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Lee talks about rising hospital rates




Lee Oct 28Jason Reynolds

Lee Oct 28Jason Reynolds

This is a summary of a press conference held by Gov. Bill Lee on Oct. 28. Officials discussed the increasing hospitalization rate in Tennessee as well as unemployment.

Lee comments:

Our hearts go out to the people of Meigs County over the bus crash. Maria and I are praying for people. Education Commissioner Penny Schwinn is in Decatur.

Blood donations are needed in Meigs County. Blood Assurance has centers in Cleveland and Chattanooga.

Maria and I completed our 14-day quarantine. We did not test negative. Our security team wore masks around us, so that is why we did not get the virus.

Dr. Wendy Long of the Tennessee Hospital Association will make remarks today.

Our case counts are growing as in most states. We had a similar surge in the summer. We went beyond the numbers of that surge.

Due to the surge, many county mayors have set mask mandates and others are considering it. 62 percent of population is under a mask mandate.

Toward the end of the month, I will extend the state of emergency to allow masks to continue and allow federal funding to come to Tennessee and virtual meetings to continue.

Dr. Long:

Tennessee hospitals are appreciative of the level of engagement with the governor. Hospitalizations are increasing at an alarming rate with new records being set every day.

We learned a lot about infection, spread, damage caused by virus, which patients will become more ill and how to treat them.

You may not assume you will be impacted, but the underlying conditions are very common in Tennessee.

COVID patients have twice the hospital stay than other patients.

The spike in cases, combined with an increase in the average age of patients, creates an environment where families have a serious ill loved one on life support that they cannot visit and who may not survive.

We can turn this around. We did it before. Earlier this year, when cases and hospitalizations in June and July spiked, we buckled down and masked up and saw a 53 percent drop in cases over six-week period. We need to do it again and we need to sustain it.

Your hospitals are willing to do their part. Workers will put their health on the line. We need the public to do your part in keeping the numbers at a level we can manage.

There are limits to how much we can increase the capacity, including when staff become sick. If the system becomes overwhelmed, it will affect our ability to respond to other illnesses.

If the increase in hospitalizations in flu season were layered on this current surge for COVID, we would have statewide capacity issues. Our message is simple: Wear a mask you in public, get your flu shot.

Lee:

We are providing testing. We are once again increasing the capacity. Besides the free testing at the health departments, we are doing pop-up testing centers over the weekends in rural counties. That will continue this weekend.

Unemployment: Federal benefits end by the end of the year.

Jeff McCord, Department of Labor and Workforce Development:

After the CARES Act, there has been no movement on extra federal benefits. The $600 benefit ended near the end of July. There are two other programs. One is pandemic unemployment assistance; it covers people who would not be eligible by the state such as 1099 workers. That lasts 39 weeks but ends on Dec. 26. A second program is pandemic emergency unemployment compensation; it extends state benefits by 13 weeks. That ends on Dec. 26. This is all subject to change.

The best strategy is to return to work. There are employers looking to hire.

Dr. Lisa Piercey, Health Department:

We do well at logistics. We are working to deliver a vaccine once it is available.

The rapid tests: We got several hundred-thousand and are giving to nursing homes, black colleges and other institutions. It will take planning.

I don’t want you to think the rise is because we are testing more. We do believe this is an increase in transmission. Please take personal responsibility.

Questions:

Q for Long: Tell people how you view the hospital situation.

Long: It is at an all-time high. We are setting records every day. We need people to mask up, to social distance, to wash hands and get a flu shot. Hospitals are doing all they can to increase capacity but there are limits.

Q: Is there federal help?

Long: There has been help. But the limit is staff availability.

Q: On testing, this seems the opposite of what we hear from Washington (more testing means more cases).

Piercey: Our test volume has been stable for several months. Our test numbers have been stable the past few weeks (low to mid-20,000 tests per day). The spread is especially in rural areas.

Q to Lee: What do you say to the unemployed?

Lee: A lot of people have suffered. We invested money in businesses through the federal funding to keep those businesses open.

Q: Isn’t there over $100 million not being used by businesses?

Lee: We are shifting our focus to reach more businesses. A large number of companies were not made aware of that. We are increasing our efforts to reach them.

Q: Couldn’t that money go to unemployment?

