 Good morning, everyone. Let me start by noting a grim milestone. Unfortunately, we've reached 100 deaths in Vermont, as well as 300,000 in the U.S. due to COVID. My condolences to all those who have lost loved ones to this virus, and let this be a reminder as to why we must continue our work to keep each other safe. In addition to our modeling update, today we'll be providing more information on the first COVID vaccines, which arrived in Vermont yesterday. As we announced, we received the first 1950 doses of the Pfizer vaccine, and we'll be receiving more today. As part of our plan, in consultation with the CDC, the first phase will be given to priority populations. Which includes high-risk healthcare workers and residents of long-term care facilities. Dr. Levine and Dr. Leffler will be sharing details soon, but this is obviously very welcome news, as it marks the beginning of our transition back to normalcy. And while this is an important and promising milestone, as Dr. Levine and I have said many times, we still have months of hard work ahead. This marks the beginning of the end, but not the end. That's why we've got to stay focused, especially as we continue to see around 100 new cases a day here in Vermont. And although case growth in our region has slowed a bit this week, it's still on the rise. So with this in mind, it probably becomes no surprise that I've extended the state of emergency to January 15th. Even with the exciting news of one vaccine being approved, and another in the not too distant future, I know hearing we still have months of sacrifice ahead is disappointing to many. But I really hope that being able to see that light at the end of the tunnel, rather than just being told it's coming gives everyone hope, because I know we will get through this. One thing I've always appreciated about Vermonters is our perseverance. It probably comes from enduring those long, tough, cold winters, followed by difficult and still cold mud seasons. But that's what's so special about being a Vermonter. We know just around the corner is spring with a beautiful summer on the horizon. So we toughen up put our head down and carry on. But admittedly, this crisis has tested our strength, especially during these holiday months where we want to be with our families and feel normal again. And I know I've asked a lot of you over the last nine months and asking you to do just a little more to go just a little longer without seeing your loved ones in person, not travel out of state without quarantining, passing up on sports and so many other sacrifices feels like a lot, maybe too much for some. But the fact is, I need you, each and every one of you, to make sure we get through the last of this on solid footing with as little loss of life as possible with our healthcare system intact with our kids having gotten as much in person education as possible. Because if we can get this right, we'll also be in a better economic position and we'll be able to return to opening that spicket and return to traveling around the region. Together, we can keep each other safe as we work our way towards the end of the tunnel. And I want to end today on why, even in dark times, I have so much hope because time and time again Vermonters reward my faith in them. As you know, we launched the Vermont Lights the Way initiative to help brighten our spirits during a holiday season like no other. We've seen thousands of people post their pictures and I hope this has played even a small role in adding a little joy during these difficult times. As part of Vermont Lights the Way, I also wanted to recognize Vermonters for what they've done to help others as they get through this, their acts of kindness, goodwill, community spirit, and service. So we asked Vermonters to tell us about those who have gone above and beyond and deserve to be recognized. And we've received a lot of nominations. So I'd like to highlight one or two of these rays of kindness as often as I can. First, I'd like to talk to you about Misty and Gary Greeno who received several nominations. Back in March when indoor dining at restaurants was closed, the Greenos wanted to help. So they created a group on Facebook called To Go Tour to promote restaurants who are still doing takeout. The page took off and now has over 20,000 members. It provides a place for people to post their meals and encourage folks to support and try new restaurants. Many restaurant owners have said the page has made a huge impact and helped them survive while waiting for better days. The group has also expanded to help restaurant employees and the page has raised thousands of dollars to support servers who have been hit hard by closures. This sense of community spirit and goodwill is exactly why Vermont lights the way. We also received a nomination for Margo from Franklin County because every time Margo goes through a drive-thru she pays for the person behind her. She says, you never know what someone behind you is going through. You could be making their day with one small act of kindness. Her nominator noted that in times like these we need more people like Margo. Selflessly giving to those who don't even know they don't even know to make their day just a little bit better. Now I agree because you never know what even the smallest gestures can do for someone in their time of need and that's what this season is all about. And these random acts of kindness are contagious but in a good way. So I want to thank the Greenos and Margo and to the thousands like them across the state. So with that I'll turn it over to Dr. Levine for more on our vaccine rollout. Thank you Governor. I'll start with a very brief update on our cases. We're reporting 66 cases of COVID-19 today after a three-day period where we averaged 101 cases per day and unfortunately we're also reporting four deaths three of which were in long-term care facilities. As you all know the U.S. passed a very grim milestone yesterday with 300,000 deaths. Though my comments this morning are mainly upbeat and optimistic I would like us to take a moment to reflect upon the fact that Vermont as you heard from the governor has now reached the 100 death mark which proportionately is a greater share of our population when compared with the U.S. statistic. Hospitalization data has also leveled off with 20 patients hospitalized for whom are in the ICU. Although the case numbers are still high for Vermont I am encouraged to see that our numbers have leveled off and we've not seen the surge on a surge that could have been set off by Thanksgiving. Our epidemiology section is currently following 225 non-outbreak situations 180 of which are non-healthcare and 45 are healthcare related and they're also following 37 outbreaks 25 non-healthcare 12 healthcare related. I know how exhausted so many of us are from this pandemic which is why I truly am heartened that for monitors seem to be following our guidance. These sacrifices are not easy to make but I also know we can hold on to that need to protect one another through the upcoming holidays and winter season. A lot has happened since our last press conference. Operation Warp Speed clearly lived up to its name because we now have a vaccine developed in an unprecedented amount of time and it's here in Vermont. This is a truly pivotal moment in the pandemic one that should give us hope for the future but at the same time we all need to remember that this is just the start of a long process to receive and administer enough vaccine to bring COVID-19 under control. At the end of last week the vaccine advisory panel to the FDA recommended the Pfizer BioNTech COVID-19 vaccine be given emergency use authorization and the FDA quickly agreed. Over the weekend the advisory committee on immunization practices made a recommendation for the vaccine's use in persons age 16 and older and the CDC's director quickly agreed. On Sunday the CDC published their interim recommendations in Morbidity Mortality Weekly Reports. They based this on a randomized trial of over 43,000 participants age 16 to 91 with a median age of 52 that showed that the vaccine was 95 effective in preventing symptomatic laboratory confirmed COVID-19 in participants who had no evidence for previous infection. These results were seen across ages, sex, race, ethnicity and underlying medical conditions. While there were frequent, mild to moderate symptoms of what is termed reactogenicity like discomfort at the injection site, the incidence of serious adverse events was very low and was similar between the vaccine group and the placebo group. Only small numbers had symptoms like fatigue, headache, muscle aching and chills. Things that are not yet known and are still under study include the length of time one is protected, the safety and effectiveness in pregnant women and if the vaccine protects someone who has no symptoms from transmitting the virus in the mucous membranes of the nose to someone else. Overall, appropriately the vaccine was applauded by the scientific community for the remarkable level of safety and efficacy it had demonstrated thus far. While Vermont was told it could count on seeing vaccine Monday through Wednesday, we were pleased to see 1,950 doses delivered yesterday with 975 going to the UVM Medical Center and 975 coming to the state vaccine depot. This was the first installment of a first installment of a first week allocation of 5,850 doses. The health department received an additional 1,950 doses just prior to this press conference and another 1,950 doses will ship later this week directly to pharmacies that have contracted with the federal government to administer vaccines at long-term care facilities. These will be administered to residents and staff beginning on December 21st making Vermont one of the earliest states to become operational within the federal government pharmacy partnership program. The health department along with the state emergency operations center is in the process of distributing vaccine to hospitals throughout the state as we speak. This will be done in coordination with the