Here & Now

Here & Now for March 20, 2020

Announcer:

The following program is a PBS Wisconsin original production.

Frederica Freyberg:

I’m Frederica Freyberg. Tonight on “Here & Now,” on the front lines, Governor Tony Evers is here with the latest about what’s happening in Wisconsin as COVID-19 cases continue to rise. Then we’ll get medical answers from State Epidemiologist Dr. Ryan Westergaard. It’s “Here & Now” for March 20.

Announcer:

Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.

Frederica Freyberg:

Tonight, the latest COVID-19 numbers. 206 cases have been confirmed in the state with three deaths. There is community spread in the counties of Milwaukee, Dane, Brown, Kenosha, and Columbia. Many of you had questions you wanted to ask our guests tonight and we incorporate them. In a reduced studio footprint to limit staff and also not bring guests into our space, we are joined now, via skype, by Governor Tony Evers. Governor, we want to thank you very much for joining us.

Tony Evers:

Thank you, Frederica.

Frederica Freyberg:

First, what message would you like to give the people of Wisconsin tonight?

Tony Evers:

Great question. First of all, as I’m sure most of your viewers know, we’ve lost three Wisconsinites to the COVID-19 virus. And our thoughts and prayers are obviously with that family, and their friends and relatives. It’s a tragedy. It’s a public health tragedy, a tragedy nonetheless. And the other thing I want people to know is that our healthcare workers, whether it’s emergency responders, people that work in hospitals and the clinics and so on really need our support now. They are working 24/7, and under really difficult circumstances. And what we can do as Wisconsinites is obviously pull together. And I feel confident about the resilience of Wisconsinites, but we’re encouraging people to stay at home. The way we will conquer this virus is to make sure that we are not infecting each other. And one of the ways we can do that is obviously around social distancing, but there’s enough requirements around that we’ve done through executive order. Frankly there’s not much more people can do than stay at home. So stay at home. Be safe, keep that distance, and we can beat this, but we have to have — this is something the people of Wisconsin can solve. Obviously we’re trying to support our healthcare workers as much as possible, but if we do the things that we know we have to do: hygiene, making sure that we don’t interact with people that are sick, that if we’re sick, we connect with our doctors, all those things are common sense things that if we do this, we can solve this problem.

Frederica Freyberg:

Other places as you know have gone to more kind of extreme shelter in place orders where everyone stays inside, although you say that mostly we’re staying inside, but what would be the tipping point for you to declare that kind of social distancing?

Tony Evers:

It would be difficult for me to get to that point. I think we have enough constraints on people’s lives already that I think — I believe what we have in place will work. I understand other places have different needs, but Wisconsinites are people that care about each other. We’re good neighbors. We understand that we have an obligation to each other. So it would be — I have great — I would have great problems doing the shelter in place. Obviously if we’re directed to do it, I’ll follow those directions, but for me, I think we have the adequate pieces in place.

Frederica Freyberg:

You added some kind of new clarifying rules around closures, and released them today. What are those?

Tony Evers:

Primarily they’re around beauty salons, barbers, tattoo — places where you get tattoos. We believe that those cannot remain open. And so we’ve banned — those places will be closing as of this afternoon.

Frederica Freyberg:

How concerned are you that people still on the job can maintain services for the rest of us? Healthcare workers, of course, but grocery clerks or pharmacists?

Tony Evers:

Yeah, it’s all going to be difficult. Again, we’ve looked at every possible supply chain that exists. We’re leaving it open for manufacturers to continue doing their good work and we’re being as supportive as we can to make sure those supply chains be in place. But you know, we’re operating under 3.5 or 3% unemployment rate, so there’s not many spare people around. And so we always are concerned about that. But I think the pieces are in place where our food chain is great in the state of Wisconsin. We know that for a fact. So we’re continually interacting with all those business– food supply chains to make sure that we can live.

Frederica Freyberg:

You said today that the state needs to take legislative action and that you are working with legislative leaders to develop a package. What do you want to see in that, and when might it come?

