WEBVTT 00:00.250 --> 00:03.917 (speaking foreign language) 01:51.791 --> 01:53.244 - It's with great pleasure 01:53.244 --> 01:56.461 that I introduce this group of professionals 01:56.461 --> 01:59.208 that have been working from day one 01:59.208 --> 02:01.259 to make sure Puerto Ricans 02:01.259 --> 02:04.509 receive the best health care available, 02:04.735 --> 02:08.674 especially through this process where we've been facing 02:08.674 --> 02:11.140 the usual challenges that come up 02:11.140 --> 02:13.473 with the event of this type. 02:13.952 --> 02:17.251 It's been a great partnership since day one, 02:17.251 --> 02:21.334 whereby federal agencies are working hand to hand 02:21.687 --> 02:24.104 with local state counterparts 02:24.450 --> 02:27.950 in making sure Puerto Ricans are delivered 02:28.063 --> 02:31.563 and receive the best health care available 02:31.647 --> 02:33.230 in a timely manner. 02:33.579 --> 02:37.162 So structures have been designed to address 02:39.582 --> 02:42.059 the different challenges in the island 02:42.059 --> 02:44.446 to make sure there's complete coverage 02:44.446 --> 02:48.022 as to the distribution and delivery of services, 02:48.022 --> 02:50.189 and we have the capability 02:50.247 --> 02:52.080 and capacity to adjust 02:52.229 --> 02:53.646 as needs require. 02:57.244 --> 03:00.906 These professionals in the health care field 03:00.906 --> 03:03.619 will be addressing all the initiatives, 03:03.619 --> 03:06.286 that through the last few weeks, 03:07.410 --> 03:11.577 the healthcare system of Puerto Rico has been facing, 03:12.253 --> 03:15.086 and how we've been able to deliver 03:15.269 --> 03:17.936 the best quality health services 03:18.338 --> 03:19.755 to Puerto Ricans. 03:19.798 --> 03:22.548 That sense, we are very satisfied 03:24.653 --> 03:26.070 with the outcomes 03:26.426 --> 03:30.009 and how stable our hospitals are right now. 03:31.906 --> 03:34.489 As you will learn this morning, 03:35.077 --> 03:39.160 all the measures that make sure that we are ready 03:42.024 --> 03:45.274 to do all, take measures so any patient 03:45.288 --> 03:47.389 that needs a little additional care 03:47.389 --> 03:50.389 or a health institution, a hospital, 03:51.789 --> 03:54.622 which needs support and transfers, 03:56.212 --> 03:58.462 everything is done swiftly. 03:59.484 --> 04:02.339 To begin, I would like to introduce, 04:02.339 --> 04:04.256 from HHS, Captain Cote, 04:07.462 --> 04:10.712 who is working very closely through HHS 04:10.747 --> 04:13.121 and the Puerto Rico Health Department, 04:13.121 --> 04:15.280 on making sure, since day one, 04:15.280 --> 04:17.720 that we have the proper structure. 04:17.720 --> 04:18.803 Captain Cote. 04:21.147 --> 04:22.631 - Good morning, everyone. 04:22.631 --> 04:24.286 As was mentioned, I'm Captain Mick Cote 04:24.286 --> 04:27.764 with the Department of Health and Human Services. 04:27.764 --> 04:29.863 I'd like to first thank you for the honor 04:29.863 --> 04:31.946 both to be here to assist 04:32.425 --> 04:34.979 the island of Puerto Rico and the health care structure, 04:34.979 --> 04:37.158 and to thank our partners from the Department of Health 04:37.158 --> 04:38.741 for inviting me in. 04:39.530 --> 04:41.555 I've got a few points I'd like to make. 04:41.555 --> 04:43.834 I'd like to emphasize, again, 04:43.834 --> 04:46.294 what was just said, and that is that 04:46.294 --> 04:49.556 we are here to assist our Department of Health partners 04:49.556 --> 04:52.506 in making sure that you have a stable hospital environment. 04:52.506 --> 04:54.703 That you have a place for your patients 04:54.703 --> 04:57.436 when your patients need to be treated. 04:57.436 --> 05:00.209 And I'm here to say that we feel very comfortable right now 05:00.209 --> 05:02.412 that we have an excellent plan in place. 05:02.412 --> 05:03.926 We continue to work. 05:03.926 --> 05:07.305 You are aware of the general status of your hospitals. 05:07.305 --> 05:08.834 Many are still on generator power, 05:08.834 --> 05:11.824 but the majority are back on grid power today. 05:11.824 --> 05:14.023 So I believe your healthcare infrastructure, 05:14.023 --> 05:15.618 your primary hospitals, 05:15.618 --> 05:19.785 are moving, definitely, towards a very stable situation. 