April 22, 2020
Thank you for joining me for our Wednesday COVID-19 briefing. Today I will discuss the considerations we are taking into account as we work towards a phased re-open of the Tennessee economy. We will also cover the Unified-Command Group’s work to ensure vulnerable populations in our long-term care facilities remain safe through this pandemic.
Today our case count:
- 7,842 confirmed cases
- 166 confirmed deaths
- 4,012 recovered
- 114,980 tested
As we think about reopening our economy and monitoring the results of that, I wanted to talk a little bit today about the data we’re looking at to inform our decisions now and the data we will be watching to determine how well social distancing is working during this first phase of recovery.
Virtually every indicator of success in containing COVID-19 shows that our efforts have been working. This is not an indication that we can slack off, but it does give us a path to doing some of the things we did before, but in a new way that incorporates social distancing.
The federal guidance for phased re-opening has largely informed our path moving forward.
In the White House guidelines for Opening Up America Again there are three buckets of data that are called out. Those three buckets are: Symptoms, Cases, and Hospitals. There are also some additional data points that we’re tracking and I’m going to talk about those as well.
First symptoms. This is probably the one we’ve talked the least about to date, but it’s very important. We’re looking for a downward trajectory of flu-like and COVID-like symptoms in emergency departments across the state. For the past three weeks, both flu-like symptoms and COVID-like symptoms have steadily declined within the vast majority of our hospitals, meaning we are hitting this important benchmark.
Second, case data. According to federal guidelines, we’re looking for a downward trajectory of documented cases over a 14 day period. For the last 19 days, we have a steady decline in the growth rate of new COVID-19 cases.
Third, hospital capacity. Here, we’re looking for the ability of our hospitals to BOTH treat all patients without crisis care or relying on surge capacity. To date, we have had 775 of our 7,842 COVID-19 positive patients hospitalized. Through these hospitalizations, we have kept a close watch on the capacity of our hospitals and they continue to deliver on care without a change in normal operations.
The guidelines also call for an emerging capability to conduct antibody testing. We expect to begin antibody testing in the coming weeks when they become widely available.
Let me talk about some other data points that we’re looking at.
Our state has been aggressive on testing and identifying new cases of COVID-19 thanks to private sector partners and the work of the Unified-Command Group. We are ranked 12th in the country for total tests and 15th in the nation for tests per 100,000 people.
Another key consideration for us has been watching is how the virus moves in our state. We watch the average day over day increase in the growth rate of COVID-19 and want to see a doubling rate of at least 11 days.
So all of these are going into our considerations as we make these decisions. And while we’re looking at medical data like this first and foremost, we’re also paying close attention to economic data.
Again, this data does not control our decisions but we must consider the economic impact this has on our people including the more than 250,000 initial unemployment claims on our state.
Indeed, the economic impact leads to other troubling statistics. As this pandemic has stretched on, we are seeing an increase in crimes like domestic violence. We are also seeing a troubling decrease in the reporting of child abuse.
So taking all this together, we’re going to open as many things as can safely in 89 counties. And soon after we hope to see our larger communities in the remaining six counties work towards safe reopen plans.
We’re going to get Tennesseans back to work as soon as we can. And we’re going to continue to beat the drum about social distancing and other safe routines and keep an eye on all of these critical data points.
Speaking of social distancing and safe routines - I want to remind all Tennesseans of the most important things they can be doing in the coming weeks whether out in public or at work include utilizing cloth masks, frequent hand-washing, and remaining at home if you feel sick.
Tennesseans must know that these actions are critical to keeping our vulnerable populations safe. Our Unified-Command Group has made great efforts to ensure vulnerable populations are protected, especially those in long-term care facilities like nursing homes.
Today, Tennessee’s COVID-19 Unified-Command Group released new data on COVID-19 in the state’s long-term care facilities and outlined its action plan on how to prevent further cases and mitigate existing clusters within these facilities.
