Cooper lays out new pandemic restrictions for NC
Gov. Roy Cooper and state health and safety officials provide a Dec. 8, 2020, update on the coronavirus outbreak in North Carolina and the state's response to it.
we have had 404,032 cases 4670 new cases reported since yesterday 2373 people in the hospital a new record high and sadly 5 605 people who've died We continue to mourn with those who've lost loved ones I know this can be especially hard during the holiday season as cases across the country continue to rise We've seen rapid increases in our key metrics here in North Carolina Our case counts have broken single day records on three separate days in just the last week and the percent of tests returning positive has increased to more than 10% A month ago we were deeply concerned to see daily case counts go above 3000 Now we're shocked that the number has doubled with some daily counts at more than 6000 The county alert system shows a large increase in orange and red counties the most concerning designation signifying substantial and critical spread respectively Dr Mandy Cohen the secretary of health and human services will talk in a minute about that I know that news of effective and safe vaccines has given us all hope but vaccines aren't here yet We have to act now to save lives safeguard our hospital capacity and preserve our economy Today the state will announce additional action to combat covert 19 But first I'd like to ask Dr Cohen to share an update on our trends and our county alert system Dr Cohen Thank you Governor I'm gonna jump right into the data is a reminder We look at a combination of trend metrics Cove it like syndrome A cases new cases positive tests as a percentage of the total tests and hospitalizations On our first graph we look at people who have come into the emergency department with co vid like symptoms This is our earliest detection mechanism and you can see when looking at that yellow line that trend has increased sharply It is at its highest level since the pandemic began Next we'll look at new cases This first graph shows you the trajectory of new cases each day Since we had our first case back in March And you can see the Yellow Line has a very sharp increase We are also experience our highest daily numbers of reported cases since the start of the pandemic And if we narrow in on this next graph on the trajectory of cases since early October through today you can see a clear picture that our cases air trending up significantly As the governor said we had more than 6000 cases reported in a single day twice in the past week Let's send A month ago on November 11th we had a record day of 3000 cases Now we more than doubled that number on Saturday and then again on Sunday To give some perspective we had more cases in a single day than the entire population of Governor Cooper's hometown of Nashville in Nash County Next we look at the percent of tests that are positive This graph also goes back to the beginning of October and looking at the Yellow Line R percent of tests of pot that are positive has significantly increased over the past 14 days It's been above 10% the last week and again these are our highest rates since early in the pandemic when our testing levels were much much lower On the next graph we look a day over day hospitalizations This graph also starts in early October and you can see looking at that yellow line This trend also continues to increase significantly We're setting records both for the number of people hospitalized with co vid 19 and the number of people in the intensive care units we are seeing increases across the state Hospitals are feeling the strain Okay here's where we are Are surveillance data has increased It gets a Red X North Carolina North Carolina's trajectory of cases is up It gets a Red X North Carolina's trajectory in percent of test returning positive is increasing This also gets a Red X and North Carolina's trajectory of hospitalizations is increasing Hospitals again are feeling the strain and this is worrisome But today we are able to manage capacity right now at this point so for today this still gets a yellow line Now that we've taken a look at our statewide metrics let's see what's happening more locally Given our statewide trend it's no surprise that our county alert map presents a sobering picture And as a reminder we use a combination of three metrics two categories Counties case rates per 100,000 people over 14 days percent of tests that are positive and then a third composite hospital impact score Using these metrics we then categorized counties into three color tears to describe their level of viral spread and healthcare impact Red represents critical orange Substantial yellow Significant Here is the updated county alert map Now almost half of our counties are red In our last report just two weeks ago we had 20 counties in the red We now have 48 counties in the red at critical levels of viral spread In addition there another 34 counties that are now orange with substantial levels of viral spread That means over 80% of counties in North Carolina are red and orange with the remaining 18 and yellow still having significant viral spread If you are in a red or orange county you should limit going out to essential activities You should avoid people that you don't live with On this next slide you can see how quickly things have escalated That first map at the top is from just three weeks ago There is a lot more yellow then and remember yellow still means significant viral spread as you can see from the map on the bottom are state now is mostly red and orange and this paints a dramatic picture of where we are These numbers likely do not yet even reflect the impact of Thanksgiving gatherings I'm very worried This is a global pandemic This virus is highly contagious and dangerous but we can slow it down Do not wait until it is you or your loved one Who is sick with co vid to