05:19.932 --> 05:22.191 There is still some decreased capability 05:22.191 --> 05:24.731 and that's what we, and our partners from DoD, 05:24.731 --> 05:28.871 Department of Veteran's Affairs are here to help support. 05:28.871 --> 05:29.954 In that vein, 05:30.213 --> 05:32.729 in addition to your existing hospital structure, 05:32.729 --> 05:34.045 we have established, 05:34.045 --> 05:35.937 in consultation with the Department of Health, 05:35.937 --> 05:37.354 additional sites. 05:37.754 --> 05:40.031 Sites that support both capacity 05:40.031 --> 05:41.807 for your existing infrastructure, 05:41.807 --> 05:44.626 and surge should your existing infrastructure 05:44.626 --> 05:46.653 need a quick response capability, 05:46.653 --> 05:49.409 that is, a large number of patients need to move. 05:49.409 --> 05:50.602 I won't go into details 05:50.602 --> 05:53.156 until the question and answer period if necessary, 05:53.156 --> 05:54.830 but we have established, 05:54.830 --> 05:56.288 in support of the Department of Health, 05:56.288 --> 05:57.871 12 additional sites 05:58.160 --> 05:59.756 that cover the gambit 05:59.756 --> 06:01.506 from surge capability 06:01.883 --> 06:03.716 to acute care support, 06:03.907 --> 06:07.074 and to low acuity stepdown capability. 06:08.817 --> 06:11.011 In general, there are six acute care sites 06:11.011 --> 06:14.434 that are providing acuity support to hospitals, 06:14.434 --> 06:17.184 or in areas where there is a need 06:18.215 --> 06:20.642 and there is not capability to support 06:20.642 --> 06:22.167 citizens of Puerto Rico. 06:22.167 --> 06:25.610 We've also established three surge capability sites, 06:25.610 --> 06:27.590 which Colonel Garcia will tell you about 06:27.590 --> 06:29.130 with the Department of Defense, 06:29.130 --> 06:30.553 and those are higher acuity sites 06:30.553 --> 06:32.861 that can take on patients in a rapid fashion. 06:32.861 --> 06:34.651 And finally, we've established three, 06:34.651 --> 06:35.651 what we call 06:36.175 --> 06:38.342 low acuity stepdown sites. 06:38.361 --> 06:41.241 Their official name is Puerto Rico medical shelters, 06:41.241 --> 06:43.149 and their purpose is twofold. 06:43.149 --> 06:46.235 One, to allow hospitals that are at capacity 06:46.235 --> 06:49.160 to discharge their lower acuity patients 06:49.160 --> 06:51.075 to an environment where they can still receive 06:51.075 --> 06:53.576 the care they need and allow those hospitals 06:53.576 --> 06:55.977 to accept higher acuity patients. 06:55.977 --> 06:58.488 In addition, those facilities will also be available 06:58.488 --> 07:00.930 to support individuals who are 07:00.930 --> 07:03.220 in a home health care situation, 07:03.220 --> 07:05.681 that need a lower acuity medical care. 07:05.681 --> 07:09.848 We can bring them in and provide that support there. 07:10.793 --> 07:12.805 I think I'll pass up on talking about 07:12.805 --> 07:14.460 specific facilities, again, 07:14.460 --> 07:16.258 until I'm asked specific questions, 07:16.258 --> 07:19.302 but in general, the dialysis system in Puerto Rico 07:19.302 --> 07:22.135 is at 92% operational status. 07:22.634 --> 07:25.467 So that is a great number to know. 07:26.696 --> 07:29.249 I mentioned your hospitals, and your hospitals, 07:29.249 --> 07:30.633 there are 67 on the island 07:30.633 --> 07:32.811 that we're tracking, and 42 of those 07:32.811 --> 07:34.144 are on grid power 07:34.144 --> 07:34.977 and 20, 07:36.219 --> 07:37.653 I believe 21 is the number 07:37.653 --> 07:39.775 that are still on generator power. 07:39.775 --> 07:42.495 Four remain closed, so that is still good news. 07:42.495 --> 07:43.828 Work to be done, 07:43.862 --> 07:45.862 but good news for today. 07:48.516 --> 07:49.874 I'd like to talk a little bit about 07:49.874 --> 07:52.402 what we've brought to the island to support. 07:52.402 --> 07:54.388 From the Department of Health and Human Services, 07:54.388 --> 07:56.497 we have over 600 federal employees 07:56.497 --> 07:57.728 that we've brought in. 07:57.728 --> 08:00.084 We've also invited volunteer agencies 08:00.084 --> 08:02.770 to join our multi-agency support. 08:02.770 --> 08:05.820 We also have friends from the city of New York 08:05.820 --> 08:08.150 who have come down under a state-to-state agreement 08:08.150 --> 08:10.317 to support the Puerto Rico 08:10.628 --> 08:12.524 in their medical response efforts, 08:12.524 --> 08:14.865 so we're glad to have that partnership. 