Starting today, the Tennessee Department of Health will report the number of confirmed cases and COVID-19-related fatalities in all long-term care facilities across the state.
Governor:
I will open it up for questions, but I want to remind everyone that we have on hand today, Commission McCord, with the Department of Labor, in case there are any questions about our unemployment efforts here in the state.
Governor:
Commissioner Nichols with the Department of Children Services to address any questions that have come up. I mentioned the troubling lack of reporting for child abuse, so I've asked Commissioner Nichols to be here, and members of our unified command group are here as well, so we're happy to take questions.
Speaker 2:
Thank you, Governor. First, we'll go to Kim Crusey with the AP. Kim, your line is open.
Kim Crusey:
Hi Governor. My question is regarding the data that was released today. I know that this is the first time that we're seeing this publicly, but there are some discrepancies over in Shelby County, for example. Over at the Parkway Health and Rehab Center, the health department reported a death, one death, in that center. That's not showing up on the state website.
Kim Crusey:
I gather that's from today, but over in Gallatin, the mayor has said there were 21 deaths at the Gallatin Nursing Home. The state data currently says 19. I was wondering if you could maybe help shed some light about maybe why some of these numbers may not add up right away.
Governor:
Thanks, Kim. I'm going to let Dr. Piercey address that question.
Dr. Piercey:
You're exactly right. Our data will oftentimes be behind what is reported by facilities or families because we wait until we have the official death notification, through death certificate, and confirmation of that death. It's not only unsurprising, it's actually expected that our numbers will be a little bit behind what you may see reported publicly.
Dr. Piercey:
That's important because we're the last source of truth and that is the documentation of those deaths and we want to be absolutely certain that we're reporting it accurately, so we do take a little bit more time to do that.
Kim Crusey:
All right. Thank you.
Governor:
Thank you.
Speaker 2:
Next, we'll go to Chris Davis, with News Channel Five. Chris, your line is open.
Chris Davis:
Doctor Piercey, continuing on with the discussion about the nursing home numbers, why are you only releasing long term facility names if they have at least two cases? Isn't one case notable as well?
Dr. Piercey:
One case is notable and we absolutely investigate those and know about all of those. The definition of cluster is two or more and so that's why we note clusters in those facilities.
Chris Davis:
Thank you.
Speaker 2:
Next, we'll go to Alex Apple with Fox 17. Alex, your line is open.
Alex Apple:
Governor, my first question for you is, you cited, and I want to say it correctly, it was on one of your slides as well, that there's been a downward trajectory in documented cases over, I think, 19 days, but the number of new cases has fluctuated. How did that rate stack? Or, how is that calculated?
Governor:
I'll let Dr. Piercey address that specifically, but if you look at the trend of that number over the last 18 days while it fluctuates, it has a downward movement over that extended period of time and that's what we're looking for. We're looking for a downward movement of cases over that period. Do you have anything to add to that?
Dr. Piercey:
I won't rehash all of the math technical terms that I got into yesterday. I'll try to simplify it more today for you. So what we look at is a downward trajectory in the growth rate. A lot of the confusion, I think, has come from the either/or criteria in the White House guidelines for opening up America again.
Dr. Piercey:
It talks about a decreased number of cases or a decreased growth rate, a downward trajectory, over time, if your test number is increasing. That's why it's important to look at the percent growth, day-over-day. The 19 days ago is when we first started seeing that come down into single digits. It started out at the eight to nine mark and now, except for today, because of the special circumstance that I noted, over the last two days, it's been in the low 2% range.
Dr. Piercey:
We went through a little exercise just earlier today looking at the groupings of those numbers and if you group those numbers, you have about an average of seven, and then about an average of five, and then about an average of three. So anyway you slice or dice it, there's a downward trajectory.
Alex Apple:
And Doctor, may I ask, did you have a problem processing test results at all in labs this weekend or did you have some extra capacity as the state started to do more tests?