hospital's clinic schedule and the 120-hour window to use the vaccine. The majority of our hospitals are delivering the first doses of vaccine to their frontline health care workers tomorrow and the UVM Medical Center, as you'll hear from Dr. Leffler, will administer its very first dose today. As you might imagine, education and training is being provided at an accelerated rate right now, not just for those eligible to receive the vaccine but also for those who are providing it to Vermonters. Preparedness, training and patient safety are foremost in everyone's minds at this time and abundant CDC guidance and health care system educational programming have been occurring since the weekend. We're going to continue to see more shipments. The health department has been allocated weekly shipments of 5,850 doses of the Pfizer vaccine through December. We also expect to receive an equal number of the second dose in the coming weeks. All those who receive a first dose will get their second dose 21 days later and we have placed a pre-order for the Moderna vaccine pending its approval by the FDA. Should it receive emergency use authorization, which we would anticipate later this week, Vermon could potentially see 11,400 doses next week and 5,000 doses at the end of the month. This would bring our total amount of vaccine in the state to almost 34,000 doses. So you've heard a lot of numbers. What's important now though is that while supply is limited, vaccine will go to certain priority groups, the first being high-risk health care workers and residents of long-term care facilities. They will be notified directly about when and where they can get vaccinated. Health care workers include those who have direct patient contact in long-term care facilities, emergency departments and intensive care units, emergency medical services, home health care services and others. These are the people who comprise priority group 1A. What does the future hold? We anticipate the finalizing of priority group 1B within the next one to two weeks by the advisory committee on immunization practices and by our own Vermont advisory group later this week. Both of these groups will be advising best practices when it comes to identifying those who comprise these groups and how they will know when their turn has arrived. They will almost certainly involve some combination of people over 65, people under 65 with chronic or immune compromising conditions and frontline workers. For most Vermonters, it will likely be several months before the vaccine is widely available. But when it is available to you, you will know through our own communication pharmacies and others who will actually provide the vaccine across the state. We'll also collaborate with community organizations and other partners to make sure that people who are disproportionately affected by COVID-19, including Black, Indigenous and people of color, have equitable access to the vaccine. Please know that we are not taking names now or preparing a list of people eligible for the vaccine. I appreciate your patience as we work together carefully, safely and effectively, moving closer to a time when we can make vaccines available to every Vermonter. I must also emphasize that as people do start getting vaccinated, they still need to take those same steps to help prevent the spread of illness and follow the same guidance as everyone else, including wearing a mask and avoiding close contact with others. This is because even if the virus protects you from illness, we still don't have enough information on whether you could still transmit the virus to someone else. Even once we do learn this, there are a number of things we need to know before we can ease up on things like mask wearing and physical distancing, including how many people will have gotten vaccinated and how the virus is spreading in communities. On that count, it is very encouraging that more and more Americans, up to 75 percent by the latest Kaiser poll, once they were surveyed, state they will indeed be vaccinated. So let's be hopeful as we look ahead, but not let our optimism for the future overtake our need for vigilance. COVID-19 is still here and we need to remain focused on protecting ourselves and our communities as we move through this next more promising chapter of the pandemic. Now, I believe Dr. Leffler is going to make his comments by video. Thank you, Dr. Levine and Governor Scott. I'll just say that this is an exciting day. UVM Medical Center is very excited to be able to begin vaccinating our staff today. We're vaccinating a small group of our employees today and more tomorrow, and then really ramping up our vaccination clinic by the end of the week. If the fighting news of the vaccine arrives in Vermont, soon it will be expected, so like all hospitals across the state, we're mobilizing our teams to be vaccinating our people as quickly as they possibly can. Having vaccine available brings us to the next phase in the fighting against COVID-19. This is truly great news. We've all been waiting for this for the past nine months. We will be vaccinating first to health care workers who are most at risk of COVID-19 and then expand after this as more vaccine doses arrive. As I've already noted, it will be very important for us to continue following all safety measures that we know work. Massly, socially distancing, and hand washing will be important to help us finish this fight against COVID-19. But having the vaccine is a huge next step, it brings us to the next phase of the pandemic. We start to actually fight back and be able to vaccinate people. Thank you. Thank you, Dr. Leffler. And we'll now have Commissioner Pichek give his modeling update. Thank you very much, Governor, and good morning, everyone. This week provides us with the greatest hope and reason for optimism since this terrible pandemic started so many months ago. As we just heard from doctors Levine and Leffler, the COVID-19 vaccine is here in Vermont. It's highly effective and in time it'll put an end to the pandemic. This week, however, also delivers us great sadness. As of yesterday, we crossed over 300,000 Americans who have lost their lives to the virus, a truly staggering number that is almost equal to half of our own state's population. Americans are also dying more often. We lost an additional 50,000 citizens in just the last 23 days, the highest rate for deaths we have experienced to date. As Dr. Levine mentioned, here at home we are also met with sad news. This week was the pandemic's deadliest in Vermont with 15 COVID-19 deaths reported, bringing our total cases to 100. With the end of the pandemic in sight, the rising death tolls remind us that we must do everything we can currently within our power, wear a mask physically distance, to ensure that we make it together to that finish line. And we have new data that suggests Vermonters will continue to meet that challenge. We previously presented data regarding the significant decrease we saw around mobility for Thanksgiving the day before and after, which was down close to 60% when compared to 2019. These difficult sacrifices made Vermont the third least mobile state in the country regarding Thanksgiving travel, and we are seeing those sacrifices reflected in our case counts. We feared that our cases might surge in the weeks following Thanksgiving like they had in Canada and like they had here in the United States following other national holidays. However, as you can see, during the seven to 19 days following Thanksgiving, a period where we would expect cases to show up, our seven-day growth rate was very mild, increasing a little over 8% while our positivity rate declined during the same period. Not all states in the country were so lucky with some seeing significant increases during the same period of time. And similarly, if we measure the same seven to 19 day period following the Canadian Thanksgiving, you can see that they experienced a significant surge in cases during this period, giving us greater confidence that we are likely to avoid any similar surge here in Vermont. Again, due to Vermonters' good work and sacrifices that were so difficult and challenging, but truly are paying off. Turning to our Vermont numbers, we reported 771 cases this week. Again, our largest single week total. And further, our active cases are just about as high as they have ever been. But like our counts in recent days, our active case count is also showing signs of plateauing here in Vermont. But again, with a high active case count, this means that our risk of being exposed to someone with COVID-19 is greater now than it has been at any point in the pandemic, giving all the more reason to following the public health guidance. Turning to our forecast, our forecast does predict that cases will continue to rise for the next few weeks before they start to decline. However, I am confident that together, Vermonters can beat this expected outcome, particularly if we keep up the good work that we've recently experienced. Relating to the region, this is the 16th straight week in a row where cases have increased. However, unlike last week's significant 50 percent increase, the weekly cases rose just 6 percent. This slowdown in growth is certainly encouraging, with some states even seeing a trend of decreasing cases over the past week. However, this is still a very high level of case volume in our region, with over 150,000 cases being reported, equalling the most weekly cases reported to date. And then looking at our regional heat map, you can see or if you remember that Vermont used to be a sea of green in the northeast. And although our cases have increased, you can see how much more significant the case volume is all around us, close at home in the northeast and a little further away in the Midwest and mid-Atlantic. Again, highlighting that Vermonters are doing their best to keep case counts here, even as we are faced with these challenging external factors all around us. Looking quickly at our restart metrics, we see again some room for some reason for optimism and some