wear a mask wait 6 ft apart and wash your hands often Do not wait until it's you or your loved one alone in a hospital bed struggling against this virus Do not wait until it's your family that loses someone to Cove in 19 act Now do those three W's now protect yourself your loved ones and your community Right now your actions can keep people from getting sick saving lives and making sure our hospitals can care for people whether it's for a heart attack or a car accident or cove in 19 As you think about the upcoming Christmas and New Year's holiday we have a tough ask Please avoid traveling and gathering this holiday season If you absolutely must it's essential you get tested ahead of time where a mask all the time Keep it small and keep it outdoors This pandemic will not last forever We are so close to having a vaccine The first people in Britain began getting Covad 19 shots yesterday and this week the Food and Drug Administration is reviewing data and we could have vaccine in North Carolina as early as next week For those who care for patients with co vid 19 and those working and living in long term care as supplies increase will reach more people we will get there until then it is up to every North Carolinian to step up and protect each other Thank you Thanks so much Dr Cohen As you can see North Carolina's trends are alarming is Dr Cohen said More than 80% of our counties air in the orange and red categories The virus is upon us with a rapid viciousness like we haven't seen before Even though we're all frustrated and weary of the fight is more important than ever to take this virus seriously So today I'm announcing new action to slow the spread effective Friday December the 11th North Carolina will enter into a modified stay at home order This order will require people to stay at home between the hours of 10 PM and 5 a.m. It means just what it says people are to stay at home between those hours Businesses including restaurants bars entertainment venues personal care businesses and most retail stores and MAWR will be required to close by 10 PM In addition all on site alcohol consumption sales must end by 9 p.m. We already have strong safety protocols and capacity limitations in place including a statewide mask mandate With this additional action beginning Friday we hope to get these numbers down Our new modified stay at home order aims to limit gatherings and get people home where they are safer especially during the holidays It's also a reminder that we must be vigilant the rest of the day wearing a face mask When we're with people we don't live with keeping a safe distance from others and washing our hands a lot And let me be clear we will doom or if our trends do not improve That means additional actions involving indoor restaurant dining entertainment facilities or shopping and retail capacity None of us wants that and in fact all of the's small businesses need substantially more federal help and Congress and the president need to do that Now however our top priority is and must be saving lives and keeping our health care system from being overwhelmed For some people saving lives is more than just a nice idea It's their life's work I want to take a moment to thank our frontline healthcare workers the doctors nurses specialists AIDS technicians custodians and more who are making tremendous sacrifices right now to treat our growing number of covert patients Despite excruciating physical and emotional stress they keep going toe work to care for those who need it Let's all show that we really care for these heroes by doing our part so we can reduce their burden When this pandemic came to North Carolina in March I know many people didn't expect to be living this way in December This year has been tiring and frustrating and painful With the holidays here many of us feel it more deeply but the stakes are dire This is truly a matter of life and death We've lost more than 280,000 Americans in this pandemic and While promising vaccines are so closed they can help us Yet on Lee all of us working together can do that Where a mask even with people you know and trust it helps protect your loved ones and you make your gathering smaller Move it outside Or better yet move it online Stay home when you can and under this order be sure you do so by 10 p.m. North Carolinians are strong and resilient and more than that we look out for each other especially when tough times demanded dig deep and keep tapping into that North Carolina spirit to keep each other safe If we do that I know that we'll get through this and be stronger on the other side Also with me today is Department of Emergency Management Chief of staff Will Ray Commissioner Prisons Todd Ishii and our secretary of the department of Public Safety Eric Hooks Lee Williamson and Brian Tipton our our sign language interpreters and behind the scenes jasmine material and run Vasquez Our our Spanish language interpreter's will now take questions from the media and if you can identify yourself and your organization we would appreciate it We'll take the first question The first question is from Aaron Thomas with W r E l Yeah Hi Governor Cooper This is Aaron Thomas for wre L hope all is Well um had a question particularly about the countdown to the cove It vaccine questions kind of two fold one Our North Carolinians advised to take it And also what's being done to dispel the trust off are the mistrust rather of vaccinations particularly with black and brown communities We are encouraging people to take this vaccine What is is their turn Experts from around the world are examining this data carefully to make sure that these vaccines are safe and effective The preliminary data shows that they are People may have some concerns about it but the risk of getting co vid and what might happen after that is so much greater Vaccines have done so much to protect people from many different diseases And covert is another one