Remarks by the Vice President and Members of the Coronavirus Task Force in a Briefing on COVID-19 in Baton Rouge, Louisiana

THE VICE PRESIDENT: Well, first off, Governor, thank you for the hospitality. More importantly, just thank you for, really, a seamless partnership. I want to say in front of your team, in front of these members of the Senate and the House, how grateful we've been for the continuous communication.

Louisiana — as I just said at the podium out front, Louisiana has been here before in the coronavirus. And people of Louisiana, federal and state, responded well, brought the numbers down, and we're going to do it again.

And I just want to — I want to thank your team for all the hard work and the endurance that you've demonstrated. We brought, really, our A-team with us. Dr. Deborah Birx, I think, needs no introduction. She's been the coordinator of the White House Coronavirus Response from — I think I called her the day after I got asked to lead this effort. We brought her back from Africa, and she's really become my right arm.

Seema Verma has been, I'm going to say, doing a remarkable job resourcing our long-term care facilities and nursing homes. We have a pretty big announcement today, when we do the press stuff later, about the deployment — and I mentioned yesterday on our call — the deployment of point-of-care tests that she and Admiral Giroir, who is our — I just want to call him our "test guru" in the country — has done a phenomenal job at the U.S. Public Health Service.

But we're going to be — we're going to be announcing officially, in Louisiana today, the deployment of point-of-care tests at nursing homes — all 15,000 nursing homes in the country, beginning with those most at risk.

But I'm mostly here just to say two things. Number one is I want to thank your delegation to Congress for the stalwart support of Senator Cassidy and Senator Kennedy and Congressman Scalise. And your entire delegation have literally been there every step of the way. Congress will be coming back in a few days, and we're going to be rolling our sleeves up and identifying what further needs there may be.

And so I know — I know, Governor, I speak on your behalf when I tell you how grateful you are for the way that they've been champions for Louisiana's needs and the families in Louisiana through all this.

And secondly, I just want to say to you, in front of your whole team: We're with you. We're really here, mostly, to listen. We'll do a fair amount of talking when the cameras are on later today, but we really want to just take some time to hear where things are at.

What I can tell you — and Deb Birx can probably break it down a little bit more for you — is that our default setting is to defer to state and local health officials. We asked the American people to take mitigation steps for 45 days, and then we gave guidance for opening up. I think you're in phase two of opening. I think you've announced you're going to stay there.

I want you to know you have our full support in the steps that you're taking for Louisiana. And you have our commitment to — whether it be testing, whether it be PPE, therapeutics or the like, to — we're going to continue to move heaven and earth and to make sure you have what you need to implement your plan.

But we — we come to today with listening ears, with recognition that it's a serious situation, but real confidence based on what Louisiana — the people of Louisiana have done already in the early days of this pandemic. And also, we're also emboldened by the fact that because of what these people have supported, because of what the administration has been able to marshal at the President's direction, I just want your team to know we are in a substantially stronger position today to meet your needs in every category than we were when this was first hitting New Orleans. We met those needs then, working closely with you.

So what I — what I want to know, Governor, is — we'd love to have a sense from you and Courtney: Where are you? We see the numbers, but there's no substitute for people that are living it hour by hour every day. Where are you? And how can we help?

And I will also say one of the real success stories here was the deployment of military, active-duty personnel. We've got people in the region. If there's a need for reinforcements for your healthcare workers, we're here to listen.

But I'd love to know where you're at, how we can help. But again, Governor, I want to say among your team and your peers in public service here that — I know I speak for the President when I say we're just — we are grateful that we've just been able to work so closely together without any distractions on behalf of the people of Louisiana.

So, appreciate you.

GOVERNOR EDWARDS: Thank you, Mr. Vice President. Really appreciate your visit today. And I want to thank you for bringing so many of the members of the task force with you: Ambassador Birx and Administrator Verma and Admiral Giroir, who is from Louisiana. It is great, great to see you again, Brett.

ADMIRAL GIROIR: Yes, sir.

GOVERNOR EDWARDS: I want to thank our congressional delegation for the work that they've done. It's just been tremendous.

THE VICE PRESIDENT: It took me about a week to learn how to pronounce his name, so you didn't have to tell me — (laughter).

ADMIRAL GIROIR: Sir, it was about two months before (inaudible). (Laughter.)

THE VICE PRESIDENT: — he was from Louisiana. Had to tell me.

PARTICIPANT: (Inaudible) butchered it pretty bad (inaudible). (Laughter.)

THE VICE PRESIDENT: (Laughs.) I'm just telling you. That's the first thing he said to me. He said, "Sir, say it however you want. I'm from Louisiana." (Laughter.)

GOVERNOR EDWARDS: I want to tell you how — how comforting it is when you get a call from the Vice President of the United States and he knows what's happening in your state to the parish level, before you tell him. And then when you think that he's doing that for every state and for the (inaudible) areas and so forth, it's just tremendous work that you've done with your task force.

And as you know, we've been on a roller coaster. Twenty-four days after — after Mardi Gras, we had the highest case growth in the world, as best we can tell. Certainly in the country. And then by the 13th of June, we had — we had hit the bottom again, and we were hoping we were going to keep going down, and then we started trending up.