improvement. First, our growth rate has stabilized and actually decreased over the past few weeks. We were concerned when we saw the growth rate increasing at a steady pace. That is now gone in the opposite direction. It's actually declined. And our positivity rate has similarly leveled out. Just as importantly regarding hospitalizations, we are in a position where we have enough resources to treat those who are currently in need of treatment. But more importantly, we're also projected to be able to cover all of those in the weeks ahead that might need treatment if our cases continue to rise. Across Northern New England, we saw 321 cases that were reported in K through 12 schools. This is a decrease of about 70 cases compared to last week with 158 cases in New Hampshire, 126 cases in Maine, and just 37 cases here in Vermont. And relating to long-term care outbreaks, this week the outbreak at Avril Place was officially deemed closed. However, we did see two additional active cases added to the long-term care facility count. We did report fewer new cases this week. However, it was still a significant number with 94 bringing the total active total to 272. Finally, an update regarding our flu vaccination data. We are three quarters of the way to meeting our goal of having 325,000 Vermonters receiving a flu shot this year. This places us about 8% ahead of last year's goal at this time. And while most of us will have to wait a little bit longer for our COVID-19 vaccine, the flu vaccine remains ready for anyone who wants one. And again, by getting a shot, you're not only protecting yourself, but you're protecting your community and those who are more vulnerable by preventing the flu from further circulating within our state. And to ensure that our hospitals continue to have the capacity that they need to treat everyone that needs treatment, we encourage you and remind you that there is still time to get your flu shot this year. And with that, I will now turn it back over to the Governor. Thank you, Commissioner Pichek. With that, we'll open up to questions. Probably a couple questions for Dr. Levine. So I'm wondering how many people are in this first group of health care workers and people in long-term care facilities. How many people are in this group and if the state has enough vaccine right now to administer all these people? Clearly the first 6,000 doses are nowhere near enough for that group. By the end of the month, I mentioned 34,000 doses, that will take care of the majority of those in health care and those living in a skilled nursing facility. However, if you begin to add on other health care employees and assisted living, which is a large community in Vermont, that brings you up in the 50 to 60,000 range. So it will be into January before we have sufficient vaccine for that entire umbrella population. And then I guess just a kind of a big picture question here. You know, we're starting to roll out the vaccine. You mentioned that it'll be, you know, still months before we're back to normal per se. But I guess that, you know, at what point, you know, will people, you touched upon this in your opening statement, but at what point will people have to, you know, or won't have to social distance and masks and that sort of thing? I mean, where, where is that threshold? Yeah. So some of our national scientific leadership community is talking about the fall, to be honest, not the point in time when everyone will have been vaccinated. We think more general population will be vaccinated early in the spring. And that point forward. But in terms of actually changing the current lifestyle that we've learned to lead with masking and all of the rest, probably the fall. But again, life would be very, very different way before the fall. And, you know, clearly we'll be outdoors more because it'll be spring and summer and fall in and we'll also be able to do a lot more. And I think that we'll be able to do much more than we do now with the extra precautions we take with things like masks and distancing. Thank you. Probably also for Dr. Levine. But with the vaccine coming out this week, I think there might be a lot of remoders sitting at home, maybe listening to this news conference who aren't a healthcare worker aren't in a high risk group, but are wondering, you know, should I be talking to my doctor to maybe get on some sort of a list? Do you think in the future that might be the case that if we get into group two or group three into the springtime, will they have to talk to a doctor in order to get a vaccine? Yeah. So obviously the group one B, which as I emphasize hasn't been set in stone yet, either from a national or Vermont level, but we have a pretty good idea. It's going to involve higher risk people over 65 under 65 with immune compromising conditions or chronic diseases and frontline workers, those many of those know who they are right now. And we're going to be working extensively to deliver the vaccine to them through the primary care community, as well as through some of our health offices in our districts, especially for those who are less insured. So the communications mechanisms for all of those are being developed as we speak to make sure that at least that early group, which we're now talking into January and February, maybe March, depending on how widely vaccine becomes available, will spread to that time. So anything beyond that, which would involve more, if I could use the word general over monitors, will be quite a few months away yet. There is really no list at that point in time. At that point in time, we really anticipate vaccine is going to be available throughout the health care system, the state health care system and the pharmacies. And it will be a matter of just making sure that people arrange appointments to have those immunization needs be taken care of like they would for any other immunization. That's I don't want to give people pessimism, but that's a number of months away yet for that more general population. So I guess just for for higher risk, risk for monitors who may be getting the vaccine in January, should they be calling their health care provider and saying, you know, I'm interested in getting the vaccine. I just want to let you know. Yeah, I wouldn't be calling their provider at this point in time, because most of their providers now have systems in place that they can actually be arranging with them as part of the way they monitor their care to deliver their vaccine. So I would probably it's not like a reservation system. I wouldn't probably do that at this point. Thank you. Governor, this may be for Secretary Smith, but do we have any update on the inmate death in out of state here? Yeah, that is a Secretary Smith question. Secretary Smith, did you hear that? I did, and the answer is no. And you know, we had a 59 year old that died in our out of state prison in Mississippi, the contracted prison that we send some of our prisoners to. The death does not appear to be suspicious or COVID related. And we will conduct an administrative review and medical reviews as as soon as possible to find out what was the cause of death there. So there's no update even other than what I just said. I answered my my follow up. So great. Thank you. All right, moving to the phone lines, we'll start with Tom from the Vermont standard. Hi, everyone. I have two questions, presumably for doctors Levine and Lefler. The first is, is there a list available with those pharmacies in Vermont for the contract with the federal government to administer vaccines, the long term care facilities, those that will be receiving 1950 doses this week and more in the coming weeks? As a reminder, Dr. Lefler had to leave the call, so he's not available for that. But Dr. Levine is still here and can answer that. So the three chains of pharmacies are Rite Aid, Walgreens and Kenny. That's very helpful. Thank you. And then my second question relates to what was said earlier by Dr. Levine about providing access to the vaccines for groups that such as people of color, Indigenous communities and so on that have not here for had kind of access when we close for my question is, what is the state plan for assuring that economically challenged rural Vermonters and high risk groups and other access to vaccines in the near and long term future when they typically don't have established relationships with a primary care provider or ready access to health care facilities? Yeah, great questions. So we do have district health offices in all regions of the state and for any Vermonter who has lax health insurance of which, fortunately, we now only have a few percent of Vermonters, but that could still be a lot of people. They will have access to our health offices to get free vaccines there and will make sure that they're part of the distribution network. Thank you. That answers my question. Thank you, Tom. Wilson, AP. Hi, everybody. I am curious, I guess, Dr. Levine, as the population, as more and more members of the population get vaccinated, do you anticipate seeing a drop in the number of COVID cases in the state? As the vaccinated population goes up, the COVID cases will drop and at what point would you consider, I presume COVID will be around forever in some sort of background form, but how low would it have to get the prevalence before you would consider the pandemic in the past? Those are great questions. So for the first question, we'd like, there's a number of factors at play. By the time more and more people get vaccinated, it will actually be warmer weather. That alone will impact the caseload just because of the fact that we know from our experience until we got into the indoors weather that our numbers were much better than they are now here and everywhere else in the country in the world. But in addition to that, we don't know yet with the vaccine if the person who's been vaccinated is able to or not able to transmit the virus to someone else. If the virus enters somebody's nose and is in the mucus membranes of the nose and then gets into the bloodstream, the antibodies that the vaccinated