[Richard Quest, Cnn Business Editor-at-large:] And that's different. Normally, they can tell you X, Y, Z. Now, they simply say, we don't know. Don't take the risk. Wear a mask. Socially distance. Not a big price to pay.
[Kate Bolduan, Cnn Anchor:] Yes, not knowing is always some of the scariest part. Well, it's good to see you. Thank you. Thank you for sharing, Richard. It's great to see you, buddy. Thank you so much for joining us today. I'm Kate Bolduan. Brianna Keilar picks up our coverage right now.
[Brianna Keilar, Cnn:] Hello, I'm Brianna Keilar, and I want to welcome viewers here in the United States and around the world. Yet another day is passing without a coordinated national plan to deal with the pandemic. As the calls from doctor after doctor grow more urgent, the crisis is getting worse. And this just in. the World Health Organization says worldwide coronavirus cases are, quote, accelerating. With the world seeing about 200,000 new cases each day, twice the rate that we saw this spring, and CNN analysis showing how the crisis is deepening in the U.S., 31 states are experiencing a rise in infections. Arizona just reported its highest number of deaths in a single day and its lowest number of ICU beds, the military sending medical personnel to San Antonio, Texas, to the area there. And in Florida, local officials setting themselves up for what many fear could be a bigger outbreak. Cases are surging, hospital bed availability is shrinking, and yet Florida just announced public school buildings will be required to reopen and classes next month. Moments ago, Governor Ron DeSantis said this about the increasing spread in his state, especially in the Miami-Dade area.
[Gov. Ron Desantis:] Especially understanding that 20 to 30-year- old cohort you are seeing, more and more infections in that age group. They probably were always happening to a certain extent but I think the transmission rate has increased over the last month. So it's very important to be careful and to continue to exercise caution.
[Keilar:] I want to bring in CNN Senior Medical Correspondent Elizabeth Cohen. And, Elizabeth, your heard the governor there, cases still rising but schools are going to soon be back in session.
[Elizabeth Cohen, Cnn Senior Medical Correspondent:] Yes, that is really worrisome. I mean, schools are where kids get together. Kids are vectors, even if they don't get sick, their vector is actually even more problematic that they don't get sick because they don't know enough to stay home. And I think about the teachers that work there, the custodians, the school bus drivers, how worried they must be. I was actually just speaking to the family member of a teacher in another state where this is being considered and she is really worried what is going to happen to this teacher when they go back into this mix. It is interesting that they are saying this. It's still early July. Schools don't start until next month in Florida. Are they going to hold to this? They have several weeks to see how this goes and possibly change their minds or come up with some kind of a combination of in-school and online early, something that might help mitigate having all of those children in one place.
[Keilar:] Yes, all right. Elizabeth, if you could stand by for me, as we continue to monitor this press conference, among the new announcements that are coming out of Florida, the state is going to require all the schools there to reopen for in-person classes this fall. I want to talk more with Alberto Carvalho. He is the Superintendent of Miami-Dade County Public Schools. And, sir, I think we can all agree that in-person learning is the best for our kids. I think a lot of us are seeing that first-hand. And it's best for parents certainly who are trying to get back to work. But that order seems to entirely ignore how much worse the cases have gotten in your state. Is you district ready to go back to school as usual?
[Alberto Carvalho, Superintendent, Miami-dade County Public Schools:] Number one, thank you very much for the opportunity, Brianna. Our district is ready to go back as long as the options that we have put before our parents, our community, the surveys with parents and teachers are honored. And I believe they will. Look, the executive order that was published yesterday does require schools to open for up to five days a week across all of the State of Florida but it also allows for innovative models to be considered and that's exactly what we want to take advantage of. We have innovative models. We have models where students do not need to come to school to get their education. In fact, during the last quarter, we demonstrated how effective they can be, continuous remote education without necessarily forcing all students in to the same building at the same time. And I think that's the game changer is can we open schools with some number of students in schools for a traditional schoolhouse approach while allowing parents, teachers, individuals with underlying conditions the ability, the opportunity to continue to learn from a remote location. That's our plan, that's how we open. We will open the 2021 school year.
[Keilar:] Are you saying that the remote learning opportunities are as good as the in-person learning opportunities?
[Carvalho:] No. I think there's general agreement that the best approach of teaching children is that physical, that social connection that exists in the classroom. But we need to consider the riskbenefit analysis associated with bringing a huge concentration of students into the same building. That is why we surveyed our parents, we surveyed our teachers, and about 60-some percent of the parents feel comfortable of sending the children back to school. But there's about 30 percent of those parents who say, look, I experimented with remote learning. I am happy in my circumstances allow me to actually supervise my child at home while he or she is being taught from a distance by a competent professional dedicated teacher with a same level of engagement and time on task. And that's exactly the types of options we have before our parents in Miami-Dade.
[Keilar:] So, you say that the order respects local decision-making. If you are seeing cases continue to spike in Miami-Dade, do you feel confident that you could pull the plug on the reopening plan? Actually, sir, if you could stand by for me for a moment, I want to go to governor now, Governor DeSantis in Florida taking questions at his daily briefing.
[Desantis:] with remdesivir is the federal government bought out a bunch of it and then they sent it to the state departments of health. So our health department has distributed to the hospitals as they have needed it. That is no longer what's happening. So now the next shipment that's due in soon is not involving the state anymore. It's going directly from I think Gilead or whoever is the distributor is directly to the hospitals. I talked to the vice president, told him that we want to make sure that we don't have a gap so they're working on it as well. But it's a change in how it's being distributed now. It's no longer coming through the department of health. It is going directly to the hospitals.
[Reporter:] I have a question about contact tracing. So we've been learning a lot about from some of the communities that have been able to get ahead and managed in states like in New York, when they started their reopening plans, they had a pretty robust contact tracing program that dovetailed on that reopening strategy. Infectious disease experts this morning, again, reiterating to me that there are not enough contact tracers on the ground, this as we are now experiencing this rollback, this economic toggle back triggered, the
[Desantis:] Well, I have already green lighted 138 million for the department of health to support not just contact tracing but other personnel. All the counties have gotten huge amounts of money from the CARES Act. The contact tracing is something that can be done, and it's a component. But understand, when you're talking about an asymptomatic virus that largely doesn't create symptoms in people who are healthy and under, say, 50, you know, the contact tracing is not going to be enough. You have to have some of the things we're doing with the nursing homes, some of the other things that you're doing with social distancing. So we have put in a lot of money for it. The counties have a lot of money to be able to do it. But, New York, they went through the boom and bust, it wasn't because of contact tracing. I mean, that's the way it was, they had massive infections. We have had a flatter curve so those infections spread out over a longer period of time. That's what everyone said we wanted back in March. But we have put 138 million from the state. These guys have money. I know you've invested in contact tracing, I believe, as well. But at the end of the day, this is not a disease in which you get visibly sick, then you're contagious, so that if you isolate, contact trace, you do. Most of the people walking around with this either don't know they have it or they have very mild symptoms, and will never come in contact with the help. Another problem that you've seen is particularly younger folks aren't cooperating with contact tracers. And so when they're trying to call, they're just not getting a lot of support. You do have some informal contract tracing that's gone with younger people, where someone will have like a party at somebody's house and someone at that party later tests positive and then they tell everyone, hey, I tested positive, and then those people go and get tested. So you do see some of that. But, yes, we have put in a lot money for it. And I think it's important but it doesn't do the whole thing when you talk about an asymptomatic. So it's not as simple as saying you could just contact trace everything, not when you have a largely asymptomatic illness. Yes, sir?
[Reporter:] Please, let me ask a question. It's a two-part question. Restaurants beleaguered. And, oh, my gosh, we thought we did everything we have done. And then I want to ask you about gyms. What can you say to restaurant owners? I know you have expanded it to allow outdoor dining. But what do you say to these beleaguered restaurants in Dade County saying I have done so much and, oh, my gosh, we have to go back a step? What can you say to them, Mayor?
[Mayor Carlos Gimenez , Miami-dade County, Fl:] It's unfortunate that the way they do business means that people have to take off their masks, and taking off your mask in an interior space, according to our experts, is very it's dangerous because the virus spreads as people talk. And so the nature of the business is not that they did anything wrong, it's just the nature of the business and the number of people and the percentage of positives that we have Miami-Dade, and so the percentages are that in that restaurant, somebody, one, two, three, four people may have COVID-19 and may be spreading it. That's why it's okay to do it outside. They can have outdoor dining. So that will be allowed. In terms of the gym, we came up with a compromise. Now, people when they go in the gym, they must wear their mask and must wear their mask all the time. If they have to do something strenuous, then they have do it outdoors. And so the gyms are going to remain open but under a new set of rules, which they're okay with. And so we reached a pretty good compromise with that.
[Reporter:] A follow up in English, please? How long do you think, Mayor, that will last with the restaurants?
[Gimenez:] It will last with the restaurants until we get a positivity rate somewhere around 5 percent, because that's what the CDC guidelines call for. And so we, right now, are running at a positivity rate of over 20 percent. And one of the reasons that I have asked please keep your mask on is so that we can start to reduce the positivity rate. And once we get that down to about 5 percent, then we can start to, again, open up the restaurants in the interior spaces of the restaurants. But until then, we're going to have to go with what we got right now.
[Reporter:] Governor, Miami-Dade said that only Florida can contact trace and the Miami-Dade County cannot. Can you please explain why Miami-Dade County could not contact trace?
[Desantis:] Has has hired contact tracers. He's
[Reporter:] He announced on May 14 that he was going to hire between 800 to 1,000 contact tracers, and has not been able to hire them. And we asked them and they gave us a statement saying that, in Florida, only the Florida Department of Health can contact trace. Can you explain why during a pandemic?
[Desantis:] Well, I don't think that that I'm not sure that's correct. I mean, we want the county health departments to be involved in this working with their local leadership. That's how they have been doing it the whole time. As I said, we do have $138 million with CARES Act money that I approved weeks ago for this, and for other things that are significant. But I think that they should be able to do it and help do that.
[Reporter:] We have the county mayor with as of last Thursday who said contact tracing is a mistake purview. You're sitting here, the governor of the state now saying the county can do anything. Can you guys just look at each other right now and decide who's hiring contact tracing?
[Desantis:] Well, no, he announced that he was going to do it and he told me he gave us the heads up that they were going to be investing in some of it. We obviously have done it at the state level. I mean, as I said, it's a lot of CARES Act money. That was what the department of health, state department of health requested of me. They created a plan. They had different levels. They had some that were a little bit less, but I approved the more robust plan. And so what they're going to be doing at the state level. But I just also want to just stress on this. Look, we understand now how this thing is transmitted. I mean, we understand kind of the things, like especially when it's hot out you, pack a bunch of people in a private residence, have a party, loud music, a lot of hooting and hollering. That is going to be a strong venue for transmission. They understand that if you maintain physical distance, the chance of you infecting somebody or being infected drops dramatically. We understand that doing things outdoors, fresh air, heat and humidity, the virus doesn't transmit as readily in those circumstances. And so those things, I think, are really the significant behaviors and then obviously for the vulnerable populations to be limiting your close contact outside your home, to avoid crowds as much as you can, to be able to protect yourself. I mean, that is really where we're going to be needing to do this. And so we're doing that, it's part of it. But it's really the behavior that I think the mayor has been talking about, that we have been talking about, protecting the vulnerable, by far the most important. Clinical consequences in the vulnerable group way higher than clinical consequences in the younger groups, but the younger groups are able to spread it to other folks. And so that is the message, protect our vulnerable population and then just follow the guidelines that have been put out, whether it's a state guideline on social distancing, whether it's some of the things that the mayor has done here in Miami-Dade. We've really not had a lot of problems in Florida when folks have been following the guidelines. And I can tell you that throughout all if you go from the beginning of May through the beginning of the second week of June, our statewide positivity rate was under 5 percent, six weeks. Sometimes it got as low as 3 percent statewide. Miami's was down in the single digits. And that was part of our phase one. You had businesses open but you had people, by and large, following the guidelines. And I think when that happens, we are able to have a lower positivity rate and to move it in a better direction.
[Reporter:] So, how many contact tracers do you guys have in Miami-Dade County on the ground that are working right now? How many contact tracers?
[Desantis:] You have to ask the department of health for the exact number.
[Unidentified Female:] One at a time, please, one at a time. Samantha.
[Reporter:] Miami-Dade County has published hospitalization how many people are being admitted to the hospital today. But the state has not published that data in a county-by-county basis. The state has promised that that data would be made available, I think, last Tuesday
[Desantis:] So if you look I mean, like so this report is something that you get kind of I get it every day from department of health, but they have so much raw data on there. I mean, people can pull out these information. I mean, it's really incredible the amount of I mean, people do the charts and graphs and everything. So that's all available for folks and they're able to do it. Now, obviously, not everything is presented in this report, but just an unbelievable amount of data that's available for folks.
[Reporter:] The data that she is asking about is not being released. She is asking specifically about the number of patients
[Desantis:] So all the data that goes into this is all available.
[Reporter:] The spreadsheet of that, Governor, it is not available. It is not available. And the data that's available that shows the total number of hospitalizations is the number, that if you analyze it, it really does not give us any information. The only way for us to be able to inform the public in a better way is to know the number of just like Miami-Dade does it. Mayor Carlos Gimenez releases the data every single day, we are able to look. Here in Miami-Dade, the hospitalizations in the last 13 days have increased by 90 percent. We are able to see that because the county releases the data but the state is not. And we're wondering
[Desantis:] Yes. I mean, so, I think a couple things to think about here is so, obviously, you know, you are seeing, as the mayor has mentioned, we have seen more traffic, particularly in Dade and Southern Florida. Now, part of that is when he's reporting, that includes these 30 percent, 40 percent of people who are incidental. So you obviously have had increases for the COVID treatable but you've also had increases that kind of supplement that. So I think when you look at in March and April when they were doing this, you didn't have testing of people coming in for other reasons at the time. If you are an expectant mother, you wouldn't be tested. If you're in a car accident, you wouldn't be tested. Now, all of those people are being tested. And so they're capturing a certain percentage of people in the community who are largely asymptomatic, would not require hospitalization for this, but are doing it. And so we I think, by them talking about their rate I think Jackson is probably the highest that we've seen in that 30, 40 percent but I think others like Orlando Health and some of those, they are 20, 25 percent, maybe a little less in the Tampa Bay area. But it's definitely a phenomenon that we have seen. But I think that the message is the census, you know, I think that there were I don't know 13,000, 25 percent of the beds statewide are available. That's pretty consistent with where we have been. We have been, I think, between 20 and 30 percent since the elective procedures were put back in in May and people started to become more comfortable about going back to the hospitals. So we have abundant capacity but I think that having some of the personnel support will be very, very important. I know some of the hospital systems have done a little bit on how they are handling elective procedures. I don't think you guys have gone to any type of second level yet. And so they have a lot of levers that they can pull, and then, obviously, I think providing this support for the personnel, the 100 for Jackson obviously working with HHS to be able provide more is something that's very, very significant and will allow the hospitals to be able to handle folks as they're coming in, not just for, obviously, the people because of COVID but be able to have the appropriate isolation procedures for folks who may be giving birth, who may have a broken leg, who may be coming in for something else but are also found to be carrying the virus. So So we did so I've told you. I approved a plan $138 million for the department of health. They can provide the details of that plan if you want to. So that's already been agreed to and approved. And that may be enough, I mean, to what we would need. It's a lot of people. It's a lot of stuff. But I think it's also important to just point out when you have a lot of these asymptomatic 20-year-olds, there's not a lot of contact tracing that's being effective with them because they haven't been as cooperative with doing it. And so there's limits to how much if people aren't going to cooperate how much that could be done. But that 138 million, and that's probably the biggest commitment that you have ever seen before in terms of doing that. So that's what the state has done So the nurses are we have had contracts in place at the state this whole time in case there is just basic preparation in case there is a need to have folks. We have used some of those contract nurses at places like test centers, some of these other things, in addition to National Guard. And so we have capacity to be able to bring some more folks on. Some of that may be shifted from things that they are doing that they may not need to be doing as much. So that's just things that the state we plan for contingencies and have the ability execute accordingly.
[Reporter:] For a lot of states or just Florida?
[Desantis:] Well, I think a mix. I mean, there's places you can contract with for personnel. How they choose to deliver that, we have obviously waved any out of state limitations. So if people are coming from Georgia or from other states, they will be allowed to do that. But that's really a function of what's going on with how the companies are doing it. But those have been in place since March. We didn't really need to do much of it beyond helping with the test centers in March and April. Obviously, May beginning of June was light for us. But then as we have gotten into now, we hear the demand signal. That stuff is ready so you the flip the switch, and then you need to flip another switch, you flip the other switch. That's just basic kind of planning to be able to meet whatever contingencies. And I would stress, I mentioned this yesterday. When we were in March, obviously, there's a lot of people didn't necessarily know what was going on. The idea was flatten the curve, have a flatter curve, which meant that you'd push this out over a longer period of time. The places that went boom and bust and have the highest death rates, that's what people said you didn't want to do. Now, by spreading this out, you now have the ability to have way more robust testing. They're testing everyone that comes in the door. No one could do that in March. It just wasn't being done. There wasn't enough of an infrastructure. You have that. You had PPE shortages in March. Not that PPE is never an issue but the PPE lines are much better now. We have the protective equipment. The state has sent out huge amounts to hospitals and to long-term care facilities, so they're in a much better position. Of course, we mandated PPE in the long-term care facilities third week of March and we've been supplying them ever since. So you have that, which is very significant. You also have some of the different treatments that have been used, the steroid, you have remdesivir, you have some of the other techniques which are much better and delivering better patient outcomes. I mean, the fact of the matter is, the mortality rate for people who are hospitalized now is lower than it was in March. And I think that's worldwide probably but certainly true in the United States and here in the State of Florida. So you have that, which is something that is really, really significant. And so and then, of course, now with having long-term care facilities that are COVID only, you are in a situation where, obviously, we don't want to discharge a COVID positive person back into a facility. We have never done that. But you also have the ability where these facilities can be stepped down from hospitals, so you don't have hundreds of people dwelling in a hospital who don't necessarily need to be there but then can still be appropriately isolated. And so all these things that we now have in place is much different than was in March and, remember, the whole point of the curve, flattening the curve was to make sure we had enough healthcare capacity. People understood that you have a virus, people will get infected, you want to shield the vulnerable, of course, but you want to be able to deal with what ends up happening. And so we're in a way better position today to be able to do that and I think that that's something that has taken a lot of work. It wasn't obviously all just the state. I mean, we were involved in some of it. But a lot of the hospitals, the physicians have gotten much better at this. So that really is the nature of what we were trying to do. We obviously want to see get over this wave as soon as possible. But we have the tools in place to be able to deal with it in ways that not only Florida didn't, really, no state in the country had did when we're talking about the beginning or middle of March. It's just something that wasn't there. Now it is there and we are much better off to be able to handle it. All right, thanks, everybody.
[Keilar:] All right. You are listening there to Governor Ron DeSantis of Florida holding his daily coronavirus briefing. I want to bring in our experts to talk about, Elizabeth Cohen, as well as Dr. Celine Gounder, CNN Medical Analyst. And we're back as well with Alberto Carvalho, who is the superintendent of Miami-Dade County Public Schools, which factors very large in what we hearing from the governor there. OK. First off, to you, Elizabeth. I want to ask you about something that we heard the governor say. He was talking about particularly at a place like Jackson, I think he said, where they have folks come in that's the health system. They have folks come in for things totally unrelated to COVID. He said they get into a car accident, they have heart problems, everybody who is coming in is getting swabbed and they're getting tested for COVID. Well, I think the rate you guys are seeing, 30 to 40 percent are testing positive. They're asymptomatic. They're incidental COVID positive in the hospital. That stood out to you. Tell us.
[Cohen:] It really did. I think that's a stunning number. I mean, in a way, it's maybe the closest we get to sort of a surveillance number. Gee, how many people in this community have COVID? You can't test everyone. But when they come into the hospital, you can, so they're coming in after a car accident or after a heart attack. And 30 to 40 percent of them have COVID, that is a very high number. And so when you hear that number juxtaposed against the governor's decision to require that schools reopen when schools open back up again in August, why? That proportion of the community has COVID and you're going to require the schools open, really crossing my fingers that there will be some flexibility here. Do they need to open just like as normal or can there be some flexibility? Some children will learn at home. Some children will learn at school. Let's figure out a creative way to address this. Another thing that really struck me also about this press conference is that the governor mentioned problems. Young people are not cooperating with contact tracers. People are having big gatherings at their homes. I'm sure both of those things are true. What I didn't hear is this is what we're going to do about it. He seemed to be complaining quite a bit. I didn't hear a lot of solutions.
[Keilar:] Yes. And also on the contact tracing, just to fact check him on that, CNN looked at this. And he is talking about people asymptomatic so they can't be contact traced. CNN contacted 27 people who had tested positive. So these are not asymptomatic folks. These are folks who know they have COVID and 5 of the 27 had been contact traced. So like that's the least of the problems, dealing with people who have it positively, they haven't even touched that. I want to ask you, Superintendent, because you heard Elizabeth making that point there about flexibility when it comes to going back to school. I know you are looking at flexibility. So explain to us how your hybrid system would work.
[Carvalho:] Thank you, Brianna, and Elizabeth is absolutely right. Without flexibility, without some degree of creativity, we are really asking for a bigger problem than what the county is currently facing. For the better part of a month, we have developed a plan of reopening schools well informed by medical and health experts in our community and beyond. In fact, the former surgeon general of the United States was part of the working group. And our plan relies on, yes, a model for traditional schooling with all of the precautions being observed with social distancing, with a wearing of PPEs, with visors and dividers and masks. But in addition to that, as a means of reducing student density in any one school, additional options, such as hybrid models that rely on alternating cohorts of students in school and out of school in alternate days of the week, in addition to something that we have perfected over years, which is a 100 percent online remote learning opportunity. Without that flexibility, in addition too, by the way, which was not discussed, the possibility of a later start day for the school year depending on local conditions at the time, obviously, all in collaboration with the local health department taking into account the reality right here in Miami-Dade, not just the general reality across the State of Florida.
[Keilar:] Superintendent, if you can this is something I know that administrators everywhere are trying to figure out. But how do you make that work when you have parents who are going back to work?