Dr. Piercey:
That's a great question because we absolutely have to maximize our lab capacity and our private sector of partners have stepped up to the plate. That's one of the reasons we have done such a good job in Tennessee with some of our turnaround times.
Dr. Piercey:
They're not always perfect, but we have so many good private sector lab partners across the state and we've called on almost all of them to say, hey, we need you to ramp up because you're about to get a flood of tests and that's exactly what we've given them over the last three or four days and, quite frankly, we're continuing to do that, day-over-day, and expect another big surge this coming weekend.
Speaker 2:
Next we'll go to Sam Stockard, with the Daily Memphian. Sam, your line is open.
Sam Stockard:
Yes, thanks Governor. Appreciate your time. You told the legislators this morning, it felt like the state's efforts have saved thousands of lives. Some physicians and several legislative Democrats say opening too soon will cost lives and then there's several Memphis Democrats have also said that people are going to be confused by the state's April 30 or May 1st opening and then, I believe, Memphis has a May 5th reopening of businesses. How do you respond to those?
Governor:
I spoke with the Memphis mayor yesterday and have been weekly and more frequently than that talking to leaders of our major metropolitan areas. The way that we will make sure Tennesseans are safe is by doing all of the things that we're talking about doing following data, making sure that we develop guidelines for businesses to open. Because as businesses open up, they will not be opening up in the same way that they did before.
Governor:
They'll be incorporating social distancing. That's how we prevented the rapid spread of this virus in the state and that's why if we do a phased reopening, that includes social distancing, and every component of that opening, then we will continue to keep our citizens safe and continue to mitigate the spread of the virus.
Governor:
But with regard to Memphis versus the other 89 counties or the six counties versus the other 89, there's been a great effort to work together. We have developed guidelines for those counties for which the State department has jurisdiction over the health department there. The State has jurisdiction over the health department, but for all other counties, we're working to develop a strategy and a plan as well. Those mayors are.
Governor:
Those individual counties will be doing so and we believe they'll have a safe reopening plan to go along with the one that we've developed in the state.
Sam Stockard:
But do you feel like people will be confused by the different timeframes?
Governor:
Well, I think if you live in Memphis that it'll be clear that that is the timeframe for Memphis, and if you live in one of the counties for which our timeframe is laid out, it should be clear to you that that is the timeframe that will be applicable to residents of that county.
Governor:
We are working together. Let me just say that. There is a real effort across this state. We make calls to county mayors, to municipal leaders, to city mayors, to all of the mayors in both the counties and cities and those six biggest counties. We've stayed in continuous contact and are working together to make sure that we have a coordinated plan that incorporates safety as we open up our economy here in Tennessee. I'm encouraged by the way that our leaders all across this state have worked together.
Speaker 2:
Next we'll go to Steven Elliott with the National Post. Steven, your line is open.
Steven Elliott:
Hey, just checking that you can hear me.
Speaker 2:
Yeah, we can hear you.
Steven Elliott:
Okay. Metro Nashville officials identified a cluster around Antioch that they said was tied to the disproportionately immigrant population there, continuing to work on the front lines. Has this data identified similar clusters elsewhere?
Governor:
Do you want to address that?
Speaker 3:
Yes, we actually have a cluster summary that we look at every day. It's a dashboard of all the known clusters in the state. I know we've talked some today about clusters in longterm care facilities, but we're looking at them everywhere. A lot of those are in workplaces where people are working in close quarters because they have to to get their job done. Some of them are in religious organizations where people gathered together. Some of them are just in geographic communities where people are living in very close quarters as well.
Speaker 3:
We have identified several clusters in various ethnic communities and there are different reasons for that, but we are working with them in very culturally sensitive ways to help mitigate any of the issues that they may be having. Specifically, what you're referencing in Antioch is under the Nashville Davidson County jurisdiction. And so, the state is not necessarily intimately involved in that, although in many, if not all, of the major clusters in a metro area, the state does provide assistance and support.