08:14.865 --> 08:17.224 Our partners from Department of Veteran's Affairs, 08:17.224 --> 08:18.446 I don't know if anybody in the room 08:18.446 --> 08:20.638 is from the Department of Veteran's Affairs, 08:20.638 --> 08:22.083 but, thank you, sir. 08:22.083 --> 08:23.416 Department of Veteran's Affairs 08:23.416 --> 08:25.919 has been doing a great job in supporting 08:25.919 --> 08:28.001 this federal augmentation mission 08:28.001 --> 08:29.187 to the Department of Health. 08:29.187 --> 08:31.164 So thank you for your help. 08:31.164 --> 08:33.254 Also, last thing I'd like to mention 08:33.254 --> 08:35.504 is that we are also working 08:35.539 --> 08:36.797 with the Department of Health 08:36.797 --> 08:38.938 to build that transition plan 08:38.938 --> 08:41.220 to a more stable environment. 08:41.220 --> 08:43.474 As you'll hear, perhaps later, 08:43.474 --> 08:44.841 we have identified, 08:44.841 --> 08:48.508 with consultation with Department of Health, 08:48.926 --> 08:51.176 a phased approach to ensure 08:51.221 --> 08:53.651 a very stable infrastructure environment 08:53.651 --> 08:55.873 for your hospitals moving forward. 08:55.873 --> 08:58.595 Hospitals may be on grid today with a backup generator. 08:58.595 --> 09:00.855 We're looking at how stable that environment is 09:00.855 --> 09:03.670 and what we can do to increase that stability 09:03.670 --> 09:06.470 so that we don't have fluctuations in grid power 09:06.470 --> 09:08.739 or generator power that may affect 09:08.739 --> 09:10.671 the provision of care at those sites. 09:10.671 --> 09:14.254 So there is a phased plan that's identified 09:14.502 --> 09:16.252 in a equitable manner 09:16.309 --> 09:17.714 across the island, 09:17.714 --> 09:19.823 north to south, east to west, 09:19.823 --> 09:22.217 to support and continue stabilization 09:22.217 --> 09:24.878 of the health care facilities moving forward. 09:24.878 --> 09:26.184 With that, I'm gonna step back, 09:26.184 --> 09:27.601 turn it back over 09:28.767 --> 09:30.850 to the Secretary of State 09:31.030 --> 09:32.780 for the next speaker. 09:32.794 --> 09:33.627 Thank you. 09:33.628 --> 09:35.045 - Thank you, sir. 09:36.252 --> 09:38.669 Thank you, sir, Captain Cote. 09:38.856 --> 09:42.773 (speaking in foreign language) 10:59.768 --> 11:03.252 Next up, I'm gonna allow the Colonel Garcia, 11:03.252 --> 11:07.419 the director of operations for the Department of Defense 11:07.434 --> 11:09.851 for the Puerto Rico missions, 11:10.513 --> 11:13.513 and he will make sure you understand 11:14.037 --> 11:16.145 how they've worked to make sure 11:16.145 --> 11:18.940 they have the capability and the capacity 11:18.940 --> 11:20.819 to address all health needs 11:20.819 --> 11:23.402 for the citizens of the island. 11:24.238 --> 11:26.413 - Thank you, Mr. Secretary. 11:26.413 --> 11:27.577 Good morning, everyone. 11:27.577 --> 11:29.269 I'm Colonel Jose Garcia 11:29.269 --> 11:32.186 and I'd like to mention I'm the DoD 11:32.393 --> 11:34.163 Director of Medical Operations. 11:34.163 --> 11:36.819 In a lot of things that Captain Cote alluded to, 11:36.819 --> 11:38.145 with regards to the capabilities, 11:38.145 --> 11:40.923 one thing I can tell you from the DoD perspective, 11:40.923 --> 11:41.756 we remain, 11:42.128 --> 11:44.572 we have partner and remain committed 11:44.572 --> 11:46.827 to the Department of Health and to HHS 11:46.827 --> 11:48.018 when it comes to all the efforts 11:48.018 --> 11:50.329 of taking care of the Puerto Rican people. 11:50.329 --> 11:53.207 And that's something that we certainly take seriously, 11:53.207 --> 11:55.639 and our directive is to do whatever it takes 11:55.639 --> 11:57.955 in order to ensure we set the conditions 11:57.955 --> 11:59.515 for a better tomorrow. 11:59.515 --> 12:00.943 So with regards to the capabilities 12:00.943 --> 12:02.392 and the capacity that we brought, 12:02.392 --> 12:04.350 that we were call upon to do so, 12:04.350 --> 12:06.840 as you know, we got three hospitals right now. 12:06.840 --> 12:08.098 As least we got one, 12:08.098 --> 12:10.017 which is the Comfort that is well known, 12:10.017 --> 12:13.546 and the Comfort has extensive capabilities and capacity 12:13.546 --> 12:15.546 of 250 beds, it has ICU, 12:16.178 --> 12:18.074 and a lot of people understand 12:18.074 --> 12:20.523 that it's well been advertised 12:20.523 --> 12:24.384 as one the best hospitals that we have within DoD. 12:24.384 --> 12:26.402 In addition to that, we've brought in 12:26.402 --> 12:28.297 a combat support hospital. 