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thank you all for for joining us today.we're going to talk a little bit about.some of the medical aspects of this.virus which we're learning more about.every day here in Colorado nationally.internationally especially some of the.new impacts that have been found on with.children with symptoms like Kawasaki.disease a multi inflammatory syndrome in.children which is seldom fatal but in.many instances the the doctors worry.about a long-term heart damage for those.who are affected but I think the biggest.takeaway is really how little we know.about this very strange virus this novel.coronavirus which has manifested so many.different kinds of seemingly mutually.exclusive in different symptoms across.the world they might not all be borne.out clinically as resulting from this.virus but we've seen everything from.circulatory and Claudian issues to organ.inflammation and failure to of course.the lung issues that are the hallmark.and often the fatal aspect of this.disease - circulatory issues in the toes.and extremities - multi inflammatory.syndrome in children and of course one.of the most unusual and and and I'll put.sort of the positive and negative spin.on it but the most of one of the most.unusual aspects of the virus is the high.percentage of people that are.asymptomatic that's spreaded right we.all know the legend of you know typhoid.mary.right somebody who was was didn't have.manifested of any typhoid symptoms but.was contagious and had hundreds of cases.that were traced to a somewhat.fictionalized version of her but.probably several people that were.asymptomatic that spread typhoid that is.not abnormal for this disease there are.many typhoid mary's among us unknowingly.people who are contagious and have no.symptoms and wouldn't even know it might.be contagious for a week might be.contagious for three weeks that's.why there's no substitute for our.efforts your efforts on staying six feet.away from others where you can and.wearing mass when you go to the store we.hope that you know any worker there if.they're sick they're staying home.there's been a number of outbreaks at.different stores but there is the real.danger of somebody not even knowing that.they're infected because they have no.symptoms and yet they pass it to.somebody else and that person could be.hospitalized seven eight days later so.another area of inquiry for scientists.not the one of the topic of the.presentation today but they're trying to.determine whether there's genetic.markers or other markers to see who has.such an adverse manifestation of this.disease and who seems to have no.symptoms they don't yet know what leads.that there's correlations hypertension.obesity with poor clinical outcomes but.there are people in all those categories.people with obesity with hypertension.who are still asymptomatic and spread it.so they're not determinative they're.correlated so it's a lot of mysteries.we're learning more every day in the.early days of Cova 19 and through today.thankfully I would add we are seeing a.much lower fatality and hospitalization.rate in children but the flipside of.that is is people of all ages have.succumbed to Kove at 19 and that while.children have milder presentations of.symptoms and in fact some that later.present with multi inflammatory symptoms.didn't even know they had kovat because.those they test positive when they're.admitted and that's what cause seems to.have caused or multi inflammatory.syndrome but they did not have any fever.or symptoms in that earlier stage we.don't have the conclusive statistics but.whereas for the general population it's.estimated that around half of people who.contract Cova 19 are asymptomatic I.think you can we could say it's likely.even higher for children we don't know.that for sure but it's likely even.higher but certainly at least half of.children are not showing the fever the.COFF any of those symptoms but some of.those after that a week or two later are.showing a very.set of symptoms including several here.in Colorado now it happens a Children's.Hospital is one of the leading research.institutions in multi inflammatory.syndrome in the country.and of course Colorado parents like.others across the country in world have.been alarmed by reports of the Cova 19.linked symptoms of children in Italy in.the UK in New Jersey in New York and.Massachusetts in Virginia and it has a.correlation with those who just got over.kovat 19 have antibodies in this system.and while the syndrome is again seldom.fatal it often requires clinical.intervention and it can cause lasting.heart damage as well we have two of the.top medical experts here our state.epidemiologist as well as dr. Dominguez.from Children's who has both an MD and a.PhD which I would you must really love.school because that's always so.impressive you know I had friends that.when they went to get their you know MD.I finished my undergrad and they're.finally getting out to be able to.practice seven eight years later you.know after all that and then my goodness.going in for a PhD I don't know if it.was before or after but another four or.five years it's amazing so thank you for.for all of that the good news is as far.as we know multi inflammatory syndrome.is is rare children typically recover.after the acute crisis phase they do.often need clinical treatment to.maximize their chances I want the people.of Colorado to know that we were taking.just as any new risks that we find about.this virus we're taking this very.seriously we're working hard to educate.community doctors out