ANNOUNCER: Now, from CBS4 NEWS
this is Facing South Florida
with Jim DeFede.
Good morning, and welcome
to Facing South Florida.
This week I spoke to
Jackson CEO Carlos Migoya,
who revealed to me that one out
of every five Jackson employees
who have been tested this month,
are now positive for COVID-19,
but the testing
has been limited.
So, I start by asking him if he
should be doing more testing
in the hospital?
Frankly, we don't have enough
tests to test every one of our
employees, and what's going on
with the reagents and so forth,
but we have enough tests to deal
with the people that are either
asymptomatic, or have actually
impacted with asymptomatic,
as well as all the patients
that are walking in the door,
as well as all the patients that
are going to the emergency room.
Well, and I
think you just hit on it.
I think you just said it.
If you had the reagents, if
you had the testing capacity,
you would probably be
doing more widespread testing.
I'm not saying it's a failure
on your part that you don't have
the reagents, but when we hear
that there is adequate testing,
and the testing system is great,
and everything about testing is
fine, the reality is you
do not have the chemicals,
the reagents necessary to do the
type of testing that you would
probably want to do on a wider
scale basis for your employees.
Am I wrong?
CARLOS: So, it's not
just the employees.
Let's talk about testing,
because you're obviously
hitting a point.
When we started this
thing back in April or May,
from a communal perspective,
we were doing maybe
2,000 tests a day.
Now, we're doing
between 8,000 and
9,000 tests a day, and
it's still not enough.
We've got 2.8 million
people in Miami-Dade County,
plus whatever
number is in Broward,
I don't know what it is, 1.5
or 2 million people in Broward.
I'm not familiar as much
with the population of Broward,
but the bottom line is,
we believe that between,
there's a study that
says 25% of the people,
could possibly have,
or have had COVID.
There's a possible
chance that that's the case.
That's half, over half a million
people that either have it or
have had it.
Are you immune from it?
I don't know.
I had it, and it doesn't
mean that I've been immune,
so I'm still very careful,
using a mask and the social
distancing, as well
as everybody should.
So, the issue is with our
employees as well as anyone
else, when you're
in the community,
you're exposed to
the same situation,
so everyone needs to
be careful with that.
And are we going to get enough
testing to test 2.8 million
people in Miami-Dade County?
I don't think that
will ever be the case.
We're trying to, every way
possible and nationally because
you have so many states
whose numbers are growing,
everybody wants to be tested,
and there's more and more people
being tested and needing
tests, so we do our own internal
testing, which
means we need reagents.
Most of these other
places go to outside parties,
third-party labs that
are growing nationally,
and that's why there's a delay,
because there's so many people
that needed to be tested.
Even though
testing is important,
Jim, we're not going
to get enough testing,
so therefore the assumptions
that everyone has COVID,
and being social distancing, and
masking is the most important
message that we can get to
everybody in the community,
including our own employees.
And I completely
agree with that,
and the reason that I'm imposing
these questions to you though
are, you are the CEO and head
of the largest health system in
south Florida, and so that's
your area of responsibility.
You're absolutely right about
people in general need to be
more proactive.
I'm just asking about the folks
that you have something to say
and control over, and the last
point that I'll just make about
testing is you could also
institute a pool system,
where, you know if you don't
have enough reagents to test
individuals, maybe you test 20
or 30 employees at a time in a
pool, like you used to do with
HIV testing in the clinics back
in the day, and then you can
sort of get a sense for where
we're at.
I think until we
know where we're at,
we don't know the
problem we're facing.
The fallacy with that,
the fallacy with that,
Jim, if I test you
today and you're negative,
it doesn't mean that you're
not, you're not positive.
You could be positive and not
have enough virus in your system
that hasn't tested positive yet.
You might test
positive tomorrow.
The only way that you're assured
that everybody is negative,
is to test them every day,
every one of the people.
Testing 20 people a day
does not solve the problem.
So, the question
becomes, why do any testing?
If you adopt that belief,
then testing is irrelevant.
I think we should try to
find people and isolate them,
and do contact tracing,
so testing has merit.
I think testing is valuable.
I totally believe
testing is valuable.
You need to understand what
percentage of your population
has had it, or have it, and I
think that part is important,
but I think beyond that, we're
not ever going to have enough
testing to what we
need to be doing.
I mean if you look
at this herd idea,
which is impossible to do with
60 to 70% of the population in
having had it, it's
very impossible to do,
so it's important to continue
to make sure that people believe
that they all have it
and are social distance,
and masking.
I can't say that enough.
JIM: Carlos, I don't want you to
think that I'm trying to put you
on the hot spot
with regards to this,
it's just Jackson is such a
vital part of this community,
you know that, you've been
leading it for 10 years,
you've helped
rescue it financially.
I can't even imagine where we're
going to be financially when all
this is said and done.
That's another
conversation to have,
but I just want to stay focused
on what you're dealing with
there, because I do think that
until leaders like yourself and
others, and I'm not saying
you haven't been candid,
but until you sort of paint the
picture of what the problem is
that we've got, people can tend
to become lax and not take it as
seriously as they should, and
that's one of the reasons why I
was raising this issue.
