> GOVERNOR HOGAN: Good afternoon. Joining me from the Maryland Department of Health is Deputy Secretary for Public Health Jinlene Chan, along with the Executive Director of the Maryland Institute for Emergency Medical Services Systems Dr. Ted Delbridge. We’re here to provide an update on our ongoing statewide public health response to COVID-19 and the delta variant.
I want to begin by thanking the millions of Marylanders who have rolled up their sleeves and gotten vaccinated. Earlier this week, the nation finally hit President Biden’s July 4th goal of getting 70 percent of adults vaccinated. Here in Maryland, through our no arm left behind effort, we achieved that milestone back in May. In fact, we’re already heading towards 80 percent with 77.9 percent of adults now vaccinated. And we vaccinated 93.4 percent of all Maryland seniors.
While most states have seen their vaccination rates drop off over the past several weeks, Maryland has continued to sustain a daily rate of more than 11,000 shots per day. As a result, we continue to have some of the best health metrics and one of the strongest recoveries in the nation. Maryland is much better prepared than most states to withstand the very significant summer surge of the delta variant, which the other states with low vaccination rates are now experiencing.
Right now, just three states, Florida, Texas, and Louisiana, account for 1/3 of all the new cases in the country. They are seeing their highest number of cases per day, and their highest hospitalization levels of the entire pandemic. The delta variant is spreading like wildfire in areas with lower vaccination rates. In Maryland, our very high vaccination rates is helping us contain our numbers. These are actually some of the darkest days in the pandemic, while fortunately in Maryland, our hospitalizations are down 83 percent from their peak and deaths are down 94 percent from their peak.
We have one of the lowest case rates and the lowest positivity rates in the nation. Being one of the most vaccinated states in America, and with our low metrics in comparison to the rest of the country, Marylanders should feel confident about going about our daily lives, keeping businesses open, getting even more people back to work, and getting our kids back to school. We are, however, very concerned about the delta variant and the rate of infections among the unvaccinated. Look, there’s an incredible amount of misinformation, confusion, frustration and fear out there right now.
From day one of this pandemic, I have followed the science, stuck to the facts and the data and have always given it to you straight, and that’s exactly what we will continue to do. So here are the facts as we know them. The delta variant is without question far more serious than the original COVID-19. In fact, it is two to four times more contagious than the original virus or any variant that we previously had to deal with. Through the robust sequencing program that we established in the spring with tests for these variants at a level much higher than the national average, we know that right now the delta variant accounts for nearly 100 percent of the new cases currently being sequenced in Maryland. And it accounts for 93 percent of all the cases nationwide.
We also understand that it may cause more severe illness than the earlier variants. We do need to take the delta variant very seriously. After consulting with our team of public health experts and consistent with our science-driven and database-based approach, today we’re instituting new vaccination requirements for state employees who work in congregate settings, dealing with our most vulnerable citizens. This includes employees in 48 different facilities including healthcare facility at the Maryland Department of Health, and facilities at the Department of Juvenile Services, the Department of Public Safety and correctional services, and the Department of Veteran Affairs.
The state employees who work in these congregate settings will be required to show proof of vaccination. If they are unable to do so, they will be required to adhere to strict face covering requirements, and will be required to submit to regular ongoing COVID testing. These protocols will take effect as of September 1st by which date they will need to have received their first vaccine. Anyone attempting to provide false proof of vaccination will be subject to disciplinary action.
These actions are being taken to further protect our most vulnerable citizens. The state will lead by example with our own employees who are working in congregate facilities, but today, we are also strongly urging the private operators of the state’s 227 nursing homes to institute similar vaccination requirements for their employees, just as the state’s major hospital systems have already done.
While our data does not show infections among nursing home residents increasing, we are seeing an uptick in unvaccinated staff member infections, which was a consistent source of the earlier outbreaks among nursing homes residents which resulted in so many deaths. The Maryland Department of Health will consider taking further actions if necessary. Since May when our mask mandate was lifted, the Maryland Department of Health has strongly recommended that unvaccinated individuals wear face covering and indoor settings and situations where physical distance canning not be maintained, and this continues to be the strong recommendation.
Businesses and other work places across the state are able to set their own policies to protect public health as they deem appropriate, and we support their ability to make those decisions. The state is not imposing any new restrictions for mandates at this time. Mask mandates, or shutdowns, will not be able to eradicate the threat of the virus or this delta variant. The purpose of those mitigation measures last year when there was no vaccine or any kind of widespread testing or PPE was to save lives and to keep hospitals from overflowing and to give our healthcare system time to expand capacity to adapt.