that we look forward to getting out in the population and getting it to people as quickly as possible dot Cohen would you like to add anything Okay Next question please Our next question is from Alison Smith with Fox eight Hey governor surrounding basically state has asked local enforcement to ramp up or handle uh people not following with the restrictions that are in place I know In the city of Greensboro they discussed fines They discussed closures but they have said that they want compliance They don't wanna have to do closures or we have heard from people We have seen pictures of people clearly not complying So I guess as we see these hospitalizations go up as we see the cases up when is enough enough And when do we really crack down and say If you are not following along and not doing what you're supposed Thio there are going to be repercussions Well first a lot of people are complying with these orders and are acting responsibly You always have those who do not and some of those do it flagrantly We are encouraging local governments to use their personnel and to pass ordinances that would allow for finds in and other restrictions if businesses and people continue to disobey the rules It's so important for us to come together on this way aren't putting these orders out there in order to get anybody in trouble We're putting them out there to save lives And people need to realize that these things are scientifically proven to help slow the spread of the virus and we need to get it done We're looking forward to continuing to work with our local partners Are Department of Health and Human Services has stepped up to take action Our ABC boards is uh law enforcement has stepped up to take action and we need to continue to do that to make sure that people comply Next question please Our next question is from Laura Lee with Carolina Public Press Good afternoon Governor Barley from Carolina Public Press Um as it pertains to the vaccine we saw a report yesterday of 11 hospitals that would initially received that this is a vaccine and I'm wondering how and when other health care providers particularly doesn't rural areas will receive the vaccine and also there have been reported reports of shortages Um the White House's disputed those reports but there have been reports of shortages and I'm wondering if you anticipate the North Carolina will be affected side that reported shortage We have worked very hard to put what I believe will be an effective vaccine distribution plan in place And people are gonna be working hard to get the vaccines to people uh in order of the prioritization as quickly as possible But I'll let Dr Cohen address those other issues in the question Hi Laura As far as the 11 hospitals we do have 11 sites that are going to be our early ship sites Those were 11 sites that had the capacity to do the kind of storage with ultra cold freezers that we needed for the initial Pfizer vaccine So we had 11 sites They're gonna get shipped that vaccine and then hold it Hold it until the FDA authorizes it And the C D C S advisory committee says gives us the okay within 24 to 48 hours we believe we will get the vaccine directly ship from the federal government and Pfizer to about 50 or 60 of our hospitals so 11 will have it pre positioned But the rest of those 50 or 60 hospitals will get it As soon as we get that okay from the federal government than the federal government and Pfizer We'll ship it directly to those 50 somewhat hospitals as You know we have more than 100 hospitals here in North Carolina so we know that first week of shipment will not even touch All of our hospitals were working with those 56 60 hospitals to make sure they're ready on day one when they when they do get the vaccine to start the vaccination process We've been training on our IT systems making sure that they are getting all their processes in place and know how to store and and to do the vaccinations themselves Eso we are getting ready and planning but the supplies are limited at first Um and so we are going to work with the allocations that the federal government gives us We hope by the second week we may even have to different types of vaccine Both the Pfizer and the Madonna vaccine here in North Carolina Bye week to that will certainly increase our supply but again still going to be limited So right at first it's really going to be just to our hospitals for health care workers who are working directly with co vid patients either clinical staff or the cleaning and environmental staff who worked directly with covert patients or in co vid units We're also going to be working with Walgreens and CVS to begin vaccinations in all of our long term care facilities both the residents and the staff So those will be the first folks Because again Laura's you mention your question There is going to be a limited supply at first And so that is where the vaccine will go as we start Thank you Right Next question Please way Have a follow up Loralee Carolina Public Press Thank you for that I'm just wondering We've seen in other states freezer use and storage facilities Um uh institutions outside of hospitals So for example Smithfield and we've seen in North Carolina freezer space use universities I'm just wondering if there um is the possibility Or maybe even the plan of using freezer space in a non hospital settings to keep these vaccines cold Laura Thanks for that question So the company Pfizer that has um manufactured this vaccine has also created the ability for us toe have dry ice in order to keep those vaccines that the proper storage temperature eso we believe with e cold storage that we have now as well as the dry ice available through the Pfizer process that we will have the type of ultra cold storage Um certainly we are looking at other places if we might need to tap into them But because the supplies are limited at first and we are targeting it to our health care settings we