That is part of the
entire community,
and I will tell you right now
that just about every patient
that we get in the door, they
go through the emergency room,
that does not need
to be hospitalized,
we're doing the
testing from a third-party,
not from within, because we
don't even have enough
testing internally.
We can do about 500 tests a day,
that's all we can do from a
lone lab standpoint.
Anything beyond that,
we're using third-party,
so we're prioritizing
from a need perspective,
and anybody that
needs to be hospitalized,
we absolutely have to have
them tested immediately,
because we need to
understand the level of care
that they need.
And by the way, of those people
that are walking in the door
that are positive COVID,
40% of them are coming
for a different diagnosis.
They didn't even
know they had COVID,
so they either had no
symptoms, or mild symptoms,
but when they come in, you still
have to treat them the same,
because you have
to isolate them,
and you have to be
able to have the PPE,
and make sure that those people
are not infecting other patients
or employees.
What is the current
status of when they're severe,
and your level of
allotment of if,
your supply of
it, do you have it,
when will it be coming?
And I realize it's sort of
controlled by the federal
government, and
controlled by the state,
so where do we stand
right now with this drug,
which is by many accounts seen
as the best effective treatment
for COVID-19?
So, let's talk about that,
because that's important.
So Remdesivir, there's a
very limited supply around
Remdesivir, and frankly when
you talk about Remdesivir,
we're only really providing
Remdesivir to patients at a
certain level, when
they're in intensive care.
It doesn't come, we can't
do if prophylactically,
and we can't do it
for people in med surg.
It's only for specific people,
and we're doing it only for
basically a handful of people.
It's not a huge
number of people,
and frankly too, even
with that number of people,
we have a very short supply.
Right now, the supplies are no
longer going from the federal
government, they're coming
directly from the manufacturer.
There's still
certain controls on that.
If you, and now I'm reading,
I'm going from what I've read
nationally, the United States is
taking control of all of those
supplies for the
next three months,
but they're saying
it's 500,000 of them,
which is wonderful, except only
100,000 of that will happen
in the first month, and 200,000
will happen in the second
and third month, so if you
look at 100,000 for the entire
country, it's not
a lot of these.
The Remdesivir is not
the answer to all of this.
We don't have enough supply,
and I'm not sure even with the
500,000 that we're talking about
over the next three months,
that that will be enough
supplies for all of the
hospitals in the United
States, and all the
patients that need it.
Are ventilators an issue?
Not just today, but as you
project out in terms of worse
case scenarios, do you have
the ventilators that you need,
because I know in Houston, we're
seeing stories of some hospitals
running short and doctors having
to make decisions about who to
place on a
ventilator and who not?
Are we close to that
at all in Jackson?
So, we're using more
ventilators that we did before.
The percentage of ventilators,
have continued to be on the low
side, and we're comfortable
for the moment that we have
enough ventilators.
Remember that besides the
regular ventilators that we
have, we've also
acquired back in April,
a group of portable ventilators
that are usable one time for
patients, that we
haven't even touched.
There's several
hundreds of those,
and in addition we have
anesthesia machines in the
operating rooms
that if it came down,
they'd shut it down.
So, we have plan Bs, and Cs,
and Ds in this environment.
The best part of, the silver
lining in this very dark cloud
that we're under today, is the
fact that our intensive care
physicians have learned a lot
from the experiences in
New York, and they're
ventilating these
patients later.
Now we're seeing
very acute patients,
so they need those ventilation,
but they're going later and
because of that we're receiving
much better outcomes than they
did in New York.
All right, now let's talk
border messages that you've been
sort of wanting to talk
about, that you've
raised several times.
Thank you.
You're doing,
you're, Carlos, again,
it's, I ask you tough questions,
because I know that you're
someone who can handle
tough questions, you know,
but again, let's go
to the larger issue.
You're on the front lines, and
you're seeing what's happening,
and you're seeing the stress
that it puts on your employees,
the nurses, the
doctors, the residents,
the folks that you
have in your system.
You know, talk to
me about what you,
what message do you want to give
the public who maybe is just
tired of staying at home, and
they don't really want to wear
a mask, and they want to
go out and they're tired
of all of this.
What do you say to them?
So, here's the issue.
I'm tired of
wearing the mask, okay.
I want to hug my family,
and I want to hug my friends.
I'm a hugger, and I want to
be able to do these things,
and it's been over 100
days since we have done this,
but there's a complete
disrespect out there in the
community, and
all south Florida,
frankly most of the country, of
people not being social distant
and not wearing a mask.
That is, as long as
those continue to happen,
and more people continue to get
this disease and of a course a
small percentage, but still
major percentage of the people
get hospitalized, it will get
to a point where we don't have
enough hospital beds in
the entire south Florida,
to manage what is going to
happen in our community.
So, the best way
to keep, you know,
if you want to worry about the
bed size and the number of staff
and all those things, the
best way to keep that down is
by managing the infection from
a community wide perspective.
The most important message that
we've got to give the people
is wear your mask and
be socially distant.
When we come back,
Miami-Dade County Commissioner,