Red Poppy

My grandmother, born in 1894, was active in the American Legion, so my mom carried on that tradition. I remember going with mom to our local bank to hand out paper poppies, handmade by veterans to raise money for veteran healthcare. Mom taught me to approach the businessmen by saying, “Poppy, sir?” The gentleman would hand mom some spare change, putting the poppy into the buttonhole on his lapel. Photo Credit: Marc Merlin

The poppy, like Memorial Day, reminds us to reflect on the legacy of our fallen soldiers. But this Memorial Day weekend the Boy Scouts aren’t out putting flags on graves. Kids have already been out of school since March. And families aren’t excitedly waiting for the gates of swimming pools to swing open so they can take their inaugural summer splash.

Like many of you, I’ve been “sheltering” for about two months. As a friend says, “I can only think four weeks at a time.” So we’ve been at this about 8 weeks, two four week “chunks”, and we’re about to start a third chunk. Time to take stock.

Some Really Good Stuff

Last March, I wrote that we have all “the right stuff” to get through this. Some of that “stuff” is beginning to reveal itself:

Bringing it all together: South Georgia farmers have been hit hard. School and restaurant closures mean no one’s buying their crops. Bring together those farmers, DeKalb county, $40,000 of federal CARES Act money, and you get 600 boxes of Georgia-grown produce and 600 boxes of frozen chicken distributed to families in need. Bringing it all together means crops don’t get wasted and people don’t go hungry.

COVID Treatment: Two treatment options for hospitalized COVID patients are showing promising outcomes, antibody blood plasma treatment and the antiviral medication Remdesivir. Georgia has received two free shipments of Remdesivir. The first went out to eight hospitals, treating 110 patients; the second to 29 hospitals for 310 patients.

A New Vote-by-Mail System: As Georgia’s Secretary of State, Brad Raffensberger, said during a recent conference call with legislators, “It usually takes 6, 7 or 8 years to put a (Vote-by-Mail) system like this in place.” Utilizing Georgia’s existing absentee ballot program, almost half-a-million people have already cast their ballots by mail for the June 9th primary. Georgia received 10.8 million in CARES Act dollars designated for elections. The scary thing is that seven million dollars have already been spent (4 million on printing and postage alone), and we still have the November election to get through, when many health professionals are predicting a second wave. Call your congressperson and tell them we need federal assistance to continue Vote-by-Mail in the November election.

You still have a little more time to request a ballot if you do it quickly! Secretary Raffensberger said they are now processing Vote-by-Mail applications in “real” time (2 – 4 days). Print the application, fill it out, and either mail it or email it to your local elections office. If you don’t have a printer, or if you have any questions regarding voting, call the Voter Protection Hotline at 1-888-730-5816. 

Early In-Person Voting has started. Click here for early voting hours and locations. Gwinnett county posts polling place wait-times on-line!

Click here for Vote-by-Mail Dropboxes. Click here for dropboxes in DeKalb. If you choose to mail your ballot, I’m told you generally need one stamp, but two for Gwinnett (Gwinnett’s ballot is longer since it’s printed in two languages).

The Democratic Party of Georgia advises Voting-by-Mail for your safety. Also, the Secretary of State’s office is asking people who started the Vote-by-Mail process to stick with it, if possible, rather than switching to in-person voting. If you show up to vote in person after requesting a ballot, a poll worker must cancel that ballot, which takes time and leads to longer lines. If you have an absentee ballot and need to vote in-person, it helps to bring the ballot with you (although this is not mandatory).

Room for Improvement

Test Kits: Georgia continues to work on ramping up testing, with over 100 test sites now located across the state, and 200,000 test kits promised from the feds (30,000 have arrived). Unfortunately, Georgia has been artificially inflating test numbers by including antibody tests in the totals. (More about this below). It is currently recommended that 2 percent of the population be tested every month. In DeKalb that means we should be testing 15,000 people per month. Clearly, we have a long way to go. DeKalb’s Board of Health director reports we don’t even have a system in place in DeKalb to know exactly how many are being tested, because we don’t yet have a county level sharing platform. Some businesses, such as Emory and MARTA, have begun doing their own testing, which is not recorded in any official capacity.

Contact Tracing: The State’s Contact Tracing program has hired and on-boarded 500 tracers. These tracers are now following 3300 COVID positive individuals and 9000 of their contacts. By mid-June they will have 1000 tracers. Johns Hopkins estimates needing 7 tracers per 100,000 people. The State has promised DeKalb 60 tracers, slightly above the recommendation.

Quarantine: COVID-positive people are asked to quarantine at home, but many people do not have a way to isolate themselves at home, and live with vulnerable family members. This week, I spoke with Insurance Commissioner John King, Doraville’s former Chief-of-Police. Gen. King is heading up the response in Hall county’s hotspot. I’m happy to report that Gen. King has secured the floor of a hotel for quarantine space. However, Gen. King said it’s hard to convince people to use it. Many of Hall county’s COVID positive people are young males who work in the poultry plants and are asymptomatic. They just don’t see the need to quarantine. As Gen. King said, preventing spread of the virus is all about getting the message out through people who are trusted and known in a community. The key word is trust. None of this works without trust.

The Really Ugly

Data Manipulation: Speaking of trust, last week the Governor’s office came under fire for manipulating data to make it look like cases had been in decline for two weeks. This week they were under fire again for including positive antibody tests in the numbers for total tests, making it look like we are testing more people than we are. And as if that’s not enough, I’ve noticed that my calculated hospitalization numbers have not shown the drop the Governor’s office reported this week. In fact, my hospitalization totals, calculated from the cumulative totals on the Dept. of Public Health website, have increased during the last week. The Governor’s numbers do not include people who are “under investigation for coronavirus.” And according to NBC news, even if they had a positive COVID test before being admitted, they are still “under investigation” until they have a hospital administered positive test. With labs backed up, it’s quite possible that some people could be discharged before test results return. A quote from the Scottish poet Andrew Lang seems apropos: “He uses statistics as a drunken man uses lamp posts — for support rather than for illumination.”

Hospital Lay-Offs: Much has been said about how we need to protect our healthcare workers. But now that the surge is over, instead of getting a little rest, healthcare workers are being laid off. This is because hospitals are reporting losses of hundreds of millions. Patient volumes are down. Emergency rooms are at 34% utilization, way down from normal, and people are coming in more sick due to delayed care. In-patient beds normally stay 80 – 90% full, but they are down at least 25%. In a for-profit healthcare system, these losses are not considered sustainable. What if our nurses, already in short supply, decide it’s just not worth it, and leave the profession? Without them, we are toast. A for-profit healthcare system during a pandemic is not sustainable.

The Opportunity

COVID is about to break our healthcare system. 

Georgia’s unemployment rate hit 11.9% in April. More than one out of every ten workers is without a job, worse than anything we saw during the Great Recession. Many of these workers have also lost their health insurance. In 36 other states, these workers can sign up for Medicaid, but not in Georgia, because we did not expand Medicaid. When you see underutilization stressing the financial viability of Georgia hospitals, you are seeing the effects of people afraid to seek care. Not because they’re afraid of catching COVID, though many are, but because they know they can’t afford the care. If you end up hospitalized with COVID, it will cost you an average of $78,000. How many people have that much spare change?

We can create policy that takes the profit out of healthcare. We can expand Medicaid in Georgia. We have an election coming up this November and it’s a big one. Get your friends to vote like their lives depend on it. Because they do.

Healthcare Heros

Action One:
Help Someone Apply to Vote-by-Mail

This week is “Vote-by-Mail Week”, and the Democratic Party of Georgia (DPG) set a goal of helping 70,000 voters apply for Vote-by-Mail ballots. On Friday they had already assisted 67,859 people, so they increased their goal to 80,000. Help blow-the-top off their goal by reaching out to people you know today.

Each person you get to apply for Vote-by-Mail this week will be more likely to Vote-by-Mail in November, which will help us deliver the votes to defeat Donald Trump. The DPG has on-line resources that explain how to Vote-by-Mail.  Check them out — I especially like the video!

Voter Protection Hotline: 1-888-730-5816: Applied, but haven’t received your ballot? Can’t find a ballot dropbox? Call this hotline for any questions related to voting. This service is the single most important effort I have ever seen the DPG accomplish in the twenty years I have been involved in Georgia politics. One Senate 40 constituent called the hotline this week because she had not received her ballot. She was patched through to the DeKalb Elections Office, where she found out they had no record of her request (she had faxed her request and they had some faxes that had not come through clearly). The lesson? Be tenacious!

Action Two:
Donate to a Food Bank

I have a long list of people I’m helping to obtain their unemployment benefits.  Some of them have been waiting for weeks and their situations are heartbreaking. It’s frustratingly slow.  I’m practically stalking the Department of Labor’s Commissioner, Mark Butler, trying to get updates and information — even begging him to personally help. During a Senate Democratic Caucus conference call, he literally told me to send him an email, and “put it in red,” so he could find it among the thousands of emails he is getting. I’m happy to be “The Senator in Red,” if it helps people get the cash they need to pay rent and put food on the table.

During a normal, pre-pandemic month, the Department of Labor is staffed to process about 20,000 claims. In April alone, they processed over one million. They don’t have the funds to staff up to meet the demand, and one of their offices has been hit by COVID.

These are the people who need the help of food banks on a temporary basis to feed their families. The Atlanta Community Food Bank estimates that they are serving 30 – 40% more families than they did before the pandemic, and that the financial support from donors has been “unbelievable.” Stimulus money continues to be slow to reach the people who need it. Consider making a monthly contribution to your local food bank, or donate to the Atlanta Community Food Bank.

Action Three:
Call the Governor’s Office

Last week I told you about a huge Softball Tournament scheduled in Dalton, potentially drawing a crowd of up to 5,000 people from various states. When I called the Governor’s office to ask if this event might violate the bans on large group events, I was told the Governor would soon be announcing a “clarifying Order.”

The Order was announced on Tuesday, May 12th. It’s 30 pages long and loosens some restrictions for daycare, restaurants, summer camps, and swimming pools. But it keeps in place a ban on large group gatherings where social distancing cannot, or is not, adhered to.

I can report that the Softball Tournament was cancelled. Wednesday of this week, I received the following correspondence from the Governor’s office: “We strongly discourage large gatherings like this. If they choose to move forward then they need to ensure proper social distancing guidelines are taking place. If there is a violation then people need to contact local law enforcement. Again, we strongly recommend that they don’t take place because of the difficulty of social distancing in these events.”