went to make sure that we could have our health care settings be the ones that are receiving that Those first vaccines that require that ultra cold storage Thanks Next question please Our next question is from Dawn Bond with the News and Observer I don't bond with the news and observer I wanna ask about the time frame of the curfew from 10 to 7 Is there e You know what happens in that time period that leans meets the viral spread Is it more about alcohol Consumption is a factor in those businesses and then with this order reading it through really quickly goes until January 8th which I guess is four weeks How does our vaccine distribution timeline factor into the restrictions Timeline I think I think it's pretty clear that the later in the evening you go the larger some of these gatherings can be At some of these businesses people become mawr uninhibited and people get closer together and can be uh Mawr opportunities to spread the virus And what we're trying to do is to chip away at those times to slow the spread of the virus by trying to avoid these indoor gatherings that we see And this uh stay at home order after 10 tells people they just really need to go home They don't need to be gathering in other people's homes They don't need to be gathering at other places or any of these uh retail establishments need to be home because they're safer at home and you're slowing down the spread of the virus This doesn't mean that you shouldn't be careful Uh from 5 a.m. to 10 p.m. At night during the day You need to be careful during the day You need to wear the mask and keep social distancing and we have the mask mandate that's in place all of the time and we have gathering limits and capacity protocols for all of these retail establishments and we want employers in our construction and manufacturing to do the things they need to do to protect their employees there So it's happening all the time But this this attempt this modified stay at home order is to try to cut out some of those times and to send a signal to everybody how important it is to not be it these gatherings and to protect yourself when you're around other people who you don't live with Next question please Do you have a follow up Don Von is an observer Thanks for a follow up Um yeah about the vaccine timeline And if we have maybe a certain number of people you know beyond that first wave or two that are vaccinated that will change with the restrictions are and then you just mentioned private gatherings A Zafar people going home Is this gonna still just be up to the local law enforcement to enforce Uh it's up to local law enforcement but a number of local governments are adopting ordinances and they have other employees that they can use to infer force those ordinances And we are encouraging that Like I say we're not instituting these orders to get people in trouble We're trying to provide these important guidelines to tell people what they need to do in order to slow the spread of this virus is which what we've got to do As for the vaccines were not looking at them having a major effect on viral spread in the near future Here we're only gonna have a few doses at the beginning And I might let Dr Cohen address that Thank you Governor That's exactly right And I want to remind folks that with both vaccines that are under review by the Food and Drug Administration they require two doses So even when we say we're getting a first dose of 85,000 doses and we move into a second week um it's not going to be until 21 or 28 days later That's that First folks get their second dose So we have ah lot of work ahead of us to make sure that folks get not just one but two vaccines before they are um protected from the from cove It s o that does not impact our timelines at this point in terms of thinking about restrictions but we certainly want everyone Thio make sure that they're thinking about wearing a mask waiting 6 ft apart and washing their hands all the time no matter what time of day it is Thanks Next question please Our next question is from Amber Lake with W i t n Hi Governor This is Amber Lake with W I p m News in Greenville Um my question is a lot of people look at the hospitalizations and the available beds as the figure to be concerned about But just last night Vital Health CEO here in Greenville pointed out that it's the employees as well that we need to go be concerned with that The virus is sidelining so many and basically just saying that the employees air tired Can you comment on that It's one of the reasons I wanted Thio lift up healthcare workers and my comments today because many of them are tired and frustrated because they are on the front line and when they see people who would violate the rules and who don't seem to care about this virus being transmitted from one person to the other that frustrates them as well So I'm encouraging everybody for us to pull together not only to slow the spread of this virus but to help out the health care workers who are on the front line And when you talk about bed capacity it is just as much if not Mawr making sure that hospitals have the personnel to take care of the people They may have additional bed capacity that they may not be able to put patients there because they may not have enough workers available to do it So hospitals Right now we'll say that Dr Cohen and the team Andi I frequently talked to hospital CEOs across North Carolina keeping in constant contact with them They're making hard decisions right now about whether they surge whether they start cutting back on procedures that are not emergency procedures and their elected procedures And they are making those hard decisions to make sure that they have the capacity both in the bed space and with personnel to deal with increased cases Because we know we're continuing to see and increasing the viral spread And that's why this executive order is important And that's why I am urging North