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Governor Kristi Noem

Lori Walsh: As the rest of the nation seeks ways to reopen the economy, South Dakotans were never on a statewide shelter in place order are locked down. Now, many business owners, faith community leaders, and others are seeking CDC and South Dakota Department of Health guidance to inform and support those individual decisions about what back to normal looks like in their community. Governor Kristi Noem joins us today for an update. Governor Noem, thank you for being here with us today.

Governor Kristi Noem: Oh, absolutely. Thank you, Lori, for inviting me to be on with you,

Lori Walsh: Tell us what you're hearing from mayors and civic leaders or business leaders about how they are looking at the CDC guidance and the South Dakota back to normal plan, and making some of those decisions about what it looks like for them.

Governor Kristi Noem: Yeah. I think that a lot of our local leaders are wanting to give some more opportunities for businesses to open and for activities to resume, but still recognizing that keeping public health a priority needs to happen. So for us, we consistently point to CDC guidance and also give them recommendations and checklists on what they can do locally to make sure that they're putting in place opportunities to still keep groups small, to encourage people to socially distance, to get the vulnerable population to stay at home. And so that's an ongoing communication that we have going with each community because every community has a completely different situation for what kind of facilities they're dealing with, what the layout of their businesses looks like.

And so if we can give them the opportunity to, to have some flexibility to implement practices, I think they've appreciated it, but I do really want to express my gratitude to them for still maintaining some adherence to the recommendations that we've given because we do need people to still recognize we can't completely go back to normal today, that we still have to continue the mitigation measures we have in place to get through the spread of this virus and protect as many people as possible.

Lori Walsh: I was looking, Governor Noem, at the CDC guidance that was leaked to the press, a 68 page report, and then I was looking at what was through the white house coronavirus taskforce, which had been released. And so much of the theme of this is mitigation while minimizing social and economic impact. And the gating criteria is a largely about public health capacity and health system capacity, which you've said from the beginning, watch that hospital number, watch how many people are hospitalized because that's so key, but also the transmission. And I want to give you an opportunity to talk to people in places like Sioux Falls who, if you look at the CDC guidelines might say, there's widespread community transmission in this city, even though our public health capacity is holding strong and our health system capacity is holding strong, and we still have this, and it's so much different than if you were in a different town. What do you say to people who are in that, those places, where there is widespread community transmission? What's your message to them?

Governor Kristi Noem: Yeah. I would still recommend to them that they have the opportunity, if they're concerned about the activity they see around them or actions that are being taken, that they still have the opportunity to stay home. I've been recommending to businesses and employers to give their employees the flexibility to do that, if they need to, especially if they've got somebody in their family that has a preexisting health condition that could be devastated if they happen to catch the virus, or if they have somebody older in their home population, that CDC guidance is something we've constantly pointed to as a state and looked at.

But also I've been pretty honest with the people of South Dakota that every day we're learning new things about this virus. Every day, there's more scientific data and facts that are coming out and studies that are going on that we need to be flexible too. And so while folks really are anxious to get back to normal and have their day to day lives resume, I do recognize that we do have several communities where there's still quite a few active cases and that there's extra precautions that should be taken in those areas.

Lori Walsh: You allowed that executive order for vulnerable people in Minnehaha and Lincoln County to expire. Do you reevaluate that decision on a day by day basis? How do you sort of look at that as to decide, does that need to be reinstated at some point?

Governor Kristi Noem: Yes, we absolutely do. In fact, it's multiple times a day. My team with the Department of Health, my executive team and the Governor's Office, and then communicating with the healthcare systems and local leaders are communicating about what we're seeing on the ground and what changes we might need to make as far as mitigation measures. So the decision to let that executive order lapse was made after visiting with Sanford and Avera officials, and then also with visiting with local city officials and county officials in the area too, that we would allow that to lapse, but still keep our strong recommendations in place and remind people that if they are a part of that vulnerable population, we would still like them to stay home as much as possible, that we still need people willing to run their errands for them and help them out to be protected as much as possible.

So that really is something that we'll continue to look at day by day, look at active cases, see who is getting exposed to the virus, and then we are coming out here in the next 24 hours with a testing plan that will be specifically looking at vulnerable populations for the entire state that we'll be putting in place as well, which will help us identify a potential spread and stop it as well. So we're continuing to add more and more elements to make sure that that poppy population is, is protected going forward.

Lori Walsh: You mentioned Sanford and the Avera. And for those of us who live in the City of Sioux falls or will have experience with those two organizations, it seems like a big win for the state throughout this whole pandemic has been cooperation from competing healthcare agencies and how they have come together under your leadership. So strongly, Sanford, Avery and Monument Health. What are the wins that you feel as you look back? And we started planning and talking about this in January, as early as January, what do you feel like you look back now on it and say that worked really well, that that was effective?