And I will tell you what you and Ambassador Birx said yesterday about this pandemic, it was like you were speaking directly to our experience here in Louisiana, because it was the 13th of June that we started going back up again.

THE VICE PRESIDENT: Is that the — that's the date when you —

GOVERNOR EDWARDS: Yes, sir.

THE VICE PRESIDENT: Okay.

GOVERNOR EDWARDS: And the most real-time information is -every day you get tests, but some of those tests are from this week, some of from the week before and so forth. But you know how many people are in the hospital on any given day.

THE VICE PRESIDENT: Right.

GOVERNOR EDWARDS: And the lowest number we had from the peak was on June the 13th. It started rising again the very next day, and it hasn't — it hasn't stopped.

In terms of cases, we reached number 2, per capita, in the country, then fell to number 10, and now we're back at number 3 today, in terms of — behind New York and New Jersey.

Most concern to us right now is that if you look at test results from data specimen collection and looking at the most recently collected specimens, we're right at 17 percent positive. And that gets hidden if you — if you just look at all 2,300 tests that get reported in any given day. But that's what's got us most concerned, along with the hospitalizations that have been growing.

And unlike the previous iteration, this is not centralized or driven by the New Orleans area. This is truly statewide. And, in fact, Orleans Parish is still performing very, very well, all things considered.

So with the additional challenges that we're having — on Monday, we went to a situation where we stayed in phase two, as you mentioned, but we did a mask mandate with an opt-out for parishes not at a high-incidence rate, which is defined by CDC as 100 cases per 100,000 over a two-week average. We have three parishes — so 61 parishes don't qualify for the opt-out. Three — three did.

But we closed our bars again because our contact tracing revealed —

THE VICE PRESIDENT: When did you do — when did you do that?

GOVERNOR EDWARDS: As of Monday.

THE VICE PRESIDENT: Okay.

GOVERNOR EDWARDS: Contact tracing revealed that bars were responsible for the vast majority of the cases that we could — that we could track to, even though they were closed during phase zero and phase one. We only reopened them in phase two, at 25 percent. At 25 percent. And they're still driving.

And what we saw — and this was the biggest concern we had — is young peoples were becoming positive at just a tremendous rate. And then, after about two and a half weeks of that, you started seeing where they were delivering — transmitting to older people, and those cases started coming back up again.

So, consistent with what you've been telling us from the beginning — we're going to save lives, protect the vulnerable, and reopen - we are trying really hard not to go backwards in phases. And so these additional steps were taken in order to try to keep us at phase two as we move forward.

And for some of the successes here in Louisiana, we have a monthly goal, Admiral, of 200,000 tests per month. We're at 248,000 in July today, on the 14th of July. But we're number one in the country. And the additional tests per capita for the month of July, we're number two overall. We will — we will easily go over a million people tested this week in Louisiana. And we couldn't do that without your help. I mean, we just couldn't. We have a tremendous team, and I — I've got them here, and we're working with local partners and so forth. But the resourcing that you all have sent to Louisiana for testing has just been tremendous.

I wanted to just very quickly give you the numbers today. We added 2,187 new cases on 23,000 tests — 23,029 to be to be exact. Twenty-two new deaths. And so we're at 3,337 deaths overall.

The overwhelming majority of all of our cases now are coming from the community and not from congregate setting. The last couple of days, congregate setting has been 1 or 2 percent. So this is community spread.

And I really appreciate Dr. Redfield yesterday talking about where you have high incidence of community spread and you're looking at going back to school, the most important tools you have are universal masks and making sure that you distance where you can, because we intend to open our schools safely, on time, following CDC guidance. And it's easier said than done, as you know, but we're working really, really hard on that.

THE VICE PRESIDENT: That's great. That's great.

GOVERNOR EDWARDS: And I'm going to wrap up and let Dr. Phillips speak. But I did want to say that we — there are so many heroes out there who've worked so hard, but the medical professionals have just been tremendous.

And what we're seeing now is, is even though we haven't gotten back to the hospitalization numbers that we had at the peak, and now they're squared across the state instead of being focused in New Orleans, with the community spread we're having, there are enough medical professionals, doctors — or nurses, I should say — who were positive themselves that staffing is becoming an issue already in Louisiana.

We spoke with 20 hospital either CEOs or medical directors of both last week around Louisiana, and staffing is already an issue, even at the number of hospitalizations that we're talking about right now.

THE VICE PRESIDENT: Did you talk to Pete about that yesterday?

GOVERNOR EDWARDS: Yes, sir. Yes, sir, we did.

And anyway, thank you so much for the partnership. The Baton Rouge surge testing is not lost on us that there are only three of those in the country, and one of them is Baton Rouge. The concept that we're going to, I think, pilot for you all on the pooling testing here at a federally sponsored site, we're excited about that.

And so we just appreciate the attention and the help that you all have given to Louisiana. We would be in much, much, much worse shape were it not for you and your leadership and your task force.

THE VICE PRESIDENT: Well, thanks, Governor.

Courtney?