12:28.297 --> 12:31.153 And that is, we call it the 14th CSH, 12:31.153 --> 12:33.545 and that is established down in Humacao 12:33.545 --> 12:35.128 in the arena there, 12:35.646 --> 12:37.043 and right now has been pretty busy 12:37.043 --> 12:39.734 since it's established about four days ago. 12:39.734 --> 12:41.151 That has 44 beds, 12:41.252 --> 12:42.502 it has 24 ICUs, 12:43.074 --> 12:45.275 it has basically all the capabilities 12:45.275 --> 12:48.491 that you find the hospital of the smaller scope, 12:48.491 --> 12:51.013 but certainly has the capabilities of surgical, 12:51.013 --> 12:53.096 behavioral health, OBGYN, 12:53.293 --> 12:54.746 preventative medicine, 12:54.746 --> 12:57.790 pediatrics, and it has an emergency room. 12:57.790 --> 12:59.457 In addition to that, 12:59.564 --> 13:01.767 starting today, we gonna have the third hospital 13:01.767 --> 13:04.085 that's gonna be established in Aguadilla, 13:04.085 --> 13:06.381 and that one is the Air Force Expeditionary 13:06.381 --> 13:07.992 Medical Support hospital. 13:07.992 --> 13:10.167 That comes in with 25 beds, 13:10.167 --> 13:12.417 to include 12 of them ICUs. 13:12.540 --> 13:13.867 It has similar capabilities 13:13.867 --> 13:16.537 that the combat support hospital has in Humacao, 13:16.537 --> 13:18.366 but that's gonna be directed to the west coast 13:18.366 --> 13:20.878 in order to alleviate and provide the capabilities 13:20.878 --> 13:22.230 and capacity they need 13:22.230 --> 13:25.099 until the hospitals get back to normal operation, 13:25.099 --> 13:27.516 at least as much as possible. 13:27.557 --> 13:31.000 In the aggregate, you look at having hospitals 13:31.000 --> 13:32.429 throughout the island 13:32.429 --> 13:34.096 to absorb the surge, 13:34.246 --> 13:36.433 to support when there's overflow 13:36.433 --> 13:38.502 on the local healthcare system, 13:38.502 --> 13:41.524 we're prepared to receive and support accordingly. 13:41.524 --> 13:44.045 So that's pretty much what we have to offer, 13:44.045 --> 13:46.216 and we'll continue like I said before. 13:46.216 --> 13:47.743 We certainly remain committed 13:47.743 --> 13:50.273 and we'll do whatever it takes in order to support 13:50.273 --> 13:52.285 the Puerto Rican healthcare system. 13:52.285 --> 13:53.118 Thank you. 13:55.202 --> 13:57.219 (speaking in foreign language) - Thank you. 13:57.219 --> 14:01.136 (speaking in foreign language) 15:17.306 --> 15:21.473 In this team, one of the integral parts and components, 15:22.383 --> 15:25.966 it's the environment, the quality of water, 15:27.505 --> 15:28.672 and the access 15:29.967 --> 15:32.717 to purify water for all citizens. 15:34.965 --> 15:38.632 It entails that the EPA has been fundamental 15:38.678 --> 15:41.565 in making sure that these teams addresses 15:41.565 --> 15:44.157 all health issues to Puerto Ricans, 15:44.157 --> 15:47.498 and to that sense, they've been working very closely 15:47.498 --> 15:51.407 with our state agency, the Environmental Quality Board, 15:51.407 --> 15:53.074 which is presided by 15:54.490 --> 15:56.074 its president which is here 15:56.074 --> 15:58.837 with us this morning, Tony Vazquez. 15:58.837 --> 16:02.837 And to go further into what Pete Lopez mentioned 16:03.153 --> 16:03.986 with EPA 16:04.457 --> 16:06.391 I'm gonna introduce Pete 16:06.391 --> 16:08.891 so he can get into more detail 16:09.210 --> 16:11.377 on what EPA has been doing 16:11.985 --> 16:14.255 to make sure we stay healthy. 16:14.255 --> 16:15.088 Pete. 16:27.287 --> 16:29.177 - Good morning, everyone. 16:29.177 --> 16:30.922 I just wanted to preface by saying 16:30.922 --> 16:33.486 that we are very pleased to be with you today 16:33.486 --> 16:35.403 and to give our report. 16:36.260 --> 16:39.363 We are very sensitive to the challenges on the island, 16:39.363 --> 16:41.300 and we are very dedicated and motivated 16:41.300 --> 16:43.917 to helping the community recover. 16:43.917 --> 16:45.763 Just from a personal note, 16:45.763 --> 16:48.165 (speaking in foreign language) 16:48.165 --> 16:50.263 so I have family from Camuy. 