person will have made against the virus will prevent them from getting sick. However, those same antibodies may not be in very high quantity in the secretions from their nose. So they might be able to transmit replicating active virus to others. We just don't know enough yet. And the studies that are being done, their outcome measure, their endpoint is people getting sick. So we hope to learn more from these studies as time goes on about actual measures of the virus in people in their nose, in their mucus membranes to really get a sense for how likely or unlikely it is that you can transmit the virus when you're ill, when you've been vaccinated. Sorry. So that question's a challenging one to answer. For the second question, we really look at community or what used to be called herd immunity. And we'd like to see a number 75%. So kind of where the number was in the survey today, close to 75% of people accepting vaccination and becoming vaccinated. So if you get to that level and it's warm weather and people have had the period of time we've talked about to continue wearing masks and stay distanced, the virus will be very, very, very suppressed. And it just won't be encountered so much. And we will see ourselves coming out of the pandemic. That is sort of the vision everybody has for the what the future looks like. Okay. And I heard you talk about getting into the general population, but reaching the 75% of the population. How long do you estimate that will take? Well, that'll be into the late spring or summer. Okay. Okay. Great. Perfect. Thank you. Leah, VPR. Hi. This question is for Dr. Levine. You mentioned that Vermont is one of the earliest states have become into operation with the pharmacy programs again as a long term care facilities. And I was wondering if that had anything to do with the fact that Vermont is a relatively older population and higher prevalence of chronic conditions. I mean, does that put us like higher on the list for the vaccine priority or the amount of vaccine that we're getting in these early stages of distribution? Well, I wish what you said was true. But it isn't and it doesn't put us into a priority. The vaccine distribution is purely being done on the basis of what percent of the nation's population each state has. So we're getting our share, so to speak, of a very precious commodity right now. I will say that we still will be one of the very first states to be able to deliver this to people in long term care. Because many governors across the country wanted to really prioritize this population, the CDC did take a little bit of flack because they really, and not just the CDC, but the federal government, because though this plan with the pharmacies is an excellent plan, and it will, I think it will be carried out very effectively and efficiently, it really isn't deemed to start till the 21st. Because they took a lot of flack, the CDC did allow four states to try to start a little early, and they did not choose Vermont as one of those states probably because of our size, unfortunately, even though you would agree that our demographic would make that even better. But we'll be like one of the first states to do this on the 21st, so that's only six days away, and a lot of good work will happen during that time in terms of making sure the pharmacies and the long term care facilities are equipped to do this task, because it's not something they do as part of health care every day in those facilities. And there's a significant need to obtain informed consent, often from somebody who's not the patient, if the patient's cognition isn't adequate to carry that out. So it will start very soon, and we are eager to do that, because obviously that is our most vulnerable population right now. As the state developed its vaccination plan, it sort of identifies the population in the groups that will be vaccinated next. The fact that we have an older population and more people with preexisting conditions, is that going to mean you're going to have to be a little bit more specific in who is going to be next in line just because there's that many more people, and so you're going to have to prioritize kind of the highest risk of this high risk category? Yeah, I do think you're correct. First of all, the category will be large. The last statistic I saw was that where the fourth oldest state somehow we dropped down, which might mean we've had the blessing of having many younger people move in, because we've seen that happen during the pandemic. But at any rate, that number will still be a large portion of the population. And one of the pieces of guidance we'll be looking for from the CDC's advisory committee as well as from our own advisory committee is how one prioritizes within a priority group, because obviously everyone in that priority group has reasons to be in the priority group. So that will be a challenge. And hopefully the challenge will be met by the Moderna becoming authorized and having more doses of vaccine coming into the state. And even beyond that, hopefully other companies like AstraZeneca becoming operational as well. Great. And then just a quick question for the governor. Governor, what do you expect to be vaccinated? And are you considering doing something like the three former presidents who are going to be vaccines, like do some sort of public vaccination to raise public trust in it? Yeah, Liam, that's a great question as well. I more than willing to have the vaccination as soon as Dr. Fauci, Dr. Levine, and others said it was safe. I was all in. But from my, you know, I struggle a bit because I would not want to take one dose away from someone in one of those priority groups, whether it be in a long term care facility. I think from my standpoint, my perspective, those in the long term care facilities should come first and the staff along with them. And obviously the health care workers should be in that mix, which they are. So I want to show confidence. I will do anything I can to make sure if we get to that point when there's a lack of confidence, if that's what I have to do, I could be more than willing to do it. But again, I just want to to make sure that everyone understands that I don't want to take away from someone else. I'm not in one of those categories at this point. And I'll wait my turn. I'm not going to jump to the front of the line for the sake of saving myself. Thank you. Pat WCAX. Hi, my questions are for Dr. Levine. Dr. Levine, what are some of the common misconceptions that you hear out there about the vaccine that you want to cite? I don't know if there are misconceptions as much as as much as just need to understand. One of them is that these two first vaccines, Pfizer and Moderna, use what's called a messenger RNA platform. And that's not a common platform in the vaccines we've come accustomed to using all these years. It's part of our new technology and new understanding. And it's a scientific breakthrough, frankly. So it wasn't possible for some of the older vaccines. But what, and I'm not going to go into a lengthy explanation during this press conference, but the bottom line is that messenger RNA, it's because it's RNA, it's part of a nucleic acid. So it's part of our genetic code. And it basically has been engineered for this piece of messenger RNA to code for that protein that's on the virus's exterior. That's called the spike protein that enables it to get into our body. So when you make an antibody to the spike protein, you essentially don't let the virus move in and do all that it's going to do. So the messenger RNA goes into the cells of our body and the muscles that we inject to and can make this protein and then we make the antibody against it. Our muscle then degrades what was just injected into us so it doesn't hang around. People are worried it will interfere with their own genetic code, but that never gets into the nucleus of the cell where that machinery is. So it's very safe in that regard. So that's one thing. Another misconception is that, and I think this was fed even a little more by the two cases in Great Britain where there was an anaphylactic reaction, but the perception that, you know, this vaccine is going to come with some really bad side effects. And I think at least the two studies that I'm aware of right now are showing small percentages of people having things like muscle aches, fatigue, chills, headache, things of that sort, even less having fever, most just having some redness or some mild discomfort where the injection was like any shot. And comparing the group that didn't get the vaccine at all with the group that got the vaccine, the most serious adverse reactions were no different between one group or the other. So I think those are the two things that I hear the most about. Yet another question? Yeah, I mean, so we get a lot of questions here of these people who are, you know, they might read something online and they're concerned about, you know, like, am I getting a live virus, you know, injected into me? And I believe that it's still not the case with any of the vaccines being developed. Would I be correct in saying that? You're correct in saying that. Okay. And so then what are a few of the key facts that you would like people to know about the vaccine that is available now and then the ones that are coming down the line? Yeah, so the one that's available now, I just gave you a couple key facts, which is really how it works and what the side effect profile is. The other key fact is that it's 95% effective. And the other key fact is that it is still a little bit up in the air as to if you can still transmit active virus to others or not. I mentioned in my opening comments that there wasn't a lot known about pregnant women and breastfeeding. The Academy of Obstetrics and Gynecology is recommending, I believe, the vaccine to women who are pregnant who would like to receive it after a decision making process with their own obstetrician so that they can talk about pluses and minuses in the individual case. So it's not that pregnant women shouldn't even consider it. They should have a discussion with their obstetrician for sure. With regard to other good things about the vaccine, it didn't seem to matter if you were young or old. It didn't seem to matter if you were one race or another race. Those are all very encouraging. Obviously, with 40,000 people in a study, you can't look for every factor that you're interested in. So if somebody has a certain chronic medical condition or what have you, it may not be able to tell from what's out there yet if one person would benefit more than another person. But I think it's very encouraging. And I think that there were a sufficient number of older people that we feel comfortable that there may be a good immune response in those who are older and protect them. I think that there's still a little bit more to find out with regards to some other subgroups, which we'll hopefully learn from some of the other vaccine trials that are going on. And I will say that the UVA Medical Center trial or the College of Medicine trial with regard to AstraZeneca is obviously looking to enroll an older population if possible, which will help further enhance our understanding for that population specifically. We still need more information on children. And that's why the current vaccine is only age 16 and older, because we just don't have the information yet. But there may be other studies that are coming out that will inform us more in that age group as well. I'll stop there. Thank you. Can I just add just two more things and maybe Dr. Levine can talk about these as well. But it's important for everyone to know that it's you're not immune as soon as you have the vaccination, that it takes some time. In fact, you need the second the booster shot either 20 days later or 28 days later. And then sometime after that, you'll become immune. But that two to four weeks later, so it takes some time. So don't think that as soon as you have one vaccination that you're immune to this virus. I think that's really important for people to understand. We still have to be careful that you may have covered that before. But I just want everyone to understand and to make sure they have the second shot, the booster shot, because that's when you get to the 90 to 95% effective rate. And to have the second shot for the vaccine you got for another month. Right. And you have to have the same vaccine, the same manufacturer, the Pfizer Pfizer, Moderna, Moderna. Ed, Newport Daily Express. Yeah, I've got a question about a hidden population in Vermont. Recognizing a course that you have, they're prioritizing who's going to get the vaccination first. What I'm wondering is as you open it up and it's more available, are you going to do a reach out into our farm communities and our agriculture where we have both citizens, American citizens, we have documented workers and undocumented workers. All of them just be really vulnerable. So those populations might not want to go out and get a shot if they are being reported. So I'm just wondering, down the road would be planning to reach out into the agriculture community to make sure that they're vaccinated as well. Yeah, the simply answer is yes. And it's not just the agricultural community, but those who are undocumented will reach out to, because we want to make sure that we reach everyone for all our sakes and that not only being an elaborate. Yeah, that's a great question. Many, one criteria that those groups often meet in terms of prioritization, though it hasn't yet made it there yet because it's a later priority group is living in congregate group settings. And we have experience with that obviously, because we talked previously about some of the outbreaks we've had in Vermont, at least one of which was in a guest worker population who lived in congregate settings. So we really keyed in on that. Fortunately, even though those people might not be noticed as much or want to be noticed as much, they do actually have very good health care when they come to Vermont through a lot of good volunteer health worker activity. So there is an element, I believe, of preexisting trust which we're critical to build the foundation on so that they will want to have the vaccine. Makes me think also of homeless populations because they would be regarded as higher risk as well. And so another population that again can be hard to find may not be as trusting of the health care system, but we do have many structures in place in Vermont to actually work with those populations and try to create a level of trust that I think would be sufficient so that they would have a more open mind about the possibility of getting vaccinated. Great. Thank you very much. Go to Greg at the county courier. We're seeing a 75% increase that sent all this health in rehab, which seems to be the largest increase in the state right now. And that's even as we go into third week of this outbreak. What duration of time would the state expect or should one expect to see a facility like this breaking outbreak under control? I think we'd have to look back at other facilities. Maybe either Secretary Smith or Commissioner Levine could answer that better than I could. Why don't we, Governor, why don't we start with Commissioner Levine and then I'll chime in afterwards. Yeah. So, you know, the natural history, unfortunately, of an outbreak in a skilled nursing facility once it occurs, it's not an open and closed book. It takes a long time. We have experience already from the early part of the pandemic where I'd say we were following for a couple months plus because you develop some cases, you then follow over time. Unfortunately, more people are incubating than you realize and you follow over time and you find more cases. Or you find there are people who work at the facility who have kept themselves safe, but then because there's more virus in the community they live in, test positive and may have inadvertently exposed others to the virus. So, you know, there's no simple answer. But when we look at the epidemiologic curve of these kinds of outbreaks, they generally span a couple of months even under the best of, you know, even under the best of attention and taking care of things. One thing we have in our favor right now compared to the very earliest part of the pandemic is that we have very aggressive testing regiments. So, our ability to quickly identify a positive staff member or patient and cohort them in the appropriate part of the facility making sure that we keep COVID with COVID and non-COVID apart from COVID is really enhanced at this point in time. So, I think we're ahead of the game with that. But still, you know, it's a 14-day incubation period every time you're concerned about somebody who's been exposed to the virus and you need to go through a number of those incubation periods before you see the whole epidemic outbreak there play out. And then you need to go through some incubation periods to make sure that you've not only passed the peak, but you've reached a period where there are no new infections. So, it does take more time than I care to talk about. Okay, again, this may go, sorry, go ahead, Secretary. No, I was just going to add on to what Dr. Levine said in terms of the aggressive testing, especially in skilled nursing facilities where we're doing daily testing nowadays in those facilities of staff. And this may or may not be related, I'm hearing incidents of health care workers in this facility as well as potentially some others that are being told to return to work in as few as 10 days after testing positive. This doesn't sound like it falls in line with the guidance of the health officials. So, I guess I'm asking, does it, and if it doesn't, how to sustain sure the workers are really kept out of the workforce long enough not to spread it to other workers, especially in health care industry? Yes, so there are protocols in all of health care, which are CDC guided protocols for returning health care workers to work once they're free of infection. So, a 10 day period would actually not be unusual if that's what you were referring to, to return to work. Likewise, a person may actually have been asymptomatic the entire time, but test positive, especially if they're a staff worker. And as long as they're using PPE appropriately, there are ways to return them to work sooner than you might have imagined as well. So, I don't know of instances where people are being forced to go back to work, I would think that would be very unlikely. But I would agree that there are protocols that the facility can follow to allow someone to be back at work 10 days after they test the positive. Thank you for that very informative response. Thank you, Governor, for your time. Erin, BT Digger? Go ahead, Erin. I'm sorry. Yeah. Is there a way for the state to kind of track or register people who do have underlying health conditions? Because, from what I understand, there's not like a state health registry where, you know, people with chronic health conditions or underlying health conditions are automatically blocked. So, how are you going to find those specific people? That will be... Yeah, though we do have lots of health statistics in the state, we don't have that specific information on every citizen in the state. But again, with a good 97 plus percent of people having insurance and accessing healthcare in the state, those people are all known to their own primary care practice and to the healthcare community. So, I don't think it will be a huge challenge for them to be identifiable. And again, if they don't identify themselves at the time their priority group comes up, there's still plenty of time for them to get a vaccine as more vaccine comes in the state and we're vaccinating the more general population. So, though it might be preferable for them to have it early on, the fact is, if they don't come to attention during that time, they certainly will still get vaccine. You know, I would expect that people with underlying health conditions would visit the doctor more often. But if they actually know what percentage of people with poor health have visited a primary care physician in the past year. In aggregate, we do keep that kind of data in terms of trying to assess our primary care systems capacity and things of that sort. Not on a person-by-person basis, but we have a sense. I don't have a number off the top of my head to give you, but we do research that kind of stuff because that's an important healthcare statistic. Okay, review. Follow-up to get that number. Thank you. Sure. Tim, from our business magazine. Hi, Governor. You've seen the latest concert and this is not included the $1,200 immediate payments, but it does include extending the regular UI and the PUA plus $300 on top of that. $600 earlier in the spring. But I'm wondering, first of all, get your reaction to both of those things and also the letter you sent over the weekend regarding Vermont being cut up extended benefits. How much would Vermont lose? Would that still be the case under this new plan or is that still in the weeds at this point? Yeah, kind of in the weeds, Tim. You know, my highest priority, as I've said over the last few weeks, is trying to come to some conclusion on this extension of unemployment benefits for those in need where we would lose there would be 10 to 20,000 people who would automatically be kicked off the unemployment compensation or PUA in this state, which is dramatic and would have a devastating effect on those enrolled. So from my perspective, focusing on that first, making sure that we can come to some agreement in Washington is so important and then build from there. And you can always do a second package later in January or whenever to accommodate all the other things that we need. But take care of the highest priority first. It sounds as though they're making some ground, I think. I'm cautiously, again, optimistic. I believe that they will come up with something before they adjourn for this year and before the holidays. I think many share in that feeling in Congress. So again, we'll see what happens. But again, I'm cautiously optimistic about what I'm hearing and seeing. But I don't know the specifics of each each initiative because they've changed on a daily basis. So hard to keep up at this point. Yeah, there's of course trading between the direct payment and the sound like the regular UI payment, you know, one of the other. Would you have a preference either way? You mean between PUA and traditional unemployment? Well, no, the direct payment that Senator Sanders has been pushing for. Yeah, I would. Unemployment, from my perspective. And the other direct payments are equally important. But we need to solve this problem for us in many other states right now. Again, this is this is 10 or 20,000 people who would automatically fall off the cliff at this point in time and not have any benefits available to them. So that that would be catastrophic for them individually and for us as a state. So we don't have the means to support them at this point in time. So we need them to act. We need them to act on that issue. But secondary to that, the direct payments is is important as well. But from my perspective, not as important today as the unemployment dilemma. And if they clarify, if they gave you the nod to use the trust fund, that'd be another way to sort of adjust that. It would be because, as I've said, again, previous and previous press conferences, we have the availability. That's the frustrating part. We have funds available to us. We're just not allowed to use them because it's a trust fund. And it's called the trust fund for that very reason. We can't just dip into it anytime we feel like it. We have to follow the guidelines of the trust fund. So yes. But but at the same time, the PUA, for instance, is picked up by the federal government that wouldn't come out of that doesn't come out of the unemployment trust fund at this point in time. So it'd be more beneficial for us to have that shared responsibility with the feds so that we wouldn't deplete our trust fund here in in this state. Yeah, so you're probably pivoting off of the report that just came out in the last 24 hours about a mutation that was discovered in Great Britain. And and so I probably know as much or as little as you, you know, based on just what's in the news right now, it's a little early for me to know much more. But the word that they're giving and that people seem to be agreeing with is that these mutations are not unexpected. They're not that unusual. And they've not anticipated to have any impact with regard to effectiveness of the vaccine. We do know that the coronavirus itself with what we've seen over the course of the pandemic has not been showing a great tendency to mutate. And so this is not unexpected. It's not frequent either. But I think the take home message that I've heard today is that it should not really make the vaccine less effective against the virus. And I'll stick with that until I see other news about it. But like I say, it's so early that we haven't even had a chance to really examine what the scientific community is doing over in Great Britain and what their level of understanding is. Thank you very much. Liz Burlington Freepest. Thank you for taking my question. I wonder if there's any information at this point as to how long the vaccine protects from COVID-19. If this is something that, you know, you get both doses and you're done or, you know, if it's more like a tetanus shot where like weight a certain amount of time and then have to get it again in order to keep up your immunity. Yeah, obviously a Dr. Levine question, but it's very early at this point. And that's why you have to pay attention to the vaccinations, who's getting them and work and make sure that you're keeping up with the data to support whether you have to have a yearly or a periodical vaccination in order to stay current or has to change if it does mutate. So the phase one and phase two trials, you know, people who are enrolled in those continue to show levels of antibody, which is which is good. This phase three trial, which is what got the vaccine approved hasn't had sufficient follow up yet for us to really be able to answer your questions well. So this topic of durability of the vaccine, it's a moving target right now. It's going to get longer and longer as time goes on. We just don't know what the endpoint will be. But because we don't know that should not discourage anybody from getting this vaccine because it still is going to be effective for some period of time. We know that for sure. Whether it's like a tetanus shot, which is like every 10 years that you would get one. I don't know yet, but stay tuned. Thank you very much. Dr. Levine as well. Doesn't it make a difference? It's probably good news that there's multiple platforms, multiple companies working on this because every company, Pfizer, Moderna, maybe Johnson and Johnson and others, years might be more durable. It might be more long lasting. We just don't know at this point. So it's good to be able to compare between all those different entities. And then maybe one will be better than the other. But time will tell. There will be more people to follow. Right. Keep track of the data that we're going through that trial in some respects. Great. Thank you very much. Joe Tabarton Chronicle. This was asked a while ago, but at the time there didn't seem to be sufficient information to provide an answer. But is there any reason to think that the cases that have recently made Providence County kind of a hotspot for COVID are related to each other? Or does this seem like just a collection of random infections? It's probably never random. They're all connected at some point, but Dr. Levine. Yeah, we've been watching that with interest, Joe, actually. And the Secretary Smith and I have a meeting on the books this week with members of the leadership, both municipal and legislative in Orleans County. Nothing has really shown up to be a unifying theme. So in terms of like an outbreak that we could look at and go, that's where it all came from. As you're learning and as we're learning to, as the level of virus in a community increases, it's just more likely that a person is going to come in contact with someone who has been in contact with the virus. So as the governor was just saying, it's never really random. It's only random and that you don't know all the people who've been in contact with the virus. But it's not like it was one school system, one workplace, one healthcare system. It's just cases here and there and all those areas and beyond. So I can't really give you a unifying theme, sorry. Given that the special amount of COVID in the area, is there additional advice that you intend to give to municipals or other people that you speak to when you meet with them? I mean, I've noticed in my own dealings that a number of boards, committees and the like continue to have in-person meetings. Is that something that you would suggest might not be the greatest idea? We would definitely agree with you on that. And that is the kind of benefit that comes out of the meetings that we're talking about. And we had similar meetings with Washington, Orange County as well. First of all, we learn from them because they may have more boots on the ground knowledge of things that we don't have. But from the other direction, we discuss the kind of things you just talked about. So in some cases, people had questions about schools being open or not. And I can tell you almost all the time the schools can remain open as long as they haven't had a significant impact on their staffing related to the virus. We get questions about municipal offices remaining open or not. And it turns out there are many times that most of the work of the municipal office doesn't have to occur in person. And that they can get by with more telework and other forms of communication with their citizens. We get questions about leaving libraries open or not leaving libraries open. And we're able to actually feel those pretty well as well. So you never know what's going to come up. But I think the general theme of trying to do telework, if the profession allows it, and making sure that when a business has decided to go remote, that they don't gather together when they have a big meeting, but they keep the meeting on a Zoom platform or something similar, it makes a lot of sense. And, you know, there are often questions about retail. And the reality is, we rarely find that retail is a cause of any problem with the virus. People are in there on a very transactional basis. They go to do what they need to do. And there's usually very good protection at the level of the cashier. And they're able to accomplish their task and not expose themselves in any significant way. So we certainly listen when people have questions about keeping a business open or not. But again, the data would not support making a big move in that direction. So those are the kind of things that we learn and that they learn as we have these kinds of meetings. Can I just add one more thing? The medical community was very excited to hear that the two vaccines being one was just approved. The other we think is going to be approved 90 to 95 percent effective. I mean, that's almost unheard of in terms of a vaccine. But what we have in the meantime is all the simple things we talked about. But this right here, wearing a mask, 50 percent, 50 percent effective. So if you want to reduce your chances of getting COVID by 50 percent, just wear a mask. Stay away from others and wash your hands. Don't go to go to work when you're sick. I mean, it's just as simple as that. You can reduce your chances by just taking those simple measures. Next questioner is Dana, local 22. Voluntary care facility. So if you've been in thought to the process, is this something that's going to be mandated for residents? Well, they have to have someone sign off for them, depending on their prognosis or what they're dealing with health-wise. Or will this be something they decide on their own on the voluntary basis? Yeah, as we've covered previous and previous press conferences, I can't mandate the vaccine's because it's under an emergency order and approval. So you can't force anybody to have the vaccine. But I'm sure they're signed off and have protocol for that. Yeah, so with any procedure like getting a vaccine, there needs to be an informed consent process. So the person knows the risks and benefits to them specifically, as well as the general risks and benefits. And clearly, if the person's cognition is good, and they're of sound mind, they can make that decision on their own. If the reason they're in a skilled nursing facility is because of a memory loss like dementia, obviously they're going to need someone else to be a durable power of attorney or someone in a position that could actually make those decisions as a surrogate. So nobody would be forced to get it without going through that process. That would be very important. And the facility wouldn't force anybody to get it without seeking counsel from some relative or whoever was designated. So that's the way that works. Same goes for the staff. The staff at this time can't be mandated to take the vaccine because it isn't, as the governor said, under an emergency use authorization at this time. Doesn't mean the staff shouldn't do that. I would recommend that. And of course, as we just talked about, using personal protective equipment at the level of the staff is the best way to prevent outbreaks in these facilities. Thank you. Eric, the Times-Argus? Yes, Governor, the City Council in Barrie tonight is going to be discussing potentially shutting down the ice rink because there's no one to use the rink given the state's restrictions. And they're looking to you to see when those restrictions might be lifted because it costs a lot of money, but I'm going to keep the ice intact. Do you have any updates on that or any guidance you can give them? Yeah, I wish I had the answer for them, especially today, but I don't. We are still contemplating what we're going to do in particular with youth sports and we're trying to get through that this week. We received some good news today with a number of cases, positive cases from yesterday, but one day doesn't make a trend, so we want to see if that continues. And as we contemplate youth sports and what to do about the holidays, all of that will factor in, but it's just too early for us to tell. I mean, we just have to take it one day at a time. And hopefully by the by the end of the week, we'll have additional information that will guide us to making the appropriate decision. But I can't tell you today what that what that's going to be. I wish I could be free WCAX. My question is probably for either Dr living in our governor's God, there was a report out of Maine. There was an informal polling done in nursing home administrators that showed about 60% of deaf members and 60 to 70% of residents, or their family members were willing to be vaccinated. What's been the discussion with long term care facilities about the back things or staff and the willingness to get vaccinated? And how is the state working on trying to kind of turn the tide of that mindset once vaccinated? You know, I think overall, I'll let Dr Levine get into the specifics, but overall, people are understandably hesitant. You know, if you ask them, would you take this without knowing without seeing without proving ourselves, it's difficult for some understandably. So I think it's incumbent upon us to to monitor this be transparent to show that it is effective and doesn't have any adverse reactions and so forth. And I think that will build confidence. And I think people will see the benefit of this as a society that this is needed in order for us to get back to normal. So we'll we'll we'll continue to to show how many the vaccinations were given the percentage of acceptance. And if there's any problems along the way, we'll we'll highlight those and give reasoning reasons for that when we can. But but again, transparency and and being forthright and honest, I think builds confidence. And that's what we strive to do. I wish I had specific numbers to give you in the long term care staff and patient populations, but I don't. The only numbers I have are in health care workers in general, who work in our hospitals across the state, because many of the hospitals have been sometimes formally, mostly informally surveying their workers. And the numbers actually sort of parallel what's gone on in the country. We're early on, it was kind of a 50 50 mix, moving into 60%. The most recent as of last week was between 70 and 80%, which is kind of where the national polling just showed us as well. So for that population, if you could say that health care workforce is probably going to be the most critical in terms of analyzing what's out there for data and making sure that if they accept it, they know what they're doing. I think that's pretty good. And I assume it will get only larger with time, as opposed to smaller. But I can't give you a specific number on the workforce or on the patients who are in long term care facilities right now. Again, I just think it's normal for any of us to want to see what happens. And so not all of us are thrill seekers and want to be the first to jump out of an airplane with a parachute as Secretary Smith would be the first in line for that as a former seal. But not everybody's like that. And so they want to see, you know, whether the shoot opens up, they make it to the ground, and then they might be more willing to do that and be the second or third. So I think it's just normal. But I think it will build in time. Thank you. I believe Dr. Levine said earlier that he thought it would be late spring or summer, that sort of timeframe before the general population or most of the general population would have been vaccinated. I mean, I'm wondering, since you seem to know the number of doses we're going to get, and you certainly know how many people live in this state, do you be a little bit more explicit about the timing of that? Is that May? Is that July? I don't think he can be Stuart. And it's not that he doesn't want to be. It's just we don't know what the supply is going to be. I know that they're they're manufacturing this as we speak, just as quick as they possibly can. I heard that Pfizer hopes to be able to distribute a billion doses over the next year. But we don't have a timeframe and we don't know, you know, Moderna again coming online. We don't know how fast that they can they can supply either. So it's really, you know, we may have the demand. We may not have the supply in the beginning, but that's going to increase as as again, the acceptance of the they have to get through the approval. And then they can they can move forward and and continue to manufacture this serum. So it's it's difficult for anyone to forecast that. I think he's talking Dr. Levine is talking in general terms. We also again, this point was made earlier, but we have to keep in mind when you when I think Dr. Levine had answered, you know, when when is this over? When when will we see the benefits of this and so forth? After you have your first first shot in the arm, it's two months before you might get to a point where you're not you can't you can't become contagious. So that's a while. So if you think about how long it might take if we get into April or May or June in terms of of getting vaccinations in the in into place, it could be two months later. So we could be in the August before even if we had the supply. So again, I think it's hard to say, but there's not much how much we can do. Obviously, the quicker they can manufacture the more these these approvals come into play. Again, there's other companies that that that may become may become authorized in the in the next couple of months. We just we just don't know. You wouldn't make any late summer travel arrangements then? Well, it depends where I'm going, Stuart, you know, if you want to travel to like the northeast kingdom or into, you know, beautiful Lake Champlain or down the southern part of the state, I would be willing to do that. Make those plans. What about