Since the beginning of this pandemic, I have repeatedly stated that our primary goal was preventing hospitalizations and deaths. That continues to be our focus. And while hospitals in some less vaccinated states are peaking and at capacity, Maryland is not near any of the three pandemic triggers that we have instituted. We remain at very low levels of hospitalizations and well within our capacities.
There is nothing more effective at saving lives and keeping people out of the hospital than the vaccines, which are doing exactly what they were designed to do, which is preventing serious illness, hospitalizations, and death. If you are among the nearly 78 percent of Maryland adults who have been vaccinated, your chances of getting sick and hospitalized are extremely low, and your chances of dying are almost nonexistent.
Less than 0.01 percent of those fully vaccinated in Maryland have been hospitalized. And less than 0.001 percent of those fully vaccinated in Maryland have died, which means 99.99 percent of those fully vaccinated have remained free of serious illness. Look, I don’t care what misinformation or conspiracy theories that you have heard, the plain and simple fact is that these vaccines are working. If you’re still unsure about the vaccines, here is the important fact for you to consider. Nearly every single person hospitalized or dying with COVID-19 in Maryland right now is unvaccinated.
Those of you who refuse to get vaccinated at this point are willfully and unnecessarily putting yourself and others at risk of hospitalization and death. You are the ones threatening the freedoms of all the rest of us — the freedom not to wear masks, keep our businesses open, and to get our kids back in school. And tragically, it may be only a matter of time until you do get COVID-19. We’re seeing heartbreaking reports across the country. The first thing that so many people do after being hospitalized with a severe life-threatening case of COVID is to beg doctors and nurses for a vaccine. And sadly, by that point, it’s too late.
We do not want any Marylanders or any more Americans to become one of these preventable stories. So please, just get the damn vaccine. These vaccines are free, safe, and they’re widely available everywhere, everywhere all across our state at thousands of distribution points, including hundreds of pharmacies and primary care providers. To find a vaccine near you, go to covidvax.maryland.gov or call 1-855-MD-GOVAX where our call center remains available seven days a week.
Maryland has now transitioned from the crisis phase of a state of emergency to a more sustained ongoing, long-term public health management response. All of the things that you’ve repeatedly heard me talk about for the past 18 months, testing, tracing, PPE, hospital surge capacity, and vaccines, all of the infrastructure that never existed that we had to build from scratch have now become part of the day-to-day response operations of state government.
While the pandemic is currently under control in Maryland, the unfortunate reality is that COVID and its variants are going to be with us in one form or another for the foreseeable future. And so we need to continue to adapt, to take the right precautions, and to look out for one another, which is exactly how we’ve gotten through this pandemic so far. It’s how we have remained Maryland Strong. So with that, Dr. Ted Delbridge, the Executive Director of MIEMS will talk about the current situation in our hospitals.
> DR. TED DELBRIDGE: Good afternoon, and thank you, Governor, Hogan, for your continuing leadership. When first confronted with the challenges of COVID-19, we had clarity. Despite this journey, it was going to be much more like a marathon than a sprint, and certainly that has proven to be the case. Among our chief concerns has been the capacity of our healthcare system, including primary care networks and hospitals in Maryland to accommodate surges of patients related to COVID-19. Until now, we have observed four waves of COVID-19 in our states, the most profound occurring during this past winter. During January, COVID-19 related hospitalizations around the state on several days exceeded 1,900 seriously ill people. To be certain, our healthcare system has been stressed, however, it continues to pass the test. This is a testament to the commitment and dedication of our emergency medical services clinicians in the field, primary care networks and their clinicians, and the tens of thousands of Marylanders who go to work in hospitals each and every day.
Without that, we owe them our gratitude. They have put themselves in harm’s way, often without knowing, as they cared for those suffering from COVID-19. Unfortunately, they have been witnessed to the tragedy like nobody else. As we experience a bitter reprieve earlier in the summer, we did not take our eye off the ball. The facilities continue to treat COVID-19 patients as they were established to do. The critical care ordination center based at MIEMS with a collaborative expertise of a team of critical care clinicians facilitate optimal resources for Marylanders in need.
Now, we are responding to a fifth wave of the pandemic. Since the beginning of July, COVID-19–related hospitalizations have more than tripled. Today there are 337 COVID-19 patients in hospitals and 26 percent are in intensive care unit. Each wave of pandemic has been accompanied by unique circumstances and concerns related to hospital capacity and the abilities to meet the needs of our state. And now is no exception. Hospitals are busy with the work they typically do when there is no COVID. People are out and about and on the go. They’re seeking the care they previously deferred. They’re becoming ill as they otherwise do.
For example, each day the state’s EMS system is treating numbers that are typical for this time of year of people suffering from respiratory illnesses and taking them to hospital emergency departments. People are getting hurt in car crashes and in other ways, including hurting each other. Our hospital emergency departments are back to being the busy places they were before there was COVID-19. Additionally, as older Marylanders were the first to be eligible to be vaccinated, and second, most readily sought COVID vaccine, they now are a lower prosecution of the hospitalizations.
Earlier this year, 22 percent of COVID-19 patients were less than 50 years old. Now more than 42 percent are younger than 50 years. Finally, our healthcare workers are worn out. We may be tired of wearing masks. They are fatigued from giving 100 percent for more long and need a break. We are focused on protecting the vulnerable residents of nursing facilities so they do not need hospital care. We’re working with our pediatric centers. Each of us has ‘responsibility to ask how can I help? The core answer to that question remain constant — pay attention to the actions that keep you and those around you healthy. Wash your hands often, stay away from others if you’re feeling ill, if you’re not vaccinated or if you can’t assure that the people around you are, play it safe. Wear mask. Even if you have been vaccinated. It provides one more layer of vital protection and quite frankly, it’s just plain easy.
The best tools we have to complete this job are our vaccines. As long as there are unvaccinated people for the virus to be transmitted to, there will be COVID. The unfortunate reality is if you’re not vaccinated, it’s not a matter of if you get COVID-19, it’s a matter of when. Despite the best medical care, people will continue to die. The real tragedy — it doesn’t have to be that way. If only we use the best tool we have. The vaccines are effective and safe. They’re preventing hospitalizations, death and long-term disabilities associated with COVID-19.
As a physician, I’ve been asked which one? The answer is the one you can get the soonest. Members of my family have received all three. The first one they could get. The next weeks will be crucial to overcome the COVID-19 delta variant. However, this is not likely to be the last challenge before crossing the finish line. In the meantime, we can all get vaccinated if we’re 12 years old or older. When we can’t be certain, including anytime we’re around people we don’t know, wear mask. Thank you and I’ll now turn it over to Dr. Jinlene Chan.
> DR. JINLENE CHAN: Thank you, Dr. Delbridge and thank you, Governor Hogan, for both your leadership throughout this pandemic. I’ve been really honored to work with both of you side by side. So good afternoon, everyone. I would like to start by reiterating a lot of the pointing that Governor Hogan made in terms of this delta variant that we’re currently facing here in the state. We have seen an upsurge in the number of cases in the last few weeks, and it is being driven by delta variant.
As the Governor said, it is to two to four times more contagious than prior variants we’ve seen or the original virus that came to us last spring. There are various aspects to this new virus, this delta virus that we are learning more about each and every day, and some of the new studies suggest that people infected with the delta variant actually have a higher viral load, and so they can shed more virus. In addition, they may also be able to shed for a longer period of time so that they’re contagious for a longer period of time.
This may also be seen among vaccinated people, at least in some early studies, who may be infected with delta and who may then be able to infect others. We’re also seeing, as the governor mentioned, some early evidence that this variant may cause more severe disease among adults and possibly children, but there’s no additional information. We continue to monitor this across the country as we hear those stories coming out of hospitals in Texas, Louisiana, and other states.
As indicated, the proportion of these new cases is nearing 100 percent. It is the vast majority now. This is the predominant virus here in the state of Maryland, and it’s spreading extremely rapidly, more so than prior viruses. Next slide, please. So I want to talk for a moment about vaccine breakthrough cases or post-vaccine infections. These cases are when a PCR test is positive in a person at least 14 days after they’re fully vaccinated, so they complete their series with a COVID-19 vaccine. Again, two doses if this was Pfizer or Moderna, or one dose of Johnson and Johnson.
We have seen post vaccination infections happen among vaccinated Marylanders, as well as other people across the U.S., but this is something that has been expected all along. Not only with COVID vaccine do we see post vaccination infection, but really with any vaccine. Because there is no vaccine that’s 100 percent effective. People should also expect that the number of post vaccination infections will increase as the proportion of people who are vaccinated increases.
It is important to keep in mind, and I want to reiterate this, I know the Governor mentioned, is that the initial and primary purpose of COVID-19 vaccinations and of our entire vaccination campaign, the first goal that we had was to prevent severe cases and death from COVID-19 above anything else. And this is exactly the benefit that we have been seeing since the springtime and don’t see now from the vaccine.
The number of COVID-19 cases, hospitalizations and deaths that will be prevented among vaccinated persons has far exceeded the number who may be infected. The next slide. So today, we are adding post vaccination infection data to our COVID-19 dashboard at Coronavirus.maryland.gov, which will be updated every Wednesday. We’ll be doing this to further show how vaccines are the most effective and critical tool we have in preventing COVID-19 infections, serious illness, hospitalizations and deaths.
So on January 26th of this year, we identified the state’s first post vaccination infection, and then to date, so cumulatively, among the 3.2 million Marylanders who would be considered fully vaccinated, we have identified 3,836 people who have tested positive for COVID-19. Again, let’s think about those numbers. 3.2 million people and just under 4,000 individuals of those who have been identified. That is less than 0.12 percent.
Of those Marylanders who had post vaccination infections, 454 have been hospitalized. That is 3.6 percent of all COVID-19 hospitalizations since January 2021. 53 have died, representing 3.7 percent of all lab-confirmed COVID-19 deaths here in the state since January. And lastly, only 3.2 percent of all confirmed cases have been among the fully vaccinated, again, since January.
So the number of COVID-19 post vaccination infection cases, hospitalizations and deaths are very, very low. In other words, and I’ll flip it around, about 96 percent of all cases cumulative since the beginning of the year are among those who are unvaccinated. Last slide, please.
So to emphasis, the COVID-19 vaccines were designed to prevent severe disease and death. And that’s exactly what they’re doing. Getting the vaccine is the single most important thing you can do to protect yourself and your families. As our dashboard shows, the vaccines are working exactly how they’re intended to do. If you’re vaccinated, you are well protected against severe disease. If you would like to add a further layer of protection for yourself, particularly if you or your family have any immunocompromised diseases or are ineligible to get the vaccine at this time, you should strongly consider wearing mask, indoors or when you’re out in public.
If you are still not yet vaccinated, you remain at the greatest risk of contracting and spreading COVID-19. We don’t have — we didn’t have this tool in our tool box this time last year and at the beginning of the pandemic. And as Dr. Delbridge indicated, our hospitals revved up in ways we never would have imagined. And now we’re 18 months in or so, and we continue to fight this battle alongside each and every one of you. And we unfortunately lost over the last year many Marylanders to COVID-19, but we now have this tool in our tool box.
So in the face of this new delta variant and others to come — make no mistake, there will be other variants in the future — not getting vaccinated if you are eligible is denying yourself and your loved ones the chance to be able to combat this disease if you get infected. Please, go to covidvax.maryland.gov to find a vaccination site and make yourself an appointment. Thank you so much.
> (question off-mic).
> GOVERNOR HOGAN: I think that’s mostly what I talk about in all of my remarks is that we’re in a far different place. We’re one of the most vaccinated states in the country, and if you’re vaccinated, you have very little risk. So it’s different than the way it was before. They are states that are having big problems currently. We don’t happen to be one of them. But we’ve always, since May 1 have continued to say, there was no longer a mandate, but we were strongly suggesting, particularly if you’re not vaccinated. If you don’t get a vaccine and you don’t wear mask, you’re going to get COVID-19.
> (Question off-mic).
> GOVERNOR HOGAN: I said today and I said from the beginning that we support the ability of local jurisdictions to make those decisions for themselves. I believe every county is different, but they probably have the authority to make those decisions on their own and, you know, I’m sure they’re trying to make the best decisions we can. I know we’re facing, as we always have, our decisions on the actual data, and the advice of all the health experts.
> (Question off-mic).
> GOVERNOR HOGAN: Again, it’s spreading faster than the original one, but at much lower numbers. So we talked about before, we had far more people getting infected because most of the people in our state are vaccinated. They’re not getting infected. So our hospitalizations aren’t at 1,900 anymore. They’re at 300. Just as an example. One day a couple of days ago, Florida had 21,800 infections in one day, and we had 500. They have 10,000 hospitalizations. We have 300. Not to make light of it. It’s a serious virus, but we’re managing it pretty well because we’re so well vaccinated. I think we consistently are one of the very best in the entire country.
> (Question off-mic).
> GOVERNOR HOGAN: Well, these are discussions that — by the way, just because we don’t have press conferences every day about COVID like we had to do at the beginning when nobody knew anything about it does not mean we’re not talking about it and meeting about it and focused on it every single day. Certainly one of the things that some of our public health doctors and our epidemiologists, all of our experts have talked about is potential need for boosters at some point. And our team is actively preparing for that eventuality.
> (Question off-mic).
> GOVERNOR HOGAN: No, I mean, the mass vax sites were necessary at the time. It was one part of our arsenal. We had 3,000-some places. I kind of said this is going to move from the crisis part of the emergency to an ongoing public health management issue. It’s kind of like we do flu vaccines every year really effectively. And we do it through our doctors and our health departments and our pharmacies, and everybody seems to get that done. I think we’re at the point now where we don’t need the mass vax sites.
> (Question off-mic).
> GOVERNOR HOGAN: I announced earlier today that we’re doing it in five, six different departments and in 48 different facilities where they’re actually dealing with congregate living, where they’re actually putting people in the greatest danger, our most vulnerable people they’re providing services for. And they will be required — we give them until September 1 to get their first shot. They could get them today if they wanted to, but it gives them a little more time to get prepared. If they do not show that proof of vaccination, then they’ll be required to do multiple times a week testing, and they will be required to be wearing a mask. And if they somehow falsify those documentations, then they’ll have further repercussions.
> (Question off-mic).
> DR. JINLENE CHAN: So we’ve been working — so all labs by state law are required to report results to us for COVID-19. So these are PCR test results so they’re required to be reported. Antigen test results as well. But this is based on the PCR test. We work very closely with our health information exchange to pull the aggregate information together and couple it to immunization data we have in our system. So we are pretty confident the data is accurate, but we’re definitely pulling together information from multiple locations to prepare the data that we share today.
> (Question off-mic).
> GOVERNOR HOGAN: So most employers have not done it, but we’re hoping that by leading by example today more will, and we’re encouraging more to. Some of our largest hospital systems have taken that action, but not all of them. And our nursing homes haven’t taken these acts. So these are the appropriate actions today given the facts and the data where it stands. But we batch it every single day and will take whatever additional actions we believe are necessary when we believe they’re necessary.
> (Question off-mic).
> GOVERNOR HOGAN: I mentioned briefly, and I don’t know if maybe Dr. Chan will jump in on this, but we’ve seen a couple of nursing home — first of all, nursing home workers are at a very low vaccination rate compared to the state. Luckily, our nursing home residents are vaccinated at one of the highest rates in the country, almost 94 percent. But with some.
For breakthrough infections, with people coming in who maybe not have gotten vaccinated, we’re very concerned about the staff members. And we have had some outbreaks. At this point, I think, primarily staff, but we’re concerned about that enough to say they’ve got to take a more serious look at it.
> (Question off-mic).
> GOVERNOR HOGAN: We have Charlotte Hall that is a veteran home. That’s similar to some of the private facilities taking that action. We haven’t had outbreaks but we’re trying to prevent the outbreaks, because we see it as the most vulnerable populations. Our juvenile facilities, people providing healthcare, these are the ones to be addressed first because these are the folks that need to be vaccinated. They’re putting folks in danger every day. They should have been already, but we’re going to make sure they get it.
> (Question off-mic).
> GOVERNOR HOGAN: At this point, I think it’s really critical important that we do get our kid back in school. They suffered greatly, many of them not being in the classroom for so long. And while we are starting to see a small number of younger people getting infected, right now I think most people look at school systems and everybody else feels very confident about getting our kids back in school. Hopefully we will get vaccines built for the kids. But right now, young children, we’re catching up on the 12 to 17-year-olds, by the way. We’re over 60-some percent, even though they started much later. We want to make sure everybody who’s eligible gets it. That’s the focus right now. Hopefully they will approve vaccines for younger kids, but at this point, it hasn’t yet been a huge problem.
More than half of our school system has been in school for the whole year, all of our private schools have, and we’ve had very little cases. So we’re watching it.
> (Question off-mic).
> GOVERNOR HOGAN: The largest state employment union asked me to sign an MOU when we signed a contract earlier in the year to allow us to take this action. The other two smaller unions, I think we had discussions with them, and they don’t have a problem with it, but it wasn’t already negotiated as a part of their contract. What was the other part?
> (Question off-mic).
> GOVERNOR HOGAN: A lot of people took advantage of that. It’s a carrot and a stick. We’re trying both approaches and making sure the folks who haven’t taken advantage of that —
> (Question off-mic).
> GOVERNOR HOGAN: We do have the legal authority to do it. We just didn’t feel it was necessary and appropriate at this point. We did have discussions about that possibility, a robust discussion with lots of people that know a lot more about it than I do, and this was the decision that we came down to at this point. We’re going to start with the ones in the facilities with the most vulnerable folks. We haven’t had serious outbreaks in our normal agencies or operations throughout state government today.
Thank you.