The lesson of the story: Phone calls can make a difference. The Governor’s phone number is 404-656-1776

Action Four:
Know your Tests and Be Cautious

I have noticed confusion about the different kinds of COVID tests, and private clinics throughout the district have signs out front advertising “COVID Tests Here.” So I asked Senate 40 resident Mark Perloe, MD, to write up a summary to help people navigate this confusing testing landscape. Thanks, Mark! Here’s what he has to say:

“It has been suggested that increased testing for COVID-19 will help us move past the pandemic. Unfortunately, too many questions remain about the implications of test results and how to act on them. This is further complicated by a multitude of different test types and companies offering test kits. And a negative viral test today does not mean you won’t be exposed and develop COVID-19 a week or two later.

There are two types of tests being offered. The first type of test, offered at no cost through your local Health Department, looks for the presence of viral RNA particles by using a sample obtained from high in your nasal passages. The results are usually reported in 2-3 days. If the virus is found, you will need to quarantine for a period of two weeks after your symptoms resolve. This type of testing is rather uncomfortable, but it is the most accurate method to determine the presence of the virus. A similar type of test to detect the presence of the virus uses a cheek swab or saliva sample. It has been reported that up to 30% of people shedding virus may test negative by this method. So, if you have tested negative with this less aggressive sampling, you should go ahead and quarantine.

One to three weeks after the initial infection, a second type of test looks for COVID-19 antibodies. While a positive result shows that you have been exposed to the corona virus and that your immune system is mounting a response, unfortunately, it does not indicate that you are immune to reinfection. Your immune system may have produced antibodies for other types of corona virus [the common cold virus] which affect the accuracy of antibody tests. Additionally, a positive antibody test may not remain positive a few months later. It also does not address whether you still carry the virus and might infect someone else who is less able to fight off the infection.

While this may sound rather bleak, the speed at which our understanding grows offers hope. Scientists are improving testing methods and access to testing has increased. Research teams around the world are working to develop a safe and effective vaccine against the corona virus. Until such time as we have testing that easily identifies those who carry the virus and those who are immune, we should all act with caution and practice physically distancing, and avoid large gatherings. Frequent handwashing, remembering to avoid touching your face, and remembering to keep that face mask on when in public can help life begin a new normal.”

For more information, visit the CDC website.

Action Five:
Pay your State Taxes Now if you Can

I am carefully watching monthly state revenue reports. Surprisingly, March revenues were up, but April was down by 1.03 billion. Much of this decrease is due, however, to the shifting of our income tax deadline from April 15th to July 15th. Georgia currently has 2.7 billion dollars in its “rainy day fund,” half of which will be needed to pay for State operations through the end of the current fiscal year, June 30th. If you are able to pay your 2019 state income taxes before June 30th, it will help the state make its budget for this fiscal year.

Despite having very little information about the behavior of the economy, the Governor will need to set a revenue estimate for the 2020 – 2021 fiscal year, which begins July 1. The State Economist, Dr. Jeffrey Dorfman, will advise the Governor using projections. Dr. Dorfman told the Joint House & Senate Appropriations Committees to expect revenue to lag the first quarter (July – September) when he expects revenue to dip around 10%, or 600 million dollars, before the economy picks up in the fall. For this reason, the Governor has asked all departments to cut their budgets by 14%, which is severe enough to require employee furloughs.

The 155th Georgia General Assembly will reconvene its suspended session next month. Right now the Speaker of the House and the Lt. Governor are squabbling as to whether that date will be June 11th or 15th. But what we do know is that we must go back in June to pass the 2020 – 2021 budget so the State can operate.

Like most states, Georgia must pass a balanced budget, meaning we cannot spend more than the revenue we bring in. For that reason, Georgia cannot spend money to generate economic stimulus the way Congress can. This is why we need national leadership.

Action Six:
Support a Local Candidate

In 2018 we added a significant number of Democratic votes and voices to the Georgia legislature, bringing about moderation and balance, but we need more votes to be able to put a stop to reckless governing. To help find a candidate to support, access the Georgia 159 Together Voter Guide, an amazing spreadsheet that tells you who’s running and which districts are flippable (click on GA House & GA Senate tabs at the bottom of the spreadsheet).

What if the Governor’s revenue estimate is too high? The Governor gets to slash the budget with no legislative oversight as the year moves along, just as he did in 2019 when he told departments to cut by 4% because there “might” be an economic downturn. I have only recently observed Georgia leaders overestimating revenue. Rather, our fiscally conservative state has had a long history of underestimating revenue, allowing the legislature to target additional spending if and when it comes in higher than expected.

Georgia’s government is structured to have a strong Governor and a “weak” citizen legislature. And during this emergency, the Governor has extraordinary powers. For instance, the state received millions of dollars in CARES Act stimulus money. Though much of this money must be distributed according to formulas, the State has a pretty big pot of federal money to allocate to COVID related expenses. Legislatures in some states, like North Carolina, have participated in the appropriations of these funds. I have asked the Governor’s office for the accounting of how these funds have been spent, but have yet to receive them.

When the legislature reconvenes next month, it will not be business as usual. Most of the bills we passed on March 12th, Crossover Day, will remain “on the table.” Because physical distancing is not possible in the House and Senate Chambers, legislators will distribute themselves throughout the Capitol complex, only to return to the Chamber when they are called in small groups to vote. This process will be very slow, thus our calendar of bills and amendments will be limited. I don’t expect healthy debate to occur, and the most important part of Democracy, participation by the people, is certainly jeopardized.

We have a Governor who campaigned on slashing government. Remember the ad where Kemp says, “I’m Brian Kemp. I’m so conservative, I blow up government spending,” while viewing a literal explosion in the background? This Governor is not going to be crying over slashing the very services our State government provides —  education, healthcare, transportation, parks, nursing home care for the elderly, and services for the developmentally diabled. If this upsets you, promote Vote-by-Mail now, and find a candidate to support. We might be physically distanced, but that doesn’t mean we can’t get things done.

 

May 15 Capacity In Use Available
Ventilators 2,840 852 1,988
ICU Beds 2,963 2,082 881
ER Beds 3,348 966 2,382
General Beds 15,146 10,492 4,654

source- Georgia Hospital Association

Curve Balls & Motherhood

There’s a dose of bittersweet about Mother’s Day this year. Missing are the usual celebratory brunches, ornate corsages proudly worn at worship services, and lively family gatherings. Yet I can’t recall a year when it’s been more important to love our mothers, as the last few months have sent many of them a curve ball. Those in long term care facilities suddenly stopped getting visitors. Homeschooling became the norm for moms who didn’t sign up for it. Wanda Cooper-Jones, mother of slain Ahmaud Arbery, grieves this Mother’s Day, along with all the other moms whose sons have been murdered for being black. Many of our mothers and grandmothers have recently departed. But held within all this bittersweetness, there’s more love than any corsage can hold. Reach out to a mom today, even if she’s not yours, and shower her with love. She needs it.

Asiatic Dayflower

 In honor and memory of our moms, who love and care for us even when we don’t know it.

You have to be quick to catch a glimpse of this small, yet powerfully blue flower, known as the Asiatic Dayflower. It only shows its glory for one short day — truly bittersweet.Photo credit: Marc Merlin

Batting Average

Testing Update: When I first started tracking Georgia’s testing, we were testing about 800/day, while New York was at 18,000/day. Now Georgia is averaging about 10,000/day and has over sixty test sites across the state. In the early days, it took up to 10 days to get test results. Now rapid tests get results in 30 minutes and tests that require lab processing are available in a day or two.

All Georgians Can Get Tested: This week the Governor announced that anyone can get tested — no symptoms required. Unfortunately, the media made it sound like everyone should get tested, which is not the case. While we have enough tests to meet the need, we don’t have enough tests for 11 million Georgians to get tested on a regular basis. But if you want to visit someone who is medically vulnerable, and are willing to quarantine yourself while you wait for results, getting tested could give you some assurance that you won’t unknowingly share the virus.

Hospitals Take A Seventh Inning Stretch

Except for hotspots like Albany and Gainesville, and possibly a new one in Hancock county, hospital admissions have continued to decline. Administrators are very cautiously opening up essential and elective procedures that were put on hold during the surge. Every new patient is being tested for COVID prior to undergoing procedures. For the Atlanta based WellStar system, this means 300 potential patients were tested last week — four unexpectedly tested positive.

May 8 Capacity In Use Available
ICU Beds 2,976 2,089 887
ER Beds 3,348 1,010 2,338
General Beds 15,137 10,259 4,878

source- Georgia Hospital Association

Extra Innings

Contact Tracing: Dr. Kathleen Toomey, Commissioner of the Department of Public Health, calls Georgia’s contact tracing program a “logistical deployment.” In an effort to build a team of 1000 tracers, 300 new jobs have been posted, 1000+ people have applied, and a second wave of 300 more jobs will soon be posted. Since traditional tracing approaches prior to the shut-down failed to keep up, this new tracing program will employ non-traditional approaches in order to embrace the massive task. Georgia has entered a contract with the MTX group, in coordination with Google, to assist with voluntary symptom self-reporting, which will free up valuable time for contact tracers to do other things. The Google app Georgia is using does not include location tracking.

Augusta University Health*: Here’s something I need your feedback on. During Gov. Kemp’s press conferences, he has spoken proudly of a partnership with Augusta University Health Express to provide free, statewide COVID-19 video and telehealth screening and referral to testing through a downloadable app. Legislators have been asked to share this app with the public, so I tried it out myself several weeks ago. For various reasons, I was not comfortable with it. The app asks for a very detailed medical history, including security information like birthdate. You’re then asked to choose a provider based on a photo, and finally, you are asked to create a log-in for a health portal to store and access your records. At Gov. Kemp’s most recent press conference, he announced a 1 million dollar contribution in private funding from Chick-fil-a Peach Bowl to support this service. A recent AJC article describes some start-up problems. If you are interested and can look at the app, I’d love to know what you think about its usefulness to the general public.

*Augusta University is the new name given in 2015 to the Medical College of Georgia and Augusta State University, which merged in 2013.

Play Ball! – or Not? (stay tuned)

As spring rolls into summer, the question of summer recreation comes up. Will summer camps meet? Will swim teams swim? The Governor’s office recently clarified that only government run swimming pools are closed, along with amusement parks and live entertainment venues. We’re still waiting to determine the impact of all this activity — will the lack of social distancing cause another surge?

A constituent brought to my attention a huge Girls Softball Tournament that is planned for next weekend in Dalton. We’re talking upwards of 5,000 people from various states crowded into four ball-parks — many very happy to be playing softball in Georgia, since they can’t yet hold tournaments in their own states. Crowded bathrooms, dugouts, and spectator areas that don’t allow for social distancing. Cash being passed around for concessions. Hands reaching for ketchup and mustard in common condiment areas. You get the picture. Lots of germ sharing.