Governor Kristi Noem: Well, I think, looking back when we first started to realize in January that we needed to get an emergency operations plan and start coordinating care was the fact that we had three health care systems in the state that most of our doctors and nurses and care teams were under the umbrella of. We're all willing to come to the table and we're willing to partner in ways that they necessarily hadn't before, or wasn't even happening anywhere in the nation. I don't think there's another state that could have gotten all their healthcare systems on the same page to come up with a plan that worked for their population like we did here in South Dakota. And what was interesting was each of these healthcare systems just didn't care who got the credit, they all just said, what do you need? We'll give you our wisdom, our expertise, our advice. And then the decision that you make, Governor, we will certainly, go along with and be comfortable with and we'll plan together because we're all a team here.

And that was incredibly valuable to me as I was making decisions. And just think that, I hope the people of South Dakota really recognize what a gift that has been to every single family here, because they were never selfish or self serving or cared more about their income than they did about public health. They just came to the table and gave us wisdom and advice and gave us their resources to be made available, to get our projections out there and then to make adjustments going forward. And overwhelmingly that partnership, I believe, was an example to the rest of the country about what's possible. And it also overwhelmingly helped us bend our curve and make sure that we do have the capacity to take care of those who might get seriously ill from the virus.

Lori Walsh: And that was never inevitable. Sometimes you look back and in hindsight you say, well, that worked well, but you forget as we're living this history so quickly, that that wasn't a given, a lot, went into that. As you look back in hindsight, are there things, the decisions processes you'd like to adjust that you think this would have been more effective if I had done this?

Governor Kristi Noem: You look back and you think about the time period making decisions that needed to be made. I would say that we did well, considering the circumstances. What was frustrating at times was not having resources that we really felt like we needed. So we had to make different decisions based on what we had for resources. And that would be not having the PPE that we really wanted to have in place in certain areas or not having access to a business soon enough, or really know what was happening earlier, or being able to make sure that, that we had the testing supplies available to us on the national level, that that would have made us more comfortable and confident.

But considering the situation that we were in and knowing it was the same situation that a lot of states were in, I think we did very well. And honestly, I think we did better because of the type of people that live in South Dakota. They recognize this was serious and they care about their neighbors. And it was kind of overwhelming to me to watch people take care of each other and make decisions that were good for the benefit of others. And I think it's one of the reasons why we're still in a really good place today in our state.

Lori Walsh: And I think scientific consensus and certainly a cry from the public for increased testing capacity, especially as we open more places, and you mentioned within the next 24 hours more announcements about testing vulnerable people, do you feel like you're in a better position now, as far as supplies with PPE and with access to testing that it's enough of enough of an advance? Are you still wanting more? Like, what can you say about that before the full announcement to sort of give us an idea of how you feel that that testing capacity is going and what difference it could make for the South Dakota economy, as well as the public health?

Governor Kristi Noem: Yes, we are in a much better position as it comes to supplies for the personal protective equipment and for testing. I don't think testing is the only answer to making sure life can go back to normal because testing someone's just a snapshot. I can test somebody in the morning and they may negative and by that afternoon, they may have now enough of the virus established in their bloodstream that they would test positive. If you test somebody, that test is only as good as a few hours because things biologically can change and you get enough of that in your system, that it would register on a testing kit.

So I don't want to give people a false sense of security that having a lot of testing is going to keep them safe. I think that what's good and what we've been pushing and what I've been pushing personally a lot at the state level too, is having therapeutics, is having treatment options too because as with every virus that we've ever experienced, it spreads, it's almost impossible to stop them until you have a vaccine online and that'll be quite some time before we have a vaccine. But to have some treatment options is incredibly helpful for those folks that catching this virus could be serious. So we did the first ever statewide and state backed with our three systems, clinical trial on hydroxychloroquine, which is ongoing, but we also now have gotten and secured from the national strategic stockpile, a supply of remdesivir, which is another therapeutic, which has shown some promising results.

And we're continuing to try to go on offense against this virus that, not only having more testing is helpful and taking some measures to protect those that would get very ill, but then having therapeutics in place puts us in a much better position to protect people should they happen to catch the virus? So I've been trying to consistently focus people on hospitalization rates rather than positive case numbers, just because a lot of people are going to catch the virus. And many of them aren't even going to know that they had it, or they might think they had a cold, but if we can protect those, that would get very ill and then have a treatment option for them. Then we're in a much better position than we were just three, four months ago.

Lori Walsh: You've said repeatedly from the beginning of your almost daily press conferences, data science and facts are driving your decisions. What have been the most reliable sources for you to guide those decisions? What science are you referring to? What data have you been have been most useful for you in your leadership position?