16:50.263 --> 16:52.847 I have been through floods with Irene, 16:52.847 --> 16:54.774 Hurricane Irene and Lee. 16:54.774 --> 16:57.479 We understand the challenges that face the community, 16:57.479 --> 16:59.820 the multiple challenges, and I'm very impressed, 16:59.820 --> 17:01.028 we've been very impressed 17:01.028 --> 17:03.195 with the resiliency of the community, 17:03.195 --> 17:05.672 very impressed with the strength of the team here, 17:05.672 --> 17:07.748 the leadership of the governor, his administration, 17:07.748 --> 17:08.665 our federal 17:08.757 --> 17:11.257 and non-governmental partners. 17:11.612 --> 17:13.195 It is a robust mix. 17:13.642 --> 17:15.627 So part of our challenge is recognizing 17:15.627 --> 17:17.710 that perseverance is key. 17:18.145 --> 17:19.497 We want to lift our people up. 17:19.497 --> 17:21.108 We want them to be peaceful, 17:21.108 --> 17:23.178 we want them to be happy, move forward, 17:23.178 --> 17:24.845 and have prosperity. 17:24.903 --> 17:29.017 With that said, our focus is on the environmental impacts 17:29.017 --> 17:30.100 on the safety 17:31.681 --> 17:34.181 to people for health purposes. 17:34.678 --> 17:37.199 We continue to assess drinking water. 17:37.199 --> 17:39.203 We continue to address issues 17:39.203 --> 17:40.786 of chemical spills, 17:41.449 --> 17:43.782 oil and chemical facilities, 17:44.031 --> 17:46.515 debris management, wastewater treatment. 17:46.515 --> 17:48.920 So as you can imagine, our role is multifaceted, 17:48.920 --> 17:51.920 and some of this includes utilities, 17:52.520 --> 17:55.893 formal systems, some of them include local base systems, 17:55.893 --> 17:58.104 where we go into the community and assist. 17:58.104 --> 17:59.905 So we're making good progress, 17:59.905 --> 18:02.246 but we know there's still much to do. 18:02.246 --> 18:03.829 As we move forward, 18:05.123 --> 18:07.990 our focus on our wastewater treatment systems, 18:07.990 --> 18:10.573 we had 51 systems, of those 51, 18:10.752 --> 18:13.423 43, to our knowledge, are up and running. 18:13.423 --> 18:15.930 So we have eight that we're continuing to work with. 18:15.930 --> 18:18.873 Course we're challenged with the energy piece. 18:18.873 --> 18:20.456 Also challenged by, 18:21.331 --> 18:25.067 some challenges with the distribution system. 18:25.067 --> 18:28.083 The wastewater piece we continue to work on. 18:28.083 --> 18:29.546 The water systems, again, 18:29.546 --> 18:31.655 we've been working very closely with PRASA, 18:31.655 --> 18:32.960 as well as with our systems 18:32.960 --> 18:35.532 that are our non-PRASA systems. 18:35.532 --> 18:37.742 PRASA has been an excellent partner, and again, 18:37.742 --> 18:39.524 working with our state 18:39.524 --> 18:41.274 and federal partners, 18:41.451 --> 18:44.034 we've been working to reach out 18:44.101 --> 18:46.041 to ensure that water is safe, 18:46.041 --> 18:48.573 to ensure that people have adequate supply. 18:48.573 --> 18:50.406 With the non-PRASA systems, we have teams 18:50.406 --> 18:52.255 going out into the community 18:52.255 --> 18:54.112 to provide multiple support, 18:54.112 --> 18:55.894 including disinfectant, 18:55.894 --> 18:57.770 and also provide power generators 18:57.770 --> 19:00.020 and other support services. 19:00.924 --> 19:03.064 In terms of debris management, that is a challenge 19:03.064 --> 19:05.332 that we're working with, and again, 19:05.332 --> 19:06.939 it is being in support 19:06.939 --> 19:10.058 of the EQB and the Corps of Engineers. 19:10.058 --> 19:11.487 They have a lot of the principles here, 19:11.487 --> 19:14.487 but we provide support where we can. 19:14.637 --> 19:15.554 In terms of 19:17.756 --> 19:19.739 additional issues, hazardous waste, 19:19.739 --> 19:20.906 medical waste, 19:21.037 --> 19:22.537 we're working with 19:22.748 --> 19:24.262 our healthcare providers 19:24.262 --> 19:26.539 and our commissioner, and others, 19:26.539 --> 19:28.132 to identify where the needs are 19:28.132 --> 19:30.567 and to make sure the waste is properly secure, 19:30.567 --> 19:33.908 and then we find methods to dispose of them. 19:33.908 --> 19:36.938 In terms of the general engagement here, 19:36.938 --> 19:39.409 we just wanna reinforce that our role is to support. 