there about what.to look for what to see and we're very.thankful that doctors at Children's.Hospital has the expertise to quickly.diagnose and treat children with the.disease to help inform others I'm.grateful to be joined by dr. Dominguez.he's the medical director of the.microbiology lab at Children's Colorado.and dr. Dominguez is also a leading.pediatric expert on Co vid with a lot of.groundbreaking observations we're also.joined by dr. Rachel Herlihy our state's.epidemiologist is doing an amazing job.helping to guide.provide the best science to me to make.the policy decisions that need to be.made.we'll talk a little bit about this new.challenge please join me first in.welcoming dr. Herlihy.Thank You governor for the opportunity.to talk about our younger Coloradans and.how Cova Dean might affect them we are.truly fortunate to have Children's.Hospital Colorado as a good friend to.Public Health an excellent partner in.identifying and treating diseases and.conditions that affect children.multi-system inflammatory syndrome and.children abbreviated Mis C appears to be.related to kovat 19 sometimes appearing.weeks after a young person was infected.with the virus we have seen it in.individuals up to age 20 and it often.affects teenagers the State Health.Department along with local public.health and health care partners have.been watching how this syndrome has.unfolded in other states and countries.we alerted the health care system here.in Colorado through a Health Alert.Network orhan message last week and.discussed it on many of our calls and.webinars with health care providers in.the last two weeks we're working to.ensure providers know what to look for.and how to report suspect cases to.Public Health we are casting a broad net.to look for this inflammatory syndrome.here in Colorado and as the governor.mentioned we have found three potential.cases which we have reported to CDC for.further review in the next few days.those cases will be reviewed in detail.and a determination will be made if the.cases are confirmed or not one of those.cases wide n F was identified through.review of previous cases in the state.and two other cases were identified more.recently to protect protect patient.privacy no other details about these.cases will be available additionally we.and our partners at Children's Hospital.Colorado are working to determine.whether any previously identified cases.of kovat 19 that we continue to identify.as we look back in our records could.potentially meet CDC's case definition.for this syndrome we know parents and.guardians are worried about this.condition in our young people especially.since Coppa 19 itself is normally very.mild and children by definition young.people who develop this syndrome are.sick enough to require hospitalization.but most recover well parents should.call their child's doctor for advice.when the.as concerning symptoms you can't predict.how many kids in Colorado might wind up.with the syndrome we do know that it.appears to be rare and our partners at.Children's Hospital Colorado are in a.great position to be able to identify.and treat the illness.thank you again governor Poulos for this.opportunity to devote some time to.talking about how kovat 19 might affect.younger people I'll now turn it over to.dr. Sam Dominguez from Children's.Hospital we'll talk more about Mis C and.what parents should look for.you.Thank You governor Poulos and dr..Herlihy for inviting me to speak today.and yes I'd you like school it's a big.joke in my family actually just like to.say about this newly described an.emerging syndrome MICR multi-system.inflammatory syndrome in children first.of all I want to reiterate that over all.children who are infected with the SARS.coronavirus - virus do very well we are.fortunate that covin 19 has not impacted.kids as severely as adults a majority of.infections and children are either.asymptomatic or mild and do not require.hospitalization in regard to this new.syndrome Mis C I went to first emphasize.that this syndrome is quite rare the.first cases at M ISC were reported in.countries throughout Western Europe only.a few weeks ago and we're initially.given the name paediatric multi-system.inflammatory syndrome temporarily.associated with copa90 nor Pimm's quite.a mouthful I just wanted to make sure.that we understand that that syndrome is.the same so now we're talking about that.the CDC has named Mis C in the past week.or two there have been just over a.hundred total cases reported in multiple.states throughout the US where the most.cases being reported in New York we have.been involved with the care of three.children with suspected nasc at.Children's Hospital Colorado.but due to patient privacy concerns I.can't go to any specific details.regarding these patients because this is.a new and emerging syndrome there is.still a lot that we do not know about.Mis see what we do know is that it is a.strong association both temporally and.geographically with astara Scobie -.virus this suggests that what we with.most cases presented about four weeks.after exposure to the virus this.suggests that what we are seen in these.children is likely a post infectious or.inflammatory response to the virus as.opposed to direct ongoing damage from.the virus itself from a clinical.standpoint we know these children.presenting with very high fevers usually.for multiple days with evidence of a.high degree of inflammation in their.bodies and involvement in multiple.bodies and symptoms systems in.particular most of these patients have.presented with gastrointestinal.complaints