DR. PHILLIPS: Thank you, sir. Well, good afternoon, everyone — Mr. Vice President, Dr. Birx, Admiral Giroir, and Administrator Verma. Thank you all for being here. And, of course, our congressional delegation.

As the Governor mentioned, I'm Courtney Phillips, and I have the pleasure of serving as the Health Secretary for LDH. I will share that, as someone who moved back to the state in the height of COVID, in late March, early April, I was really comforted in terms of the quick actions that our Governor took and the partnership with the federal government being brought in in the midst of it.

And as the Governor mentioned, without that partnership, we would not have been where we were so early on. I think, in Louisiana, we have one of the unique epi curves in terms of the early rise, immediate decrease. And now we see that rise again.

THE VICE PRESIDENT: Yeah. You actually do. That's actually true.

DR. PHILLIPS: Yes, sir. And I think — you know, as you mentioned in terms of the partnership, that's what will help us get through it. As the Governor mentioned, the communication is critical, and so you all have not only made your teams available, but you made yourselves available and accessible. And I think that goes a long way. Sometimes we forget in these conversations to recognize that, so I want to make sure that while you all are here today, we do recognize that, that we see it and we appreciate it, because sometimes we're calling at the last minute in terms of needs, questions, clarifications, and y'all have always been available and accessible for us to have that kind of communication, and it goes a long way.

Sometimes we were in communication with our counterparts, but it's nice to know from a higher level, in terms of what you're seeing across states of what's working, what's not working, that we can try to replicate here or to make some improvements on.

As the Governor mentioned in terms of where we are with our numbers and some of the opportunities that we have, we'll walk through that today. So just a couple of things that we'll talk about in this conversation. Of course, feel free to answer — ask any questions, any comments as we're going through.

So we do want to give you an update and touch a little bit in terms of the pool pilot project that we're talking through. You've heard about the Alex Box at LSU. We want to discuss the (inaudible) collaboration and how much we've done in terms of this mobile community testing and that partnership.

Also, just an update in terms of our PPE and our federal supplies. We also want to give an update in terms of the Region 2 surge, that — where we are today. And then also talk about our nursing home successes and some of where we are today with that.

We also want to talk about some of the opportunities, so some of the testing limitations that we've seen across the state and where we could potentially partner; remdesivir — that purchase and a request that we put in for Dr. Birx; and some of the insurance coverage testing that we've seen that may have tightened our state in terms of some of that ramification.

Dr. Birx, the recent report that you just shared with us in terms of the state report, I think some of the information that will be in there will be critical. It provides information on a parish level in terms of recommendations for each parish based on incidence level. We are starting, per the Governor's request, local legislative delegation calls to share with them their local data. We will accompany that with information that you shared. And I think it will go a long way in terms of those communities understanding where they are, what are some of the recommendations they can do. Of course, you have in there masking, closing bars. You also have a dropping down in terms of the restaurants moving from indoor to outdoor.

So I think that will be very helpful, and we appreciate the ongoing updates to that state report.

So with that, I am going to turn it over to Dr. Billioux, who's our Assistant Secretary of Public Health, who will jump in and just highlight some of where we are and then talk about pooled testing.

Thank you, sir.

THE VICE PRESIDENT: Thank you, Courtney.

DR. BILLIOUX: (Inaudible) Vice President, Administrator, Ambassador, and Admiral — three A's. I had the pleasure of meeting Administrator — or rather, Ambassador Birx and yourself at the White House with the Governor in April. And part of the reason for that visit was to discuss the testing commitments that you and the President had made, and our appreciation for that. And I just want to echo that — that that commitment that was made in April we've seen come to fruition in May through July.

To give you a sense of where we were in testing, we were one of the early hotspots, as the Governor said. In the month of March — our first case was March 9th — we did a little over 34,000 tests. Most of those ended up not being done by our state labs. Our state lab was really the only game in town for about the first week of testing. So, really, you're talking about two weeks of testing, where suddenly you saw our healthcare systems, especially Ochsner, LCMC, and some of our LSU hospitals, really pick up on testing in the month of March.

But at that time, we realized that we couldn't really have testing just be done disorganized, have people sort of stand up their own testing. We needed to coordinate. And so, in April, what we did was stand up something called the Testing Action Collaborative, where state leadership brought together private sector partners, private labs, hospitals, health systems, but also research institutions that had testing capacity but were not used to doing clinical tests. And really came together on weekly calls, initial (inaudible) calls, to coordinate the kind of systems we were using, making sure we weren't pulling on the same reagent supplies, and early emphasis on trying to make sure testing wasn't just in urban centers but it was everywhere across the state. We have many rural parishes. Eight percent of Louisiana is rural. We wanted to make sure that we weren't leaving people behind. So that was early on, (inaudible).

And so in the month of April, we had a 400 percent increase in testing, moving to 139,000 tests done in that month. And then, again, with federal support, that commitment of specimen collection kits — right when you're starting to feel a pinch of not being able to deploy tests. In May, we were able to increase that to 218,000 tests done, so another 157 percent increase, and that has continued. In June, we did 351,000 tests — another 161 percent increase. And as the Governor noted, we're already at 247,000 tests, and we're not yet at mid-July.

