we also have to understand that within the context of the moment. A comment on some of the cases because i think we hear a lot about a number of cases and that is true, somebody tested positive, that creates a case, the way the staff is reported. It is also important to understand if you have x number of cases, how many tests were conducted to get to that many tests. For example, the last two days, people have talked about a record number, two days ago and then today not as many but still a significant amount, two days ago the state of florida conducted 144,000 cases. Put that into perspective when we were here in march, we were doing hundreds a day and we got up to doing five or 10000 a day, the whole United States was probably not doing 144,000 test at the beginning of march, that is an enormous amount of test, this todays report was 112,000, 113,000 test, thats a huge number, fortunately although the cases were high without testing, the percentage of people who were testing positive has finally started to decline, we will see if thats a trend or something that is shortlived. Certainly the percentage of people that come in and test positive has stabilized throughout march and april and typically 90 92 of everyone who attesting come back negative as we got into may in the beginning of june, we would typically have 95 of the people who test and come back negative, more recently its been about 85 of the people who test, come back negative and we would like that to get back to 90 of the people testing negative. We think we may have stabilized and we may be going in that direction, it is also the case as you see more cases, we have also seen a decline in the case for totality rate, florida as of today was 1. 5 , thats a fraction of the National Average which is 4 in another state are looking at states that have six, seven, 8 . Thats first entry partially because the folks in florida have learned a lot how to treat this in the fact that many of our cases are occurring in people who are low risk, people in their 20s, 30s an early 40s, nevertheless that is something that they are mentioning. Were in a situation where were taking action every day to be able to address the issue with the spread of covid19 saturday we were able to get the therapeutic remdesivir dropped in for the hospitals across the state, that was a request because even though they were due as shipment coming this week or next week they wanted to have enough because they were using it and with the uptick in people in the hospital was needed and that was able to drop and we will make sure that supply is replenished as much as we can going forward. Were also assisting at the state level with places throughout florida but predict lee in south florida with personnel, particularly nurses and we will talk about, if you look at the number of beds available, countywide or statewide, theres a lot of beds available. In statewide, there is 13 or 14000 beds available, the key is having the requisite personnel to be able to address, not just Covid Patients but people to come in for things other than covid so weve already dedicated 100 personnel that the state had on contract basis to jackson and miamidade, we put 100 on the way in the tampa bay area and we have a total of 1000 that will be parceled out which was our initial mobilization and were also going ahead and mobilizing another 2000. Some will be used to support our covid only Long Term Care facilities. Some will be able to go the traditional long care facilities to sub in for staff who may test positive and need to no longer be around the residence. Personnel is probably the number one thing that i have heard from our hospitals in her medical community, we are delivering and we have a request pending with the federal government and hhs for their teams to come down and assist effort. We are expanding the amount of beds in our covid only nursing facilities, florida from the very beginning prohibited discharging covid positive patients into a nursing home from a hospital if they were still sick with the virus, we also later as we went on and saw covid positive patients being transferred from a nursing home if they were happy to test positive. Sometimes that means they get sent to the hospital and a lot of times they are not necessarily in need of hospitalization, their medically stable but they need to be isolated. We now have 14 facilities and seemed to be adding some every day under the leadership of secretary mary, we are rapidly expanding beds including the Miami Care Center hearing date in were expanding in broward and palm beach counties, this will provide a safe place where covid positive resident of the longterm care facility can be isolated if theyre in the hospital medically stable but still contagious, they can be discharged safely to these facilities without endangering the other residents in their home longterm care facility, were also doing and in the midst of getting results back with testing every worker at a longterm care facility, all staff almost 200,000 staff on every other week basis. Every two weeks theyre getting swabbed, were sending it in and were getting the results back. We got the results back for over 100,000 of the staff and fortunately the percent positive has been under 3 and thats probably lower than we anticipated given the prevalence in the Community Seems to be higher than 3 . That will be an important way to protect those who are the most vulnerable to covid19, residents in longterm care facility represent 50 of the covid related for tallies in florida and many other states. We are looking to help fortify Lab Resources at hospitals, when people come into the hospital if they have covid symptoms, its important to the hospital know if there positive so they can be treated accordingly, hospitals are running low on the Lab Chemicals and were working with the white house to try to get more supplies down to the state of florida for our hospitals, we understand there is a need for faster results for people going through things like the drivethrough testing site and the fact of the matter is, theres a lot of testing going on throughout the state of florida and you have 700 plus thousand test today that are being processed mostly by commercial labs, they are backed up, when people go through a lot of times theyre not getting results back for seven days, obviously we want to improve that and what were going to start doing here in dade, broward and Orange County is establishing dedicated lanes for tickly for people who are symptomatic where they can then test, swab and go to a lab that can turn it around quicker so they get the results. We will be working on that which is very, very important. We have capacity, throughout the Health System and is very important for people to understand, they plan for these types of eventualities in their keeping their senses very stable even as covid has represented increasing part of the senses, we have a special obligation to protect those most formable to covid19, we are obviously doing a lot more than any other state in terms of protecting the longterm care facilities, we will continue to do that and folks who are not on longterm care facility, that are 65 and older are an increased risk, we have advice since march that they limit contact outside the home as much as they can and avoid crowds, i think its important to listen and follow the guidance that is put out by local officials such as mayor gimenez in here and Miamidade County, that means being diligent about wearing the facial coverings