consisting of severe.abdominal pain vomiting and sometimes.diarrhea.these patients also present with the low.blood pressures and inflammation of the.heart muscle of note the majority's.visions do not represent with.respiratory symptoms.finally a subset of these children have.presented with symptoms similar to.Kawasaki disease in particular rash red.eyes and red lips or red strawberry like.tongue I mentioned Kawasaki disease.because there's been a lot of discussion.about how Mis C is similar and different.from Kawasaki disease Kawasaki disease.the febrile inflammatory illness of.children that primarily affects toddlers.with 80% of the cases occurring in.children less than five years of age.Kawasaki DS is known to be a systemic.vasculitis meaning it's an inflammation.of the blood vessels that primarily.affects the medium-sized arteries and in.particular can cause inflammation and.potentially damage of the arteries that.supply the heart the coronary arteries.unfortunately we don't have a specific.diagnostic test for Kawasaki disease so.diagnosis may based upon clinical.criteria including fever for multiple.days evidences stomach inflammation and.multiple clinical symptoms including.rash red eyes red lip red lips or tongue.enlarged lymph nodes in the neck and.swelling or redness of the hands and.feet similar to some of the findings.that have been seen in this new syndrome.Mis C at Children's Hospital we are very.aggressive in diagnosing and treating.Shola Kawasaki disease because about 20.to 25 percent of children who are.untreated can go on and have.inflammation and damage of the coronary.arteries that can result in these.arteries getting bigger and the most.severe severe form causing outpouching.of the vessel walls or aneurysms.interestingly several the patient so.that mi FC have also been reported to.have complications of coronary arteries.similar to what is seen in patients with.Kawasaki disease I think it's also.important to point out some key.differences between this new syndrome.and Kawasaki disease first of all while.Kawasaki disease primarily happens in.the toddler age group most cases of Mis.see have occurred in children well in.older children ages 5 to 15 years old.kids with this new syndrome also are.much more likely to have severe.abdominal complain.of heart problems and blood pressure.problems compared to children with.Kawasaki disease it is important for.parents and providers to be on the.lookout for kids with potential MI OC.and Kawasaki disease as both likely.benefit from earlier recognition and.treatment in particular appearance.should call their primary care providers.if they have several days if their.children have several days of high.persistent fevers are having severe.abdominal pain or have a combination of.any of the symptoms that can be seen in.MI HCR Kawasaki disease that we.discussed such as the rash red eyes red.lips.the cervical lymph nodes in the neck or.hand and feet involvement I want to.highlight that our team at Children's.Hospital is well prepared to recognize.and treat patients with Mis see we have.a long history of recognizing and.treating new and rare syndromes a.particular node toxic shock syndrome was.discovered at Children's Hospital by my.colleague and mentor dr. Jim Todd.my colleague dr. amigo de pioneered the.use of intravenous immunoglobulin for.the treatment of Kawasaki disease and we.own a nationally recognized Kawasaki.disease clinic clinical and research.team furthermore we are part of an.international working group of pediatric.experts who are caring for these.patients Children's Hospital has formed.a multi districting team consisting of.our infectious disease experts.rheumatologists cardiologists.hospitalists and intensive care and.emergency care providers that have.gently drafted guidelines to assist and.recognize and in treating patients with.Mis C I want to end by saying that I.know that there are a lot of parents who.are afraid and anxious when it comes to.thinking about this new SARS coronavirus.and about getting to them about going to.the right or bringing their child to the.hospital this is the normal feeling and.expected whenever there whenever we are.faced with uncertainty and something new.but I want to reassure everyone that is.very safe to bring your child to the.hospital for care we at Children's.Hospital Colorado have taken all the.necessary precautions to ensure their.children are safe and provide the care.they need additional additionally.primary care offices around the state.have worked very hard to keep their.clinic safe and they are prepared to see.your children it is critical that.children continue to receive their.needed checkups and vaccinations during.this time.thank you very much governor Poulos.thank you you know and and I'm sure.you'll have a lot of medical questions.here but I think the biggest thing to.reflect on is how ever much we think we.know about this virus there's even more.that we don't know it it's similar to.people might recall the early days of.another virus that took far too many.from us the HIV virus and AIDS in the.early days it manifested with people.going in with carp si si coma of unknown.causes these rare diseases and and.sometimes dying from them in San.Francisco and New York and it took many.months and years to figure out what was.happening first the isolation of the.virus itself the detection of HIV that.caused AIDS and then learning about all.the different clinical manifestations of.that this one too I think that.scientists across the world have made.great progress in a short period of time.but