Tony Evers:

Well, I can address the second one most specifically. The meetings we’ve had thus far just discussing general places where we have agreement. This is clearly, clearly, I think everybody that we’ve been talking to understand that this is a bipartisan time, actually non-partisan time. So I’m not at liberty to talk about the issues that we’re looking at, but there are really important issues to make sure that the state has the flexibility to react to this crisis. I believe at the end of the day, we’ll find some common ground and we’ll be bringing legislation forward for the legislature to consider.

Frederica Freyberg:

What’s being done now for hourly workers who under current orders have lost their jobs and businesses that have shut down?

Tony Evers:

Yeah, exactly. Our Department of Workforce Development has ramped up their unemployment insurance issue. We’ve had obviously a big spike in that. Through executive orders, we’ve relieved some of the constraints we have around that. So we have now that 99% of the people can actually apply for unemployment compensation insurance online. We’ve beefed up the folks that are answering those questions, so I think that’s in a good place. On the business side, we’ve tasked our Wisconsin Economic Development Corporation to really focus on small businesses, focus on finding resources to make sure that our small businesses, our main street merchants are not harmed irreparably. So that’s Missy Hughes, undersecretary in that area, that is her task and she’s already reached out to those communities. I personally have met with business owners and others across the state to find out what those needs are, but clearly it’s financial, you know, our restaurants and bars, and if you think about it, we have a strong manufacturing climate in the state of Wisconsin, but most of our employees in the state are — work in the service industry, which is really struggling now. So we’re going to be working on that.

Frederica Freyberg:

We got word that a prison employee tested positive for COVID-19 at Waupun. Several viewers wanted to know what actions the state is taking to prevent the spread inside these kind of already overcrowded institutions.

Tony Evers:

Yeah, absolutely. And we’ve had things in place now for some weeks in preparation of this, to make sure that the people that were responsible for those institutions are safe and things are working well. And we’re continuing to provide food and free phone calls and things like that, but yes, there was an individual in one of our correctional institutions who tested positive. We’re now in the process of working through that to see which employees were exposed to that and getting them the care they need and to find out how close it is to the prison population. We don’t — I don’t have that information at this time, but we feel it’s a good place where it’s contained.

Frederica Freyberg:

A viewer asked this question as well: if hospitals get overwhelmed, have you considered retrofitting large spaces like county expo centers as kind of field hospitals?

Tony Evers:

We’re running through every possible scenario. Lots of people working on it. Lots of good people from our universities and others that are helping us out in each type of scenario. Absolutely, dormitories might be used for quarantines, and we have the ability through various mechanisms to actually create more beds if we need to. So do we feel that we’re absolutely on top of this? No, but we’re in a position now where we feel comfortable that if we have this surge, if it is more people being hospitalized and more people needing quarantines, that we’ll be in a good place. In addition to that, we’re also concerned about our homeless populations across the state because they’re struggling to begin with. And so I’ve been working with mayors to make sure that they understand and obviously they do or they wouldn’t be [unintelligible] that we’re looking for places for homeless people, especially those that are struggling with healthcare issues.

Frederica Freyberg:

As you know, there are great concerns about Wisconsin’s upcoming election on April 7. Election clerks that we have talked to are already overwhelmed with these absentee ballots and worry about election day itself. What if they get sick or their staff? What should happen? Would you favor delaying this election?

Tony Evers:

No, I wouldn’t. And first of all, I’m not in the position to delay it. That’s something that would have to have the leg– happen legislatively. But the fact of the matter is, this primary election is primarily a general election. General election, the only primary is the presidential one. The rest are local and county races that need to be decided or positions that are making important decisions around what we’re talking about, there won’t be people in them. So, A) it makes no sense to cancel it. I understand the difficulty of it but democracy has to go on. And then the second piece is, frankly, if we moved it a month, if we moved it two months, there is absolutely no guarantee that it wouldn’t be as complex as it is now. So our message is quite simple. If you want to do this, you’re not willing to go to the polls, myvote.wisconsin.gov, you can have an absentee ballot sent to you. You put it in the mail and send it in. We hope that the vast majority of people will do that. I’m working with the mayors across the state to make sure that we get the poll workers in place and it won’t be easy. I’m not saying that at all, but we need to get this election in in order to let democracy continue, and local governments and county governments work a good way.