I brought this to the attention of the Governor’s office, inquiring as to whether this activity falls under the still closed “live entertainment venues”. Friday I got a response: “The Governor will be announcing a clarifying Executive Order next week.” Stay tuned.

Voting During a Pandemic, Addendum

I received lots of follow-up questions about elections last week. Between elections being postponed, recommendations to Vote-by-Mail, and new voting machines for in-person voting, there’s a lot to be confused about.

Voter Registration Deadline is May 11 (Monday) for the June 9th Primary. Most voters can update their registration online at “My Voter Page.” (did you bookmark it last week?)

Early Voting: In-Person voting begins May 18th. You can vote at any early voting location in your county. Find a list of times and locations here as soon as they become available.

Democratic Party of Georgia Voter Protection Hotline: 1-888-730-5816

Do I Need to Vote in June? For those of you who voted in March, yes, you need to vote again because the June 9th election has lots of additional races. Everyone needs to vote in the US Senate primary, and depending on what county you live in, there are other races such as US House, county commission, school board, sheriff, and lots of judges and offices of the courts. If you voted in March, your previous votes in the Presidential Preference Primary still hold and you will not need to cast those votes again (and they should not be on your ballot).

How Do I Know My Vote-by-Mail Ballot Will be Counted? Trust in our election system has been eroded no matter which way you choose to vote. All I can say is that there are lots of people working to make sure your vote is safe. Voting-by-Mail keeps YOU safe. The Democratic Party of Georgia is recommending everyone Vote-by-Mail for the June 9th election.

How Do I Request a Vote-by-Mail Ballot? If you have your Red, White & Blue “Secure the Vote” application form that was mailed to you over a month ago, you can still use that. If you don’t have that, print a copy off the Secretary of State’s website. If you don’t have a printer, call the Democratic Party of Georgia Voter Hotline at 1-888-730-5816 and they will mail you a ballot request form.

How do I complete the Application to Vote by Mail? The Democratic Party of Georgia has several resources available to guide you through the process, including a step by step guide and an instructional video.

Where is my Ballot? Many people requested a ballot over a month ago but still have not gotten it. Ballots are being mailed by an outside mailing house, after the requests are processed by the counties.  We are seeing delays in mailing out the ballots and status updates on My Voter Page are not necessarily in “real time”.  Call the Voter Hotline at  888-730-5816 if you think your ballot should have arrived by now.

How many stamps do I need? Ballots in different counties weigh different amounts. I understand Gwinnett’s is heavy enough to require two stamps. DeKalb’s is light enough for only one stamp. It has been widely reported that ballots will be delivered even without postage, but I wouldn’t depend on that. I’ve already heard reports that Gwinnett might not deliver them if they don’t have any postage. If you want to be super safe, call your Local Elections Office to find out where they have Ballot Dropboxes. You can find that number here.

Inner Envelope/Sleeve: Once you receive your Ballot, the instructions tell you to seal your ballot inside the “inner envelope.” These instructions are not accurate. Instead of an envelope, there is a privacy “sleeve,” and you do not need to seal it. Here’s some additional information on this topic.

DeKalb Sheriff’s Race: If you live in DeKalb and did not vote in March, there will be two separate Sheriff races on your ballot and they will look pretty much the same. This is actually correct. One race is to elect a sheriff to fill an unexpired term (from the election until the end of the year) and the other one is to elect a sheriff to the term that starts in January.

What if I request a ballot but later decide to vote in person? If you still have the ballot, try to take it with you to your polling place so the poll worker can cancel it. If you forget to take your ballot, or have not received it yet, the poll worker can still cancel it. You will need to sign an affidavit saying you have not already voted.

Get in the Game!

Here’s a fun challenge. During the next three weeks, see how many people, especially young people, you can get to apply for a Vote-by-Mail ballot. Go ahead and print out the application, get some envelopes and stamps, and make it easy! Once people get in the habit, they’ll be more likely to Vote-by-Mail in November. Make a point to follow-up so you can help at each step of the process. Every year, there are too many registered voters who don’t vote, especially people under forty. This is not the year to skip the election!

Voting During a Pandemic

In 2019, the legislature appropriated well over 100 million dollars in bond funding to purchase new, state-of-the-art touch screen voting machines. I opposed the purchase of these machines for a long list of reasons, but never in my wildest dreams did I imagine what a bad idea touch screen voting would be during a pandemic.

These new machines were supposed to be rolled out for the March 24th Presidential Preference Primary, but it was abruptly terminated and postponed until the May 19th General Primary, due to community spread of the virus. The election was then postponed again until June 9th.

The virus will still be lurking in June, so how do you safely vote during a pandemic? Vote-by-Mail — the same process we have always had, known by the name of absentee ballots. Before 2005 you had to state a reason for voting absentee but now anyone can Vote-by-Mail by personal choice. If you have never voted by mail, now is the time to prepare, because there are several steps involved.

Check Your Address: First, you need to make sure the address on your voter registration is up-to-date. Do this by looking up your record on My Voter Page. This is a really easy-to-use site. You should bookmark it and check your registration well ahead of any election. You must make any changes to your registration 30 days prior to the election, so your deadline for this step is Monday, May 11th. Do it now!

Request a Ballot: Second, you must request a Vote-by-Mail ballot every time you vote (there are exceptions, including those over 65, disabled, or military who can check a box to apply for a ballot only once per election cycle). Most people were mailed a Vote-by-Mail request form about a month ago — it had a Red, White & Blue “Secure the Vote” logo (scroll to the bottom of this email to see a picture). If you still have this request form, you can use it. Or, you can request a ballot by using the My Voter Page —  did you bookmark it? Once you find the request form, you need to print it out, fill it out, and either mail it to your local elections office or take a picture and email it. There is no fixed deadline for requesting a Vote-by-Mail ballot, but your voting ballot must be received by the final day of voting, June 9th, so do this right now!

Complete Your Ballot: Third, wait for your ballot to arrive. You can get updates on My Voter Page — did you bookmark it? Once it arrives, fill it out, put a stamp on it and mail it back in, or find an official dropbox and save the postage — do it in plenty of time for it to be received by the last day of voting, June 9th. Check My Voter Page to make sure your ballot was received. You did bookmark it, right? You will be in good company voting by mail. Already, the Secretary of State has received ballot requests for the 2020 Primary from as many people who voted in the 2016 General Primary overall!

Let me know if you have questions, and I’ll have a volunteer reach out to you to help. If you prefer, you can still vote in person using those new touch screen machines — just don’t forget your hand sanitizer and mask.

Targeting our Interventions

Each week I listen to a conference call provided to elected officials by the WellStar Health System, getting updates from both hospitals and Public Health Directors. It’s been an invaluable resource.

Black & Hispanic Communities: This week we had a special guest — Dr. Jeffey Hines, who works for WellStar and specializes in gynecologic oncology. Dr. Hines not only spoke insightfully about why black and hispanic communities across the nation are being hit particularly hard by this virus — he also shared some concrete COVID-19 containment action steps.

Dr. Hine’s short, yet powerful presentation got me thinking, and I haven’t stopped since. I can’t stop because Georgia is not taking the necessary actions to help the people this virus is hitting the hardest.

Hall County is showing signs of being Georgia’s next new hotspot. Recently, the Atlanta Journal Constitution reported that almost 400 poultry workers across the state had tested positive for the virus. Gainesville has been called the Poultry Capital of the World. And President Trump has now signed an Executive Order aimed at preventing supply chain shortages, keeping meat processors open and workers as risk.

This illustrates the daily peril so many of our essential workers, many of whom are brown and black, face everyday. They risk their lives to go to work so that the rest of us can have what we need. And when they get sick, they are told by our leaders to self isolate in their homes. Never mind that they don’t have rooms to isolate in, nor a separate bathroom, and that they live alongside their vulnerable grandparents who have also been mandated by our leaders to shelter-in-place to avoid getting the virus. This is a major reason Dr. Hines says this population ends up getting hit harder by this virus than others. Yet our containment policies are written for the “others.”

A couple of weeks ago, a constituent shared an article with me entitled “Coronavirus Advice from Abroad: 7 Lessons America’s Governors Should Not Ignore as they Open Up their Economies,” asking me to share it with Governor Kemp. One of the lessons presented in the piece was radical, advocating that the sick be isolated from their families for 14 quarantine days. This was a lesson from Italy, where multi-generational living is commonplace. However, lessons from Taiwan during the 2003 SARS outbreak found that this type of quarantine was often viewed as being sent to jail, and people ran away, so they learned that you have to treat people really well. Put them up in the Hilton, feed them good food, check on them often, and let them watch movies. This is the kind of policy that can protect those being hit hardest by this virus.

One might think this would be a hard sell in Georgia. But it’s not really that far-fetched from what I’ve seen Georgia already do. We housed over 200 sick homeless people in a hotel in downtown Atlanta and provided public health professionals to care for them. And early last March when there were only a few cases of the virus, Georgia set up a quarantine site at a State Park where people could go if they couldn’t self isolate at home. At some point, land was identified for the construction site for a larger quarantine facility. What happened to this effort? Certainly we can’t quarantine every sick person, but perhaps we could return to this idea so that our essential workers don’t have to put their families at risk in order to keep life more “normal” for the rest of us.

Six Lessons from Other Countries as we Open the Economy

The “Lessons for Governors” article continued with six other lessons. Let’s take a look and see how Georgia is doing.

Build an Army of Contact Tracers: The Georgia Department of Public Health has shifted its focus the last couple of weeks to developing and recruiting an “army” of contact tracers, much like the state of Massachusetts has done. They currently have 500 public health employees across the state who have been temporarily reassigned to contact tracing roles. In addition, new positions for 300 contact tracers have been posted, and hiring will begin soon. Student internships will be offered to 175 Master of Public Health students for school credit. Public health has also partnered with Google, though the Google app is not a replacement for contact tracing. Georgia’s contact tracing program has already been rolled out in three communities and will go statewide next week. No one in public health has any experience with an effort this large, and I’m sure there will be hiccups, but I applaud public health for having the vision to give this a try.

Prepare to Test Constantly: Gen. Tom Carden, Director of the Georgia Dept. of Defense, has been put in charge of testing. Over 50 drive-thru testing sites have been set-up, and more are being added. Over the last few weeks, the number of tests conducted each day has ranged from 3000 to around 19,000, although data graphs do show signs of “batching” — holding test results from one day to the next, making some daily totals look larger than they are. Testing is improving, but Gen. Carden has refused to state an ultimate daily goal. When pushed, I have heard him say that testing 10% of the population is not realistic, and that trying to test 11 million Georgians is like trying to boil the ocean. When pushed further, Gen. Carden said he’s going to push testing until the system breaks. Let’s hope not.