And so that testing has been a core part of our strategy in Louisiana from the beginning, understanding that if we didn't know where COVID was, we couldn't give actual information to providers — most importantly to patients — and to understand where to surge the various resources that both you have, from the federal level and at the state level, given to us to help combat COVID.

Unfortunately, that comes with some — you know, we're victims of our success in some ways. So we continue to be well supplied with specimen collection kits. But like many other states, as I'm sure you've been hearing, we're now feeling the pinch from the manufacturers of the actual testing reagent supplies, whether it be Palogic or Cepheid or Abbott or Roche.

And so while we're able to collect the specimens, what we're starting to see is those testing partners that we continue to meet with on a weekly basis, across the state, are starting to have throttle back their daily run rates, and we're seeing turnaround times increase, which obviously has some impacts on our ability to do contact tracing.

And so I think we already heard some of the planning that that's already been done. And I know our testing plan that we did for the ELC grant — you know, we itemized all the machines, what they're (inaudible). We know that that data will be used by you to work with those partners and make sure that the supply chain has, sort of, the forewarning to continue to increase.

Again, I think we're victims of our success because even the numbers that we've projected there, we've been able to exceed. And so, you know, it's tough to manage a supply chain when there's more (inaudible). But we do think that that's going to be really critical moving forward, that we continue to have that access to the reagents, even more so than the specimen collection.

We've been trying to do things for the specimen collection side, like local 3-D printing. LSU Shreveport was an early adopter of printing swabs. We have labs, like the veterinary lab here in Baton Rouge, that has been producing vital transport media early on. And we've got more plans, more people continuing to do things, like producing those supplies.

The reagents for the tests, though, we really can't home-grow, and so that's kind of a pinch point that we're sort of limited in what we can do. But again, appreciate that we're even in that position because of the amount of specimen collection we're able to do.

The Secretary also noted the benefits that we've had from your remdesivir allocations. And again, I harken back to that day in the Oval Office. I was sitting next to Ambassador Birx when Dr. Fauci announced the preliminary results of the remdesivir trial and that FDA would be making an announcement about emergency access to that drug.

Since that time, we've been fortunate to have over 17,480 vials distributed to Louisiana. We've been allocating those based on COVID inpatient admissions, with some kept in reserve because, you know, some of our large hospitals have somewhat predictable levels of COVID admissions. Some of our small rural hospitals, though, you know, may not have seen somebody with COVID for a long time, but now that we really have a statewide epidemic, they're seeing patients show up. And so we didn't, sort of, push allocation, but now, on the back end, they're requesting allocations, and we've been able to give them those.

As we move to the new system with AmerisourceBergen, you'll have 2,400 vials delivered this week and using a similar sort of upfront push allocation, based on in-patient admissions. Here, the one — the one — and we understand the need to streamline with a single source like AmerisourceBergen. The one concern we have is that the current system doesn't really allow us to build that reserve. You do have, within the Office of Public Health, a pharmacy, and they request to Amerisource that we would purchase, say, 10 percent of the allocation to have within the Office of Public Health pharmacy to distribute to our local drug distributor, Morris and Dixon, and then they would essentially take purchase orders from the small rural hospitals that needed drug as needed, and then reimburse us so that we'd be sort of net neutral cost.

The challenge is that we're being told, since we're not a hospital, we don't have the ability to buy that reserve. We just sort of put that out there that, I think having reserves so that we can adapt our distribution is going to be critical, and still allow, you know, 90 percent of the vials available to go to the major hospital systems that are (inaudible) COVID admissions.

THE VICE PRESIDENT: Yeah. Brett, you'll check that out.

DR. PHILLIPS: (Inaudible.)

THE VICE PRESIDENT: Go ahead, Courtney.

DR. PHILLIPS: I think we've seen a couple of times where our hospitals, based on their initial allocation that we've provided them, in the next couple days after that allocation, they've had a spike in cases. And so because we have that reserve in our current capacity, we're able to immediately provide that to them. So if we could continue some sort of similar model where we have a reserve and, as needed, we can allocate it, it would be extremely helpful for particularly those rural (inaudible).

THE VICE PRESIDENT: Brett, did you want to respond to that?

ADMIRAL GIROIR: I think this is in Dr. Birx's area, but that —

THE VICE PRESIDENT: Deb, go ahead.

ADMIRAL GIROIR: — but that seems to make absolute, 100 percent sense. And, you know, I think the last thing we want to do is get in the way of fair distribution that you're doing, but I defer to Dr. Birx.

DR. BIRX: You know, this is why we come on the ground to listen because what makes sense to us in Washington — we can see it being distributed — and these unique situations, we really want to hear about, and we could take that back. That should not —

THE VICE PRESIDENT: It shouldn't be a problem.

DR. BIRX: You know, I'm not sure it would be 10 percent, but we could talk about 5 percent and really take that back to the Secretary to really — because I hear what you're saying, because it really — some of these hospitals may only — you know, they may go another month. So if you do it against new admissions and you have that 38-year-old come in that's pregnant that needs it, you need to be able to get it to them.

PARTICIPANT: Is that something that could be done administratively? There are legislative limitations and statutes that —

DR. BIRX: No.