Frederica Freyberg:

What do you need most now from the federal government?

Tony Evers:

We need — well, the good news is that one of the best things I think the federal administration did is they’ve kind of passed the baton for things that we need to the emergency management people at the federal area. So instead of every day wondering what’s going to be done at a press conference in Washington, D.C. and responding to that, we actually have people in their regional and local areas that we can get help. We’ve already got some — very good news. We’re getting some more respirators. We’re getting some more masks, in the hundreds of thousands of masks. All those things are good. It’s not enough. We need more, and we’re working with local people in the state of Wisconsin to get that to happen locally, but the federal government really needs to step up in the area of protection equipment and make sure that we have all the testing materials that we need.

Frederica Freyberg:

And lastly, you’re a former teacher, governor. What do you say to our children?

Tony Evers:

You know, this is a multifaceted crisis that we’re having here. So we have to make sure our kids are safe. That they’re mentally in a good place and we’re answering their questions directly.

Frederica Freyberg:

We leave it there. Governor Tony Evers, thanks very much, and good luck.

Tony Evers:

Thanks a lot, Frederica.

Frederica Freyberg:

For more on COVID-19 in Wisconsin and from “Here & Now,” visit pbswisconsin.org/news.

The virus is coursing through our state’s population, even as we try to slow its spread. We have medical questions now for State Epidemiologist Dr. Ryan Westergaard. He also joins us by skype. Dr. Westergaard, thank you very much for joining us.

Ryan Westergaard:

Thank you for inviting me.

Frederica Freyberg:

We knew there would be deaths, as the numbers of people testing positive for COVID-19 continue to rise, but what should we steel for in terms of more?

Ryan Westergaard:

I think the picture is concerning right now because what we’ve seen in the data from both this week in Wisconsin and nationally is that we really seem to be in an acceleration phase of the epidemic. Where we’re seeing the number of cases increase day by day. And with that, we know there’s a subset of people who are going to have severe disease of all the people who get diagnosed. So I think we can expect to see increased numbers of deaths. I think the things we’re doing to mitigate the spread of the virus in community is going to determine how many, but certainly we’re going to see more in the coming weeks.

Frederica Freyberg:

People are, of course, very afraid, and we hear conflicting information, but of the most at-risk population, what should the elderly and those with underlying conditions be doing right now?

Ryan Westergaard:

I think the message for everyone but particularly for people who are medically vulnerable or fragile is to stay home and prevent contact with other people. It’s not the kind of recommendation we like giving people, but at this moment, with a very contagious virus circulating in the community, the best strategy we have to prevent infection is for everyone to stay in place. And also when you are out in public, for doing essential things, to be very vigilant about hand hygiene and sanitizing surfaces. Things that we all know prevent the spread of germs out in public.

Frederica Freyberg:

We now hear that younger people are also very much at risk. Has that messaging changed?

Ryan Westergaard:

Well, it hasn’t changed in that we’ve known from the beginning of the epidemic in China that young people have developed severe illness and some have died. The risk, meaning the percentage of people who have severe illnesses in the under-50 or under-40 age group is quite a bit lower. Here in the U.S., the data that we’ve seen in the past week looking at the first series of hospitalized patients was that the mortality rate for people under age 50 was lower, 1% or less. Where among people in their 80s, it was higher, as 10%. So all people are at risk of becoming infected with the virus. The risk of having severe complications when someone is infected varies quite a bit by age. But I think the risk — the message for everyone is that if no one is immune to this virus. Everyone can be infected and everyone does have some risk of getting quite sick.