and following the other directives that he and some of the other officials have put on. It will make a difference if everyone does their part you got the state, we have also stressed the need to avoid the 3c use when it comes to social distancing. That is close spaces where your packed in tight and poor ventilation, that is a good venue for the virus to spread in crowded places, the more people that you have together the more likely to see a spread in really close to staying contact, most of the infections incur in the home because you close contact among family members, that is something to think about whether your with friends and family, that is a vector for transmission. We are leaving this program for live coverage of the Senate Session and we will return to the briefing when the senate gavels out. The senate wrapping up the presiding officer the senate will come to order. The parliamentarian will read a communication to the senate. The parliamentarian washington, d. C, july 13, 2020. To the senate under the provisions of rule 1, paragraph 3, of the standing rules of the senate, i hereby appoint the honorable tim scott, a senator from the state of south carolina, to perform the duties of the chair. Signed chuck grassley, president pro tempore. The presiding officer under the previous order, the Senate Stands adjourned until stands adjourned until the senate wrapping up the session of the week, theyve another one thursday at 1030. Members of that next week for legislative business, they can be monday at three later that afternoon they hold a confirmation vote for russell to be director of the office of management and budget. Next week more work on the Defense Authorization bill. We now return to the briefing by Florida Governor ron desantis. We have taken measures in new rules and regulations due to the curfew to try to drive down the levels of positivity rates so we can start to reduce the number of people that we have in residents that are in the hospital. We do not want to overload the Hospital Capacity of Miamidade County, the governor has been great and adding Additional Resources here in Miamidade County to the hospitals, he will continue to do that and also thank you for your efforts in bringing the medicines that we need in the resources that we need down here. Very appreciate of that. We have to follow the rules. If you follow the rules that we all do and what were supposed to do, we can drive the level of contagions down here in Miamidade County. Contact tracing is something that we need to have, we need additional contract tracers, in the end until we start the drive down the contingent level here in miamidade, you cannot get a handle on it. Again it is up to us to reduce the level, its up to us to protect each other, it is up to us to protect the economy if we have further rise in the contagion more and more people going to the hospital we have to take additional measures now whip to rollback the openings that we had in the past please follow the rules and change social distancing, washing hands, dont touch her face with your hands and if we all do that, we can drive the contagion level down and stop the rise in the number of people going to the hospital and we can get back to normal much faster. Thank you, governor for all your efforts, thank you for courtney dinner efforts with all the hospitals and as a governor said they are very creative in how to create additional capacity in miamidade. Im sure we will have less and less of the elected surgeries being conducted, most of them have been stopped to create additional capacity and so we are not there yet, it is up to us to make sure we never get there. With that i want to turn it over to the president and ceo. Thank you mayor, i want to thank you, governor for being here, i also want to thank you for your support. And for all the support that youre working, i know youre working on the reagents which is something there right now is extremely near and dear that test every patient that walks in the door. We are entering the fifth month of having Covid Patients. This is about four months ago you were absolutely right the time that you got here and around the time that we had to push patients in the door. That makes it very, very difficult for all of our employees specifically healthcare workers that are dealing with the patients on a daytoday basis and the stress that goes with that, its extremely difficult and it works through them and every other employee in the hospital. We have seen a dramatic increase of patients over the last 30 days, about three or four weeks ago we were around 200 patients in today were exceeding 400 patients of which about 100 are nicus. The challenge to that not necessarily running out everybody covers the fact that you have 70 patients you cannot get anywhere. We have not been able to manage from the 200 400 number by maintaining our senses the same. How have we done that you might ask, the fact that we reduce the number of surgeries we are doing. By doing that we are getting less nonCovid Patients in the door. Our senses throughout the system runs in the mid1300 range for this time of the year. Weve been able to maintain that for the last month from the fact that we went from 200 400, a higher percentage of Covid Patients today than we did a month ago. It is very stressful for every employee we have to make sure we have the ppe and make sure everybody is covered and protected. The three things that we work on everyday which is extremely important priorities to make sure that we have made only the people that need to be admitted and we discharge the people once they dont need hospitalization as quickly as possible to make a bed available for the next patient and last but certainly not least to make sure all of our employees are protected and only in the hospital but in the community. So we can keep working. We have seen an increase of employees that have a higher percentage in the normal percentage of our employees is not as big of an issue and having the extra nurses that has helped us a lot but we are managing the numbers, is not as the governors and the numbers of beds, we have the beds available, and to do that we have to make sure not only that we have the extra nurses in the state provided us but to make sure our employees continue to work and make sure they do the things that are necessary. We saw for a while the number of patients becoming younger. We saw that for a while and now the same number of younger patients are being admitted but because increases happened in that increase we saltwater people coming back in and the younger people have been contaminated and making it difficult for the older people. On a percentage basis, the number of people has reduced but the number of people are the same. And those of the challenges and we are still doing some surgeries and we have a lot of patients in covid is not the only disease in miami and many of these people have been deferred for too long and now have become emergent patients. This is a tough balance and were dealing with today, we focus every day on our employees and the employees are focusing on the patient the best we can do. But i will tell you, the mayor joined me in the four clock meeting with all the hospital ceos from out south florida and were all going to the same balance of balancing our senses with bringing in more covert patients, we can do that for a certain period of time we cannot do that forever. The message when you hear the governor and the mayor, we need to be wearing masks, that is absolute