GREEN BAY, Wis. (WBAY) - Wisconsin's Safer at Home order is set to expire on April 24, but there's a possibility it could be extended. The order prohibits all non-essential business and travel in the state during the coronavirus outbreak.

Gov. Tony Evers has said he may consider extending the order. We talked to Prevea Health President & CEO Dr. Ashok Rai about what needs to happen before Wisconsin reopens for business.

Watch the videos attached to this story for all three segments from Wednesday.

SHOULD SAFER AT HOME BE EXTENDED?

"It's a lot easier to turn things off than to turn things on in a situation like this. So there's a few things that are necessary to make sure we're safe to turn things on," says Dr. Rai.

"Number one, you want to make sure hospitals and health care overall has the capacity to take care of COVID-19 patients going forward. And we'll probably see more as people are out in public. So can we take care of that increased number of people? Remember, the stay at home being lifted doesn't mean COVID-19 is gone. It means it's still there, and we're going to have some spread. We may even have some more spread. So do we have the capability? The capability means having the beds, the ICUs, the physicians, the ventilators and more importantly, that personal protective equipment. We also need to make sure that we can test people on a more broad level. As people go back to work, we hope employers screen them. Ask them questions, take their temperature. If someone screens positive, they need to be tested right away and quarantined. That's part of a successful strategy to getting back to any kind of normalcy, is to be able to identify somebody who has risk factors or symptoms, be able to test them, and be able to isolate them.

"Even more on top of that, what the governor's asking for and what we're all asking for, is the ability to do what's called contact tracing. Having people--public health officials--find somebody who's positive, figure out everybody they've been in contact with--close contact, not going to the store kind of contact--and be able to test them and isolate them. That's how you actually continue to control those hotspots as we call them, and be able to return to normal and not have to rewind to the beginning of March, end of February.

"It's going to be a constellation of things for the governor to make his decision on. And I don't know what resources he has available to him to actually pick a date. But the things we need to see from local government and state government is definitely a lot more into public health. For us to be successful, we need to be able to effectively screen the population, test the population and isolate them. That last step, that isolation part, the contact tracing we talked about, that takes public health officials--a lot more than we have today. So the governor's going to need to make an investment there. He's going to have to tell health care where we can get our tests from. They've been diverted to other states. We need those here. And personal protective equipment--not only for hospitals and clinics--but for nursing homes, for law enforcement. We definitely need to see that supply chain come into Wisconsin.

"Once those things are accomplished and we know we can trace people, we know we can protect people, we know that the hospitals have capacity--that's when you can make a decision to say this is how we can get back online.

"But if you're going to tell employers to mask, if you're going to tell employers to shift differently, to spread people apart, the employers are going to need resources, too. You can't just tell everybody to put a mask on and make sure they can't get one. I think getting those state resources, funding for employers to help them get back to work, is going to be really important for us to see a return to normalcy."

WISCONSIN PEAK

"When we look at any kind of modeling situation, it's only as good as the data that's being put into it. Certain things, certain environmental changes, certain laxes, if we were to get rid of stay safe at home the peak could change. Those are all factors that go into that University of Washington modeling. It did change a day or two. Two weeks ago it was April 27. Then it got narrowed down to April 12. Then it went back to April 14. We really hope that is the peak. How do you know it's the peak? You have to have a downward turn to know that you've hit your peak. You don't know you're at the top of the mountain until you start walking down. Hopefully we start to see a downward turn in hospitalizations and death rates to really justify that that was the peak," says Dr. Rai.

WEARING MASKS AT WORK

"This might actually come back as part of our normal life as we give some government advice to it. Even Dr. [Anthony] Fauci said as we get back to normal maybe part of that is people wearing masks. For it to be successful you need both sides of the party to wear the mask--the employee and the customer--to do that. We also have to look at the practicality. These businesses have not had a lot of time to educate their employees on how to wear a mask, acquire masks for them. We have to give that time for employers to be able to get their supply chain going to get masks. And even more importantly, educate their employees how to use them, how not to take them on and off throughout the day. Those are things we need to give employers time to adapt to," says Dr. Rai.

"From a health care prospective, if you're a patient and you're coming into a clinic or hospital, be prepared to ask those questions, possibly have your temperature checked, and we're likely going to put a mask on you. If you refuse to put one on, there's a chance you may not be put into a health care facility for that visit. Soe people have to understand we are doing those rules in health care, and employers are doing those rules not only to keep you safe, but to keep our employees safe and to make sure we don't take a backslide where we have to shut everything down again.

"They're inconvenient. You may not like what we're asking you to do, but they're there for a purpose."