Frederica Freyberg:

One viewer asks, I work at a Target store. Should I be taking a shower and changing my clothes as soon as I get home?

Ryan Westergaard:

I don’t think so. I think the most important message is — comes from how we know these respiratory viruses get spread. And that’s through respiratory droplets, so coughs and sneezes but also from touching contaminated services. So people that are in public, the most important thing right now is what we’ve been referring to as social distancing. So keeping at least 6 feet of separation from other people. The other thing that’s very important, and I would say particularly important for viewers who work in public settings, is hand hygiene. So hand washing with hot water, alcohol-based hand sanitizer, the more the better. So those are the really highest impact strategies that everyone should implement if you have to be out in public and working.

Frederica Freyberg:

So is it safe to go to the grocery store or pick up takeout?

Ryan Westergaard:

Yes, I think it’s safe to do that if people pay attention to the infection prevention things that we’re talking about and we’re knowing about. Overall, the restrictions on gathering are really to reduce the probability of getting in contact with the virus [unintelligible] to as low as it possibly can to slow the spread in the communities. But certainly, people need to get their basic needs met. If people need to be out in public, need to get food. So there’s risk of being out in the community when there’s an infectious disease spreading, but we still encourage people to make sure that they’re getting all of their needs met and doing things like getting food and going to the grocery store.

Frederica Freyberg:

Even with hand washing and cleaning and distancing, should we all just assume that most of us will be infected with this?

Ryan Westergaard:

Well, I think the answer to that really depends on how well we execute the types of things that we’re recommending. It’s certainly not a foregone conclusion that most of us will become infected, but the virus is contagious enough that if we did nothing, the possibility of the majority of people would become exposed and infected. But we really believe if we do these activiti– these restrictions on gathering. We focus on hand hygiene during this period of the epidemic where it’s starting to spread in communities, we can keep that as low as possible. So it’s really up to us on how well we heed these lessons and implement some of these processes.

Frederica Freyberg:

Do we have enough ICU beds in Wisconsin?

Ryan Westergaard:

We do. That’s something we’re actively monitoring. We’re in communication here at the Division of Public Health with hospitals around the region to know what their capacity is under normal circumstances and what their surge capacity is. So we have a handle on those numbers and we’re trying to keep it updated in real time. I would say that– whether that becomes — whether we put a strain on those resources, again, really depends on how well we execute these public health interventions.

Frederica Freyberg:

Another viewer asks if ventilators get to the critical supply level, how will it be determined who gets to use one?

Ryan Westergaard:

Again, I’ll say again the most important response to that question is whether we get to that point really depends on how well we control the spread of the virus. And that’s something that’s in our control. We have a finite number of ventilators in the state. They are manufacturing more and there’s also strategies that health systems are doing to free up more [unintelligible] more ventilators. For example, canceling elective surgery in outpatient settings so we have more. So all of what we’re doing when we talk about stopping the spread in the community, it’s all aimed at this health system capacity question. So we don’t have to– we want to avoid having to make those really challenging decisions about who gets a ventilator and who doesn’t. Now that is possible. In some areas of the world have had to come up with that. In those strategies, we really try to focus on doing things that are equitable and transparent and having guidelines that everybody can follow and agree to. Some of the considerations are sort of how much benefit can come from the ventilator use? Meaning people who are highly likely to recover will be offered ventilators. People who have less– are more gravely ill might be given a short term of a ventilator to see if they respond. In some cases we may need to really focus more on palliative care for patients that don’t seem to be responding. So there are decisions that we make all the time in ICU care. And we’ll just have to be very deliberate and very open about it if we get to that. But I think the most important priority is that we’re doing everything we possibly can to preserve our health system capacity to provide ICU-level care to everyone who needs it. Hopefully we’ll be fine in that regard.

Frederica Freyberg:

We know we also have a shortage of protective gear like masks for healthcare workers. One paramedic that we spoke with said if it comes to that, they will use scarves or sheets and cut them up and make masks out of them. How close are we to having to do that?