Carolinians Thio to pull together on this and to try to help these health care workers and to try to slow the spread of this virus Would you want to add anything to that dock Okay Next question please Our next question is from Marino Boil with wbtv Good afternoon Governor This is Maureen O Boyle from WBTV We were talking about the vaccine coming The first wave Ah question some people are asking is people who have already tested positive for covert 19 Should they be anticipating that they too should be getting the vaccine or what should they just say I'm going to be at the end of the line What will it be A will People who've had covert 19 be encouraged as well to get the vaccine Well first I don't think we know for sure yet the kind of immunity that someone has after they have had covered 19 and how long that immunity would last But I'm gonna ask Dr Cohen to specifically address your question about vaccine Hi Maureen Great question The governor was exactly right Is that we don't yet have all of that information We're going to see how the FDA their external advisory board as well as the C D C s advisory board how they make their final assessment of the data and how they're going to make recommendations for those who have already had cove it So stay tuned We will certainly be digging into that It may be something that they aren't able Thio make a judgment on at this at this point But we hope that they will continue to look at the data again Some of these trials continue to go on so they can collect more data So we can better understand how folks who have had cove it need to interact with with a vaccine or not My assumption is that we're going to be asking everyone to get a vaccine whether or not you had cove it Um But again we're gonna wait for that final word from the FDA as well as the CDC advisory bodies Thank you Thank you Next question Way Have a follow up Marino Boil Wbtv Dr Cohen if I could ask you please could you speak to those people Were seeing the age groups of 20 thio early fifties to be that the largest group of people who are testing positive Can you speak to those people specifically about their role in um being in places where we're seeing community spread What do you want to say directly to those people out there who don't seem to be following social distancing gathering capacity numbers And they are being a part of this community spread Yeah Maureen thanks for that question Really important that we have to understand We're all in this together No matter our age no matter where we live in this state or in this country um we all impact each other Let me give you a very concrete example Someone who's 32 may feel like they don't They don't have their not at high risk but they're good friend works at a long term care uh center They work at a nursing home and they're they're gathering together and then maybe they they don't feel like they have a risk But then they have passed it on to their friend who also feels well goes into work and unfortunately spreads that virus to some of our most medically frail in a nursing home Right That's how this virus works right You can spread it when you don't know you have it And even if you are at lower risk for severe disease you can give it to someone who then comes into contact with someone who has has who could have severe disease So unfortunately this virus doesn't show its head when we need it to You can spread this virus when you don't know you have it Which is exactly why we talk about masks masks masks mass prevent you from spreading the virus toe others who can give it to the Then again anyone they come into contact with who could unfortunately get sick and die And what we're seeing in our numbers that we've shared over and over today is that MAWR and more people are going into the hospital They're going to the hospital very ill and unfortunately because we are trying to keep this virus level low there alone in those hospital beds are frontline healthcare Workers are with them day in and day out caring for these folks Andi that's who we're doing this for To make sure it's not your loved one alone in a hospital bed We need to act right now Thanks Next question please Our next question is from Andrea Blanchard with ABC 11 Hi Governor It's Andrea Blandford with ABC 11 You've said multiple times over the last few weeks that it is the informal social gatherings among families and communities leading to the viral spread in the clusters s So how well closing a restaurant or business earlier Stop these in home gatherings especially during the day on How do you keep people from getting together Thank you Well the informal gatherings or not the only place that spreading of the virus occurs It's whenever people are together uh indoors particularly as the weather gets colder in places where they gather uh places like restaurants where you have to take off your mask Thio eat those air places where the virus can be spread One of the reasons why we're entering this modified stay at home order is because we don't want people to go over and visit or gather together outside of their homes or in another person's home during this time because we are seeing more viral spread And this is just sending a message to the people of North Carolina that we have to be more careful We have to do mawr to help those frontline healthcare workers to prevent more people from dying alone in a hospital bed in order to be able to slow the spread of this virus Next question Please come in Our next question is from Michael Highland's with CBS 17 Hi Governor This is Michael Highland from CBS 17 uh awareness regarding the curfew in other states that have tried this already Is there any clear evidence to show that this is indeed effective And might this have the unintended impact of driving people into homes when other places will be closed We've seen this work in Massachusetts in Ohio with some success It's hard to measure at this