Governor Orders Hoosiers to Stay Home in Fight Against COVID-19

In statewide address, Governor also limits state government services

INDIANAPOLIS — Governor Eric J. Holcomb delivered a statewide address today to order that Hoosiers remain in their homes except when they are at work or for permitted activities, such as taking care of others, obtaining necessary supplies, and for health and safety. The order is in effect from March 25 to April 7.

“The next two weeks are critical if we are to slow the spread of COVID-19, and we must slow the spread. You must be part of the solution, not the problem,” said Gov. Holcomb.

The first positive case of COVID-19 in Indiana was reported on March 6. Since then the number of positive cases has increased on a near-daily basis, escalating as the capacity to test has grown. As of this morning, the number of tests completed in Indiana is 1,960, the number of positive cases is 259 and 7 deaths have been reported.

“I’m setting the example by sending state government personnel home to work to the maximum extent possible and closing our facilities to public interaction beginning Tuesday, for at least the next two weeks,” said Gov. Holcomb.

Beginning Tuesday, all state government offices will be closed to in-person public activity until at least April 7. This includes the Government Center complex in Indianapolis and other offices throughout the state, including the Bureau of Motor Vehicle branches. State employees will work remotely whenever possible and continue to provide core functions online and by phone. All public safety functions will continue.

In conjunction with the closures, Gov. Holcomb ordered an automatic extension of all state-issued licenses and will advise law enforcement to refrain from issuing citations for a driver’s license or registration that expires during this emergency.

The state, in conjunction with the city and all hospital systems in Marion County, has activated a comprehensive emergency operations center to maximize hospital capacity and provide joint coordination. The center is charged with tracking the inventory of all hospital beds, supplies and personnel as the number of COVID-19 patients grow.

“I am proud of our hospital systems that are participating in the initial phase of this process, Eskenazi Health, IU Health, Franciscan Health, Community Health Network, and Ascension,” said Gov. Holcomb. “Marion County is where we’ve seen the most community spread to date, but we will expand this model to other parts of the state.”

In all, Governor Holcomb issued four executive orders:

• EO 20-08. Stay at Home. Provides for essential and non-essential business and operations, infrastructure, government services, travel, and activities outside of one’s home. Click here for answers to frequently asked questions regarding the stay-at-home order.
• EO 20-09. Continuity of State Operations. Provides for the continuing operation of state government from 5 p.m. today through 8 a.m. April 7 with restricted access to government buildings and services.
• EO 20-10. Enforcement Directive Regarding Prohibition of In-Person Dining.

o   Directs that state and local boards of health and the Indiana Alcohol and Tobacco Commission (ATC) take all available administrative and enforcement actions against establishments that continue to offer in-house dining services, in violation of the governor’s executive order of March 16.

• Health departments will deliver letters ordering restaurants that continue to provide in-person dining to cease such operations. If they do not comply, fines will be levied.
• For restaurants with alcohol permits that continue to offer in-person dining, the ATC will issue an order in writing for the establishment to cease such operations. If the activity continues, the ATC will suspend the entity’s liquor license and will consider the non-compliance at the time of permit renewal.
• EO 20-11. Provisions for carryout consumption of alcohol.

o   Relaxes the sale of carryout alcoholic beverages for dining establishments. This includes establishments that allow for on-premises consumption only and those that are permitted carryout permits dependent on a percentage of on-premises sales.

 Links to all executive orders may be found here: https://www.in.gov/gov/2384.htm

The complete text of Gov. Holcomb’s address may be found here: https://www.in.gov/gov/3233.htm

Link to the Stay-At-Home Order FAQ may be found here: https://www.in.gov/gov/3232.htm

More information may be found at the ISDH website at in.gov/coronavirus/ and the CDC website at https://www.cdc.gov/coronavirus/2019-ncov/index.html.

Lupus Patients Can’t Get Crucial Medication After President Trump Pushes Unproven Coronavirus Treatment

Trump’s unproven claim that hydroxychloroquine could be used to treat COVID-19 has led to hoarding, putting Lupus patients and others at even greater risk. As of Saturday afternoon, Anna Valdez had 27 pills left. That number is now down to 25.

by Charles Ornstein for ProPublica

(ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published)

The drug Plaquenil keeps Anna Valdez’s lupus in check.

Late last week, as she sheltered in place at her home outside Santa Rosa, California, Valdez called her local pharmacy and ordered a refill to treat her autoimmune disorder, thinking a 90-day supply would help her ride out the coronavirus outbreak.

But the pharmacy told her it had only 10 pills left. Valdez called other pharmacies. They, too, had run out.

Valdez and lupus patients around the country have learned in recent days that an extraordinary force has upended the supply chain they all rely on: President Donald Trump.

These days, Plaquenil is better known by its generic name, hydroxychloroquine. It is the medication Trump has been hyping as a potential treatment for the novel coronavirus, even though it is not approved for this use and there is scant medical evidence so far that it works to treat the virus.