Ryan Westergaard:

Well, the shortage of that personal protective equipment is really a big concern. We’re encouraging all of our health systems and other partners like pre-hospital care and EMS to take inventory and let us know how many days or weeks supply they have. We just received shipment from the Federal Strategic National Stockpile and have been able to allocate additional supplies to places that need it. And we’re actually prioritizing areas that are really high critically need, like first responders and local EMS. So we’re preparing for this. We’re trying to make the best use of all available resources we have and giving people advice about sort of the best strategies to conserve and make use of these resources wisely, but it’s something that we’re really following closely.

Frederica Freyberg:

Is there more coming from that strategic stockpile?

Ryan Westergaard:

I think that’s still to be determined. The Wisconsin state also has a stockpile of a large number of masks that we’re allocating. So we’re trying to be the best stewards of those resources that we can. At the same time, encouraging other areas of the supply chain and increasing manufacturing to make sure that we have personal protective gear.

Frederica Freyberg:

Now Wisconsin has ramped up its testing but you wrote in a memo this week that only the most critical patients can be tested. Why?

Ryan Westergaard:

Well, the way that we framed it was that we need to prioritize testing for patients for whom it’s most important to know quickly. And that really comes to hospitalized patients. There’s a couple reasons for that. Spreading the virus inside hospitals, both to healthcare workers and other patients, is really one of the most important things we want to try to prevent. So we want to make sure that we know those answers to those questions of who has COVID-19 in the hospital or other healthcare settings as urgently as possible. So if we have to make choices about what tests get done quickly, if we have a longer turnaround time, we need to prioritize those. Now the other reason is that a lot of people with mild symptoms of COVID-19 don’t really require medical care at all. And right now since our recommendation for everyone in the population, whether you have a mild cold or you have influenza, is to stay at home. Recover at home, and protect those around you from potentially becoming infected. Knowing the result of a COVID-19 test isn’t as important for everyone. In fact, from an infection control perspective, the advantage is actually being able to support people remotely. Not have people come in and get tested in a healthcare setting. So it’s another strategy we’re trying to use to preserve healthcare resources. When people who are young have mild illness, even if they have COVID-19, our message is most people are going to be able to recover. Call us if you have concerning symptoms by any means but you don’t necessarily need a test.

Frederica Freyberg:

Excuse me, doctor. With just about a minute left, in a letter to the FDA, Wisconsin’s Congressional delegation described extreme challenges in hospitals across this state in getting reagents and even swabs to conduct the test. How long does Wisconsin have before it runs out of what it needs to complete the testing?

Ryan Westergaard:

We’re in conversation nearly daily with our laboratory partners. We have two public health labs in Wisconsin, in Madison and Milwaukee. An increasing number of clinical labs and hospitals, they have been very open and collaborative in terms of taking inventory on an ongoing basis of how many ingredients or reagents they have to do the tests and are actually sharing, when necessary, to make sure that they have enough supplies. So we are not in a position that we are going to run out and not be able to do the testing that we need right now, but we’re actively looking at that.

Frederica Freyberg:

All right, Dr. Ryan Westergaard, thank you, thank you very much for your time.

Ryan Westergaard:

Thank you.

Frederica Freyberg:

For additional reporting on COVID-19, go to our partner website at WisContext.org. You’ll also find answers to frequently asked questions about the virus.

Finally, Wisconsin’s April 7 election day as of tonight is unchanged. Next Friday at 7:00 p.m., “Here & Now” journalist Zac Schultz will conduct one on one interviews with the candidates for state Supreme Court. Incumbent Justice Daniel Kelly and challenger Dane County Circuit Court Judge Jill Karofsky. That is next Friday, March 27 at 7:00 p.m. Wisconsin Public Radio will simulcast that program. “Here & Now” will follow at 7:30. And that is our program for tonight. I’m Frederica Freyberg. Goodnight.

Announcer:

For more “Here & Now” 2020 election coverage, go to pbs.org and click on news. Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.