point because we're right in the middle of all of us This and a lot of other factors are coming into play But whenever you reduced the times that people are together indoors you are making a difference And I think you know a lot of people want to do the right thing I think most North Carolinians want to do the right thing And if we're saying it's really important for you to be home after 10 and you not to be gathering in other places I think a lot of North Carolinians will do that It's one of the reasons we wanted to get this out there today we have other things that we can do We have mawr tools that we can use to to fight the spread of this virus But we think right now if we do this and people our abide by it then it will make a positive difference Next question please You will follow up Michael Highland's CBS 17 Hi This may be a question for Dr Cohen but with the numbers we saw over the weekend where we had more than 6000 new cases reported each day are we able to attribute that to Thanksgiving yet before seeing numbers At that point you're saying we're still not seeing the full impact of gatherings from Thanksgiving How much higher are you anticipating The case is going in the next week or two What they will tell you is we're just beginning to see the Thanksgiving impact but I'll let Dr Cohen address that more specifically Yes thanks Michael When I consulted with our epidemiology team they were um unfortunately sharing that we yet have have yet to see the impact fully of Thanksgiving gatherings because if you think about it if someone went to Thanksgiving they were feeling pretty well because hopefully if they were feeling sick they would have stayed home thes air folks that went to Thanksgiving We're feeling well but then came down with with Cove it in the next number of days and they were likely the ones that may have spread it to other family or friends over Thanksgiving So what we saw last week in our numbers I think was likely those who went to Thanksgiving already sick So what I expect to see this week is people who now are going to be coming back co vid positive because they were with those who are unfortunately sick of Thanksgiving So um I do expect our numbers to go up over the course of this week It's exactly why we are taking the actions we are today We need to work exceptionally hard to get our numbers back down Having 6000 new cases in one day is really really worrisome and we have a lot of work to do and I think the actions the governor is taking today is exactly what we need at this moment to try to slow the spread of this virus Um and so we all need to work together on that Next question please Our next question is from Brian Anderson with the Associated Press Hi Governor Hi Dr Colin Brian Anderson here with the AP Thanks for the question I was just curious I'm looking through the language of the order Are any business is entirely shut down or any capacity limits reduced And also can you just sort of explain whether uh target in Walmart which close at 11 but do have groceries available are gonna be allowed toe stay open past 10 or whether the 10 p.m. deadlines and post on them as well None of the capacity limits have been reduced Most retail establishments will have to close a 10 unless you are selling groceries food pharmacy or fuel There is moving back of the time for alcohol sales last on site consumption Alcohol sales have to be at 9 p.m. And no other businesses is This does not affect construction and manufacturing If they happen to have a third shift people can still go to and from work during this period of time Next question please Our next question is from Alex Shabaab with wcnc Governor and Dr Cohen Uh there were some positive developments with the Pfizer vaccine today about its efficacy and safety and just curious if you governor and you Health Secretary Cohen um have any plans to take the vaccine and if so when uh I plan to roll up my sleeve and take this vaccine as soon it is my turn you can go to the DHHS website and see the plan We're doing frontline healthcare workers first and then long term care facilities and then people with two or more chronic conditions Uh there is uh schematic of how we're doing it But I encourage people to do it And as soon as it's my turn I will roll up my sleeve and do it And I know that Dr Cohen will as well Next question please Our final question today is from Will Michael's with W u N C My governor Will Michael's W U N C You touched on this a bit but I wanted to talk about a report out today from researchers at Duke and UNC saying that while there are regional differences that as a state hospitals air about six weeks away from being a capacity if the current trends continue um hospitals have said they're ready to take action if necessary like limiting elective procedures But at the state level Uh what red flags are you looking for And at what point would you implement stricter measures to prevent hospitals from reaching capacity I appreciate that And we're grateful for this report from Duke and UNC and we've been getting information from this group all along very early in the pandemic and now lately And so I have looked at that Dr Cohen and the team has looked at that One of the reasons why we are taking action today because we know that hospital capacity is threatened here and we can do things to prevent that The study I think showed what would happen if we aren't doing anything else And so we are doing That's something else today to try to affect this trajectory E think it's really important for us to continue to work with our hospitals so that they can have the beds that are necessary the I C U beds the ventilators and the staff to do the job Next question please Okay Thanks We appreciate all of you being with us today This order takes effect Friday Uh please do everything you can to keep you and your family and your friends and others you contact and contact with safe Thank you