Trump’s push to use hydroxychloroquine to treat COVID-19 has triggered a run on the drug. Healthy people are stocking up just in case they come down with the disease. That has left lupus patients like Valdez and those with rheumatoid arthritis suddenly confronting a lack of medication that safeguards them, and not only from the effects of those conditions. If they were required to take stronger drugs to suppress their immune systems, it could render them susceptible to more serious consequences should they get COVID-19.

The shortages have caught the attention of the Lupus Foundation of America, which said it is working “to take steps that ensure people with lupus will be protected from a disruption in access to critical medications.”

Lupus afflicts about 1.5 million Americans, and women and African Americans are disproportionately affected. The immune system of a lupus patient attacks its own tissues, causing inflammation and tissue damage in an array of organs, from the joints to the kidneys and lungs.

Many lupus patients use Plaquenil to combat these effects and have taken to Twitter with their fears for what the Trump-driven run on the drug means for them:

Valdez, 49, has been taking Plaquenil for 15 years, and it has enabled her to work and lead a relatively normal life. Here’s what she said on Twitter on Saturday, referring to Lupus as SLE, which stands for systemic lupus erythematosus.

Valdez was diagnosed with lupus when she was 31 or 32, in the early 2000s. She was working 12-hour shifts as an emergency room nurse and felt sick all the time. She chalked it up to working hard and maybe being a little overweight. “When I really started to worry is when I had a hard time gripping a soda can or managing a syringe. That’s what drove me to get seen and get a lot of testing.”

Lupus isn’t easy to diagnose, and doctors typically work to rule out other conditions first.

The first medicine Valdez’s doctor put her on was Plaquenil, a mainstay for decades that is also used as an anti-malaria drug. “Most everybody that has lupus takes Plaquenil unless they can’t tolerate it,” she said. “It’s usually the first medication that anybody with lupus is put on. It can be protective of us. It can protect our immune system from attacking our own organs. It’s the least severe of all of the medicines that are out there.”

In Valdez’s case, Plaquenil was not enough. She takes the steroid prednisone every day, as well as CellCept, an immunosuppressant drug that reduces rejection in transplant recipients and others, in addition to a weekly injection of Benlysta, which reduces her lymphocytes, the part of white blood cells that fight the immune system.

What happens if she runs out? “I am likely going to go into a flare or I am going to have to increase other, more dangerous medicines to keep me out of a flare. I take a bunch of medicines to keep my immune system from working so it doesn’t harm me. If I have to replace it [Plaquenil] by increasing my CellCept, which is a more powerful immune suppressant, I am basically putting myself at a higher risk. I am basically increasing my risk of having very serious complications of coronavirus. I already have that risk.

“When I think about the other people out there with lupus and other autoimmune disorders, we’re all really scared right now. I haven’t left my house in nine days. I’m working completely remotely. If I get coronavirus, unlike someone else my age, almost 50 years old, who is likely to recover and will be fine, I will likely end up in the ICU.”

Making Valdez even more nervous is that her 32-year-old daughter, who lives with her and has diabetes, has come down with symptoms consistent with COVID-19: fever, shortness of breath and a cough. The daughter has quarantined herself in a bedroom and uses a bathroom that no one else uses, but Valdez worries.

“She’s not here in our area,” Valdez said. “She’s not sick enough that we feel it warrants taking her to the ER to get a test. … We’re doing everything that we can but there’s no guarantee that I won’t get it.”

Valdez is angry at Trump for recommending a drug that is unproven for COVID-19, upending the way medicine has been practiced and taking a medicine that works away from her.

“When the president stands on the stage and he makes uninformed statements that are not backed by science and are not vetted by professionals who have expertise in that area, he leads an entire massive nation to think what he says is true,” she said. “You have people running around thinking there’s a cure for coronavirus, that there’s medicine.”

More robust studies are already underway. The University of Minnesota began enrolling patients in a clinical trial last week. New York State is also going to study using hydroxychloroquine in combination with the antibiotic azithromycin to treat COVID-19 patients. New York Gov. Andrew Cuomo announced Saturday that the U.S. Food and Drug Administration is acquiring 10,000 doses of azithromycin and hydroxychloroquine to be used by New York on a trial basis.

“I spoke to the president, he spoke to this drug therapy in his press conference yesterday and I spoke to him afterward,” Cuomo said Saturday. “I said that New York would be interested and we have the most number of cases and health professionals have all recommended to me that we try it, so we’ll try it.”

In light of the pandemic, some prominent hospitals, including the University of Washington, have added hydroxychloroquine to their treatment protocols. “Hydroxychloroquine is an inexpensive and generally safe drug for short term use, with few drug-drug interactions,” a university protocol says. “While it is unknown if it is effective to treat COVID-19, there is a favorable risk: benefit and cost ratio. Multiple trials are ongoing, and this recommendation will be updated when further data is available.”

As of Saturday afternoon, Valdez had 27 pills left. Now she has 25.

I asked why she didn’t just take the 10 pills the pharmacy had left.

“If I were completely out, I would have driven down there and gotten those 10,” she said. “We only take what we need, and that’s true of everything. Only take as much toilet paper as you need. Only take as much milk as you need. Or only take as much medicine as you need.”