19:39.409 --> 19:40.748 Our role is to help fill gaps, 19:40.748 --> 19:43.007 our role is to provide resources 19:43.007 --> 19:45.655 and technical support as needed. 19:45.655 --> 19:47.404 With that said, we will, 19:47.404 --> 19:49.386 I'll turn it back to the secretary, 19:49.386 --> 19:51.046 and we'll be happy to answer questions. 19:51.046 --> 19:52.546 Thank you so much. 19:53.266 --> 19:54.683 - Thank you, sir. 19:55.042 --> 19:58.959 (speaking in foreign language) 20:45.564 --> 20:49.147 With flooded waters, as the EPA just spoke, 20:49.569 --> 20:52.638 which is part of the portfolio of issues they meet, 20:52.638 --> 20:56.479 they have been addressing in the island with great success. 20:56.479 --> 21:00.559 We also face health challenges with flood waters, 21:00.559 --> 21:01.642 still waters, 21:04.042 --> 21:06.209 and because of the density 21:06.625 --> 21:09.072 and population in our shelters, 21:09.072 --> 21:11.155 we need to make sure that 21:11.965 --> 21:13.465 we properly survey 21:14.274 --> 21:16.941 and take good care of our people 21:17.958 --> 21:19.958 staying in the shelters. 21:20.797 --> 21:24.490 The CDC has been also very engaged in this team, 21:24.490 --> 21:27.656 and for that I'm gonna allow Captain Miguel Cruz 21:27.656 --> 21:30.323 to give us a brief this morning. 21:32.567 --> 21:34.184 - Thank you, Mr. Secretary, 21:34.184 --> 21:38.351 and thank you for allowing me to speak to all of you. 21:38.806 --> 21:40.722 My name's Captain Miguel Cruz, 21:40.722 --> 21:42.889 I'm also from Puerto Rico. 21:43.601 --> 21:45.018 I work at the CDC 21:45.714 --> 21:48.092 as an emergency operations officer. 21:48.092 --> 21:49.691 I'm here in this mission, 21:49.691 --> 21:53.070 I am in charge of the public health team. 21:53.070 --> 21:55.153 As in any major disaster, 21:57.083 --> 22:00.000 the most important activity or task 22:00.174 --> 22:01.841 that anyone can have 22:03.064 --> 22:06.314 is protecting the affected populations, 22:06.317 --> 22:10.436 and also protecting the health and safety of everyone, 22:10.436 --> 22:12.519 including the responders. 22:14.590 --> 22:15.757 Today, I just, 22:16.867 --> 22:20.241 if there is one message that I want you to take with you 22:20.241 --> 22:22.209 is the message about safety, 22:22.209 --> 22:25.126 just to make sure that people avoid 22:25.135 --> 22:26.885 contact, or drinking, 22:27.218 --> 22:28.051 or eating 22:29.425 --> 22:31.242 items that have been contaminated 22:31.242 --> 22:32.909 by the flood waters. 22:34.333 --> 22:35.638 We also need to pay attention 22:35.638 --> 22:37.921 to other environmental hazards, 22:37.921 --> 22:40.104 including the possibility of drowning, 22:40.104 --> 22:42.771 exposure to hazardous substances 22:43.780 --> 22:46.681 in the water, and also food that has been 22:46.681 --> 22:49.264 contaminated with unsafe water. 22:50.184 --> 22:53.351 We also face a lot of risk of injuries 22:53.435 --> 22:55.935 when we doing the repair work. 22:57.265 --> 22:59.919 So we caution people in the affected areas 22:59.919 --> 23:02.086 to avoid eating, drinking, 23:03.007 --> 23:06.626 anything that has been in contact with flood waters, 23:06.626 --> 23:10.025 which can cause, also, diarrheal disease. 23:10.025 --> 23:14.192 People need to boil or disinfect water from unsafe sources, 23:14.949 --> 23:18.116 including streams, springs, and wells. 23:18.502 --> 23:22.669 They may have been contaminated by heavy rains and floods. 23:25.542 --> 23:29.459 (speaking in foreign language) 24:03.232 --> 24:06.266 And with this, I just leave you for now, 24:06.266 --> 24:10.433 and I just step back and wait for additional questions. 24:10.454 --> 24:11.287 Thank you. 24:11.879 --> 24:14.873 (speaking in foreign language) 24:14.873 --> 24:18.790 (speaking in foreign language) 25:12.431 --> 25:16.348 (speaking in foreign language) 25:25.577 --> 25:27.433 - We will take some question 25:27.433 --> 25:30.169 'cause we have another press conference soon. 25:30.169 --> 25:34.086 (speaking in foreign language) 25:38.427 --> 25:42.344 (speaking in foreign language) 26:02.323 --> 26:06.240 (speaking in foreign language) 26:20.558 --> 26:24.227 (speaking in foreign language) 26:24.227 --> 26:27.359 - Well, just gonna say very brief statements in English 26:27.359 --> 26:29.398 and then we'll go to Spanish, okay? 26:29.398 --> 26:33.565 'Cause there are some Spanish, English-speaking people. 