GOVERNOR HOGAN: Good evening. Joining me here today is obviously Lieutenant Governor Boyd Rutherford, former AA County executive Steve Schuh from our COVID-19 task force, who has been leading our outreach and communication with county leaders, and Dr. Ted Delbridge, who is the executive director of the Maryland Institute for Emergency Medical Services Systems.
Last week we held a press conference warning about the fall coronavirus surge, which is raging across the country. And I said that the upticks in some of our metrics and the spiking numbers in other states placed us once again at a pivotal moment in the fight. Since last week, most of our key metrics have worsened. We’re now seeing widespread community transmission, not just in our cities and urban and suburban areas, but in our rural counties that had not experienced a large spike earlier this year. More people are getting infected with the virus, more people are getting hospitalize, more people are going into intensive care, and more Marylanders are dying.
We have now had seven straight days with more than 1,000 cases, and those numbers continue to rise today the Department of Health is reporting over 1,000 new cases of the virus. Yesterday our statewide positivity rate reached 5.05, crossing the 5% mark, which is the key benchmark set by the World Health Organization and the CDC, for the first time in 137 days, since June 25th.
Today our positivity rate increased once again to 5.24%, and it has now been slowly rising for the past 19 days.
11 of our 24 jurisdictions now have positivity rates which have gone above that 5% benchmark, including Allegany County, AA County, Baltimore County, Charles, Dorchester, Garret, Hartford, Queen Anne’s, Somerset, and Washington Counties.
Nationwide COVID-19 hospitalizations surged it a record high yesterday, with over 59,000 patients hospitalized. Here in Maryland our total COVID hospitalizations are at 761, which is their highest level since June 13th. 176 patients are in the ICU, which is the highest level since June 27. We have also now moved into the red zone as designated by the federal government for the number of cases per 100,000. Last week our average case rate was at 14.5. Today it has risen to 19.8. It has increased 36% in just the past 7 days. Case rates are now above 10 in 18 of our 24 jurisdictions, and above 20 cases per 100,000 in 7 jurisdictions, including Allegany County, Washington County, Baltimore County, Baltimore City, Hartford, AA, and Somerset County.
Allegany County’s case rate has continued to grow exponentially. Last Thursday we announced that we would be standing up a new testing site at the Allegany County Fairgrounds, and I’m pleased to report that this new site will be fully operational tomorrow.
More people are dying from this virus, including now 4,084 Marylanders, and nearly 245,000 Americans. We have been and are still doing much better than 40 other states in our health metrics, but as I have repeatedly said, this deadly virus does not recognize state borders. Our updated contact tracing continues to indicate that family gathers are the most common and therefore the highest risk activity among those who are recently infected with COVID-19. Among those recently infected with COVID-19, there’s an increased number who recently tested positive who report working outside of their home, a marked increase in the number of people infected with the virus who said they have recently dined indoors at a restaurant, as well as a large increase of those who have recently traveled out of state.
We cannot afford to ignore these trends and patterns. Last week I said that the warning lights were starting to blink on the dashboard and it appeared we were approaching a critical time in the fight. Today I’m reporting that we have now crossed over into the danger zone. Too many residents and businesses have COVID fatigue, and they’ve begun letting their guard down. Too many Marylanders are traveling out of state to unsafe locations, hosting large gatherings, crowding in bars, attending house parties, and refusing to wear masks. Too many businesses are failing to comply with the state regulations and orders, and counties with the primary responsibility for ensuring compliance of the law and enforcing public health regulations are in some cases failing to do so.
Sadly, as a result, the virus has returned to our state in a big way. We absolutely must and we will continue to use every tool at our disposal. From day one of the pandemic, I have never hesitated to take the actions that I believed were necessary to keep the people of Maryland safe. And I will continue to do so. We do not want to take actions that will further burden our struggling small businesses or actions to shut down our economy. Our primary goals continue to be keeping our hospitals from overflowing and stopping more Marylanders from dying. Today I am announcing that effective tomorrow, November 11, at 5:00 p.m., roughly 24 hours from now, the capacity for indoor operations at bars and restaurants will be reduced from 75% back to 50%. Bars and restaurants in Maryland have only been permitted to open for seated, distanced service only with strict capacity restrictions. No standing in bars has been allowed. Patrons have been required to spread tables at least six feet apart. And no large groups larger than six per table.
Now, many of those are not being followed. Customers who are not seated cannot be served, and tables must be cleaned and disinfected between each seating in accordance with guidelines from the CDC and the Maryland Department of Health.
This order will be enforced.
In addition, today the Maryland Department of Health is issuing a new public health advisory, strongly warning against any indoor gatherings of 25 people or more. This is consistent with all our contact tracing data and an uptick in cases resulting from family gatherings and house parties.
It’s easy to feel comfortable thinking that just because you haven’t engaged in any of the activities that we typically think of as high risk that it’s enough to keep us safe. The reality is that you can just as easily get the virus by hosting a group of friends to watch football on Sunday or celebrating a family birthday or the Thanksgiving holiday that’s fast approaching. Each of us has to be more cautious and more vigilant. The Maryland Department of Health today is also issuing an expanded advisory regarding all out-of-state travel, which according to our contact tracing data is responsible for a substantial increased number of cases. Under this advisory, all Marylanders are strongly advised against all nonessential out of state travel to any of the states with a positivity rate over 10% or any of the 35 states who have average case rates of above 20 per 100,000. This applies to all personal, family, or business travel of any kind.