there's still more that we don't.know than what we know about this virus.it is a zoo logic just as hiv/aids was.from primates this was from bats likely.through or perhaps through an.intermediary species like the Pangolin.which also should cause us as humanity.as a country as a state to reflect on.our practices around animals one of the.bills that I used to sponsor in Congress.and I would call upon Congress to pass.is one that could prevent a future.pandemic of antibiotic resistant.bacteria there is no good reason for.prophylactic use of antibiotics in non.sick.farmed animals very dangerous we are.asking for it we already have antibiotic.resistant bacteria it's extremely.dangerous extremely deadly it's not a.matter of if it's a matter of when I.hope that Congress and the world act to.of course allow sick animals to be.medicated with antibiotics but we don't.dose healthy humans with antibiotics or.we would cause greater incidence of.antibiotic resistant bacteria and we're.doing that on even a great yet we're.doing it on even greater scale to the.detriment of human health in in big AG.and so I hope that.addition to closing wet markets.obviously not legal in our country we.should crackdown in any that are but I'm.grateful to China has banned them that.needs to be enforced across the world we.should also look at our sustainable.practices to make sure that we are not.creating the very next pandemic like.this one from a zoological.just as hiv/aids was just as.coronaviruses just as the flu was the.1918 flu avian derive flu from birds so.really important in terms of husbandry.practices as well as limiting limiting.the the wildlife or bush meat trade to.to make sure that we can contain the.next pandemic before it starts because.we've all found out it's not very fun to.try to can can kid try to contain it.after it starts so let's do better with.the next one I have a few updates before.we get to the questions I first want to.give my praise and thanks to the brave.women of the Colorado National Guard men.and women who put their lives on hold to.help us respond to this crisis just so.everybody knows the Colorado National.Guard is the branch of the US military.that serves as the first line of defense.for the United States it's summoned.active duty by governor's in both the 50.states and three territories they.respond to domestic emergencies our.flood of 2013 fires in other areas.hurricanes thankfully we don't have.hurricanes here earthquakes and in this.case a pandemic this is the largest.domestic deployment of the National.Guard since Hurricane Katrina 15 years.ago state of emergency in all 50 states.and they are helping in so many ways.conducting testing sites across the.country here in Colorado helping protect.our senior care facilities working with.to save lives they are helping us be.able to return to more normal economic.and social activity through their work.and in in in this we should recognize.that the men and women of our Colorado.National Guard are patriots who continue.to go above and beyond the call of duty.when our state when our country needs.them they leave their jobs they leave.their.families and they serve they rise to the.occasion they mobilize without.hesitation they tackle the mission at.hand many of them are on Leafs of.absence from their regularly paid jobs.earlier this year I was proud to sign a.bill that raises the pay for many of our.Colorado National Guard members but we.know that they deserve even more they.are our friends our neighbors and they.are our heroes the National Guard.deployment was set to end May 31st and I.was while I was pleased at the White.House extended that 24 days to June 24th.we need the National Guard longer.through the end of the year and they.need us because here's the rub for the.Guard members themselves who are putting.themselves at risk many have actually.contracted the virus ending the.deployment On June 24th right in the.middle of the week means that thousands.of them find themselves with 89 days of.duty credit one day short of eligibility.for retirement and education benefits.under the post 9/11 GI Bill so this is.an issue not only where we need our.National Guard in Colorado and across.the country but this is wrong to deprive.them of one day of duty and thereby deny.than the benefits that they have earned.by putting themselves at risk if this.decision stands not to renew our.National Guard past June 24th it only.not only hurts our emergency response.but it does a huge disservice to our.heroes it would be a cruel insult to our.brave Guardsmen and women whose families.have sacrificed so much to put.themselves at risk many of whom have.even contracted the virus serving on the.frontlines of the worst public health.disaster in a century the worst pandemic.since 1918 and I'm proud that on April.29th every single member of Colorado's.congressional delegation Democrats and.Republicans sent a letter to the White.House imploring the President to.continue the Colorado National Guard.service through the end of the year and.to do right by us and to do right by.service members and I hope that that.decision is made for our benefit and for.theirs I also want to thank everybody.who's given to the Cova.teen Relief Fund help Colorado now.org.that fund are fun for Colorado to help.those most at need who are suffering the.most has raised over 18 million dollars.so far and you can contributed help.Colorado now org they've approved their.third round of funding none of the money.that you donate will gather dust dust.134 grants just went out and it's helped.people in