GLOVES

"You think about health care when we wear gloves, we wear them for a single interaction. I go into a patient's room and I put gloves on, and before I leave that room, I've taken my gloves off in a very safe manner where I may not even touch the outside of them--and then I'm using a trash can where I put my foot down and I'm throwing those away and then I'm leaving the room. You'd never think it would be normal for me to examine a patient with one set of gloves, go into the next room and touch the door handles, go into the next room and examine another patient with the same set of gloves on. That's the equivelant of what we're talking about here every time we touch something with gloves on. We're taking bacteria and viruses from one object and transferring it to the next without washing our hands. The most important thing we need to be able to do is between interactions with people, between interactions with separate sets of items, is being able to wash our hands. Whether that's 20 seconds with soap or water or the second best thing would be hand sanitizer. When you're using gloves, all you're doing is propagating that spread. You know, that doesn't make sense in that situation if what you're trying to do is prevent the spread of the virus or for you getting it," says Dr. Rai.

ARE WE FLATTENING THE CURVE?

"It's not unexpected to see an increase in cases. I'm worried people will look at those numbers and get concerned. Really, you have to understand why those numbers are there. First of all, some of those tests were done seven-to-ten days before the result was given because of the turn around time with some of the commercial labs. The state actually expanded who we can test on a faster track. So we're testing more people. So we're going to get more positives. We expect that. Those numbers are important to look at, but we're not testing enough people to actually really know if that's an upward trend, or if it's just that we're testing more people that we think are going to be positive, so we're going to have more positives. The numbers that we really should be looking at, unfortunately, is the death rate and making sure that's going down. That's what we want to happen. And the hospital utilization of patients. So do we have six COVID patients in a hospital in Brown County? Do we have 20? Is that number flat? Is it going down? And those are the things we should be paying attention to. And so far over the weekend and over the week, we saw a small increase in the number of hospitalizations, but it is relatively stable for now. Those are the things we should be focusing on. We're going to see a lot more positives. That's expected because hopefully we're going to test a lot more people," says Dr. Rai.

SALIVA TEST

"From a health care prospective, any way we can test is exciting, especially if it can be validated. When we do that nasal swab of your nose, we're looking for genetic material of the virus to test positive. So if you think of the saliva test, many people have done a saliva test lately to see who they're related to, or what diseases they may be at risk for, through some national companies. It's using that same technology, spitting into a vial multiple times, and then submitting that for genetic testing for the virus. It's awesome to see that come forward, but it's in a single situation in the university in New Jersey at Rutgers. Excited for them. Hopefully it will continue to work. But right now, it's still in that phase where it's got that emergency use authorization based on testing 60 people with swabs. And 60 people is not a huge number when it comes to health care. So we want to see them do a lot more of this. And how can they ramp that up and make it commercially available? Those are the things we'll be watching for. But it's really exciting because you're not going to have to be limited by a nasal swab. We've talked about how those are really hard to get right now. And there's a lot less interaction with the health care worker so everybody stays safer. So in a drive up testing environment, a saliva test is something we have a lot of hope for now," says Dr. Rai.

SUMMER HOME AND CABIN VISITS

"I think everybody's situation is different. If you're able to stay at home safe in that environment, bring food with you, not interact with multiple people--and we'll get to a point where we're interacting with people again--but safely doing that, maintain that physical distance. If the town there is welcoming you back, I don't see a problem with that right now," says Dr. Rai.

HOTSPOTS

"Any time that we start to see multiple cases in any kind of setting--whether that be a nursing home, a prison, a school, a specific company, or any kind of environment where people are constantly interacting with each other, where one is positive and two are positive and six are positive--those are areas where the public health department has some concern and they go in and they advise and they help quarantine people. That's going to happen everywhere. That's going to happen in multiple companies, in multiple environments, as we start to come out of stay safer at home. It's not atypical. What's really important is that public health has the resources to go into that environment, quickly help the employer or the school or the nursing home at that point, quarantine, identify, clean and then get back to normal," says Dr. Rai.

SMITHFIELD FOOD OUTBREAK

More than 400 people tested positive for COVID-19 after an outbreak at a Smithfield Foods plant in Sioux Falls, South Dakota.

"Number one the way you prevent significant outbreaks like that is to stay safer at home. Unfortunately that state chose not to have one, so they're going to see breakouts like that. We've got a stay safer at home policy so essential workers like food packaging can go to work, and then we need to be able to control those situations very closely. But when you don't have a stay safer at home order, public health will get quickly overwhelmed, and not be able to handle a situation like happened in South Dakota," says Dr. Rai.

DOCTORS WHO TEST POSITIVE

"Health care workers are under the same guidelines from the CDC as everyone else. It's seven days from your first symptom, plus three days of having no fevers or significant symptoms without medications to help with that. So in other words, three days without Tylenol, I haven't had a temperature, and it's been a week or seven days since my first symptom. Then you can work with your employee health department and come back to work," says Dr. Rai.

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Dr. Rai on what needs to happen before we can safely return to normal - WBAY

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