Protect, Protect, Protect Healthcare Workers: For our healthcare workers, COVID-19 is a marathon, not a sprint. Ensuring they have the proper PPE is undoubtedly important, but as a potential second wave looms, it’s critical we bolster their morale so they don’t quit their jobs. Low wage healthcare aides need to be paid more. And they might need to be put up in a hotel if they get sick so they don’t have to endanger their families. It means continuing all the community support we’ve been laying on them — the meals, the cards, the cheers. Put simply, without our healthcare workers, we’re toast. We’re doing okay so far, but we have to keep it up.

Normal is not the Goal: The legislature is going to go back in session sometime during the next six weeks to finish the 2020-2021 budget. When we do, we’re looking at having to work in an environment where it’s not possible to physically distance ourselves. The chambers just aren’t big enough. The Senate Democratic Caucus has discussed splitting into two groups so only half of us are in the chamber at once, but we’re hearing the Majority Party wants things to look “normal” — that’s their goal. Wearing masks is a powerful way to communicate that things are not normal.

Keep your Eyes Peeled for the Second Wave: This requires good data, and right now, I’m not trusting Georgia’s data. Last week I reported how changing the way cases are recorded would result in the 14-day downward trajectory of COVID-19 cases Georgia needs to meet the Gating Criteria put forth in the Open American Up Again plan. That graph came out this week, and as Dunwoody resident Robert Wittenstein said, “It is more brazen and outrageous than I expected it to be. That sharp decline during the “14-day window” is a result of their backdating cases combined with our current protocols of only testing folks with symptoms.  If you are getting tested, it means you have symptoms, and if you have symptoms, it means you were infected over two weeks ago!” We data geeks need to hold our Georgia leadership accountable so that their desire to make “normal” their goal does lead to being blind to a second wave. We owe that to our healthcare workers too.

Clear Communication is Critical: I still participate in a weekly conference call with the Governor’s office. Sixteen questions are selected and turned in prior to each call. The last couple of weeks, the Governor’s staff has pretty much refused to answer many of these questions, to the point where it’s like, “why bother?”  Lots of room for improvement with this lesson.

Vote Like You Mean It

It’s 2020 — the year of the big November election we’ve all been working toward. But we can’t go out and register voters, we can’t host gatherings to nurture the communities we’ve all grown to love. So what do we do? Vote-by-Mail is a tremendous opportunity to change the way we vote, to a process that makes so much more sense to so many people. It’s still not as easy as it should be, but it’s basically the “hand-marked paper ballot” so many have been fighting for. So during the next couple of weeks, tell everyone you know, especially young people, to go to My Voter Page (remember, you bookmarked it) and to request a Vote-by-Mail ballot. Let’s see how many people we can get to vote this June, just like we increased voter turnout during the 2018 General Primary. This is how we “practice” for 2020.

Elections & COVID-19: A Virtual Town Hall

On Tuesday April 28, at 6pm, please join me, State Representative Beth Moore, and Gwinnett County Commissioner Ben Ku, for a public online program entitled “Elections & COVID-19: A Gwinnett Virtual Town Hall.”

Coronavirus has changed a lot of things, including the ways we safely and securely conduct our elections. We’ll  provide you with important updates and recommendations for best practices in the 2020 election cycle. This is a non-partisan event, and all district residents are invited to watch and submit questions.

You can tune in one of two ways:
(1) Watch the Facebook Live broadcast from my Facebook page; or
(2) Listen in by calling (301) 715-8592 and entering Meeting ID 926 3171 1369.

You can submit questions in advance by clicking on this Google Form link.

We’ve Only Just Begun

Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.
–Winston Churchill

The Governor’s About-Face

Almost two weeks ago, a beleaguered Governor Kemp, just back from visiting tornado-ravaged north Georgia, stood in front of the press to address Georgia’s response to the COVID pandemic. He was asked when he thought the economy could open back up. With an overwhelmed expression he said, “On the back side of this we can focus on opening up, but not yet.”

Seven days later, standing in front of the same press, he announced the reopening of businesses including gyms, salons, dine-in restaurants, tattoo parlors, and massage spas — all before the end of his April 30th Shelter-in-Place and May 13th Declaration of Emergency Orders.

Why this About-Face? Was it his phone call with Vice President Mike Pence? Was it his conference call with other southern, Republican governors? Was it the threat of a “Reopen GA Protest” at Georgia’s Capitol? Or was he following his heart and thinking this is the right thing to do?

During times of crisis we need the steady hand of reliable leaders. Instead, Gov. Kemp’s About-Face leaves us feeling like we don’t know what’s around the corner. His premature decision to say “yes” to non-essential massages, tattoos and haircuts, while still telling most of us to stay home except for necessities, makes no sense and does not inspire the kind of trust we need in a leader right now.

Orders for Re-Opening

This week the Whitehouse released “Opening Up America Again,” a very reasonable roadmap for balancing the opening of the economy and the health of Americans, as we wait for a treatment or vaccine to be developed. Even before activating the first of three phases, the report advises certain “gateway” criteria including 14-day declines in flu-like and COVID-19 symptoms and cases, adequate hospital beds, as well as PPE and testing for health workers. Has Georgia met these? No. This question was asked during this week’s legislative conference call with the Governor’s office:

What numbers changed to support the re-opening of Georgia businesses that was announced on Monday? The President’s reopening guidelines include a 14-day drop in cases before re-opening. What is the reasoning in re-opening before this has taken place?

Answer: “As the Governor said in his press conference on Monday, the state is on its way to meeting the gating criteria into Phase 1 of the “Opening up America” plan. We are beginning to see a plateau and slight decline in new case notifications and a decline in total death notifications.

“On its way” doesn’t cut it. Georgia does not meet the guidelines. And don’t be surprised if you see published graphs of declining cases to justify the Governor’s decision. According to the Atlanta Journal Constitution, new COVID-19 cases are now being recorded differently — instead of recording a new case when a test result comes back positive, the case is being recorded according to the date symptoms first appeared. This new way of documenting cases will result in a well-timed and misleading, temporary drop in case numbers. Many of us are relying on data to evaluate potential risks in venturing out — almost like looking at the weather forecast when planning trips. These changes in the numbers leave us feeling vulnerable and confused.

A Salute to Georgia’s Hospitals

Just a few weeks ago, we feared the United States would be “the next Italy” — that people would die because of a shortage of ventilators, and that a medical triage process would choose who lives and who dies. This did not happen in Georgia, due to the hard work of Georgia’s hospitals. Right now, possibly at the peak of our first COVID wave, we have over 900 available ICU units across Georgia. The cancellation of regularly scheduled procedures provided the necessary personnel, equipment and physical space so in-patient beds could be converted to ICU beds. Private healthcare systems worked cooperatively across healthcare systems to share resources, and a system of counting ER, ICU and in-patient beds was developed so the state could plan for the coming surge of patients. It all worked because of the sacrifices of so many people, from doctors who closed their businesses, to the healthcare workers who risked their own health to take care of others, to those of us who were staying home to slow down the spread, allowing our healthcare system the breathing room it needed. These numbers show that as long as there is not a resurgence of COVID-19 cases, hospitals can begin meeting pent up demand for elective procedures and surgeries. “Elective” in some cases means cancer treatments and people who are in disabling pain needing surgery.

April 24 Capacity In Use Available
ICU Beds 3,246 2,329 917
ER Beds 3,430 843 2,587
General Beds 14,727 9,169 5,558

source- Georgia Hospital Association

A Salute to Georgia’s National Guard

Forty percent of Georgia’s COVID-19 deaths are residents of long term care facilities. Over the course of the last three weeks, almost 3,000 soldiers, airmen, and State Defense Force personnel  have been deployed across Georgia to assist in the COVID-19 response. Most of these soldiers make up Infection Control Teams, who have visited 80% of the hundreds of nursing homes and long term care facilities in Georgia, doing deep cleaning, and training local staff on proper disinfection and infection control. General Tom Carden says that Georgia’s use of the National Guard in addressing the state’s COVID crisis is a model now being replicated in other states. Georgia’s National Guard is also assisting hospitals, food banks, school lunch delivery programs, and public health departments.

Does Georgia’s Testing Pass the Test?

Several constituents have been telling me from the beginning that it’s all about testing. Yet Georgia has been slow to get adequate testing rolled out. We’ve been told repetitively that testing will be “ramping” up, yet we continue to test less than 1% of Georgia’s population. In the last few weeks, we’ve slowly climbed from 45th to 43rd in the nation for people tested, as our daily testing numbers increased from around 3,000 to almost 7,000. Questions about testing came up in this week’s Governor’s conference call:

Will the testing the state is doing have both antibody testing and positive/negative test results? More information that we could share with constituents on this topic would be helpful.

Dr. Toomey responded: Initially, the tests that the state is administering are live virus tests run through PCR machines (positive/negative test). At this time, DPH is not administering antibody tests. This test shows exposure to COVID19 and may paint a better picture of the breadth of the virus at a time when access to adequate testing was limited. However, at this time we don’t know if the presence of antibodies necessarily shows immunity. The science isn’t there yet, so we wouldn’t rely on the presence of antibodies as firm evidence that a person is no longer at risk of being infected with COVID.

Dr. Toomey also referred to the CDC’s recent statement regarding the use of antibody testing: “The test is not currently designed to test individuals who want to know if they have been previously infected with COVID-19.”  (FDA letter to healthcare providers, and CDC Serology Testing)

During Monday’s press conference, Gen. Tom Carden was asked about the goals of Georgia’s testing program.

Gen. Carden responded: If you look at the rate of acceleration of our testing program during the last week (how much it has “ramped up”), Georgia is 28th out of 54 states and territories.  We are only limited by the supply of test kits and lab capacity. Our goal is to have enough testing to be able to make data driven decisions. We’re going to test what we can source for. “Trying to test almost 11 million people in the state of Georgia is about like trying to boil the ocean.”

When the press asked about measurable goals, Carden continuedThe top two testing states in the country, Rhode Island and NY, have both been able to test a little over 3% of their populations. Georgia is at 0.71%. I’d love to say Georgia could test 10%, but that’s not realistic. “My goal is to drive it until the system breaks.” 