26:34.476 --> 26:37.872 Our main objectives right now are just to control 26:37.872 --> 26:39.839 the outbreaks and epidemics, 26:39.839 --> 26:43.565 and as we know, hurricanes and after flooding 26:43.565 --> 26:46.396 we are supposed to really work hard 26:46.396 --> 26:49.704 on that area to maintain our public health 26:49.704 --> 26:52.454 among our Puerto Rico population. 26:53.638 --> 26:56.636 It's well known that after hurricanes 26:56.636 --> 26:59.712 and a hurricane in the category that we had 26:59.712 --> 27:01.872 in the past several weeks, 27:01.872 --> 27:04.683 it was suspected that we should have 27:04.683 --> 27:07.350 some diseases like leptospirosis 27:07.618 --> 27:10.618 that has been identified previously. 27:11.456 --> 27:12.289 Especially 27:13.314 --> 27:16.397 because lepto has been in Puerto Rico 27:16.743 --> 27:20.826 for many decades because being a tropical country 27:21.438 --> 27:24.297 is expected to have that kind of disease. 27:24.297 --> 27:26.810 When we have floods and we have 27:26.810 --> 27:29.727 the situations like Hurricane Irma, 27:31.614 --> 27:34.531 our cases are expected to increase. 27:35.659 --> 27:37.742 But what we have to do is 27:38.503 --> 27:40.253 to promote education, 27:41.859 --> 27:45.276 prevention, and keep our population alert 27:46.310 --> 27:49.060 of what things they should not do 27:49.330 --> 27:52.747 in order to decrease the risk as possible 27:53.528 --> 27:56.111 to prevent more cases to occur. 27:57.200 --> 28:00.299 The good part is that for leptospirosis, 28:00.299 --> 28:02.799 there are very good treatment, 28:05.257 --> 28:08.590 the focus is very good and is available, 28:08.663 --> 28:11.619 we have plenty of medications in the island, 28:11.619 --> 28:13.998 distributing hospitals and pharmacy 28:13.998 --> 28:17.581 to take care of in any way for leptos cases 28:17.860 --> 28:19.028 of the physicians. 28:19.028 --> 28:20.630 I myself as a physician, 28:20.630 --> 28:22.372 the procedure and what we're doing, 28:22.372 --> 28:25.560 managing our patients is in case we have a case 28:25.560 --> 28:27.060 or suspect a case, 28:28.554 --> 28:31.471 we treat the case and we order lab, 28:31.628 --> 28:34.526 and then we confirm, we just confirm. 28:34.526 --> 28:38.443 (speaking in foreign language) 31:48.252 --> 31:52.169 (speaking in foreign language) 31:54.500 --> 31:55.333 Okay. 31:55.833 --> 31:59.750 (speaking in foreign language) 32:38.084 --> 32:42.001 (speaking in foreign language) 33:50.581 --> 33:54.498 (speaking in foreign language) 34:30.880 --> 34:34.797 (speaking in foreign language) 36:29.390 --> 36:33.105 (speaking in foreign language) 36:33.105 --> 36:34.743 - [Man] My question is for Colonel Garcia. 36:34.743 --> 36:37.160 I donno if you speak Spanish. 36:38.026 --> 36:41.943 (speaking in foreign language) 37:02.316 --> 37:06.233 (speaking in foreign language) 38:32.035 --> 38:35.952 (speaking in foreign language) 39:18.594 --> 39:22.511 (speaking in foreign language) 39:28.690 --> 39:32.607 (speaking in foreign language) 40:46.217 --> 40:48.324 (speaking in foreign language) 40:48.324 --> 40:52.241 (speaking in foreign language) 42:09.820 --> 42:13.737 (speaking in foreign language) 44:54.400 --> 44:58.317 (speaking in foreign language) 45:55.236 --> 45:58.376 (speaking in foreign language) 45:58.376 --> 46:02.293 (speaking in foreign language) 46:05.735 --> 46:08.691 - [Woman] It's a followup about the air and water quality. 46:08.691 --> 46:09.524 - Sure. 46:09.774 --> 46:12.410 - [Woman] I wanna know what are your major concerns 46:12.410 --> 46:14.160 right now about that, 46:14.836 --> 46:17.495 the status of the electric generators 46:17.495 --> 46:19.378 and the water, and that'll be all please. 46:19.378 --> 46:23.295 (speaking in foreign language) 46:23.729 --> 46:26.562 - I have my colleague Carmen also. 46:27.012 --> 46:27.845 Or, sure. 46:28.262 --> 46:29.444 - You wanna translate? 46:29.444 --> 46:30.527 - Sure, sure. 46:31.024 --> 46:34.441 In terms of the quality of air and water, 46:34.523 --> 46:35.789 we continue to monitor. 46:35.789 --> 46:38.852 Our main goal is to do analyses and testing, 46:38.852 --> 46:42.732 and then to assist in getting systems up and running. 