every county in the state.which we are so proud of because nobody.has been untouched by this virus from.health or economic psychological or.social perspective they're currently.making decisions on the fourth round of.funding and we're proud to say the fifth.fund round of funding is now open for.applications about impact and recovery.and if you're an organization seeking.funding the deadline to apply is.Saturday May 30th at 7 p.m. and fortune.a special shout out I want to highlight.another opportunity for organizations to.secure funding the Rose Community.Foundation is accepting funding requests.to support organizations that are.working to mitigate or alleviate the.impacts of kovat 19 for mental health.behavioral health job loss food.insecurity really all of those key areas.you can visit the Rose Community.Foundation website to find out how to.apply Thank You dr. Herlihy thank you.dr. Dominguez for everything that you're.doing to advance scientific knowledge so.that we can learn more about the.clinical implications and the public.health implications of this strange and.deadly virus the information we shared.with you today is just another example.of how novel and unknowing this virus is.and that's why we are all working day.and night to help stop the spread while.you have been so successful so.successful staying at home where you can.limonene interactions wearing masks when.you're in stores or in public it's.showing up in the numbers your your.success is having a profound impact in.helping us open everything sooner get.back to work and get back to normalcy.and you're grateful for it and I'm.grateful for it because I want to be.governor of a successful open state just.as you want to live in a successful open.state.I've said this many times and I want to.say this again especially with Memorial.Day weekend ahead this is not a vacation.this is a global pandemic that we need.to treat it as such and there are always.gonna you know what there's always.Coloradans who are ignorant and selfish.but thankfully the vast majority of.Coloradans are smart people who take.precautions when we need to most.Coloradans I think I read the other day.somebody was caught going 130 miles an.hour on one of our highways and I think.the state troopers thankfully.apprehended them you know what most.Coloradans don't go 130 miles on our.highways even if you thought you could.get away with it because you know that.the life you're putting at risk is first.and foremost your own and so - I'm so.proud that the vast majority of.Coloradans are reducing their social.contacts staying home or wearing masks.in public and being smart and just.because we're all tired of living in a.heightened threat out there we all know.that that has not made the threat go.away and you're sick of it.I'm sick of it we're all sick of it not.literally thankfully I tested negative.I'm not sick of it yet thankfully knock.on wood but the fact that we are sick of.where we are is not an excuse to behave.in risky or adrien behavior that makes.it worse for yourself and others and.puts your loved ones at the most risk.and of course decide to degrade at a.greater risk if we want which we do.restaurants to open if we want kids to.be able to return to school if we want.to be able to ski next season or even.this season and if we want to save the.lives of our loved ones or even.ourselves we need to do our part stay.home where we can remain six feet from.others where we can and wear masks when.we're in public and it's especially.important with the holiday weekend.coming up this isn't exactly a normal.Memorial Day weekend it's a Memorial Day.weekend in the middle of the of a.worldwide pandemic the worst pandemic.that we hope that we ever face in our.lifetimes in the worst global pandemic.since 1918 it's not the time for big.family reunions and massive cookouts and.celebrations you know.should honor this Memorial Day by doing.what Memorial Day is all about and.that's solemnly honoring the fallen.taking a quiet time out to remember why.we have this holiday to honor those who.died in our nation's service we don't.want to cause more deaths and desecrate.their memories by celebrating a holiday.that is designed to memorialize those.who made the ultimate sacrifice for our.country might mean a quiet trip to Fort.Logan or a cemetery to visit a.grandparent who served with distinction.or lost their life in the line of.service it might mean reflecting for a.moment at home about how proud we are of.the men and women who defend our freedom.and how grateful we are for the.sacrifice of those who have paid the.ultimate price before I take questions I.want to let you know that because.Monday's Memorial Day we'll do our next.public availability tomorrow with mayor.Hancock and then our next question and.answer press conference on Tuesday and.I'm happy to take some questions now.thank you.questions be asked by parents a lot of.time for they hear this information.today is there any statistical data to.show how many more children in Colorado.may already have this Mis C or yeah.doctor Dominguez can can can sort of.give some advice to parents what should.you look for when do you have to worry.when should you call your doctor and and.and I think that a lot of parents like I.have an 8 year old and a 5 year old I'm.listening and I know that many parents.were listening I think what I would tell.parents particularly things to look for.are if you have multiple days of high.fevers that would be a concern to call.your primary care provider the other.things that are presenting most commonly.with this