Wherever the Virus Goes, We Go

Dr. Kathleen Toomey has said repetitively that contact tracing is how we are going to keep this virus under control. Yet she admits that the logistics of setting up a tracing system for a disease that is spreading so quickly through the population is not something that anyone in our current public health system has experience with. One constituent told me recently that he was exposed to the virus in early March through the wife of one of the early COVID patients. He was never contacted by public health, even though a contact tracing program was supposedly up and running.

What is the state’s plan for getting contact tracing up and running?

Here is Toomey’s response: The DPH is finalizing its plans for substantially increasing their capacity for contact tracing by significantly increasing staffing through partnerships with our higher education institutions and leveraging technology through a partnership with Google – more details will be shared in the coming days. It will take a village. Every public health epidemiology team will serve as incident commanders. We will have videos to train staff in the districts, to train volunteers. Other states built teams using Master of Public Health students, and medical students who are not currently in classes. When a person is newly infected, we will reach out, talk to them, find out with whom they were in contact and where did they go? We will address the exposures. In the past, we have done this manually with staff. Now with the wonder of Google technology, a computer based app is being finalized. It will be customized to our own needs. This is the priority in months ahead. This is how we keep spread from occurring even as we open up the economy. 

Four Week Chunks

So if we are just now approaching the end of the beginning, what’s next? I think we continue to protect ourselves and our healthcare system while we evaluate the impact of the Governor’s decisions the best we can. I’m carefully tracking hospitalization data because I feel it’s a pretty good measure of virus activity, and it’s not easy to manipulate. This data indicates we may have reached a plateau, and conference calls with major hospital systems support this data. For the most part, hospitals are reporting that they are discharging the same number of people they admit each day.

I told my kids, who are wondering if they will have in-person college classes in the fall or not, “you need to plan, then make contingency plans.” My friend Michael Murphy-McCarthy said, “I do well with four-week chunks.” Let’s see where we are in a few weeks, then we’ll ask “what’s next?” once again. In the meantime, check on your neighbors, donate to your local food bank if you can, and do whatever makes you feel good, within limits, of course!

Conflicting Messages

Last week we were doing just fine focusing on preparations for Georgia’s COVID-19 peak. As Governor Kemp said, “On the back side of this we can focus on opening back up, but not yet.” Then, with the President’s release of his “Opening Up America Again” guidelines, the news cycle did a cartwheel, leading many Americans to believe it is now okay to go back to “normal.” After all, Easter Sunday has come and gone.

This week’s conference call with the Governor added to the confusion. Mark Hamilton, the Governor’s Director of External Affairs, made it crystal clear — Georgia IS open to business. And two special guests from the Department of Economic Development, Commissioner Pat Wilson and COO Bert Brantley, echoed his message, “Georgia has not done a shut-down. This keeps us in line with the President. Our economy has continued to move.”

But before we panic too much about unleashing a pent-up virus, understand that much of this message was likely aimed at preventing a Michigan style “Freedom” protest on the steps of the Georgia Capitol. Obviously, it IS important to think about how we are going to open back up the economy. But as Governor Kemp said, “We must do this nimbly.”

Be Prepared

The lead group for restoring Georgia’s economy is the Economic Impact Committee of the Coronavirus Task Force. In addition, the Governor has spoken with the Lt. Governor and the Speaker about what comes next. And, there was a Governor’s conference call this week with the President about his guidelines. But for now, Governor Kemp’s message is, “Our focus is on the crisis at hand — PPE, support, staff, equipment, and flattening the spread of new cases.”

COO Brantley told us that many Georgia manufacturers whose markets have shut down are shifting to produce the things we need, such as personal protective equipment (PPE).  Many of our manufacturers will be ready to provide these items for the long-term.

The Economic Suffering is Real

Unfortunately, the stimulus package passed by Congress is struggling to get real cash to people in a timely way. The first round of stimulus checks are beginning to arrive, but employees laid off in mid-March will soon be faced with a second month’s rent. Georgia has not enacted any kind of state-wide stay of evictions or foreclosures, and Small Business Administration loans ran out of money this week, leaving many businesses high and dry. Georgia’s unemployment system is completely overwhelmed. If you are able, local food banks really need your help. Here’s a great database for looking up food banks in your neighborhood. Also, call Governor Kemp’s office at 404-656-1776 and ask him to enact a moratorium on evictions and foreclosures.

What About Testing?

Epidemiologists have made it clear. Georgia’s economy can only recover if it is accompanied by a massive expansion of testingDr. Kathleen Toomey, Commissioner of the Department of Public Health, answered legislator’s questions about testing and contact tracing.

Why is Georgia so far behind other states on testing and how can we catch up?

When we first started testing, there was only one kind of test, provided through the CDC, and two batches of those tests were defective. Although the CDC is located in Georgia, we were not chosen as a priority state. Our initial challenges were not unlike other states in terms of test and swab availability. But we have overcome these challenges.

Now we have 39 test sites and are processing thousands of tests a day, including a new lab in Sandy Springs that will provide 2100 tests a day. Shipments have gone out to the health districts. This week is an important surge week so we have set up additional sites M – F and some weekends. The National Guard is helping. We think we will be able to test many more people with our expanded criteria, including anyone who has symptoms, even the loss of smell/taste — any age — young, infants, and elderly. Also many asymptomatic people in nursing homes will be tested.

Can you update us on the status of our contact tracing ability? How are we doing contact tracing for people who were not “sick enough” to be tested?

Contact tracing becomes even more critical as conversations about “re-opening” the economy continue to occur at the national level. Early on when there were only a few cases, we did contact tracing aggressively. Now with thousands of cases we can’t do it with that intensity, although we are still doing it in nursing homes or areas with close contact. DPH is working to ramp up the system’s capability to scale-up contact tracing. We are developing a plan in partnership with Google (cell phone monitoring for possible exposures) and perhaps a University partner. Also, we’re looking at putting together teams like other states (CA, MA) using student volunteers, and people in the community to help with contact tracing.

Can you address the disparities in the information being reported from nursing home facilities and long-term care facilities with respect to reported positive cases and deaths, and the data reported to the Dept. of Public Health?

For nursing homes and Long Term Care (LTC) facilities, there is a data lag time. For example rapid tests were done but not reported back until weeks later. We are telling facilities to be more prompt. In the end, we get the same numbers but it takes longer than it seems it should. Right now we are posting these numbers weekly, but in the next 48 hours you’ll begin to see this data reported daily. Lastly, we must have good infection control in LTC facilities. Infection control is what’s going to stop the LTC outbreaks.

Is this Picture too Rosy?

The expansion of test sites and who can be tested all sounds great, but this week, the number of diagnostic tests processed in Georgia actually fell significantly. And I have heard reports of tests being rationed to five tests a day by long term care facilities. The kind of test expansion experts are saying we need to open up the economy is in the hundreds of thousands range — not the two to five thousand we have been seeing in Georgia. Also, contact tracing will require a couple thousand workers, or a budget of around $50 million. Is Georgia up to this? Is any state up to this?

Here’s the best analysis I’ve heard on what is wrong. All of the tests are privately owned, and instead of FEMA coming in and buying all the tests for the county and sending them out as needed, all 50 states and the federal government are competing for the same tests. So these private businesses, who have a very finite capacity to produce tests, are making promises to all 50 states that they can’t keep. The private companies then use the increased demand to make states bid against each other, driving up the price for each state. So the highest bidder gets the tests — which is probably not Georgia.

Other Public Health Research

While we focus on hospital bed availability, PPE and diagnostic testing, scientists around the country are working on treatment, vaccines and large scale research. In other late-breaking news, Dr. Toomey mentioned Georgia is developing a partnership with Universities and the NIH to do serological testing to pick up on how many cases have been occurring throughout Georgia’s population. CDC is also studying hospitalized patients and the role of underlying conditions. These will be published in the next 1 – 2 weeks. Floyd Medical Center is utilizing plasma with antibody treatments and seeing good outcomes.

How Many ICU Beds are Available?

While ICU utilization is up by 98 beds since Tuesday 4/14, more ICU beds have come on-line, so we have a net positive of 58 ICU beds! Plus the 200 general bed facility at the World Congress Center is now open. Last week models predicted Georgia’s peak will be May 1st, but the IHME model is now saying we may have passed our peak. It’s hard to tell what will actually happen. As General Carden said, “The World Congress Center is our relief valve … pray we don’t need it, but it will be there.”

April 18 Capacity In Use Available
ICU Beds 3,054 2,142 912
ER Beds 3,446 798 2,648
General Beds 14,517 8,616 5,901

 

Judy Fitzgerald, Commissioner, Dept. of Behavioral Health & Developmental Disabilities (DBHDD)

State Hospitals: All visitation at State Hospitals has been suspended.

There have been significant workforce impacts at Georgia Regional Hospital (Atlanta) and Central State Hospital (Milledgeville). The Georgia National Guard has done decontamination, and batch testing of people and staff has been conducted at these facilities. There have been two staff deaths in Milledgeville (died at the local acute care hospital) and 20 plus positive cases. Confirmed cases are in quarantine units at both these hospitals. Additional PPE has been delivered to Central State in Milledgeville. Possible COVID positive people at the Savannah and Columbus facilities have been isolated.

Behavioral Health: A COVID-19 Emotional Support Line has been established. 866-399-8938. This statewide line provides free and confidential assistance to callers needing support and behavioral health resource information during the COVID crisis.

In addition, the Dept. of Behavior Health & Development Disabilities has implemented Wellness, Self-Care Tips and Support for Health Care and Emergency Response Workers. Requests have been made to extend this service to other state employees as well.

Developmental Disabilities: The Dept (DBHDD) has implemented increased communication channels to respond to individual, family and stakeholder questions and concerns. In addition, DBHDD has worked with the Dept. of Community Health to develop Appendix K (emergency preparedness and response) for needed changes to NOW/COMP waivers. Educational webinars have been prepared for Stakeholders, Providers and families.

Homer Bryson, Director of Georgia Emergency Management

In rural Georgia, private practitioners are the first line of defense against COVID-19. Many offices have been using the same PPE for 3 – 4 weeks. How can we help these private practices purchase PPE?

First priority must go to acute care hospitals, long term care facilities and first responders. The state has ordered several million pieces of PPE that will be sent to the GEMA/DPH warehouse and sent out to areas of greatest need. We also understand that the PPE supply chains internationally are slowly opening back up, and private practices and other facilities are encouraged to reach out to their existing suppliers initially to acquire PPE.

Miscellaneous Questions & Answers

The 2021 Budget. What action is being taken by the Executive branch in terms of plan/changes? Are the House & Senate budget offices being engaged to prepare for what will need to be done?