Speaker 2:
Next, we'll go to Natalie Alison with the Tennessee. And Natalie, your line is open.
Natalie Alison:
Hello, Governor.
Governor:
Hey, Natalie.
Natalie Alison:
The Tennesseean question today is about the Tyson plant in Goodlettsville, whereas last week there were at least 90 employees who were tested positive for corona virus. Today, their parking lot is full and it appears that they're still operating at their usual level. And elsewhere in the country, there have been meat-packing plants who are temporarily shutting down for even fewer cases.
Natalie Alison:
Can you all speak, A, to consumers about whether products coming from this plant are safe, and B, whether the state has a role in this type of case, as it's done in places like longterm care facilities to step in, order them to pause operations and disinfect, things like that?
Speaker 3:
Sure, absolutely. And in fact, when I answered the last question, I did have that cluster in mind as well. It's an interesting phenomenon that we're seeing all across the nation, which is these outbreaks in meat-packing plants and in other areas where assembly line workers may be in very close proximity. If you've ever been in some of these plants, particularly when they're carving meat, they're carving a very specific section of that, and they stand almost shoulder to shoulder. It makes it very difficult to contain infections when that happens.
Speaker 3:
The Tyson plant specifically also is under the Nashville jurisdiction and we have provided some assistance there. We've been very pleased with their response. They have done a good job at decontaminating and making infection control measures amongst the workers that are there. And I want to reassure you and the public that that does not pose a food safety concern. This is not something that is transmitted in food. And I'm pretty sure you're familiar that we're pretty quick to pull the trigger when we think there is a food safety issue, whether it be lettuce or a any type of meat in certain kinds of outbreaks. But this is not a virus that's transmitted in food, so you can rest safely in that.
Natalie Alison:
Is there any other food plants or other factories in the state where you all are aware of clusters of cases?
Speaker 3:
I am aware of another meat-packing plant that is a Tyson facility in the state. I can't think of any other major ones off the top of my head. I know that our friends in North Carolina and in other surrounding states have had significant issues in not only food production but also livestock facilities. And so, we encourage you or encourage these folks to look at industry guidance, not only from the CDC, but as our economic recovery group starts to issue industry specific guidance, to rely on that to control and mitigate the infections there.
Natalie Alison:
And about how many cases are at that other Tyson plant and where is that plant?
Speaker 3:
I know it's in Shelbyville, but I do not recall the number off the top of my head. I'm sorry.
Speaker 2:
Next, we'll go to Hannah Wall-Smith with WMC Memphis. Hannah, your line is open.
Hannah Wall-Smith:
Good afternoon, Governor. [inaudible 00:04:43] may think it's still too risky to go back to work, so if an employee refuses to go to work when the state reopens, can they still collect unemployment?
Governor:
I want to let Dr. McCord, who is our Commissioner of Labor and Workforce, speak to that and other issues around our unemployment here in the state in this unique time. Dr. McCord?
Dr. McCord:
That is a great question and we're navigating that too with federal guidance because, right now, we have federal guidance that tells us that, yes, that job refusal if somebody is afraid to go to work, they can still collect the unemployment benefits as they go up, at least the federal piece. So, that is something that we're navigating during this transition time. And we'll have more information as we get more guidance.
Hannah Wall-Smith:
And I had a follow-up question. A lot of rural county residents work in cities like Memphis and Shelby County, some of them work essential jobs. Is there any concern that they could bring back the virus back to those rural communities that they live in after you just opened them back up?
Governor:
What we really believe is that if Tennesseeans continue to practice social distancing and if they are in a workplace that is providing a safe environment for their workers, which is a what the work of the Economic Recovery Group, the work this week for that, to provide that guidance for those businesses that are going to open up, that's how we create an economy that people can go to work in, but go to work in safely and to continue to mitigate the spread of this virus. That's what the goal is, and we believe that's what's going to happen in the weeks ahead.