Governor Kristi Noem: So we are constantly going through all of these studies that are being done and the results of those studies and what we're seeing. So back in January, we started looking at a lot of the research and the spread that was happening in other countries and what actions they were taking that was making a difference in protecting people. And then as the virus hit other states, talking with their officials and their health departments, and then also their epidemiologists and doctors and nurses was incredibly helpful to us and to our team. And then what we did was once we had those discussions and looked at the virus and what more we were learning, and obviously the federal officials as well, applying that to our demographic is incredibly important. And as I sat on so many conference calls that were happening between scientists that were doing research on the virus.

I sat on conference calls with all of the other state public health labs and listen to what their directors were saying, they were seeing in their labs. And I listened. And many times I was the only Governor on these calls and listening to all the state epidemiologists, talking about what they were seeing for the science of the virus. But that was incredibly helpful to me to learn the science of it and how it was spreading and how it might be different from the cold, the common cold or flu. And then to recognize how it would impact different types of people in my state that were at different ages or had different health risks. And so using that science to understand and then applying it directly to our people, which is our facts on the ground and knowing where our elderly folks in the state lived and what counties we needed to really look at differently than other counties and all of that was very helpful in us making the best decisions.

And then also recognizing that I couldn't get locked down on a position that no matter, what I had to be teachable every day and be willing to get up and say, "I might learn something new tomorrow, that that means we have to change what we're doing and that's going to be okay. Because we're in a very serious situation where being teachable and learning more might make all the difference in the world." So I would say we didn't take anything off the table, we were more than willing to learn from anybody and then see if that was relevant to the, to what we were seeing here in South Dakota.

But overwhelmingly, I am convinced that we have a fantastic team here in South Dakota, that I maybe didn't even realize we had a year ago. Our state lab director, our epidemiologists, our researchers, and then our healthcare systems and the people they made available to us were so wise in the advice that they gave me and compared to listening to other states talk and how they were making their decisions. Boy, I was just so much more comfortable with the information I was getting than what I heard them offering up. I just think our folks stayed up day and night, really putting the details into those decisions that I think were much more accurate for us. And I'm just thrilled with our team because I think they're the best team in the nation, and they were the ones putting forward information that protected folks.

Lori Walsh: You have a busy schedule today so we have to let you go soon, but I wanted to give you an opportunity to address what's happening with your conversations with the tribes and tribal checkpoints concerns about why that became a flash point, what the goal of a federal lawsuit against the tribes would be when they've decided to have lock downs and curfews that are their right to decide to do. What do you want to say about that as that continues to unfold in conversation, but maybe just the question would be what's your goal here?

Governor Kristi Noem: Well, I certainly recognize the tribal governments wanting to protect their people. We've been having conversations with them and their teams and their leaders for months about the virus and partnering with them and getting them supplies and getting testing and requesting more resources for their IHS facilities. And then also just working with them to identify critical needs that they might have. So for at least two months, we've had weekly phone calls with all of our tribes, we've been working with them and responding to different needs that they might have. When the decision was made to put up checkpoints, we started having conversations about where those would be and a couple of our tribes have decided to put them on state and federal highways, which according to federal law is not an authority that they have. So we have, for many weeks now, been having conversations about those checkpoints and telling them that they have the authority as a sovereign nation to have those checkpoints on BIA road, but to block traffic on a state or federal highway, they don't as a tribal government have that type of authority to do that.

So we've been having those conversations and some of the discussions, and we've been having about how those checkpoints are conducted, has been ongoing, but we haven't seen any changes as far as actions or even a consistency from what's happening from one checkpoint to another. So the decision was made that the law matters and that we're getting hundreds of complaints from these checkpoints of people not being able to get through, getting turned around, even if they were just driving through the reservation or people that were trying to access their property or get essential services and were being denied. And the concern for me is that I need to make sure that if someone needs an ambulance or law enforcement or an essential service that we can get to them when it's going to be necessary and people have the ability to pass through and access that, as is federal law.

We've been asking the federal government to take action because really this is their authority, not the state government, but they have not yet. And so part of the plan, the BIA had told the tribes to consult with us, but the tribes that were in question were not doing so. So this was to set up a timeframe for which they could respond and make changes or legal action is what was talked about in the letter that I sent to them. So we've given them a plan. And I know that Chairman Frazier from Cheyenne River and President Bear Runner from Oglala have said they would look at the plan that we've given them, and we're hopeful that the plan for these checkpoints would be acceptable to them and that they would implement them in that manner. Now that would uphold law. It would allow people to move through these areas and conduct essential services and still allow the tribal government to have checkpoints in place to what they think would be adequate to protect folks.

Lori Walsh: Governor Kristi Noem, we hope to talk to you again soon in the future. Thank you for being here with us today.

Governor Kristi Noem: Absolutely. Thanks Lori, anytime.