DR. BILLIOUX: And, again, I mean, it's great — we're grateful to be in that position, to be able to distribute this drug. And we've already seen some of the impacts of having access to that in the states, so we're grateful for that.

DR. PHILLIPS: And if it can't be our state lab — and we do have a couple of state hospitals, like a lot of the (inaudible) hospitals that we could potentially use, but they wouldn't have the numbers to support that extra. So if there was some sort of exemption for that, that's also (inaudible).

THE VICE PRESIDENT: And we're working with them on production right now. We were able to secure, I think — what was it — 160,000?

DR. BIRX: Yeah, we have about 90, 95 percent of their entire production line for the United States. We don't say that — (laughs) — outside —

THE VICE PRESIDENT: We do.

DR. BIRX: — because July and August is tight with their production. It's a six-month production for the drug.

So we have September — you know, we're talking about a million vials. But up until September, we're talking about 500,000, 700,000 vials per month. So we're managing it very tightly for the very reason, and you're managing tightly. So we understand the need for America.

DR. BILLIOUX: And the two weekly distributions — you know, I think we can adjust up and down based on actual experience.

THE VICE PRESIDENT: Yeah. What we want to do is, you know — and I said this to you a dozen times — I mean, our model, first in Washington State, then in Greater New York, Louisiana, was making sure people had what they need, when they needed it. So that's the model here.

But also, you know, it's a good time to talk about other therapeutics as well. And you all have been leaning into convalescent plasma here and the collection of that. I mean, the fact that — Courtney, you made a point. I think you have — you have a unique curve in the whole country in this pandemic, and so you likely have a significant number of people in the New Orleans area who would be candidates for donating blood. And we're seeing very, very promising results from convalescent plasma, which can be an alternative to the remdesivir. So, you'd know all (inaudible).

DR. BILLIOUX: Yes, sir. And we've got The Blood Center in New Orleans and LifeShare in the north of the state working with them. And they're actually partnering with the CDC to do some surveillance testing as well. So, they're trying to build that together.

THE VICE PRESIDENT: That's great.

DR. BILLIOUX: And the last thing I was going to touch on is just that — again, thanks to the to the administration, but also to our congressional delegation. The forethought to have the Families First Coronavirus Response Act really give coverage for coronavirus testing broadly through private insurers, public insurers, as well as for the uninsured — we're fortunate as a Medicaid expansion state to have most of our population have access to insurance. But not having those limitations on copays, especially for our most vulnerable communities has been invaluable and allowed us make sure that we can get testing to folks.

Part of our testing plan, like many across the state, though — or across the nation — is to make sure that we have adequate testing in our congregate setting for people who are potentially the highest risk of spread, and certainly in our nursing homes, where you also have the highest risk for poor outcomes from that — that congregate spread.

And we've encountered some challenges just with, sort of, the private insurance and even public insurance rules about reimbursement for testing. It's not provider driven. So when we're talking about things like retesting staff and residents repeatedly — especially for staff — that's usually not provider driven. It's driven by policy and considered, sort of, employer testing. There, we're seeing our private sector insurance not reimbursing for this test.

So, as a result, we're having to absorb that as part of our ELC allocation. We had a $190 million — a little bit more than $190 million allocated to Louisiana, which we're grateful for. That's to be spent over 30 months. And, you know, one of the challenges we have now is sort of between those numbers, because we anticipate sort of a higher level of insurance reimbursement for some of those tests. And if we are in position where the state has to absorb weekly retesting for staff, it's going to reduce just the amount that the — how long that that testing allocation goes. Because contact tracing, it turns out, is relatively expensive to continue operating.

So any consideration that can be given to convening, you know, private insurance — and we're not saying that all testing for anyone in the country should be free of charge, but I think, specifically for the staff that are taking care of our most vulnerable and who we do think — and the CDC agrees — should be doing weekly tests to preserve the safety of those individuals, we'd appreciate insurance coverage for those individuals as well.

So we know that that's a significant cost for — it just has to be borne somewhere and we're having to share as (inaudible) as possible.

I think those are the main points. But, again, just thank you.

THE VICE PRESIDENT: Very helpful.

DR. PHILLIPS: The one other challenge that we are currently seeing — and this is just really happening, as the governor mentioned — in the past week, is staffing for some of the hospitals.

So, I think, as of today, we have four regions in the state of Louisiana who have put in an EOC request for staffing. Out of those four regions, six hospitals include that. And so I think this will be a continued conversation, at least for the hospitals.

THE VICE PRESIDENT: What's your number, Courtney?

DR. PHILLIPS: I don't have the exact numbers, sir, in terms of their — their estimate for each one of their — for the staffing requested. And that's what we're working on collecting from them, and from (inaudible).

THE VICE PRESIDENT: Okay. But you'll get that to Tony? And, yeah.

DR. PHILLIPS: Yes, sir.

THE VICE PRESIDENT: Yeah, we'll get after it.

GOVERNOR EDWARDS: The region five in Lake Charles, Mr. Vice President, is 95 — 30 RNs, 30 (inaudible), various technical aspect, phlebotomist, lab techs. We received that on Sunday. And Lafayette Parish President called me last night — 30 RNs for our Lafayette — the city of Lafayette, sir. The other two, I don't have.