syndrome is actually pretty.severe abdominal pain and so it'd be.another concerning sign that you should.talk to your primary writer about and.again the things that look like Kawasaki.disease so red eyes red lips rash any.constellation of those symptoms together.would be a reason to call your primary.care buyer as well so they can you talk.to them about this and whether or not.to be getting further tested or you.refer to for more specialty care thank.you telephone.yes your executive order seems to give.public colleges latitude and how they.use the Carroll Act money as cogs and.workforce development just how the state.using that money permissible for higher.education especially in light of large.cuts made yesterday and if so how does.your administration come to that liusia.so there have been costs born across all.segments of society in this crisis and.certainly our community colleges our.colleges our schools our County Health.Department's our cities our counties all.of them have are in different ways on.the frontlines for community colleges.immediately canceling in-person classes.shifting to online in many cases helping.students who didn't have access or.computer equipment with the equipment so.all of the entities that the money has.been pushed out to from cares Act our.eligible entities under the cares Act.they're their cornerstone parts of our.society and our success workforce skills.making sure that parents are able to go.to work by having reliable schools that.are a good job doing a good job.educating the next generation cities and.counties most of which didn't get money.directly under the cares Act only the.largest ones do which is why it had to.be sent out to the smaller ones so those.on the front line in our communities are.doing everything they can to tackle the.health economic and psychological.challenges faced by the kovat 19.pandemic.governor can you address you mentioned.numbers a little bit and I'd like if you.wouldn't mind dr. Herlihy weighing in as.well we have heard from a lot of people.that seem frustrated with the numbers.that have been kind of changing the CD.Phe website yesterday even had a.different look under Coppa 19 data do.you acknowledge that there's a.difference between dying with over 19.and dying from over 19 and what do you.say to people that are frustrated at the.numbers right now well I was very.frustrated and I mean Rachel knows that.I was frustrated because when I found.out that you know people that tested.positive but died of something else for.which Cova 19 may or may not have been a.contributing factor were mandated to be.reported to CDC I said fine report to.them what they want but we also need to.let the people of Colorado know how many.people have died from covin 19 according.to their attending physician coroner a.death certificate so all of those.numbers are now reported we want to err.on the side of providing more.information so if you see different.information out there it's because.they're all valid I mean it's.interesting to know how many people died.with Kovac that's a fascinating thing to.know it's also interesting to know how.many people died of kovat the actual.number is very likely in between and.keep in mind there are also people that.likely died with kovat and of kovat that.have not been discovered or found or.reported it's unquestionable there are.some how many we don't know we also.don't yet know how many of those who.died with kovat that might have been for.some of them a contributing factor but.what is most paramount here and what.most Coloradans think about how many.people died of kovat is being reported.out regularly by the terrific.professionals at CD phe it required a.change because that was not required by.CDC and we asked them to take on and.they successfully have this additional.information so the people of Colorado.can a full entire confidence in the.number of fatalities that are being.reported dr. Hurley trust issue right.now do you think I think the more.information that we can provide the.greater the public trust and we always.want to err on the side of providing.more information to the public in all.ways and that's why the website is far.more thorough than it was people said it.didn't have race.data we added that it didn't have enough.geographic data we added that go to.copa90 no Colorado gov I think there's.ten times as much data as there there.was a month that go on there I mean.there's an enormous amount of data and.we want people to be able to parse that.every way they can.that means you know armchair scientists.scientists and consumers dr. Hurley yeah.absolutely I mean we want all of the.possible data that we can produce to be.available on our website so that.individuals can assume that data and.really understand the situation with.this virus here in Colorado as as best.as possible.and and and that really requires looking.at death data specifically in two.different ways there's there's reasons.to collect data in different ways one.systems faster simpler for us it gave us.numbers earlier on but obviously there's.an important reason to be tracking.numbers of kovat cases that resulted in.death where we know that Kovac 19 was.the cause of death and so certainly.support having as much data as possible.on our website and and allowing people.to to make decisions themselves with the.data that's on our website and think.telephone.good afternoon it's David clue at.Denver's seven thank you again for this.opportunity will the new threat of this.inflammation virus impact what will be.the state's guidance for daycares and.the return