OPB Director Kelly Farr and the Governor’s Senior staff are in constant contact with House & Senate Appropriations. Actual revenue reports are reported with a lag so we are still reviewing what actual numbers will look like. We have a one-hour call today.

Should we just change the revenue estimate now? 

The impact on the economy is being assessed. We still just don’t know. The state is evaluating all options and keeping all courses of action open.

According to an April 10 CNN Report, the largest known concentration of CV cases outside of hospitals is in the nation’s prisons. What are the conditions of Georgia correctional facilities and what is being done to protect them?  Are correctional officers being tested? 

The Dept. of Corrections publishes a daily report at http://www.gdc.ga.gov/content/cases  The Georgia National Guard has been involved in training as well as sanitizing for both Corrections and the Dept. of Juvenile Justice. There have been no positive cases for any youth within the DJJ, though there have been a few staff positive.

Will Georgia’s public secondary schools and University System of Georgia schools move to a pass/fail grading system rather than letter grades or allow students to choose which they prefer?

This is a decision for the Board of Regents.

School systems are homeschooling students with the assistance of the internet. Can the state provide assistance to systems or parents to obtain internet access where it is unavailable?

Two weeks ago the Governor and the Department of Community Affairs put out a release connecting Georgians who do not have internet access to resources where they can receive internet access. http://broadband.georgia.gov/georgia-internet-access-covid-19-update

When do you think enough masks will be available for grocery store employees and even for the general public to order and receive? Can the Governor mandate food service workers to wear masks? If they are available?

The Governor did not make it mandatory, but there is guidance from the Federal Government. The global supply chain for PPE is slowly starting to re-open.

We’re in a Liminal Space Now

We’re prepared for the surge, but we’re not quite sure when we will reach it, or if we already have. We want to get to the other side, but we’re not sure what life will look like when we do. Some who have lost loved ones will go on with life but feel a void. We make plans, and then we make contingency plans. That’s our new normal.

As we ponder moving past our first COVID-19 milestone, let us remember, in this single blossom, the many recently departed souls who have left this world as we know it. (photo credit: Marc Merlin)

Reaching the Peak

There’s so much stress in the world right now. My kids are stressed; my family and my friends are stressed. We’re all hurting and worried.

Georgia Hospitals are Climbing Mountains

Last week I had the chance to hear from leaders of WellStar, one of the largest healthcare systems in Georgia. Here’s what they, and other state leaders, had to say.

Expanding Capacity: Expansion of ICU beds by converting and upgrading other units has been the hospital system’s focus. The creation of a non-ICU hospital at the Georgia World Congress Center helps make this possible. Redeployment of doctors and staff freed up from their usual jobs is helping to staff ICU rooms. There are contingency plans to double ventilator capacity — shifting equipment around to different hospitals, purchasing vents, and converting anesthesia equipment. Also, since COVID is hard on kidneys, more CRRT machines have been ordered (continuous renal replacement therapy).

How Staying at Home has Helped: Every single hospital administrator on the conference call said having people stay at home has helped. They sent you their thanks, and said keep it up! Dr. Carlos del Rio, chair of the Hubert Department of Global Health at Emory University’s Rollins School of Public Health, has the data to back this up. In the AJC, he states, “Instead of seeing one day 10 patients, and the next day 20, and the next day 40, and the next day 80, we are seeing one day 10, the next 12, and the next 14, and the next day 16. That makes a huge difference.”

Amazing things: Hospitals, including Grady, are reporting that access to PPE (personal protection equipment) is better now for healthcare workers. This has helped to achieve lower virus transmission rates among healthcare workers. Since many healthcare workers work 7am – 7pm they can’t get to the grocery stores. So, hospitals have created mini-convenience stores within the hospitals for healthcare workers, stocked with things like PBJs, paper towels and, of course, toilet paper! They have a constant supply of donated meals. They have organized small groups to care for other people’s children. Last but not least, healthcare workers are uplifted by the success stories of COVID survivors, and really appreciate all the thank you notes from family members.

Current Bed Availability: Brand New Data!

Capacity

In Use

Available

ER Beds

3.429

839

2,592

ICU Beds

2,898

2,044

854

General Beds

14,242

8,670

5,575

“We are constantly comparing hospital capacity with surge numbers. Looking at models is good guidance but not foolproof. When it comes to looking at the median numbers, we are in good shape by more than 1000 beds. But if you look at the high numbers, we are not in good shape. The World Congress Center is our relief valve should we run north of our surge capacity. Pray we don’t need it. But it will be there.” 
–Major General Tom Carden, Adjutant General, Georgia Department of Defense

Testing: According to Dr. Kathleen Toomey, testing is still inadequate, and the status quo is not acceptable. We are 45th out of the 50 states in terms of numbers tested. Though many hospitals report they are beginning to do their own testing, Dr. Toomey says don’t show up at an ER for a test — call your health department instead. “We made it too hard to get tested because it required a referral from a physician. That was too hard a barrier. Now you can call your health department directly.” There are 34 testing sites in the state, including the new GA Tech site. In addition, there is a new lab in Sandy Springs, and Georgia Universities are processing 1000 tests a day. Expansion of testing criteria is beginning to open up. Dr. Toomey says that asymptomatic people who have had direct contact with a COVID positive person can now get tested.

What Goes Up, Must Come Down

The following are answers to questions submitted by legislators and answered by the Governor during the April 8th conference call:

After the “Peak” how will opening the economy back up be approached? Is diagnostic testing being expanded? Will an antibody test be used? How available is antibody testing? 1) IHME now estimates the peak in Georgia to occur on or around May 1st, when current projections show the state will have a deficit of 218 ICU beds. More capacity is coming on-line. 2) Two companies have released rapid tests nationally. Hospitals across the state that have partnerships with these companies now have machines and are actively testing. 3) IgG antibody testing is currently entering the market and once available will be deployed by the State.4) Antibody response indicates exposure, but does not imply immunity. There are other factors of immunity including cellular immunity and no one knows about immunity to SARSCoV-2, yet.

What Metrics will be used to trigger reopening the economy? Dr. Toomey, Commissioner of Public Health, says we will look at the numbers. “Right now we continue to see widespread community transmission. It is still too early to see the impact of the Governor’s Stay at Home Order — this takes several weeks. Hopefully we will see a flattening of the curve. If we open everything up too soon we will get a rebound with a second peak — we need to keep outbreaks from occurring even after we open things back up.”

A Roof over One’s Head

Will there be a statewide freeze on evictions and foreclosures during the Emergency? No. No specific action.

What is being done to support unsheltered homeless people? We have established the Displaced Individuals Sub-Committee, which is chaired by Mayor Bottoms. Look to her and her sub-committee. We are now working with a local hotel which will open today for 200 people who test positive but require no hospitalization. This will be monitored by public health.

Long Term Care (LTC) Facilities:  There are currently 80 LTC facilities statewide with positive COVID cases. Every LTC facility is a high risk place. Dr. Toomey stated the need to get ahead of the issue and work with ALL facilities, not just those reporting a positive case. Infection control work should be part of routine care. Training on infection control should be a priority, not just testing and reporting. Sixty Georgia National Guard Infection Control Teams have sanitized 249 facilities.

Miscellaneous Questions from Legislators:

Funeral Home viewings continue to occur. Will the Governor issue additional Orders to limit these to 10 people or immediate family? The Governor’s Order prohibits gatherings of more than 10 people if the 6-ft social distancing cannot be achieved.

Will the Governor continue to allow beaches and State Parks to be open? Georgians are obeying the Order and the Order is being enforced. The closing of State Parks and beaches is not necessary. St. Simon’s last weekend had only just over 100 people on the entire beach. That’s some of the best social distancing in the state. Neighborhood block parties are a bigger problem.

What will the budget impact be? How will Federal funds help? Tax revenues were actually up for March, but we expect the rest of the months in the 2019/20 fiscal year to be down. We have established a Sub-Committee on Economic Impact, chaired by the State Economist. It is premature yet to guess. We are keeping key people updated.

Will there be direction from the Board of Education to local school systems regarding virtual learning, at-home work for students and food distribution? Superintendent Woods will partner with the Governor’s office to launch working groups and guidelines for best practices for these areas plus facilities, equipment, mental health and professional learning.

Why is DPH keeping vital information from local elected officials to include the disposition of infected persons within their community (i.e., whether the cases are located in nursing homes/prisons and/or are hospitalized)? This is inaccurate – DPH is reporting long-term care facilities with positive cases and total hospitalizations – and the Department of Corrections is putting out information regularly on confirmed cases in their facilities. As we discussed yesterday, the DPH data is the “final authority” so there may be a lag in what you read on a press release, social media, or a post from a hospital – before DPH has the ability to confirm the data as valid.

Updates from Homer Bryson, Director, GEMA

Are first responders getting the supplies they need? Yes, we are in much better shape now than we were last week. The warehouse operation is impressive. We have streamlined the process to match the large scale needed. We order one day, pull the next, then ship the third day. Hospitals, nursing homes and first responders order every other day. Sunday is inventory day, when we assess where we are. We continue to deliver urgent orders every day when we get reports of shortages. We have shipped out 86 ventilators, 871,000 N95 masks, 1.2 million surgical masks, 201,000 face shields, and 3 million gloves.

Updates from General Tom Carden, Georgia National Guard:

The Georgia National Guard has deployed 2000 soldiers and personnel.

Infection Control Teams: The GA National Guard now has 60 active Infection Control Teams (The first team was organized and put to work on March 31st). These teams are made up of 913 personnel. They have cleaned 249 Long Term Care facilities.

Medical Support Teams: The Georgia National Guard now has 17 active  Medical Support Teams (The first team was deployed to Grady on March 25th). 200 personnel are deployed to 17 hospitals. These teams are made up of doctors, PAs and nurses, doing medical care and administrative support.

Hospital Entry Control Teams: 72 GA National Guard members are at hospitals doing patient screening. This frees up healthcare workers to tend to other needs.

Food Bank Support: GA National Guard has 180 personnel assigned to nine food banks.

Public Health: GA National Guard is assisting Public Health as drivers and couriers.

Updates from Dr. Kathleen Toomey, Commissioner of Public Health

Demographics on Public Health Website: Public Health is continuing to collect data that is not posted on the website because with some of the data there are so many variables that are still missing. For example, providers doing lab tests do not always provide all the demographic information. Public Health is working proactively to correct this. For right now, 65% of positive test results lack race/ethnicity data. This is a problem because we know that the cases in Albany are disproportionately affecting African Americans.

Anti-Malarials. The National Stockpile is providing anti-malarials to the states. The window for who gets this drug, and when, is very narrow. Dr. Toomey expressed grave concerns about how physicians are prescribing these drugs across the state, and how this is leaving people without their medication who continually need this drug to live. She has sent out a letter to doctors.