Courtney.

DR. PHILLIPS: They just —

GOVERNOR EDWARDS: And what will — what will soon happen if we can't give them additional staff — and, by the way, I'm not sure where the staff will come from — is we've got hospitals already talking about imposing their own restrictions on nonemergency medical and surgical procedures so that those nurses can be moved to the COVID side.

Now, we haven't reimposed that at the state level, like we did early on when you all suggested it. I think we were one of the first states that actually did that, as a state. But we're going to start seeing that again pretty soon in order for these hospitals to be able to manage, especially with the community spread impacting their nurses who are COVID-positive and out at any given time.

THE VICE PRESIDENT: Yeah, I hadn't about that — the personnel. Greg Abbott, he identified just a couple of counties where they suspended elective surgery for a variety of reasons. But that's actually a terrifically good point. But we're ready to process a request.

DR. PHILLIPS: And that's one of the things that we work with those regions and those hospitals on, in terms of (inaudible) beds, rolling back procedures, and the use of the (inaudible) before we move to the additional staff. And so we try to use all of those phases, and all of these ideas before we move to pulling the trigger on additional staffers.

THE VICE PRESIDENT: Great. Great report. Thank you.

DR. PHILLIPS: Thank you, sir. Want to jump in?

MR. WASKOM: Yes, sir. Mr. Vice President, I am Jim Waskom. I'm the director of Governor's Office of Homeland Security and Emergency Preparedness here. So, welcome. Good to see you in person other than every week on the VTC, and to the team as well. (Laughter.) Thank you all for coming. And the honorable (inaudible) Mike Johnson, my law school classmate.

MR. JOHNSON: He got a lot further than I did, Mr. Vice President.

MR. WASKOM: No, no, no. Not true.

So, Mr. Vice President and team, what I'd like to share with you a little bit is the collaboration piece here. As my new best friend, Dr. Phillips and Dr. Billioux talked about, you have to have a system in place to get all the things that they get from you guys out to the end users and to people who are out there. And so that's where we come into place.

We operate off the N5 command system here, with the governor being the commander. I'm his deputy commander in times of emergency. And so, since the governor's tenure, we've been very busy, not with just COVID-19, but with hurricanes, floods, tornadoes — you name it. We're pretty practiced there. And as I like to say, "You don't want to meet your partners at two o'clock in the morning on a tarmac when it was raining sideways."

And so we've had 59 UCG meetings to date. We usually hold — we were doing them every day, and then we went to three times a week. We're about to ramp back up to two times a week.

In addition to numerous severe weather with Tropical Storm Cristobal — which was a good practice run for us in the COVID environment. So we learned some lessons there. We incorporated those in. I shared those with Administrator Verma yesterday.

Let me just say —

THE VICE PRESIDENT: You guys got that whole book they put out —

MR. WASKOM: Yes, sir. We did.

THE VICE PRESIDENT: — a month ago, about.

MR. WASKOM: Yes, sir.

THE VICE PRESIDENT: That's a — the members of Congress may not be aware of it. There's — you know, it's a whole different ballgame, in terms of disaster response. You know, you can't send everybody to the same gymnasium with a cot. So —

MR. WASKOM: Yes, sir.

THE VICE PRESIDENT: — we put together a whole range of proposals.

MR. WASKOM: So that — I just — I can't say enough about our FEMA partners. They've been here since Katrina, Mr. Vice President. They're on Florida Boulevard, in an old department store. We've got the first floor down there. They've got the second, in addition to this building.

And my good friend, Captain John Long, the federal coordinating official, he actually resides in New Orleans and works for Tony Robinson, so he's right here with us. They — they do great work with us.

I want to talk a little bit about, Mr. Vice President — about the Title 32 support. And I thank you again, and the President, for — for turning that on for us. It's been critical to our response. The — that peak — we had 1,070 soldiers and airmen working a mission. And I'll cover some of those missionaries in a second.

But our current staffing level is 950. We anticipate getting a request for extension up — up to the President here shortly through — through Governor Edwards, Mr. Vice President. But the major missionaries there are — we — we actually stood up very quickly, as you know, the medical monitoring station at Morial Convention Center, with some assistance on the planning side from the Corps of Engineers. They were very helpful — Colonel Stephen Murphy and his team. It remains operational. We have the capacity to take care of 60 patients there currently. We can ramp up to 250 if need be. And one time, I think we had close to 2,000 beds in there that we were — were ready to go, with assistance from sailors from Jacksonville, Florida, that came from Houston to help us out.

Right now we have — at its peak, we had 245 — cumulatively, we had 245 patients that we saw in there. And then, currently, we have six people in there. That's going to stay operational, obviously —

THE VICE PRESIDENT: Good.

MR. WASKOM: We also set up three isolation sites for those folks who could not go home for one reason or another — either they were homeless or they had folks at home that with comorbid- — comorbidity challenges. So we set up three state parks with the partnership of Lieutenant Governor Nungesser. We purchased travel trailers in addition to the cabins that he has on the state parks. We staffed them and with wraparound services. They were instrumental. We had a quite a few migrant workers that were infected. We — we put, I think, 65 of those in one of our sites there until they — they were covered.