to school this fall this is.more a heads up for parents to know what.to look for I don't think we know enough.to know whether this would have any.impact on that it is still the.scientific consensus and our belief that.the risk is greater for those over 65.and the risk is less for children it.doesn't mean that there's no risk for.children but as we think about a safer.school environment as we think about.safer summer camps of course of course.yes we're worried about the kids but.there's even bigger concerns about the.health of the adults and particularly.the older adults that are interact with.those children as teachers as counselors.and supervisors so far so good and and.we had to build in a timeline longer.than I would have liked to to make sure.that I have a degree of certainty to me.that we can move forward and that's why.we identified Monday is the day that.we'll be making some of those.determinations and then June first you.know for the rest of June but at least.restaurants on Monday Ski restaurants.summer camps Monday and then other.things later before June 1st so so far.so good but we always are weary and.worried if there's you know a spike in.the next few days we need to know that.we need to know that and so far there.hasn't been a spike there's been.regional outbreaks there's been other.areas that have had decreased incidence.regionally but statewide Coloradans have.done a very impressive job you really.have staying home when you can wearing.masks when you're in public and I.understand that you know you and the.media and and and viewers as well they.like to you know they like to do the.Man Bites talk right you like to say.here's a bunch of people partying at.Boulder Creek or at Chatfield reservoir.and the untold story is that the vast.majority of Coloradans are staying safer.at home going out when they need to.wearing masks in public and this is a.numbers game it's a numbers factor.nobody ever expected that a hundred.percent of Coloradans would do what.they're supposed to be doing 100 percent.of the time the goal in this is on.average to be around 60 percent social.distancing and that means that on.average for Coloradans who interacted.with 20 people a day you know last.January that number should now be around.12 8 to 10 people 8 people or so so so.on average right now and that means that.yeah there's somebody my parents among.them you know 76 they have limited their.social interactions to essentially zero.which is great 100 percent reduction and.there are Coloradans that are falling.short of the benchmark of 60 percent.social distancing but from the public.health an epidemiological perspective.it's important that we achieve that as a.society as an average and so far so far.the indications are that we are.all of them.good afternoon with on Colorado politics.budget for me after hunting.so 1 billion dollars short.no your viewer budget office has lots.and lots of.what else.so I was not following the joint Budget.Committee this morning I was getting.ready on the health stuff and and on a.number of phone calls so I can't comment.on that if there's a particular action.they've taken you can ask my office and.I'm happy to react but yes we have.through the great work of Loren Larson.OSP be offered up a number of different.ideas for how we can bridge that gap.looked at people Colorado know that.there's belt-tightening across the.entire economy across every sector I.mean families some families have gone.from two income to one income some.families are making a little less.because they're on unemployment.some families are out of work so of.course just as families are tightening.their belts governments are tightening.their belts school districts are.tightening their belts that's what we.all do in tough times to get through and.I'm confident the state of Colorado will.emerge out at the other end healthier.and stronger than ever before so we we.were very proud to announce that anybody.who symptomatic should get tested and we.have over 34 free community testing.sites Kovan 19 Colorado gov yes it's.expected that as we test more we will be.picking up more of the people that have.kovat 19 and having them included in the.official report that alone doesn't mean.that the incidence rate has gone up it.means that we've caught more of them I.think in the early days this is not even.the early days everything is a blur of.the last two months this was a few weeks.ago dr. Herlihy I think we thought we.were catching maybe a quarter to a third.of the cases as we have a lot more.testing we're probably getting closer to.half the cases maybe even more as we go.forward that we are positively.identifying of the symptomatic cases I.should add we are only picking up a.small fraction of the asymptomatic cases.because we obviously don't have the.ability to test everybody we are really.focusing those on testing people that.work around those who are at high risk.people who work in senior facilities and.they're also available if you're.asymptomatic for those frontline workers.nurses first responders if you work in a.grocery store and expose the hundreds of.people a day and I've been working.through this crisis yes you can get.tested as well even if you're.asymptomatic so but they're very.targeted so yes the number we expect.we're catching more of the cases that.that is factored into our modeling.meaning that that doesn't automatically.mean there are more cases we are taking.into account the increased testing and.the understanding and now we are picking.up a higher percentage of the cases look.the number of active infections