Lee: There are unemployment laws for determining benefits. We know of 250,000 open jobs in the state. We need to connect Tennesseans to those jobs. We were at 15 percent but are now at 6.3 percent.

Q: Did you lift business restrictions too soon?

Lee: Lives and livelihoods matter. There is a balance. It’s not choosing one or the other. We believe this is happening in small gatherings in homes. Dr. Birx said businesses have done a good job of masking up. Gatherings are happening among small groups of people; people forget the spread can happen there.

Q You mentioned your staff wear masks. Would you encourage each mayor to mandate masks?

Lee: Mayors should look at case counts and hospitalizations and they should consider it.

Q: You were exposed to covid by a staff member and quarantined for 14 days. Was that to set an example?

Lee: That is the appropriate quarantine time for a person who is exposed.

Q: Vice President Mike Pence was exposed; five staff were exposed. What example is he setting?

Lee: I don’t know the details.

Q: Your strategy…lifted statewide mandate on mask wearing and outsourced it to local mayors. At what point do you say a statewide mandate is needed? District attorneys were getting restive and some mayors revolted and lawsuits…

Lee: There are a lot of approaches to mask wearing. The best thing I can do is remind people it is important to wear masks.

Q: What are the thresholds to active the alternative care sites in Nashville and Memphis and who makes that call?

Lee: It has to do with surge capacity. Staffing is an issue. Hospitals reach a capacity and engage the surge capacity.

Piercey: There is no set trigger. There are many factors. An empty bed with no worker is no good. We have beds and space. We are helping hospitals. We gave a $51 million staffing grant; hospitals can use it for overtime, retain contract agencies for temps, or use for recruiting and incentives. Everyone in the nation is competing for nurses and respiratory therapists. We are looking for ways to help people use their licenses more efficiently.

Q: Who makes the call?

Piercey: Local hospital and municipal leaders, the department and emergency management.

Q: Have there been any changes on the average length of stay?

Long: We do not have much hard data. We think that will increase.

Q: Two commissioners said they will resign. Do you have a timeline to replace them?

Lee: We will start searching as soon as we can.

Q: Will you send the National Guard to poling sites?

Lee: I know of no plans. I can check.

Q: On personal responsibility, you urge that. At what point does that fail?

Lee: Personal responsibility is the only way. We can encourage and remind.

Q: California wanted to use an independent task force to test the quality of the vaccine.

Piercey: That is on the table but not something we have done yet.

Q: How would you combat fears over doing independent verification?

Piercey: We are watching this in other states.

Q: You told people before to move around less. Now people are gathering in small interactions with family and friends. Is there another option? Do we need to stop moving around?

Lee: Americans we know what creates spread and what mitigates the spread. We can put in place an environment to facilitate, but at the end of the day, people will make their own decisions.

Q: Some months ago, there was another bus crash and we talked about seat belts. Do you support that?

Lee: It is tragic. It is early to figure out…we are assessing what happened there. I’m sure that will be brought to the Legislature again.

Q: You made a point about keeping school buildings open. Now we have a high number of school age cases. Should these numbers get worse, will you keep on the table to call for another statewide shutdown of buildings over the winter especially since districts improved online programs.

Lee: Children learn better in person. They have access to many resources like nutrition and mental health. It is hundreds of students out of 700,000 students. Some schools have been open for 12 weeks. We are encouraged by the low number of cases. We went three weeks without a school closure. The numbers are very encouraging.

Q: When schools closed, it has to do with staffing. Many teachers and staff isolating. Should the state provide emergency funding to staff schools and should the state provide hazard pay to teachers who take a risk and to hire more subs?

Lee: Teachers are doing great work. The number of cases among staff has been encouraging. It has allowed us to keep less than 1 percent of buildings. We can protect our teachers; the rapid tests, we are looking at making those available to teachers.

Q: Emergency funding?

Lee: The particular funding and pay occurs at a district level. We are looking to districts to make decisions about critical infrastructure.

Q: Regarding antigen tests, you said schools would be a priority. I heard from districts they do not want the responsibility; they do not have nursing capacity to turn schools into testing sites. Is that still a possibility?

Piercey: We are very sensitive to schools having a high number of jobs beyond teaching. We do not expect them to be clinics. Third-parties could be of help.

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