PARTICIPANT: And not the — not the insignificant beef and poultry, and pork; these were crawfish processors. (Laughter.) So we've — we had to take really good care of our crawfish processors.

MR. WASKOM: And the other — the other big lift for us that the Guard provides, Mr. Vice President, as you know, is the food banks. They're volunteers. Most of them are up and aging. They're kind of scared to come back. So a big, heavy lift with our Guardsmen and women here.

Community-based testing — the surge piece here — thank you very much for turning that on for us. So the Guard mans those sites, along with the team from the federal government. Admiral Giroir, your team came down. And right now we have four fixed sites here in East Baton Rouge Parish. We have seven mobile sites that — that are out in the communities.

Cumulatively, as of this morning, we have tested 12,811. Our daily high was yesterday, and that was 387. We're not quite to 5,000 a day, but —

PARTICIPANT: Three thousand.

MR. WASKOM: Three thousand. Yes, sir. Three thousand. Three thousand eighty-seven. And then in addition, Mr. Vice President, the support that Pete Gaynor and Admiral Polowczyk, and your team up there on the PPE side has been fantastic. We literally have three National Guard warehouses; two others that we have leased, that we have stocked with PPE. Sixteen million masks, they've distributed; 2 million face shields; 11.7 million pairs of gloves; and 2.6 million gowns.

And that's a combination of both the federal government support, our private contracts that we turned on early, and donors, believe it or not — private donors that come in. All of that has to be coordinated, collaborated, and that's — that's what our agency is trying to — in charge of get our hands around.

So with that, Mr. Vice President, thank you again.

THE VICE PRESIDENT: That's great. Great effort. And Title 32, I think the current extension goes to August 21.

MR. WASKOM: Yes, sir.

THE VICE PRESIDENT: Okay.

GOVERNOR EDWARDS: So I sent a letter in last week asking for through September the 30th. And I know the National Governors Association is going to be advancing a request on behalf of all of the governors.

THE VICE PRESIDENT: Got it. Okay, we'll look for it. Very good, very helpful update, Governor. The — I might just pitch it to Deb for any reflection she'd have, and then I've got people loitering so — (laughter) — I didn't wear this tie for nothing. I actually want to go LSU. (Laughter.)

GOVERNOR EDWARDS: They'd love it if you wore that. (Laughter.)

THE VICE PRESIDENT: Deb, any thoughts, reflections for their team from our perspective?

DR. BIRX: Well, we were able to meet with the team that — in a little huddle down there, going through our data, their data. I think we see things exactly as they do: that this epidemic is very different than the March, April. This is very much — I mean, they have 44 parishes out of the 64 that we consider in the red zone for more than 10 percent test positivity and more than 100 cases per 100,000. So this is a much different epidemic. It's across the state, and I think having statewide consistent orders will be really key to really stop the spread.

I think you only have a few parishes that aren't — well, maybe 10 that aren't either red or yellow zoned because of this degree of broad spread.

But this has been common across the South. Whatever happened — I like to think of it as like the Memorial Day Weekend that became the Memorial Day week. And I don't know where all the virus came from, because you really had very low test positivity here, and that was across the South. Florida was under 4 percent and had been stable for seven weeks under 4 percent. And then all of a sudden, by June 10th to June 16th, across the South, it exploded. This is very different than what happened in the March-April timeframe, where, you know, New York had an issue; and then like, three weeks later, Philadelphia; a few weeks later, Boston. So there was a series of metros. This was uniform across the South. So whatever happened, happened across the South, and very much the first cases diagnosed were under-30. So whatever did happen, it happened in that younger age group that now is spreading through households.

And I think the reason we wanted — and Admiral Giroir brought the Baton Rouge concept to the LSU pooling is because we think the way to stop this broad of a outbreak — where a majority of the cases are asymptomatic — is to get into household testing and just test the whole household, either a whole household through a drive-through or the whole — into one tube, and run those, and then isolate that household, and eventually get back to them and figure out who is the test-positive case.

But it is really critical in these kind of community spreads, where so much of it is asymptomatic. I know we say 40 to 50 percent, but that doesn't really represent the true part behind that. Under-30, it may be as high as 80 percent are asymptomatic. It is very difficult to contact trace 80 percent asymptomatic (inaudible).

Contact tracing was built on someone presenting with symptoms who you then diagnose. I think with your 18 percent — and you could do this parish by parish — you still have room to potentially pool 1 to 2 at your major laboratories, and that would free up about 30 percent test capacity every single day, which would allow you then to decrease those turnaround times.

So the reason we are really pushing the pooling piece because, even at 18 percent, you can combine, in the laboratory, a couple of specimens. Now, no one likes to do that, because they have to go back and rerun probably about a third of them. But, you know, it decreases your turnaround time into a way that I think is really critical at this moment and this time, and they can go out of pooling.

I think still our universities are not on board with helping us. And I know you described them supporting somewhat. The university capacity is amazing. It probably is equal to your entire healthcare capacity — the amount of instruments that they have that they could turn on and use, particularly if you can get them to agree to use Thermo Fisher's and Thermo Fisher platform because there is amazing reserve tests at Thermo Fisher, but you have to do almost what we call "manual extraction," so a lot of people don't like to do it.