You should immediately postpone or cancel travel to any of these states with spiking metrics. Anyone who has to travel outside the state for an essential reason, upon their return to Maryland should immediately get tested for COVID-19 and self-quarantine while awaiting the results of the test.
Effective immediately, all state employees who are approved to telework must again begin a period of mandatory telework, except for essential direct public-facing services and other essential personnel.
Earlier today I convened an emergency teleconference of my entire cabinet and directed them to immediately execute this period of mandatory telework among the employees in their agencies.
And we are strongly advising all employers across the state to limit their workforce only to workers who are essential and who are not able to telework. Businesses are strongly encouraged to develop plans which limit the proximity of employees by rotating employee hours, instituting split schedules, shifts, shorter work weeks, or staggering start, break, or shift times.
Maryland Department of Health is issuing an emergency order today to activate the next level of our hospital surge capacity by adding alternative care site capacity and to provide additional staffing support and clinical care to nursing homes in the event of further outbreaks. These emergency plans will be activated immediately when our hospitalizations reach a critical threshold.
Finally, the Maryland Department of Health is issuing updated guidance to stop the spread of COVID-19 at nursing homes and assisted living facilities. To protect our loved ones, Marylanders should take all precautions, including all visitors getting tested prior to visiting a nursing home facility. Nursing home and assisted living program staff must minimize their contact and avoid all gatherings he and work with their management on communicating early and often about all infection control issues at their facilities.
We’re also requiring all nursing homes to develop a sufficient PPE stockpile for the winter surge.
The actions that we’re taking today are necessary based on all of the numbers, the data, metrics, and projections and are being taken in consultation with the top doctors and public health experts from our Maryland coronavirus recovery task force. These actions are absolutely necessary to help us withstand the surge, save lives, and to keep Maryland on the road to recovery and open for business. This must be an all hands on deck effort. I want to be very clear that all of our existing health orders and our new health orders are in effect and do carry the full force of the law. Failure to follow them will result in serious consequences. It is absolutely vital that county leaders and their county Health Departments, county liquor boards, county licensing and permitting departments, as well as county and municipal law enforcement agencies, they have the primary responsibility to strictly enforce these restrictions and orders to the letter of the law, and we have asked them to immediately ramp up their enforcement efforts. All violators should be warned they run the risk of jail time, fines, and the likelihood of actions being taken regarding their liquor licenses or other county licenses or even the businesses being closed for failure to comply.
I want to commend Baltimore City and AA County for the recent enforcement actions they have taken to close facilities over willfully violating the orders and refusing to follow state law.
As we brace for the impact of this surge, the state has already invested a half a billion dollars in economic recovery funding, and we are working around the clock in partnership with our county governments to get that relief quickly out in order to help even more struggling families and small businesses.
We also want the counties to recognize the importance of immediately stepping up the pace of their relief efforts. Maryland Secretary of Health, Bobby Neall and David Brinkley sent a letter to all Health Departments warning them that the deadline to spend the federal CARES Act funding is December 30th this year and that their constituents will lose out on this critical funding if it is not spent in the next 50 days.
We have held 22 calls with all of the county leaders, every 2 weeks. We will be increasing that to weekly calls with all leaders, and we will be working with them on their efforts to enforce state law to provide whatever assistance we possibly can to them and to help them to get this critically needed funding to the people who desperately need it.
I want to again remind local leaders that state law grants them the power, the authority, and the flexibility to implement more restrictive policies than the state orders if they deem necessary based on the changing conditions in their individual jurisdictions in order to slow the spread of the virus. They can and they should take those actions, and local leaders will have our full support.
The state of Maryland will continue to constantly monitor all of the metrics, and we may need to take additional statewide actions in the days and weeks ahead if the situation continues to deteriorate.
In closing, I just want to remind the people of Maryland that we have come too far and the stakes are too high. This virus does not care if you’re tired of it. It does not care if you have holiday plans. It doesn’t care who you voted for. And it will not let us move on just because we all desperately want to get back to our normal pre-COVID lives. Marylanders crushed the curve once before, and we can and we will do it again with your help.
At this time I’m going to turn it over to Dr. Ted Delbridge, who as I said is the executive director of the Maryland Institute for Emergency Medical Services and Systems, to discuss the Maryland Department of Health order ongoing preparations for additional surge capacity and the new alternative care sites.
Doctor?
DELBRIDGE: Good evening. As a board-certified emergency physician for the past 27 years, let me begin, Governor Hogan, by expressing my appreciation for your leadership during this challenging time. Thank you.
Because of the executive orders you issued early in the pandemic, we have been able to do important work to respond to COVID-19 and prepare for the next phases. Among them were provisionally credentialed more than 1,000EMS clinicians to make them available in the field. These people are emergency medical technicians and paramedics who were students at the end of training practicing in other states or reengaged after expiring. We credentialed more than 800 nursing and respiratory students as clinical externs, making them available in the system. They get valuable clinical experiences. We get enthusiasm and their caring expertise.