Speaker 2:
Next, we'll go to Grace King with WBIR. Grace, your line is open.
Grace King:
Hey, good afternoon, Governor. The latest data available shows you've made payments to a little more than half the unemployment claims filed since the pandemic. And I know not all of them will be approved, but what's your message to the other 150,000 Tennesseeans still waiting? When is help coming for them?
Governor:
And so, as of today, so far this week, we've made over 210,000 payments to the uninsured who are in our traditional uninsured employment system, the TUC. That includes the additional $600 from the federal government and it includes the back-pay from March 29th when they first were unemployed. So, I think the number is a little higher than that, the percentage is, but 210, we fully expect to be at a quarter million before the end of the week and the pay cycle is Sunday through Saturday. And so, we're working towards that.
Governor:
On the other side of the equation are the extension of benefits to the 1099 folks for the sole proprietors and we've built that system. It's in testing right now and relief for them should be coming soon in the coming days.
Grace King:
And as far as soon, what should they be doing to make ends meet right now?
Governor:
Well, we are looking, here in the next few business days, to get those payments out and it's a struggle. We know it's a struggle. Every day, when we go to work, we understand that and we understand the weight of it and the importance of it. And rest assured that we are working to do that. I think to go into the complexity of this, this is a whole nother system that didn't exist before. And so, we've had to build it, unlike the unemployment insurance system that typically would cover you that's been built over decades. We've had to build this in a few weeks. And so, I would tell them help is coming and help is coming soon.
Governor:
And I also want to just add to that that we certainly know and understand, and we've said Tennesseeans have made tremendous sacrifice in this. And some of the hardest hit are those that you're talking that are currently unemployed, and while we're making every effort we can to adapt to a incredible surge in the demands on the systems for unemployment insurance, we're also working really hard to get Tennesseeans back to work. That is one of the reasons that we are working so hard in the different avenues that we've discussed today. It's why it's so important that when people go back into the workforce that we do so in a safe way so that we can continue to keep our economy moving forward.
Governor:
The reason we want to do a phased reopening of our economy is because we believe that we're in the right place from a medical standpoint, but we're in a very important place to be able to bring Tennesseeans back to work, to get folks back to receiving a paycheck instead of an unemployment benefit. That's what we hope to be doing in the weeks ahead.
Speaker 2:
Next, we'll go to David Floyd with the Johnson City Press. David, your line is open.
David Floyd:
Hey, Governor. I had a question about something that you guys talked about during the stimulus accountability meeting this morning. You had talked about how one of the biggest challenges for the State coming up is a shortfall in revenues stemming from COVID-19. Does the State have the capacity currently to plug that gap on its own or will it have to rely on aid from the federal government to do so?
Governor:
Well, our State's in an unusual place because of the work of the legislature over the past several years and leadership that has created a stable economic situation for our State, so we have significant revenues. We have significant resources in our unemployment trust fund, for example, in our TANF fund reserves. We have a rainy-day fund balance that is significant, and all of those things have been done to prepare for a difficult economic time.
Governor:
Now the extent of the damage to our revenues is unknown. We're only a few weeks into this and there's no real data that shows just how hard this economy and the downturn of this economy will affect our State's budget. We're encouraged by the work that we've done to prepare for this in advance, but it's really difficult to know what's going to happen in the next year or year and a half. Much depends on what happens with this virus over the next year and how quickly it's mitigated either through a cure or through a vaccine.
Governor:
But we are beginning to prepare for and work. Certainly, we know that there will be a real strain on the State's budget because of the downturn in revenues and we're trying to collect data right now that will give us some indication of what that might look like and what our capacity to meet those shortfalls is with the current reserves that we have in place.
David Floyd:
Thank you.
Governor:
Mm-hmm (affirmative).
Speaker 2:
That's all the time we have for questions today. Governor, if you would like to make a closing statement.