something more immediate? I think you indicated that you were waiting a bit on Christmas social gatherings, whether they would mirror your Thanksgiving guidance. Have you made a decision? Yeah, have not. And again, we're going day to day on this. We we've seen that it's somewhat leveled out as Commissioner P check has shown. We did receives a little bit of good news yesterday. It dipped down into the 60 range, which is great news. But unfortunately, it came along with Fortress yesterday. So that's the unfortunate part. So we're we'll see one day doesn't make a trend. We'll have to see what happens over the next two or three days. And then we're going to have to again, we'll look at the data, we'll figure out what is acceptable, what we're willing to do. But but it won't be back to normal. I can guarantee that. And the more that we can adhere to the guidance now, the better we protect ourselves now, the quicker we'll get out of this. I don't want us to pay the price in all of January and February, for instance, if we do take the wrong steps now and pay the pay the price in January and February, I'd rather see us work our way out of this. And again, open that spick it back up in January and February. So we get back to some sort of normal by spring. But we'll see we'll see what happens. Okay, thank you. Andrew, Caledonian record. Yes, good afternoon. Thank you. This is for Dr. Levine. Look off for those photos it has requested. And it's hoping for significantly more Moderna vaccine, assuming it gets approval for weeks two and three, then it is getting a beside their vaccine this week. Are all hospitals requesting and or being allocated doses proportionally to phase one a population in its coverage area? Or is there the possibility that some hospitals may ramp up capacity at different cases and complete phase one sooner than others? Yeah, we've tried to be very equitable for portioning the doses, just like the government's doing to the states we're doing with the hospitals and with long term care. So it's trying to be a very equitable process. I can understand why a hospital might have a preference for Moderna. Because of course the Pfizer requires the minus 70 degree centigrade freezing systems. The Moderna is much more along the lines of what we're accustomed to in the minus 20 degree centigrade range. So it could be an easier proposition. But I think after this week, most of the hospitals will discover that they're getting the delivery from the depot. They have the 120 hours to work with. There are thawing protocols that are pretty easy to follow that come with this vaccine. And so I think they'll be able to find that implementing its use may not be the challenge that they may have thought they would have had. So we'll see. But clearly we're going to be getting doses of both starting in the next week or two if the emergency use authorization goes through for the Moderna. So if potentially one region finishes its phase one population a bit sooner than another region, you know, within a hospital's coverage area, will there be vaccine available for that region to transition to the next phase? Or are you thinking that the whole state will wrap up 1A and then the whole state will move together to the next phase? Yeah, I think the fairest process would be to have the whole state wrap up 1A. You know, one region could have a different timeline than another only based on the uptake of the vaccine in that region, depending on how much of their worker population actually agrees to have the vaccine. If most parts of the state are pretty equivalent and we get in the 70-80% or maybe even better range, that won't be as big a factor. Keep in mind that to really, you know, finish 1A requires all of the skilled nursing facilities and the other residential care facilities like assisted living. And those have large populations as well across the state. There's 37 skilled nursing facilities that are the highest priority and highest acuity, but then there's 170-ish or so of the other types of facilities which all still fit in the same priority category. Okay, and just a little bit off a topic. Does the Health Department have a mechanism to receive reports of adverse reactions, but as was the case with a couple of allergic reactions in Great Britain? Yeah, so... If there are any, if there are any in the state, will they be reported out to the population? Yes, so there's multiple platforms actually to report adverse reactions because obviously FDA and CDC really want this information real time quickly. And some of these, like an anaphylactic reaction is quick because it happens when you get the dose, but that's going to be very unusual. They're more interested in making sure over time people report any reactions that they may have felt they had that may not show up on day one or at the time of injection. So there are abundant ways for us to have these reported. There's a whole vaccine adverse event reporting system infrastructure. So we'll have a good handle on that. Believe me, everyone in the country wants to make sure that they have a handle on that early on. Okay, thank you. Mark, the Bennington banner? Mark, it's star six to unmute. All right, we'll move to Guy, Chronicle of the Vermont State House. This I suppose is for the commissioner. Employers cannot mandate vaccination until after formal FDA approval. When do you think that FDA decision would be made? Are we weeks away, months away? What's the timeline for that? I can give you a short answer. I honestly don't know. I don't believe anybody regards it as in the imminent future. There must be some discussion on because it's a rather important milestone, I would think. I mean, is there any, there's no real discussion on the advisory council and all that? Well, there's plenty of discussion, but part of the way you determine that in the more traditional sense of testing vaccines or testing new treatments is to have, first of all, more than one study. Second of all, to make sure that these study duration is long enough. And third of all, make sure that there's an ample time post study to pick up on anything that might not have shown up during the time course of the study. So that usually means quite a few months. Okay. So I would, you know, don't take me as the authority on how the FDA's process works, but I would think it would be well into many months. Governor Scott, do you have any more thoughts on the town of Stamford select boards holding a public Christmas tree gathering in spite of your November 13 order? No other thoughts. Again, unfortunate in some respects. They just, if they were going to do it, I would have hoped that they would take in the precautions for their citizens and more mass and state socially separated and physically separated. But but again, they they did what they thought was appropriate. And I hope others will learn from it. Thank you. Can you hear me again? Hi, can you hear me? Yes. Can you hear me? Yes. Yes. Thanks, everybody. And thanks, Rebecca. And Dr. Levine, I went to FDA.gov slash media slash one, four, three, five, five, seven slash downloads. And there's a list of possible adverse events or outcomes. In the interest of transparency. Would you be providing a link to that FDA website? Sounds like you just did, Steve. Yeah, but I mean, you know, for the for the average person to, to see because it looks like there's a whole bunch of stuff here that seems a little bit more serious than, you know, like redness and injection sites. So I mean, everything from convulsion, seizures, stroke, myocardia, I have cardi, cardiitis, pericarditis, thrombocytopenia, the Kawasaki disease, vaccine enhanced disease, I mean, there are over 20, there's 22, I believe. Yeah. In the interest of transparency and data, would you be providing a link to that? Me personally, probably not. But as part of the informed consent procedure, there certainly would be a detailing of commonly expected side effects and remotely expected. The problem with some of the side effects you're mentioning, if we even call them side effects, is some of them would show up in both groups, the group that got the vaccine and the group that did not. So you have to be careful about providing an interpretation of that. But if you take any medication, you will find a similar list of those side effects. And usually people will, if they have an ache or a pain, they may take an anti-inflammatory over the counter drug. Some of those side effects may show up in the list of potential side effects, but they would not be ones that we would expect to see with any frequency whatsoever. So it would usually be here are the ones that occur 0 to 5% of the time, here are the ones that occur 5 to 10% of the time, as opposed to alerting someone to every single potential side effect. But I understand where you're coming from. So I think the theme that we should leave for monitors with is not necessarily to have to link to a website that lists every single thing, but to have an informed consent process that allows them to make their decision knowing what is unlikely, rarely or almost never going to happen to them, versus what might happen with frequency. And I want to the governor, if I may. Governor Scott, given the ban on styrofoam and what would this vaccine coming in large amounts and it's all going to be packed in styrofoam containers, we can have a way to dispose of. I mean, it's not recyclable, is it? I thought some styrofoam was recyclable, but I'm not sure. I'm happy to get back to you on that because I did think about that actually with all the dry ice and styrofoam, and I've wondered about the packaging, where it goes from there, whether it's used again or not. But happy to take a look at that and get you an answer on that. Great, great. It seems like it's going to be quite a bit of it. It does seem like it's a bit of a waste. Maybe you could build like coolers or something up in the Northeast Kingdom. Yeah, they fall apart too easily. All right, thank you both very much. Thank you. That's it. Okay, well thank you very much, and we'll see you again on Friday.