46:42.732 --> 46:45.529 As we know, many of these systems are major, 46:45.529 --> 46:47.048 serving many, many households, 46:47.048 --> 46:48.598 millions of households, 46:48.598 --> 46:49.652 and our goal is to make sure 46:49.652 --> 46:51.309 that those systems are operational. 46:51.309 --> 46:53.809 So we're working site by site. 46:55.236 --> 46:57.447 Water plants, sewer plants, 46:57.447 --> 46:59.657 working in concert with PRASA, 46:59.657 --> 47:00.490 with EQB, 47:01.220 --> 47:02.825 the governor's office, 47:02.825 --> 47:05.499 to determine what are the needs at the site, 47:05.499 --> 47:07.224 and then make sure we deploy the resources, 47:07.224 --> 47:10.455 working with our partners, to get them up and running. 47:10.455 --> 47:12.038 In terms of impact, 47:12.731 --> 47:15.600 the longer the systems are out of service, 47:15.600 --> 47:17.986 the more challenges we have environmentally, 47:17.986 --> 47:19.351 so our goal is to get them up and running. 47:19.351 --> 47:21.428 So we hit major systems first, 47:21.428 --> 47:24.510 those that are part of the authority, for example. 47:24.510 --> 47:26.021 Then we work into the hills, 47:26.021 --> 47:28.266 into the non-PRASA communities for example, 47:28.266 --> 47:32.433 with water, bringing other resources and other support. 47:33.070 --> 47:35.570 Monitoring, support, resource, 47:35.626 --> 47:37.476 and problem solving has been our engagement, 47:37.476 --> 47:39.191 and we're making good progress. 47:39.191 --> 47:41.120 - [Woman] Any concern at this point 47:41.120 --> 47:44.037 about what you've been finding out? 47:44.886 --> 47:46.844 - Well, certainly the concern is 47:46.844 --> 47:48.956 we want every system operational. 47:48.956 --> 47:50.460 We want everyone protected. 47:50.460 --> 47:51.718 We want these systems in place 47:51.718 --> 47:53.333 because they're there for a purpose, 47:53.333 --> 47:55.336 to provide an important safeguard. 47:55.336 --> 47:57.388 You heard our colleagues with the CDC 47:57.388 --> 48:00.023 talk about issues of boiling water, 48:00.023 --> 48:02.423 issues of proper disinfectant, 48:02.423 --> 48:05.185 issues of staying away from water bodies 48:05.185 --> 48:06.674 for disease transmission. 48:06.674 --> 48:09.548 Our health departments, of course, focusing on that. 48:09.548 --> 48:13.215 The longer the systems are out of operation, 48:13.559 --> 48:15.508 the more challenging, we want those systems 48:15.508 --> 48:17.039 up and running right away. 48:17.039 --> 48:19.108 Again, with the generator issue, we understand, 48:19.108 --> 48:21.540 we were having a little conversation offline, 48:21.540 --> 48:22.776 the generators, of course, 48:22.776 --> 48:24.703 we wanna protect people air quality, 48:24.703 --> 48:25.911 but we also have the trade off 48:25.911 --> 48:27.568 of making sure they have drinking water 48:27.568 --> 48:29.524 and that their sewer systems are functioning. 48:29.524 --> 48:30.913 It's a delicate balance, 48:30.913 --> 48:33.996 but it's something we have to manage. 48:34.086 --> 48:36.253 In terms of the situation, 48:36.820 --> 48:38.424 this is unprecedented, 48:38.424 --> 48:39.645 the situation we deal with. 48:39.645 --> 48:41.456 So we try to bring intelligent, 48:41.456 --> 48:44.039 compassionate solutions to bear 48:44.164 --> 48:48.247 and use our best common sense as we move forward. 48:49.030 --> 48:50.618 - I just wanted to say something really fast 48:50.618 --> 48:52.451 just to thank the EPA. 48:53.328 --> 48:55.953 Mr. Lopez is the administrator of Region 2. 48:55.953 --> 48:58.919 He's Region 2 oversight, Puerto Rico, 48:58.919 --> 49:01.042 so we're in very close contact, 49:01.042 --> 49:02.476 and same with Mr. Carmen, 49:02.476 --> 49:04.473 and then also Catherine. 49:04.473 --> 49:05.890 We have now teams 49:07.056 --> 49:09.693 that are integrated from people from EQB 49:09.693 --> 49:13.233 and the Department of Natural Environmental Resources, 49:13.233 --> 49:14.519 (speaking in foreign language) 49:14.519 --> 49:17.648 and EPA, so thank you so much for that. 49:17.648 --> 49:21.565 (speaking in foreign language) 49:49.472 --> 49:50.889 Thank you so much for that. 49:50.889 --> 49:51.815 - God bless you. 49:51.815 --> 49:52.648 Thank you. 49:52.648 --> 49:56.151 (speaking in foreign language) 49:56.151 --> 49:58.568 - Thank you. - You're welcome. 50:00.021 --> 50:01.895 (murmuring)