and.deaths is will directly flow out of the.behavior of Coloradans and how well we.social it is socially distance if if.what happened in Boulder Creek and.Chatfield reservoir was the norm and.that was most of us we would have.thousands or tens of thousands of deaths.in the next few months the fact is.that's not most of us the story is is.largely untold because it's not as.exciting of the so many Coloradans who.are staying at home when they can.wearing masks when they go out being.prudent avoiding large public gatherings.of more than 10 and statistically.certainly the wide body of evidence.shows that that's what Coloradans are.doing and I'm confident that that's what.Coloradans are doing so the future.trajectory of the virus in Colorado is.in your hands not mine it depends on.smart actions responsible actions that.keep you and your loved ones safe in the.room see one more English yes.see un gran kosaki in Colorado is es.nosotros tenemos en temperaturas in.Durango para comer affero es mucho más.seguro.afuera por que podemos tener mas test NC.a-- entry meses por ejemplo in un.restaurante SOC a GU nose van abrir.tambien in restaurant.en el cuarto pero también estamos.trabajando Kanu cidades para abrir que.es e lugar este park in de carros para.poner mass mesas e denier mas de.Ciencias porque es más seguro para los.clientes tambien para los trabajadores.in los restaurantes will do one more in.a telephone and then one more now go to.Stephanie.so for phone governor this is Cara Mason.from The Sentinel in Aurora you've set.aside one hundred and fifty seven.million of Cara's act funds for local.health departments and our response to.covet 19 for the upcoming year but is.there any clear picture yet on how much.contact tracing you will cost in.Colorado I know that Trent county has.already told me that they would probably.need to hire at least eighty more people.to successfully do that work yeah we're.really exciting about the the testing.and contact tracing work I'm gonna have.dr. Herlihy addressed briefly some of.the exciting developments in contact.tracing as well state and local so our.strategy here in Colorado is to build.infrastructure for contact tracing both.at the state level and at the local.level that really works with the.existing structure we have for Public.Health.here in Colorado and so our goal is to.both increase the number of staff at our.state health department that are doing.this work.and doing this work together with our.local public health partners and really.serving in a surge capacity for our.local public health partners that need.some assistance in doing this work at.the same time we want to make sure that.our local public health agencies are.sufficiently resourced to be able to do.contact tracing in their own agencies.and contact tracing is really one piece.of a larger containment strategy so so.while we're building contact tracing.capacity we are also building case.investigation capacity outbreak.investigation capacity and also ensuring.that there are sufficient resources in.our local communities to serve.individuals who are in isolation in.quarantine and make sure that their.isolation and Quarantine experience can.be successful and then they can continue.to stay home and protect their community.so making sure they have the.prescriptions they need the groceries.they might need while they're in that.period of quarantine or isolation so.really it's part of a much larger.strategy for overall containment here in.the state and this is important.expectations none of us liked that that.time period where we had to stay at home.thankfully that that's over but there.will still be people that need to stay.at home and you need to take it very.seriously if you were contacted because.you were exposed to somebody in close.quarters for a sustained period of time.who was contagious you need to honor.that isolation and Quarantine for.yourself.so rather than quarantine in an entire.society it's only done for those who.were immediately exposed to Cove at 19.to stem that transmission and be able to.get it back get us back to normal as.soon as possible last question and.city/town issue but just wondering your.take on we've heard from some business.owners that the onus is on them to make.sure that customers that are coming in.are wearing masks and if they're not.that it's not the person not wearing the.mask that gets the fine but it is the.business owner themselves I don't know.if you're familiar with that but so at.the state level we require the workers.in retail for their own safety as well.the safety of the customers to wear a.mask when they're interfacing with the.public that's very important for a.couple reasons it's important of course.for employee morale and.keep workers in retail safe it's also.important to prevent the outbreak of.kovat 19 and finally it's important to.inspire confidence to get customers to.be willing to go back into stores.knowing that the people behind the.counter who might encounter hundreds of.people today every day including people.with kovat 19 themselves have mass to.help prevent the outbreak even if.they're asymptomatic and could could.spread it this is being forced locally.in different areas in different ways but.certainly the state is very serious.about making sure that those who work in.retail that are in regular contact with.the public where mass for their safety.the safety of the customers to prevent.the public health crisis from worsening.and to increase consumer confidence.thank you all very much.

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