Gov. Holcomb extends ‘stay at home’ order to May 1

INDIANAPOLIS (WISH) — Gov. Eric Holcomb on Monday extended the “stay at home” order to May 1.

The order requires Hoosiers to remain in their homes except when they are at work or for permitted activities, such as taking care of others, obtaining necessary supplies, and for health and safety.

Previously, the stay-at-home order was to expire Monday.

After working with the Indiana Hospital Association and the 10 health districts in the state, Holcomb will be reopening elective procedures in a “staged way,” starting Tuesday. On Tuesday, hospitals can conduct procedures to screen and to prevent conditions. On April 27, if the medical supply chain is in good shape, other elective procedures can resume, Holcomb said.

Holcomb clarified that nurseries, greenhouses and pet groomers could already be open for business and said there was more information about how those businesses could operate during the “stay at home” order.

Holcomb said Hoosiers were doing a good job of flattening the curve in most parts of Indiana. He also said the health care network in the state has experienced remarkable collaboration to meet demands.

Holcomb said he was receiving and would continue to receive guidance from Indiana businesses the new safety precautions they would put in place in their workplaces. The state will continue to accept those recommendations until end-of-business Wednesday.

Indiana health commissioner Dr. Kristina Box said the state later this week would be including presumptive positive cases in the state’s death total listed on the ISDH website. If a doctor listed COVID-19 as the underlying cause of death for a patient, but there was no virus test done, those deaths will be included. This will cause the death numbers to cause an increase higher than what the state has see, Box said. The deaths are not new, but the state is capturing the deaths that have occurred since the pandemic began and the data is now available, Box said.

ISDH is working on a plan to provide weekly totals for cases at long-term care facilities, Box said. The Centers for Medicare and Medicaid Services will soon require facilities to notify residents and their representatives of COVID-19 infections or the onset of respiratory illnesses among residents or staff, Box said. That notification was already required by the state of Indiana, Box said.

Box said there is new guidance for end-of-life care so that more families can assist in the goodbye for individuals losing their loved ones, including those suffering with COVID-19. She said those decisions should be made on a case-by-case basis.

Holcomb talked about the number of doctors, nurses and health care workers in Indiana, calling them “an army .. who is not just talking about it, they’re treating it.”

Spencer County clinic administering antibody tests. Box said that antibody testing going forward would be important but does not tell us anything about someone’s current state. It tells whether someone is immune going forward, potentially, based on their antibodies and there is only one test approved by the Food and Drug Administration, Box said. And some tests have cross-reaction with antibodies for the common cold. She also said it was difficult to know whether the amount of antibodies there would be enough to keep someone immune.

Regarding the weekend protest outside the governor’s mansion, Box said, “I respect the right for anybody to speak out and protest but I would in this time like them to social distance and to wear masks because I am concerned about those individuals becoming ill or, if they’re asymptotic carriers, infection somebody else.”

Holcomb said he respects everyone’s voice but “this would be the exact way not be productive about that. Potentially, it just sets us back. Set aside how almost demoralizing it can be to those front line people that I just talked about, that go into work every single day and who wonder every day if they’re taking that home. But when we just add to that, almost in a flaunting way, it is not helping. There’s nothing government can do to encourage people to care about their neighbor,” Holcomb said.

“There will be a new normal and we will get there. And we’re on the right path,” Holcomb said.

He said the state will get there a lot faster if everyone subscribes to the notion that we’re in this together.

Joseph Heerens, general counsel for the governor, said over the last two weeks, 982 OSHA complaints had been investigated, and 866 of those investigated were found to be without merit. And 74 verbal warnings were issued to businesses. No cease-and-desist orders, no orders to closed and no referrals to prosecutors had been sent in the last two weeks.

Dr. Kristen Dauss, chief medical officer for the Indiana Department of Correction, said the Westville Correctional Facility has worked with ISDH. She said IDOC is working to collect the total number of people tested. They had a record of the number of offenders who are positive and negative but staff members sometimes go to their primary care doctors, and those numbers are harder to know while maintaining people’s privacy.

Box said the state has matched a number of people who volunteer health care workers and that the state was emailing those individuals to see if they are matched, where and how much they were willing to work, etc.

Asked if Indiana can truly reopen without a vaccine, Box said, “Reopening will allow us to gradually open things up and have individuals to be out in community with masks on, continuing their social distancing but allows us to get back to being a productive state again and getting people back to work and to school, which is really important.” But Box said high-risk people may need to continue to work remotely or continue more extreme social distancing until the state has the ability to protect them to a greater extent.

Holcomb talked about ways the return of the workforce will look different and included additional precautions.

Box said the state is encouraging all providers to work with all labs available. Box addresses talk of ISDH turning down tests from Aria Lab. She said they have never turned down any tests and that ISDH got in touch with the lab through Mayor Brainard, and the state got 2,000 swabs from Aria Labs and was grateful to get them.

Adding the presumptive positive deaths to the state’s total counts are important to state and national numbers, Box said. In a clinical setting, a number of factors besides a virus test help physicians understand more about a case. The additions to the count ensure that we are capturing every death that is caused by COVID-19.

The suspension of elective procedures in an earlier executive order was intended to conserve personal protective equipment. The same category of providers listed in that order are listed in the new one, and based on an evaluation between now and Sunday, those elective procedures could resume April 27, Heerens said.

Box said the biggest problem with collecting recovery numbers is that many people had milder symptoms and stayed home, so those numbers are hard to include.

Asked why Indiana is not publishing the names of long-term care facilities where outbreaks have been identified, Box said the state will be providing aggregate numbers of cases at facilities but for now says that information is between residents and facilities.

The missing factor in some areas of the state is the ability of providers to get PPE so they can go in and test, Box said.

What does the state do to keep people from flooding streets as soon as we lift restrictions?

Holcomb said the lifting of restrictions will be incremental and responsible, taking into account how different industries tell the state they will be able to adjust their workplaces.

“We’ll look at shopping malls, we’ll look at theaters and museums, construction … A to Z, and come May 1, we’ll be in a position to put a little more detail on that plan going forward. But again it will be tethered, directly linked to the facts on the ground as they are at that moment,” Holcomb said.

Box said that hospital admissions did not decrease over the weekend. She said ISDH could work on including that data on the website’s dashboard.

The number of possibly related dispatch calls, flu-like symptoms and similar statistics are being tracked by his department as well,” said Dr. Michael Kaufman, Indiana EMS director.

Box said ISDH will get more data on Wednesday or Thursday to assess the peak for most of the state. Box said she is not convinced we have hit that peak but that the state is running much lower than most of the predictions or at the lowest rate that most of the projections showed for the state.