The Bird’s Eye View

 “This virus will change how we function now and in the future. We are a culture that embraces and shakes hands. This will change. Things that were routine will need to be modified because of the virus and how it transmits so easily. We will look for trends, but until we see that, I cannot give a prediction as to a date or how that decision (to open the economy back up) will be made. First we must see what community spread looks like and how our hospitals are doing.
–Dr. Kathleen Toomey, Commissioner, Dept. of Public Health

Governor Kemp, in his 4/13 press conference said, “I don’t want to speculate yet. The peak day keeps moving. … We are seeing some good signs. Keep hunkering down. Keep doing what you are doing. … We must be very nimble in dealing with what comes after … On the back side of this, we can focus on opening up but not yet.

Sally at Red River Gorge

Sally climbing sandstone cliffs in Red River Gorge, Kentucky one year ago this April.
Every mountain top is within reach if you just keep climbing.

Sunny Days Cast Shadows

Another week has passed as we anticipate “the surge.” The words of Nathaniel Hawthorne seem written for our time: “Time flows over us, but leaves its shadow behind.

As cities and counties across Georgia took the lead to enact their own Stay-at-Home ordinances, pressure mounted on Governor Kemp to do what the majority of Governor’s across the nation had already done — order people to stay home to slow the spread of the virus.

Last weekend, prior to the Governor’s Order, I shared photos with the Governor’s office of large raft-up boat parties on Lake Sinclair, pleading with him to order a shelter-in-place. My Facebook post with these pictures had gone viral and clearly people were alarmed by the callousness of the boaters.  By the end of the weekend, the Governor signed an Order requiring the Department of Natural Resources to break up large gatherings on and around lakes throughout the state.

After issuing his Stay-at-Home Order, I received calls from a number of city leaders in the district. Governor Kemp’s Order nullified their more strict ordinances, leaving them confused about how the Order affected their communities, and whether their local police had the authority to enforce the new order.

Again, I communicated these concerns with the Governor’s office, and again, the Governor released another “clarifying” Order.

Beyond the Shadow of a Doubt: After clarifying his intent, there is no doubt that reopening beaches, which had been ordered closed by local governments, was a purposeful preemption of local control. Churches, golf courses, and businesses (specifically including gun stores), remain open as long as they follow certain CDC guidelines, including keeping six feet of distance between people. Businesses such as  gyms, salons, entertainment venues, and bars/nightclubs were ordered closed. Restaurants are limited to carry-out only. Citizens must stay in their homes except for essential activities such as grocery shopping, medical care, exercise, and taking care of family members.

Dark Before the Dawn

Is Georgia ready for the “surge”? The US national average for hospital beds per capita (per 1000) is 2.8. Georgia is below the national average at 2.5.  Contrast this to Japan at 13.1; Germany 8.0; and Italy 3.2.

Most of us want to know if Georgia has enough ventilators and hospital beds to meet the need. I have been trying to get this data, but it is difficult, if not impossible, to obtain. According to the COVID Tracking Project, only 15 states are collecting data specific to ICU admissions and of those, only seven are tracking ventilator use. Rough averages of this data indicate that 32% of all hospital admissions require intensive care, and 28% require ventilators. To date in Georgia, 1332 COVID-19 patients have been hospitalized.

The following is information obtained from a conference call with the Georgia Hospital Association:

Available Bed Space: Georgia has 26,578 hospital beds. 2200 of those are ICU beds (8%). Certificate of Need (CON) has been waived so that other types of beds can be used for ICU.

New Bed Space: More bed space will be needed as the surge approaches. The State is working with the Georgia Hospital Association to identify hospitals that have extra, old, or empty space that can be brought on-line ASAP.  Opening up this space is VERY costly — the state has allocated 72 million dollars to expand space for 300 extra beds (including ICU space). Many hospitals simply cannot afford to do this. In addition, this extra space must be staffed. Georgia is already facing a severe nursing shortage right now.

Previously closed hospital space is being re-opened in Albany & Snellville to provide an additional 208 beds.

Four mobile medical units will be deployed. Twenty bed units will be sent to Rome & Albany. A 24 bed unit will stay in Atlanta, and a second 24 bed unit will be on stand-by.

Licensing rules are being suspended in order to hire nurses whose licenses have lapsed five years or less, and some scope of practice is being opened up.

Most of Georgia’s ambulatory surgery centers have been closed because elective surgeries have been cancelled. These centers can offer additional bedspace, laid off employees for hiring, and use of idle equipment. We need healthcare workers to stay in Georgia! Unfortunately, NY is offering nurses $10,000/week for temporary work.

Ventilators: Data from the National Hospital Questionnaire says we have 3387 ventilators in Georgia. 1200 more have been requested from the national stockpile and those are being shipped in week by week. Cpap and anesthesia machines can be repurposed to substitute for ventilators. Inquiries are being made with private vendors about ventilator loans. IV pumps and portable negative pressure rooms are also needed.

Personal Protective Equipment (PPE): There is still a huge need for masks, gloves, gowns, and face shields. The mask shortage in particular has caused the most concern. The State of Georgia has received some help from the national stockpile. According to protocols, each patient contact burns through one set of PPE, but nurses are now wearing masks for longer periods of time instead of with every patient.

The State of the Hospital Community: Scientists are predicting that the surge of Georgia’s coronavirus outbreak will occur sometime around April 23rd. That gives Georgia less than three weeks to build out extra bed space, recruit healthcare staff, and purchase needed equipment and supplies.

Atlanta hospitals are very busy. Albany, GA is the #4 hotspot in the world, measured by infected per capita (behind Wuhan, Italy, NY)

Healthcare Worker Morale: Many businesses are helping healthcare workers, such as restaurants and dry-cleaners. Any support you can give is appreciated. Please help if you can. Be creative. Even just supportive social media posts help.

The Governor Sheds Some Light

Once a week, members of the legislature join a 30-minute conference call with the Governor.  Questions are submitted by the House & Senate caucuses. To a large extent, the quality of the information we receive depends on the quality of the questions. If you have a question, please let me know by responding to this email.

Is Georgia considering shutting down at the state borders?:
No. Not at this time. No state has shut down its borders. Florida is doing some screening at its borders.

Can we add data to Public Health daily reports? 1) hospital bed capacity 2) number of nursing home cases 3) number of recovered cases 4) number of cases in correctional facilities?
Tracking of hospital bed capacities is being developed. The number of cases along with locations in Long Term Care facilities has been released. There are not enough resources at this point to track recoveries. Number of cases in correctional facilities is available at: http://www.dcor.state.ga.us/content/cases

Will there be change in election dates?
The Governor’s office says that election dates can only be changed by the General Assembly and the Secretary of State’s office. The Governor’s Emergency Order does not grant this authority to the Governor.

Is Public Health still using a contact tracing plan?
Yes, contact tracing has been in place since the beginning. Contact tracing will continue to be used in areas where the numbers are still small. Also, in areas where clear community transmission is happening, contact tracing will be used to notify potentially exposed people.

What is the rate of testing: What is our lag compared to other states?
The state didn’t get good test kits from the CDC until the last batch was sent to the states. Testing has really ramped up with the establishment of partnerships — universities and public/private. A new rapid test (results in 30 minutes) drive thru site has been set up at Georgia Tech for those who have been pre-screened, through a partnership with CVS.

Georgia Emergency Management (GEMA) Update:

Medical supplies are being routed through the Dept. of Public Health warehouse, utilizing the same team across various agencies who have managed distribution during hurricanes.

Getting supplies is still a struggle but less so now. The supplies are being pushed out to hospitals, Long Term Care facilities, and first responders.

Can we get protective supplies out to retail employees? PPE must be used for the highest need and right now that is for Long Term Care, hospital workers, and first responders.

GA National Guard Update

Newly formed Infection Control Teams are helping with Assisted Living, Nursing Homes and Long Term Care. Local Emergency Management agencies, legislators, and concerned citizens request help. Also, Public Health’s epidemiological team provides reports with numbers of cases so high need facilities can be targeted.

The Infection Control Teams are brand new. The GA National Guard has subject matter experts and has trained hundreds of soldiers within the last week. Adjutant General Tom Carden says, “We are learning as they go. We are adjusting protocols. We are building a plane while flying it.”

The GA National Guard has set up military triages in the state’s hotspots. They have 14 medical support teams that are new.  They recruited nurses, and other healthcare workers who weren’t already working and built teams. They trained, tailored and deployed. They have two teams in Albany. Carden says, “We will not tie ourselves to what we have on our books. We will build what is needed. We have hundreds of soldiers working.”

Between Stimulus and Response, There is a Space

Slowing the spread of the virus and “flattening the curve” is being implemented at a great cost to workers and businesses throughout the state. The Georgia Department of Labor has been hard at work rolling out the CARES (Coronavirus Aid, Relief, and Economic Security) ACT and responding to a record volume of Unemployment Insurance applications. The economic impact of the pandemic is devastating.

Too many people are having to live paycheck-to-paycheck, and stimulus efforts to put cash into these people’s hands have been slow to roll out. Community Food banks, short on volunteers and money, are responding to record numbers of people needing assistance. Their inventory is down by as much as a third because retail grocery store donations, which they typically depend on, are down. If you are able to donate cash to your local food bank, now is the time to do so. Many families are running out of food and cash.

Small Business Loans (SBA): Small businesses (under 500 employees including non-profits, sole proprietors, independent contractors, Tribal businesses and Veterans organizations) can obtain forgivable loans through the Paycheck Protection Program if they maintain payroll through the crisis. Low-interest loans can be obtained through Economic Injury Disaster Loans, including cash advance emergency grants of $10,000.

If you have applied for any of these SBA assistance options, please let me know how the process went. There have been reports of problems.

Unemployment Insurance: Chances are, someone you know has applied for Unemployment Insurance. Last week, the Georgia Department of Labor processed ten times the normal number of applications. As a result of Federal legislation, recipients will receive an additional 13 weeks of benefits, for a total of 39 weeks, and $600 extra per week. Recipients can earn up to $300 per week in wages without it impacting benefits. When laid off, the employer should apply for benefits through a “partial claim.” Applications can be submitted by individuals, but it will take much longer. Part-time workers qualify for Unemployment Insurance. Contractors, self-employed and gig workers also qualify, but this new part of Unemployment Insurance has not been rolled out yet.