But your laboratory technicians and your research universities do this every day for a living, so getting them back to school, making them essential workers, and getting them helping you move through these backlogs and getting into these household testing, we think, would be critically important. We also think it's important for them to learn how to do it, because it's your way to get your universities open and have them routinely screening dormitories, and the residence in the universities.

GOVERNOR EDWARDS: You're going to hear a lot more about a plan that we have in partnership with LSU and Southern University here in Baton Rouge to really put together the testing protocol to reopen safely and using — using everything that the university has —

DR. BIRX: Yes.

GOVERNOR EDWARDS: — because LSU is a (inaudible).

DR. BIRX: And it's a perfect opportunity for them to test it now with the community so they'll be ready when all those students come back so they can start cranking out those extra, you know, 100,000. You're just on the heels of catching New York in testing per — per resident.

PARTICIPANT: Why are universities reluctant?

DR. BIRX: Because they went home and sheltered in place. So I would say about 80 percent of your professors and laboratory technicians at the university level are at home.

PARTICIPANT: Dr. Birx (inaudible) because my wife has a public charter school which is currently doing pool testing, and LSU and academic labs are doing it for them.

DR. BIRX: Yes.

PARTICIPANT: It's actually a more — because those docs have been doing this for (inaudible) and others. You have to pay overtime. You don't have the ability to expand your number of staff. And if you reflex a full specimen to a rerun, you'd have to pay them overtime going into the next day.

So there's a real kind of practical — there's one woman who has got to get home to a kid, and she's the one doing the manual extraction.

And, Governor, can I just —

GOVERNOR EDWARDS: Yes, sir. Please.

AIDE: Excuse me, Mr. Vice President, we got to stay on schedule, so we need to wrap up in the next minute or two.

THE VICE PRESIDENT: Okay. Go ahead, Doc.

SENATOR CASSIDY: Real quickly, on the — as Dr. Giroir has pointed out, there's going to be a stretch for the capacity that we have, so in talking to some of my congressional colleagues about interstate contacts — I'd love to share that with you — and ways to get around the billing problem, because there is a (inaudible).

And one more thing, which is purely parochial, is that in the Farmers to Families Program, in which perishables are allowed, shrimp farmers — shrimp is not allowed to be one of the perishables. It's about the same unit price as pork, but shrimp is not allowed and our guys are having so much trouble. But our households would love to have shrimp instead of Midwestern pork. (Laughter.)

So, just a kind of parochial issue that would bring a lot of alleviation of hardship to (inaudible).

THE VICE PRESIDENT: I like it. Tucker, you got that for the task force tomorrow? The Secretary of Agriculture will be there. I'll bring it up. I'll drop your name.

SENATOR CASSIDY: Sounds great.

THE VICE PRESIDENT: I will. It's a great comment, Bill.

DR. PHILLIPS: (Inaudible) a pork tenderloin from Indiana. (Laughter.)

THE VICE PRESIDENT: I think we're going to go — everybody is welcome, of course — I think we're going to go over to LSU and talk a little bit about opening our schools up.

Governor, thanks for your commitment to that. We really — one of the things Deb did not say, but I think she's going to be with here with your team and break it down — we really believe that there's real evidence that, with some mitigation steps, we can keep opening and that we can open these schools. And she's actually got some modelings she'll share with your team that may give the public some real confidence about the steps that you're taking and that — that, at this point, we don't believe is necessary for states across the Sun Belt being impacted to go farther. We don't want to go back. None of us — nobody wants to go back to lockdowns or any of that.

She's actually got some very useful modeling that shows that with — you know, with the hygiene, with the masking, with the congregate settings, the things that you're doing — that we can flatten the curve just about as much as we can flatten the curve by going all in. And she was briefing us about that recently.

So I just want to encourage you all with what you're doing here. And we'll go back with the specific asks and we'll get through this. I mean, it's — Louisiana really is unique. Courtney, I'm glad you made that comment. I may reflect on it a little bit a couple times today.

I mean, Louisiana is the one state that can actually say, "We already did this once." And I just have to think that gives your people a lot of confidence in the team here in Louisiana, and in the capability of the people of this state to respond.

And we'll just make sure you have what you need. We'll go after Title 32, the reagent issue. I know Brett and I were talking over this weekend on a — some one-offs. I did one of these meetings in Florida, and we had the same kind of request. But —

ADMIRAL GIROIR: We're going to talk about what we're doing for nursing homes at the press conference.

THE VICE PRESIDENT: We will.

ADMIRAL GIROIR: It's going to solve about four of your problems.

DR. BIRX: We're not (inaudible).

THE VICE PRESIDENT: Yeah. It's a very big deal. And we told the governors yesterday, but they never talk to anybody in the press, so — (laughter). We're going to announce it.

So, Governor, thank you.

GOVERNOR EDWARDS: Thank you so much. Great to have you. And you're headed now to the home of the national champion LSU Fighting Tigers. (Laughter.)

THE VICE PRESIDENT: That, we knew. (Laughter.) Thanks, everybody. Great reports.