We issued a triage protocol, helping out EMTs and paramedics to identify patients. We established a model emulated in other states.
For the past several months, we have been charged with maintaining situational awareness, working daily with state hospitals to monitor COVID, resource utilization, and ongoing availability to meet the demands. At the outset of this pandemic, one of Governor Hogan’s first actions was to make sure capacity existed to accommodate a surge of no fewer than 6,000 COVID-19 patients in our hospitals. Anticipating a resurgence of COVID-19 this fall and winter in Maryland, we have maintained all of those measures. However, there are meaningful differences from this past spring. We know more about the virus, the illness it causes, and effective treatments. In general, hospitals already have more patients. Many people deferred elective procedures in the spring and summer and are receiving them now. Flu season has begun, and some people with the flu are going to emergency departments and requiring hospitalization.
I cannot overemphasize the critical importance of getting a flu vaccine for each of us. It’s valuable for our own health and those around us. It’s not too late.
Therefore, as Governor Hogan just announced, we are issuing an emergency health order that essentially activates our next level of surge planning. I want to briefly walk through what it does and what it means, our basic goal being to help manage hospital capacity so that people infected with COVID-19 are able to get the care they need without overloading any single hospital and to ensure all Marylanders have access to routine healthcare.
First, the order emphasizes the importance of shifting appropriate patients to specialized care sites at the Baltimore Convention Center, Laurel Hospital, and Takoma Park Hospital. It provides agility for those sites if the need arises.
Second the order requires surge plans. Hospitals should be optimizing the use of staff, space, and ensure they are prepared for the anticipated increase of COVID-19 patients. They must also be prepared to accommodate newly arriving emergency patients. We will work closely with hospitals to ensure we have accurate real-time assessments for acute care and intensive care resources to care for Marylanders as best we can.
Further, we have infection control staff available from regional hospitals if an outbreak occurs. We can be confident of two things: One, the threat of COVID is not behind us. It is quite real. And two, the entirety of Maryland’s healthcare system is ready for the next step. For more than 9 months fighting with talented people working consistently is their shared spirit of determination and commitment to making sure Marylanders are well cared for. We all need to maintain the same vigilance. Now is not the time for complacency. The virus affects people. You must be infected and contagious before you realize it. Before you know it, people will die. We are in a marathon and not a sprint. Please don’t give up. Basic steps help tremendously and reduce the risks for everyone. Please wear a mask. Wash your hands often and keep your hands away from your face. Be mindful to watch your distance from others. We’re ready for whatever comes ahead, but we need everyone’s help.
Thank you.
GOVERNOR HOGAN: Thank you, Doctor.
I’m afraid I’ve got people using bad language now.
[Laughter]
Thank you.
Any questions.
(Question off mic).
So I went through some of the metrics. We saw some of this happening. We just crossed over yesterday the 5%. We think these are the targeted actions that we need to take right now today based on the data from where we’re seeing the infection and what our contact tracing has done. These are the things that will have the biggest impact. But as I said, this doesn’t mean this is the end. I mean, we’re going to continue to take actions if need be every day until we get this figured out. We watch it every day.
(Question off mic).
It was about half and half. Some were reiterating existing orders and stepping up the enforcement. We had them in place but people weren’t following them. Some were new orders that we do have the force of law.
In other cases, the enforcement is difficult. There are public health advisories providing the people the information they need to make the best decisions and strongly encouraging and advising them to follow the rules. But we’ll take whatever further actions we deem necessary if the situation continues.
(Question off mic).
We did address the congregations at all. They’re all under different orders with managing and distancing as opposed to gathering of 25 people. It didn’t change at this point any rules on that.
(Question off mic).
Yeah, Anne Arundel and Baltimore City.
I don’t want to call everybody out. I mean, most of our businesses are doing a great job of complying. Most of the business sectors, you know, our Department of Commerce has 17 different work groups with a couple of hundred people developing safe plans, trying to keep their members following the rules. Many of the counties are doing their best. But they’re becoming more and more lax. They may have forgotten that the rules are in place or they don’t think it’s important anymore. They think we’re safe now because we’re doing so much better than the rest of the country, that it was over. But many of those orders are still in place but people aren’t following. So we have instances of jam-packed bars and restaurants when they have never been able to stand in a bar even, let alone sit and get a drink spaced out. A lot of people are not following the rules. The county liquor inspectors who were in there anyway doing other things and local Health Departments and local law enforcement, they provide licenses to all these businesses. They’ve got to start dropping the hammer on bad apples because that’s where a lot of the spread is taking place.
(Question off mic).
We look at all the metrics. Really our positivity is better than 43 other states. South Dakota is at 54%. We’re at 5. It’s not as alarming. But we don’t like the way it’s heading. We’re not in a red zone for positivity. 10% is the rate that the federal government says you’re in the red zone. We’re saying don’t travel to the states that have 10%. But on the number of cases, there are two different metrics. We did just cross it in the past few days. Again, we’re not South Dakota, but 186.5 cases per 100,000 they are, and we just went to 19. So in both cases almost 10 times worse, and there are 38 states worse than us on case rates and I think 43 states worse than us on positivity.
But we are heading in the wrong direction. And in talking with many of our experts and with my fellow governors, they saw it go from here to spike and then shoot straight up, so we’re trying to take these measured steps to stop that from happening.
(Question off mic).
In the early calls, dealing with them on a daily basis, we put county executives in charge, all of our cabinet. We have daily calls with the health leaders and many of their departments, and we have calls every 2 weeks with our entire state leadership team talking to them. So they all — if they haven’t brought up a single concern on any of those calls including the one we had last week, I know five of the ones, all democrats, by the way, and looking at statewide office sent a press release out but they haven’t expressed any concerns to us.
Nonetheless, we’re going to double the number of meetings to make them happier.
(Question off mic).
I’ve made my feelings on this pretty clear. I think if the President and his team have real evidence of widespread voter fraud, they should come forward with it. Certainly we have legal processes for a reason. They can be challenged. They have every right to do that. But I haven’t seen any widespread evidence and I haven’t seen anything that would in any way change the outcome of the election. And I mean, you know, this is the way it works in America. We cast the votes and we live with the results. And I think most people recognize that the election is over.
It’s really dangerous, I think, to in the middle of this pandemic, this economic collapse, people dying across the country, to not know if we’re going to have a transition, is the old coronavirus task force going to be making decisions or a new one, how long is this going to go on, with no stimulus package getting done, with no additional virus relief. We’ve got to move on.
(Question off mic).
So two-part question. I was the first statewide republican or republican leader I guess to kind of congratulate the President-elect on his victory, but a number of my fellow governors and a few senators and 37 congressmen and many others, former elected officials, former President Bush, Chris Christie, a lot of people are saying that the election is over and congratulating the Vice President elect. Even more who don’t want to stop the transition from happening.
I was disappointed, frankly, and I said so earlier, with some of the response from Leader McConnell and others who have a different take on it that I think is a mistake. I think it’s a mistake for the country. It’s a mistake for the Republican Party. We have the Senate hanging in the balance, two runoff elections in Georgia. Doing anything to process votes is a pretty significant event.
(Question off mic).
So we have very clear state guidelines and metrics. Our superintendent of education and our public health assistant secretary have been in constant communication with the local school boards just like we have with the county leaders. We’ve given them advice about how we can safely get some kids that are the most special needs kids, for example, people who don’t have access to the internet who are really suffering without any instruction for quite some time, we can still try to do that. But again, the legal authority lies with the school boards and they are making decisions as they have the right to do. And I think they ought to continue to follow the advice and look at the metrics on the ground and where they are.
In some places they have done it very successfully with limited people back in school with little or no issues whatsoever. But we have really anytime there’s an outbreak, they can take quick action.
(Question off mic).
First of all, we still have 100% of all of our businesses open. We have 98% opened since June. That’s a good thing. They’re safely reopened. Important restrictions and guidelines to keep people safe. But it’s helped us also have one of the best economies in the country, better than 40 some states.
We’ve got a tremendous amount of unemployment, although most people it’s twice what it used to be before the start. So we’re trying to keep people employed, we’re trying to keep small businesses from failing and going under, but we also are trying to keep people alive and that’s the delicate balance. We still have all of our businesses open. We didn’t do any kind of drastic shutdowns and lockdowns, but we’ve just had what we think are reasonable, measured, and critically needed steps right now. We have to enforce the law. There are rules we have. We have to have a few more to make it safe.
(Question off mic).
That’s a really good question, and I may turn it over to Dr. Delbridge, because we had this discussion just a couple of days ago. And I think his caution to us was that we should expect December and January to be the worst. I’ll let him answer.
But before we peaked and came back down, we did another little one in June, came back down. But this one is more of a stay at this level for a while.
I won’t steal your thunder here, Doctor.
DELBRIDGE: When we look at the modeling, we’re concerned that December, January, February are going to be the peak times, and so much is dependent on mitigating steps that the public takes, wearing a mask and keeping distance, those kinds of things. So the effects of those are a little bit more challenging to predict, but when we see what the trajectory is now, we are definitely concerned that this is a longer lasting peak and that it’s going to go into the winter months. Some have correlated the virus with changes in humidity. It happened in other places in the world. As the humidity drops and weather changes, it becomes more of a problem. So we’re thinking along those lines, which is why it is just so incredibly important, I can’t miss this opportunity to reiterate that people get a flu shot, because it just makes them comorbid, gives them another problem to have, and keeps people out of the hospital with the flu to save space for other people.
SPEAKER: Last question.
GOVERNOR HOGAN: Actually, I don’t think I answered the other half of his question. Sorry about that.
So we weren’t ready to announce this yet today, but I can confirm we just had an emergency cabinet meeting this afternoon where Secretary Bobby Neall, who has been a longtime friend for many decades and who has done a wonderful job leading a team of people throughout this crisis, he gave us notice, announced to the cabinet and to us that he will be leaving the administration, retiring, on December 1. And I don’t have any further details on that, but we will in the coming weeks as we get closer.
SPEAKER: Thank you.
GOVERNOR HOGAN: Thank you.
Thank you, Doctor.
Last week we held a press conference warning about the fall coronavirus surge, which is raging across the country. And I said that the upticks in some of our metrics and the spiking numbers in other states placed us once again at a pivotal moment in the fight. Since last week, most of our key metrics have worsened. We’re now seeing widespread community transmission, not just in our cities and urban and suburban areas, but in our rural counties that had not experienced a large spike earlier this year. More people are getting infected with the virus, more people are getting hospitalize, more people are going into intensive care, and more Marylanders are dying.
We have now had seven straight days with more than 1,000 cases, and those numbers continue to rise today the Department of Health is reporting over 1,000 new cases of the virus. Yesterday our statewide positivity rate reached 5.05, crossing the 5% mark, which is the key benchmark set by the World Health Organization and the CDC, for the first time in 137 days, since June 25th.
Today our positivity rate increased once again to 5.24%, and it has now been slowly rising for the past 19 days.
11 of our 24 jurisdictions now have positivity rates which have gone above that 5% benchmark, including Allegany County, AA County, Baltimore County, Charles, Dorchester, Garret, Hartford, Queen Anne’s, Somerset, and Washington Counties.
Nationwide COVID-19 hospitalizations surged it a record high yesterday, with over 59,000 patients hospitalized. Here in Maryland our total COVID hospitalizations are at 761, which is their highest level since June 13th. 176 patients are in the ICU, which is the highest level since June 27. We have also now moved into the red zone as designated by the federal government for the number of cases per 100,000. Last week our average case rate was at 14.5. Today it has risen to 19.8. It has increased 36% in just the past 7 days. Case rates are now above 10 in 18 of our 24 jurisdictions, and above 20 cases per 100,000 in 7 jurisdictions, including Allegany County, Washington County, Baltimore County, Baltimore City, Hartford, AA, and Somerset County.
Allegany County’s case rate has continued to grow exponentially. Last Thursday we announced that we would be standing up a new testing site at the Allegany County Fairgrounds, and I’m pleased to report that this new site will be fully operational tomorrow.
More people are dying from this virus, including now 4,084 Marylanders, and nearly 245,000 Americans. We have been and are still doing much better than 40 other states in our health metrics, but as I have repeatedly said, this deadly virus does not recognize state borders. Our updated contact tracing continues to indicate that family gathers are the most common and therefore the highest risk activity among those who are recently infected with COVID-19. Among those recently infected with COVID-19, there’s an increased number who recently tested positive who report working outside of their home, a marked increase in the number of people infected with the virus who said they have recently dined indoors at a restaurant, as well as a large increase of those who have recently traveled out of state.
We cannot afford to ignore these trends and patterns. Last week I said that the warning lights were starting to blink on the dashboard and it appeared we were approaching a critical time in the fight. Today I’m reporting that we have now crossed over into the danger zone. Too many residents and businesses have COVID fatigue, and they’ve begun letting their guard down. Too many Marylanders are traveling out of state to unsafe locations, hosting large gatherings, crowding in bars, attending house parties, and refusing to wear masks. Too many businesses are failing to comply with the state regulations and orders, and counties with the primary responsibility for ensuring compliance of the law and enforcing public health regulations are in some cases failing to do so.
Sadly, as a result, the virus has returned to our state in a big way. We absolutely must and we will continue to use every tool at our disposal. From day one of the pandemic, I have never hesitated to take the actions that I believed were necessary to keep the people of Maryland safe. And I will continue to do so. We do not want to take actions that will further burden our struggling small businesses or actions to shut down our economy. Our primary goals continue to be keeping our hospitals from overflowing and stopping more Marylanders from dying. Today I am announcing that effective tomorrow, November 11, at 5:00 p.m., roughly 24 hours from now, the capacity for indoor operations at bars and restaurants will be reduced from 75% back to 50%. Bars and restaurants in Maryland have only been permitted to open for seated, distanced service only with strict capacity restrictions. No standing in bars has been allowed. Patrons have been required to spread tables at least six feet apart. And no large groups larger than six per table.
Now, many of those are not being followed. Customers who are not seated cannot be served, and tables must be cleaned and disinfected between each seating in accordance with guidelines from the CDC and the Maryland Department of Health.
This order will be enforced.
In addition, today the Maryland Department of Health is issuing a new public health advisory, strongly warning against any indoor gatherings of 25 people or more. This is consistent with all our contact tracing data and an uptick in cases resulting from family gatherings and house parties.
It’s easy to feel comfortable thinking that just because you haven’t engaged in any of the activities that we typically think of as high risk that it’s enough to keep us safe. The reality is that you can just as easily get the virus by hosting a group of friends to watch football on Sunday or celebrating a family birthday or the Thanksgiving holiday that’s fast approaching. Each of us has to be more cautious and more vigilant. The Maryland Department of Health today is also issuing an expanded advisory regarding all out-of-state travel, which according to our contact tracing data is responsible for a substantial increased number of cases. Under this advisory, all Marylanders are strongly advised against all nonessential out of state travel to any of the states with a positivity rate over 10% or any of the 35 states who have average case rates of above 20 per 100,000. This applies to all personal, family, or business travel of any kind.
You should immediately postpone or cancel travel to any of these states with spiking metrics. Anyone who has to travel outside the state for an essential reason, upon their return to Maryland should immediately get tested for COVID-19 and self-quarantine while awaiting the results of the test.
Effective immediately, all state employees who are approved to telework must again begin a period of mandatory telework, except for essential direct public-facing services and other essential personnel.
Earlier today I convened an emergency teleconference of my entire cabinet and directed them to immediately execute this period of mandatory telework among the employees in their agencies.
And we are strongly advising all employers across the state to limit their workforce only to workers who are essential and who are not able to telework. Businesses are strongly encouraged to develop plans which limit the proximity of employees by rotating employee hours, instituting split schedules, shifts, shorter work weeks, or staggering start, break, or shift times.
Maryland Department of Health is issuing an emergency order today to activate the next level of our hospital surge capacity by adding alternative care site capacity and to provide additional staffing support and clinical care to nursing homes in the event of further outbreaks. These emergency plans will be activated immediately when our hospitalizations reach a critical threshold.
Finally, the Maryland Department of Health is issuing updated guidance to stop the spread of COVID-19 at nursing homes and assisted living facilities. To protect our loved ones, Marylanders should take all precautions, including all visitors getting tested prior to visiting a nursing home facility. Nursing home and assisted living program staff must minimize their contact and avoid all gatherings he and work with their management on communicating early and often about all infection control issues at their facilities.
We’re also requiring all nursing homes to develop a sufficient PPE stockpile for the winter surge.
The actions that we’re taking today are necessary based on all of the numbers, the data, metrics, and projections and are being taken in consultation with the top doctors and public health experts from our Maryland coronavirus recovery task force. These actions are absolutely necessary to help us withstand the surge, save lives, and to keep Maryland on the road to recovery and open for business. This must be an all hands on deck effort. I want to be very clear that all of our existing health orders and our new health orders are in effect and do carry the full force of the law. Failure to follow them will result in serious consequences. It is absolutely vital that county leaders and their county Health Departments, county liquor boards, county licensing and permitting departments, as well as county and municipal law enforcement agencies, they have the primary responsibility to strictly enforce these restrictions and orders to the letter of the law, and we have asked them to immediately ramp up their enforcement efforts. All violators should be warned they run the risk of jail time, fines, and the likelihood of actions being taken regarding their liquor licenses or other county licenses or even the businesses being closed for failure to comply.
I want to commend Baltimore City and AA County for the recent enforcement actions they have taken to close facilities over willfully violating the orders and refusing to follow state law.
As we brace for the impact of this surge, the state has already invested a half a billion dollars in economic recovery funding, and we are working around the clock in partnership with our county governments to get that relief quickly out in order to help even more struggling families and small businesses.
We also want the counties to recognize the importance of immediately stepping up the pace of their relief efforts. Maryland Secretary of Health, Bobby Neall and David Brinkley sent a letter to all Health Departments warning them that the deadline to spend the federal CARES Act funding is December 30th this year and that their constituents will lose out on this critical funding if it is not spent in the next 50 days.
We have held 22 calls with all of the county leaders, every 2 weeks. We will be increasing that to weekly calls with all leaders, and we will be working with them on their efforts to enforce state law to provide whatever assistance we possibly can to them and to help them to get this critically needed funding to the people who desperately need it.
I want to again remind local leaders that state law grants them the power, the authority, and the flexibility to implement more restrictive policies than the state orders if they deem necessary based on the changing conditions in their individual jurisdictions in order to slow the spread of the virus. They can and they should take those actions, and local leaders will have our full support.
The state of Maryland will continue to constantly monitor all of the metrics, and we may need to take additional statewide actions in the days and weeks ahead if the situation continues to deteriorate.
In closing, I just want to remind the people of Maryland that we have come too far and the stakes are too high. This virus does not care if you’re tired of it. It does not care if you have holiday plans. It doesn’t care who you voted for. And it will not let us move on just because we all desperately want to get back to our normal pre-COVID lives. Marylanders crushed the curve once before, and we can and we will do it again with your help.
At this time I’m going to turn it over to Dr. Ted Delbridge, who as I said is the executive director of the Maryland Institute for Emergency Medical Services and Systems, to discuss the Maryland Department of Health order ongoing preparations for additional surge capacity and the new alternative care sites.
Doctor?
DELBRIDGE: Good evening. As a board-certified emergency physician for the past 27 years, let me begin, Governor Hogan, by expressing my appreciation for your leadership during this challenging time. Thank you.
Because of the executive orders you issued early in the pandemic, we have been able to do important work to respond to COVID-19 and prepare for the next phases. Among them were provisionally credentialed more than 1,000EMS clinicians to make them available in the field. These people are emergency medical technicians and paramedics who were students at the end of training practicing in other states or reengaged after expiring. We credentialed more than 800 nursing and respiratory students as clinical externs, making them available in the system. They get valuable clinical experiences. We get enthusiasm and their caring expertise.
We issued a triage protocol, helping out EMTs and paramedics to identify patients. We established a model emulated in other states.
For the past several months, we have been charged with maintaining situational awareness, working daily with state hospitals to monitor COVID, resource utilization, and ongoing availability to meet the demands. At the outset of this pandemic, one of Governor Hogan’s first actions was to make sure capacity existed to accommodate a surge of no fewer than 6,000 COVID-19 patients in our hospitals. Anticipating a resurgence of COVID-19 this fall and winter in Maryland, we have maintained all of those measures. However, there are meaningful differences from this past spring. We know more about the virus, the illness it causes, and effective treatments. In general, hospitals already have more patients. Many people deferred elective procedures in the spring and summer and are receiving them now. Flu season has begun, and some people with the flu are going to emergency departments and requiring hospitalization.
I cannot overemphasize the critical importance of getting a flu vaccine for each of us. It’s valuable for our own health and those around us. It’s not too late.
Therefore, as Governor Hogan just announced, we are issuing an emergency health order that essentially activates our next level of surge planning. I want to briefly walk through what it does and what it means, our basic goal being to help manage hospital capacity so that people infected with COVID-19 are able to get the care they need without overloading any single hospital and to ensure all Marylanders have access to routine healthcare.
First, the order emphasizes the importance of shifting appropriate patients to specialized care sites at the Baltimore Convention Center, Laurel Hospital, and Takoma Park Hospital. It provides agility for those sites if the need arises.
Second the order requires surge plans. Hospitals should be optimizing the use of staff, space, and ensure they are prepared for the anticipated increase of COVID-19 patients. They must also be prepared to accommodate newly arriving emergency patients. We will work closely with hospitals to ensure we have accurate real-time assessments for acute care and intensive care resources to care for Marylanders as best we can.
Further, we have infection control staff available from regional hospitals if an outbreak occurs. We can be confident of two things: One, the threat of COVID is not behind us. It is quite real. And two, the entirety of Maryland’s healthcare system is ready for the next step. For more than 9 months fighting with talented people working consistently is their shared spirit of determination and commitment to making sure Marylanders are well cared for. We all need to maintain the same vigilance. Now is not the time for complacency. The virus affects people. You must be infected and contagious before you realize it. Before you know it, people will die. We are in a marathon and not a sprint. Please don’t give up. Basic steps help tremendously and reduce the risks for everyone. Please wear a mask. Wash your hands often and keep your hands away from your face. Be mindful to watch your distance from others. We’re ready for whatever comes ahead, but we need everyone’s help.
Thank you.
GOVERNOR HOGAN: Thank you, Doctor.
I’m afraid I’ve got people using bad language now.
[Laughter]
Thank you.
Any questions.
(Question off mic).
So I went through some of the metrics. We saw some of this happening. We just crossed over yesterday the 5%. We think these are the targeted actions that we need to take right now today based on the data from where we’re seeing the infection and what our contact tracing has done. These are the things that will have the biggest impact. But as I said, this doesn’t mean this is the end. I mean, we’re going to continue to take actions if need be every day until we get this figured out. We watch it every day.
(Question off mic).
It was about half and half. Some were reiterating existing orders and stepping up the enforcement. We had them in place but people weren’t following them. Some were new orders that we do have the force of law.
In other cases, the enforcement is difficult. There are public health advisories providing the people the information they need to make the best decisions and strongly encouraging and advising them to follow the rules. But we’ll take whatever further actions we deem necessary if the situation continues.
(Question off mic).
We did address the congregations at all. They’re all under different orders with managing and distancing as opposed to gathering of 25 people. It didn’t change at this point any rules on that.
(Question off mic).
Yeah, Anne Arundel and Baltimore City.
I don’t want to call everybody out. I mean, most of our businesses are doing a great job of complying. Most of the business sectors, you know, our Department of Commerce has 17 different work groups with a couple of hundred people developing safe plans, trying to keep their members following the rules. Many of the counties are doing their best. But they’re becoming more and more lax. They may have forgotten that the rules are in place or they don’t think it’s important anymore. They think we’re safe now because we’re doing so much better than the rest of the country, that it was over. But many of those orders are still in place but people aren’t following. So we have instances of jam-packed bars and restaurants when they have never been able to stand in a bar even, let alone sit and get a drink spaced out. A lot of people are not following the rules. The county liquor inspectors who were in there anyway doing other things and local Health Departments and local law enforcement, they provide licenses to all these businesses. They’ve got to start dropping the hammer on bad apples because that’s where a lot of the spread is taking place.
(Question off mic).
We look at all the metrics. Really our positivity is better than 43 other states. South Dakota is at 54%. We’re at 5. It’s not as alarming. But we don’t like the way it’s heading. We’re not in a red zone for positivity. 10% is the rate that the federal government says you’re in the red zone. We’re saying don’t travel to the states that have 10%. But on the number of cases, there are two different metrics. We did just cross it in the past few days. Again, we’re not South Dakota, but 186.5 cases per 100,000 they are, and we just went to 19. So in both cases almost 10 times worse, and there are 38 states worse than us on case rates and I think 43 states worse than us on positivity.
But we are heading in the wrong direction. And in talking with many of our experts and with my fellow governors, they saw it go from here to spike and then shoot straight up, so we’re trying to take these measured steps to stop that from happening.
(Question off mic).
In the early calls, dealing with them on a daily basis, we put county executives in charge, all of our cabinet. We have daily calls with the health leaders and many of their departments, and we have calls every 2 weeks with our entire state leadership team talking to them. So they all — if they haven’t brought up a single concern on any of those calls including the one we had last week, I know five of the ones, all democrats, by the way, and looking at statewide office sent a press release out but they haven’t expressed any concerns to us.
Nonetheless, we’re going to double the number of meetings to make them happier.
(Question off mic).
I’ve made my feelings on this pretty clear. I think if the President and his team have real evidence of widespread voter fraud, they should come forward with it. Certainly we have legal processes for a reason. They can be challenged. They have every right to do that. But I haven’t seen any widespread evidence and I haven’t seen anything that would in any way change the outcome of the election. And I mean, you know, this is the way it works in America. We cast the votes and we live with the results. And I think most people recognize that the election is over.
It’s really dangerous, I think, to in the middle of this pandemic, this economic collapse, people dying across the country, to not know if we’re going to have a transition, is the old coronavirus task force going to be making decisions or a new one, how long is this going to go on, with no stimulus package getting done, with no additional virus relief. We’ve got to move on.
(Question off mic).
So two-part question. I was the first statewide republican or republican leader I guess to kind of congratulate the President-elect on his victory, but a number of my fellow governors and a few senators and 37 congressmen and many others, former elected officials, former President Bush, Chris Christie, a lot of people are saying that the election is over and congratulating the Vice President elect. Even more who don’t want to stop the transition from happening.
I was disappointed, frankly, and I said so earlier, with some of the response from Leader McConnell and others who have a different take on it that I think is a mistake. I think it’s a mistake for the country. It’s a mistake for the Republican Party. We have the Senate hanging in the balance, two runoff elections in Georgia. Doing anything to process votes is a pretty significant event.
(Question off mic).
So we have very clear state guidelines and metrics. Our superintendent of education and our public health assistant secretary have been in constant communication with the local school boards just like we have with the county leaders. We’ve given them advice about how we can safely get some kids that are the most special needs kids, for example, people who don’t have access to the internet who are really suffering without any instruction for quite some time, we can still try to do that. But again, the legal authority lies with the school boards and they are making decisions as they have the right to do. And I think they ought to continue to follow the advice and look at the metrics on the ground and where they are.
In some places they have done it very successfully with limited people back in school with little or no issues whatsoever. But we have really anytime there’s an outbreak, they can take quick action.
(Question off mic).
First of all, we still have 100% of all of our businesses open. We have 98% opened since June. That’s a good thing. They’re safely reopened. Important restrictions and guidelines to keep people safe. But it’s helped us also have one of the best economies in the country, better than 40 some states.
We’ve got a tremendous amount of unemployment, although most people it’s twice what it used to be before the start. So we’re trying to keep people employed, we’re trying to keep small businesses from failing and going under, but we also are trying to keep people alive and that’s the delicate balance. We still have all of our businesses open. We didn’t do any kind of drastic shutdowns and lockdowns, but we’ve just had what we think are reasonable, measured, and critically needed steps right now. We have to enforce the law. There are rules we have. We have to have a few more to make it safe.
(Question off mic).
That’s a really good question, and I may turn it over to Dr. Delbridge, because we had this discussion just a couple of days ago. And I think his caution to us was that we should expect December and January to be the worst. I’ll let him answer.
But before we peaked and came back down, we did another little one in June, came back down. But this one is more of a stay at this level for a while.
I won’t steal your thunder here, Doctor.
DELBRIDGE: When we look at the modeling, we’re concerned that December, January, February are going to be the peak times, and so much is dependent on mitigating steps that the public takes, wearing a mask and keeping distance, those kinds of things. So the effects of those are a little bit more challenging to predict, but when we see what the trajectory is now, we are definitely concerned that this is a longer lasting peak and that it’s going to go into the winter months. Some have correlated the virus with changes in humidity. It happened in other places in the world. As the humidity drops and weather changes, it becomes more of a problem. So we’re thinking along those lines, which is why it is just so incredibly important, I can’t miss this opportunity to reiterate that people get a flu shot, because it just makes them comorbid, gives them another problem to have, and keeps people out of the hospital with the flu to save space for other people.
SPEAKER: Last question.
GOVERNOR HOGAN: Actually, I don’t think I answered the other half of his question. Sorry about that.
So we weren’t ready to announce this yet today, but I can confirm we just had an emergency cabinet meeting this afternoon where Secretary Bobby Neall, who has been a longtime friend for many decades and who has done a wonderful job leading a team of people throughout this crisis, he gave us notice, announced to the cabinet and to us that he will be leaving the administration, retiring, on December 1. And I don’t have any further details on that, but we will in the coming weeks as we get closer.
SPEAKER: Thank you.
GOVERNOR HOGAN: Thank you.
Thank you, Doctor.