The Light at the End of the Tunnel

This photo of a pink-sorrel, by photographer Marc Merlin of Atlanta, captures the play of light and shadow I am feeling in my own life right now. Marc is posting his wildflower photography on his Facebook page each day, so when I scroll through my feed, his artwork brightens my mood.
Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.
–Viktor Frankl
Living in Suspense

We’ve all watched apocalypse movies — even ones about pandemics. And even though experts warned us we were due for a pandemic, we never expected it to hit in 2020. We feel fear, and when we are fearful we want information. My role as a State Senator gives me access to information from the Governor’s office which I can share with you. I can also share your ideas and concerns back to the Governor’s office staff.

I have been relying daily on the Atlanta Journal Constitution, which is making their publication available free of charge during this crisis. Also, the Georgia Department of Public Health website is helpful.

Non-Essential Businesses Suspended (Stay-at-Home Orders)

During my first week after the legislature was suspended, I spent hours on the phone talking with local elected officials, who were wondering if they should close down areas where people congregate to promote social distancing, or if the Governor was going to use his powers to shut Georgia down. Governor Kemp has a strong local-governance ideology, so I encouraged local governments to move forward quickly, and they did. These decisions made by mayors, council members, county chairs and county commissioners were excruciatingly painful. Because of their leadership, the greater Atlanta metro area has some strong Stay-at-Home Orders. But it’s a confusing patchwork of ordinances, and there are still plenty of people who are not taking it seriously. The strong voice of our Governor ordering people to stay home is needed to save lives.

How Are the Atlanta Hospitals Doing?

Over 600 COVID19 patients have already been hospitalized across the state. As these numbers increase, many are wondering how our hospitals are faring. According to an email I got from Grady, patient volume is still within the normal range, but the acuity of cases is higher than usual. Since Grady consistently operates at or near capacity, Grady is working with state leaders to identify additional hospital bed capacity.

Grady is still in need of personal protective equipment (PPE), ventilators and COVID19 tests. A partnership of Grady procurement, the Dept. of Community Affairs, and the Grady Foundation is working on this. They accept donations and welcome referrals.

Grady is now doing all its own testing. Due to scarcity of tests, testing is limited to patients and frontline health workers.

Grady leaders continue to serve on the Governor’s Coronavirus Task Force and work with Mayor Bottoms and her team to develop solutions for the homeless affected by the virus.

Since the beginning of this crisis, Grady has treated over 200 “People Under Investigation” (PUIs) for COVID19. Of these, 51 have tested positive as of March 27th and 27 remain admitted at Grady.

Grady is grateful for donations, but is especially appreciative of those who are staying home, as this slows the spread of the virus and gives hospitals the time to prepare without being overwhelmed. Grady strongly encourages local jurisdictions to enact these policies if they have not already.

I am beginning to get updates from the Georgia Hospital Association and will share as I get more information.

The Conference Call with the Governor’s Office

The Governor has conducted two conference calls with the legislature and has made his staff available to House & Senate members.

Sixteen questions were submitted by the House and Senate caucuses ahead of the call. Unfortunately, we struggled with insufficient technology as over 250 people logged on, triggering a loud “beep” with every new caller. And many forgot to mute their phones. It was sometimes hard to hear but here’s what I have to share:

Unemployment Claims & Small Business Help: Unemployment claims have doubled and the fund is still robust at this point. The Governor signed a declaration allowing for the Small Business Administration (SBA) to provide low-interest loans to employers. The House & Senate will have a conference call with the Dept. of Labor next week for more updates.

Shelter-in-Place: The Governor’s office is still saying that there are 50 counties with no cases, so Gov. Kemp does not want to declare a Shelter-in-Place that impacts the entire state.

State Revenue Impact/Budget: A sub-committee of the Coronavirus Taskforce has been established to address the state budget. It will be chaired by the State Fiscal Economist. The House & Senate Appropriations Chairs are being continually briefed of the situation, and the Legislature will be involved in budget adjustments. The congressional stimulus package will provide funds to help the states. The state income tax deadline has been postponed, which will also impact the budget.

Essential Businesses/Services: The State has no list. Each locality is coming up with their own list.

Shelter-in-Place for the Medically Fragile: Essential activities for this population include going out for medical care, getting food and travelling back and forth to family.

SNAP (food stamps): P-SNAP has been established. P stands for Pandemic and there is an increase of $60 million. Each family will receive maximum benefits for a total of $167 in additional benefits thru April. Applications can be taken via telephone. Renewals don’t have to be reviewed. Work requirements will be waived through May. Georgia has applied to allow SNAP to be used for hot food too. On-line and telephone applications are available for Medicaid too. SNAP applications have doubled. Some days there are 9000 applications (prior totals were 9000 per week).

Child Welfare: The state is considering participation in P-EBT, which would provide supplemental benefits for families whose children are out of school, and who qualify for free/reduced lunch. Child abuse reporting has dropped by 50% because educators, coaches, etc. aren’t calling. The public should be on the watch for children at risk in neighborhoods. Caseworkers are still doing some visitation, and are also trying to use Skype and FaceTime.

Refunds for College Students: Schools have all finalized refund plans. They should be rolled out next week.

Testing/Lab Turnaround Time: State Labs are turning tests around in 1 – 2 days. Private Labs are lagging, running 7 – 8 days. Two companies, Quest and LabCore, probably took on too much. They are processing for other states too. Georgia is developing additional partnerships, particularly with Universities. By the end of next week, speed will be really ramped up. The intent is to not have to send anything through outside labs. No information was given about testing supply or purchasing, even though this question was asked. Instead, answers were given about PPE.

Physicians: Primary Care physicians can refer to 25 drive-thru testing sites located throughout the state (the locations of these sites are kept private). All physicians were sent a letter from Public Health. Doctors don’t have to see a patient in person. Patients are given a voucher number.

Care for the Indigent: Indigent care is being provided by Federally Qualified Community Health Centers where they are available. These clinics received a grant to expand COVID services.

WIC: Georgia has sought a USGA waiver so recipients don’t have to show up in person to apply.

Police/First Responders: 911 operators are asking callers if there are COVID symptoms so responders know before they show up. GEMA is vetting PPE (protective gear masks, gloves etc.) requests and filling them for first responders. They have gotten LOTS of supplies in to help.

Prisons: A strict visitation process has been in place for a couple weeks. Staff is screened when they enter. If cases are found, the sick and those who have been exposed are isolated. This protocol has been implemented at Lee State Prison, where cases of COVID19 have been diagnosed.

Hospital Space: Previously closed hospitals are being re-opened. Open space is being assessed for building additional hospitals. Modular units and trailers are in the works. They are opening additional bed space in Albany. Mapping, planning & modeling tools along with death and bed utilization numbers are being analyzed to predict the surge. Conversations with the Army Corps of Engineers is ongoing. No options are off the table at this time.

Number of ER Beds: We have just over 3000 in the state. Don’t know how many of these are used regularly.

Number of Ventilators: The state has 2400 probably. 1200 more have been ordered.They have 80 extra to push out. 30 – 50 of those have already been pushed out. Soon all those will have been pushed out.

Grocery Stores: No problem with supply chain. Surge buying will self correct.

Vendors (Labs, Testing, PPE, Ventilators): GEMA (Georgia emergency management) said they are being overwhelmed with vendors who want to help with supplies. Legislators were asked to help pre-screen potential vendors. For instance, the state cannot provide money upfront. They need people with current stock and delivery dates. They are still looking for ventilator vendors.  Everyone is pulling from China and there’s lots of price variation. No information was shared about whether or not Georgia would purchase more COVID19 test kits.

A Suspension of Disbelief

At this point, what is my biggest concern? Testing. The question I submitted to my Caucus was: Will Georgia spend resources to purchase additional test kits so we can conduct more thorough testing? Though there was a great deal of discussion about protective gear and speeding up lab tests, my question was never directly answered. The number of COVID cases reported by the news media every day does not reflect how many people are actually sick, but rather how many people were able to get tested. We’re still told we don’t need to lock Georgia down, as over half of the country has done, because we have no cases diagnosed in 50 counties. But do we? How would we know?

We Are Suspended

How we work, live and play has changed abruptly. For many of us, that means we’re at home utilizing technology to work and stay in touch with friends and family. Our lives as usual have been suspended but our purpose has not. We are stopping the spread of the virus.

Others deemed essential are still out working and cannot stop. They are our healthcare professionals, our childcare and grocery store workers, our food preparers, and all the others we call on when in need. They carry the weight that holds us all.

We need each other.

Right now I’m on official quarantine because a Georgia Senator came to work sick. The quarantine was the right thing to do, because now at least four other Senators are sick, and one was hospitalized in critical condition (he’s doing better now). Fortunately, my family’s fine, but I’ll admit I am worried, frustrated, and restless. And the things that normally sustain me and my family during other troubling times, like our church, our gym, or coffee with a friend, are not possible. 

My husband and I have made a daily walk through our neighborhood part of our routine (keeping six feet of distance from others, of course). On these walks, I think about how the nature around us is waking up from winter, and how we, isolating ourselves in our homes, have woken up to a reality we never imagined. 

So, what can we do or say to our friends and ourselves, as we face these very serious circumstances?

While COVID-19 might be new, we have faced and overcome other great challenges. People in our communities unified after September 11th. During the Cold War, children practiced duck-and-cover drills at school, and parents built fallout shelters. People marched and faced tear gas and church bombings to defeat segregation. Families grew victory gardens, shared ration coupons, and donated their scrap metal during World War II. Some of our grandparents made “Garbage Soup” with their neighbors during the Great Depression by throwing everyone’s week-old produce into one big pot with tomato soup.

It feels like we are facing all of these crises at once — a fight against an invisible enemy, economic uncertainty, and political strife. 

And I think that we can stand up for what is right and make it through this catastrophe if we remind ourselves that we have all the ingenuity and bravery that we need in our own community. 

We must stay home to protect our neighbors. We can appreciate the shelter above our heads, enjoy home-cooked food together, or perhaps do the spring cleaning that we have put off. 

Last night, I attended an online karaoke birthday party with friends through the video conferencing service, Zoom. We sang, laughed, and shared our fears with each other. Those who have a little extra cash to spare could shop or send food to those who might be struggling financially. Those who can  sew are making masks with fabric scraps.

This is our burden and our opportunity: to live up to the examples of our family and neighborhood heroes by giving up what we can, even as we acknowledge that we already are sacrificing so much. 

The situation we are in is horrifying, and for many, this may be the hardest thing that we have dealt with in our lives. 

But we are up to this fight. We will make it to the end of the tunnel. Take a deep, grounding breath and remind yourself that we have “the right stuff.” 

Stay strong, keep hope close, stay socially distant, and stay in touch.  

Here are some resources you might find helpful: