 Good morning, and thank you all for tuning in. Obviously, I'm not Governor Scott. I'm Mike Smith, Secretary of Human Services. I'm kicking things off today because as it was announced on Tuesday, Governor Scott is not joining us today. He needed this time to address some of the work that was postponed due to yesterday's commitments. So we'll have myself, our Secretary of French, Commissioner Levine, and Commissioner Shirling is available for questions as well. I'll start off today. As of last night, we have vaccinated 21,000 Vermonters. As you will see on the next two slides, if you look at it as the CDC does, as the rate of doses distributed per 100,000, Vermont ranks second in the nation in terms of the pace of receiving doses of vaccine and administering that vaccine into the arms of Vermonters. In addition, on the next slide, if you look at the doses per 100, we still rank fourth in the nation with three doses per 100 people, which is almost double the national average of 1.67. However, we need to keep accelerating our pace of vaccinations, even as supplies remain uneven and often disappointing. We have included approximately 4,500 first responders to Group 1A, primarily because we discovered that often these Vermonters are responding to accident scenes and 911 medical calls. They are administering aid or helping to get individuals ready for transport even before EMS arrives. They are directly involved in patient care. We did exclude those who do not have direct contact with patients, such as desk clerks or administrative leadership. As you recall, we have prioritized long-term care facilities and long-term care residents and staff because the long-term care residents are the most vulnerable, as well as those medical workers and others who may treat vulnerable Vermonters in order to prevent death as the primary goal of this first phase or phase 1A. We expect that we'll be moving to the second phase, phase 2, or those Vermonters in the general population that are 75 years or older once we finish 1A. I want to remind Vermonters about our primary objective in age grouping, that is to save lives. As you can see on our slide, on our next slide, most of the deaths happen in those age 65 and older. Although not on this slide, in fact, out of our 156 deaths, only 10 have been among those under the age of 65. So therefore, you can see why our primary objective is at those older Vermonters in order to prevent death. The system we have selected is the easiest to administer, easiest to understand, and uses data, as you can see, to support it instead of pitting groups of Vermonters against each other. And it fulfills, as I have said, our primary goal of preventing death. There are approximately 49,000 Vermonters in the category of age 75 and older. Once we finish this category, we'll move on to 70 plus and then 65 plus. And in total, these three groups will comprise of 125,000 Vermonters. With current allocations, it will take probably until the start of the spring to finish these groups. Lastly, over the past few days, we have seen increasing number of positive tests coming from staff at our correctional facilities. We'll be sending out a press release today about this, but staff members have five correctional facilities tested positive for COVID-19 this week through both private testing and mass staff testing. These mass staff testing are part of these mass testing strategies are part of the Vermont's DOC COVID mitigation strategy as the virus enters our facility from the outside. As a result of these staff positives, these staff members being positive, these cases prompted modified lockdowns at Northern State Correctional Facility, Chittenden Regional Correctional Facility, Northwest State Correctional Facility, and Southern State Correctional Facility. Marble Valley Correctional Facility is in full lockdown pending results from a presumed positive staff member. In total, 37 Vermont Department of Corrections staff members have tested positive for COVID-19 since March of last year, 2020. Vermont DOC and the Vermont Department of Health have immediately taken the following actions and these are standard operating procedures upon receipt of a positive test. They contact tracing team initiated with the rapid response team to immediately find out who these individuals have been in contact with and we start testing of the facility-wide testing. We also do full or modified lockdown in place for all Vermont Correctional Facilities with confirmed or presumed cases. Just to add on, we did test the Chittenden Regional Correctional Facility on Monday, January 4th, and all incarcerated individuals were negative. The Department of Corrections will have more on this today when they send out their press release, but I wanted to give you a preview of what they will be talking about today. With that, I'd like to turn it over to Secretary French. Good morning. Our students returned to school this week after the holiday vacation. Most schools have reopened under a hybrid model of some sort. We do collect these data on a monthly basis to monitor the trends around the different types of instructional models that schools are using. These data are typically collected at the end of the month. Because of the holiday period, we've delayed the December collection until today actually closes, so we'll be able to provide an update on that information next week. We did continue our weekly surveillance testing of school staff this week. The participation rate was down a bit this week, down to 31%. Typically, we've been around 40%. That's probably due to scheduling challenges with the holidays. We did identify three positive cases this week among school staff, which brings the positivity rate to about 0.17%, still substantially lower than the statewide positivity rate, which is about 2.9%. We unveiled our draft planning template this week for our education recovery work. This template currently includes three interrelated domains or area of focus, where we expect school districts to put their energies. The first one is mental health and well-being. The second is re-engagement and truancy. And the third is academic success and achievement. We'll be working with our stakeholder groups through the month of January to seek to finalize the planning framework by the end of January. I expect we're going to require each school district to submit a recovery plan so that we can develop metrics to monitor the work from the state perspective, to help coordinate the use of federal dollars to support the work, and also to coordinate the deployment of other state resources such as mental health to school districts. We expect schools will begin to engage in this recovery work later this winter and into the spring. And generally speaking, the recovery work in education is focused on mitigating the impact of the emergency on students from an educational perspective. To do that, we'll require more in-person instruction and more in-person contact than we are currently providing our students. So as the conditions improve in the coming months and with the advent of more vaccine and warmer weather, we expect most schools will be able to return to nearly full in-person instruction after April vacation. I wanted to highlight a key aspect of this recovery work will be the dollars necessary to do the work. So I want to talk briefly, give you an update on what we understand from the recent package, relief package that was passed by Congress. In this package, we expect Vermont to receive about $167 million for education. $34 million is focused for higher education and $133 million for K-12. I did want to just call out and thank our congressional delegation. They've been tremendously supportive throughout this emergency. The K-12 funding will be coming down through existing programs that we already have that were established under the CARES Act. These two programs are the Elementary and Secondary Emergency Relief Fund, what we call ESSER, and the Governor's Education Emergency Relief Fund or GEAR. Of the $133 million in K-12 funding, Vermont's expected to receive about $127 million under the ESSER program. Originally under the CARES Act, the original ESSER funding, we had about $30 million. So you can see that this new allocation is about four times as much as what we received previously under the ESSER fund. And we're expected to receive about $6.2 million under the GEAR. Previously, we had received about $4 million under the GEAR. At this point, we're waiting to receive some additional guidance from the U.S. Department of Education on how to administer these funds. But since the funds are being delivered through these existing programs, we expect to receive the funds at the state level fairly quickly. It'll be important that we do move forward as quickly as possible with nailing down our recovery planning so that we can ensure that we maximize the use of the funds for that recovery work. My initial impression as of this week is that the funds are going to put us in a really good position to make a significant impact on the benefit of students from that recovery work. So at that, I'm going to conclude my update and turn it over to Commissioner Levine. Thank you. Good morning. I'll start with our case update this morning. As you can see, we're up to 8,619 total cases, 156 deaths. Yesterday we reported 213 cases, and today we are reporting 202 cases. The one more death brings us to the 156 number. If you could go to the next slide, please. Our percent positivity rate over a seven-day period is still in the twos, but just hovering close to 3 percent. Still far from, fortunately, much of the rest of the region and the country, but as you'll note, it has been increasing along with our death rate at a time when our nation has just reported yet setting yet another record with exceeding 4,000 deaths. There are currently 29 individuals in the hospital and eight in the ICU. The range we're seeing in numbers of hospitalized patients is still certainly higher than we are accustomed to, but not markedly increasing. This is our syndromic surveillance data, which is confirmatory not only regarding COVID, but confirmatory in some sense regarding influenza as well. We're not seeing marked upticks in patients presenting with symptoms of those conditions. And much of the rest of the country is also noting that the influenza season is not really taking off at this point in time, fortunately, and hopefully we can maintain that stance. I'm showing the long-term care facility list today because I know many of you pay attention to these numbers, and I'm showing to you in a different light today. And the light I'm showing is that the list is not markedly increasing in numbers of facilities and the numbers of cases is not accelerating at a high rate. So when we talk about our new cases in Vermont, yes, some of them are represented on this slide, but they are not by any means the major proportion anymore. And as you know, when we follow an outbreak, we need to follow it for two incubation periods past the last case. So many of these facilities stay on the list for a long time. But that doesn't mean that they're having more and more cases every week at that kind of a level. We, you know, at any point in time, we follow at least 40 outbreaks, 200 range situations. Obviously, we can't report on all of those to you at this press conference, nor would there be a lot of value to that. As you know, in the past, when we've had certain outbreaks like the ice team sports outbreak in central Vermont, obviously that merited significant attention. The only one of those that at this point in time would merit attention is in Addison County. And that is, I think, well known to many already regarding Christmas weekend services, three separate services at a church where a number of households work gathered. And indeed, we've seen a lot of transmission within those households and across people who attended that church. And the number is now up to 80 total. That continues to provide part of the increase in cases, but obviously not, again, the major proportion of 200 cases reported in a night. It's fair to say that some of what we're seeing in these recent case counts is the impact of the holidays. Just like around the country, the result of people traveling and gathering together. I do get a lot of questions regarding gatherings and ski resorts, though. And I want to get into some very early available information specific to them. First regarding the ski situations. We have found nine cases among people who have been at ski areas. The majority of those are actually employees, just like we see at other workplaces at times when there's more virus prevalent in our communities. And while this is a good start for the ski season, we strongly encourage everyone to continue wearing masks and following distancing recommendations so everyone who enjoys that outdoor activity can continue to do so. Regarding gatherings, our contact tracing teams thus far have identified six gatherings related to the recent holidays that have a potential for further spread. Examples are multiple families gathering together in a large birthday party. Some are like the Halloween events that you might recall led to a rise in cases for a period of time after that holiday. Our teams are not finding evidence that significant outbreaks have occurred related to the types of gatherings that were allowed for over the holidays. And there's far more evidence of isolated cases related to community prevalence. It's still too early to see the impact of any New Year's Eve gatherings at this time. And while we're also watching for any impact in our communities from Vermonters who return to the state after attending the tragically violent event in Washington this week, this situation is an important reminder that if you do travel out of state and please don't that you need to quarantine and get tested for your safety and out of consideration for your families, Vermonters and your communities. We all rely on each other to do our part to keep the virus from spreading. Unfortunately, the U.S. continues to set records for deaths. Cases are surging, hospitals are overwhelmed in many places. We've been told by many in Washington, including Dr. Fauci that it will get worse this month. In Vermont, cases had really leveled off after Thanksgiving. But we know what this virus were never really safe and were certainly not immune to the havoc that COVID-19 is causing in the rest of the country. We know there's more virus in our communities now and more potential for spread. We see it in our situation reports every day where every aspect of society is being impacted in one way or another. So what does this mean for Vermonters? I wish I could offer new advice because I hate that the COVID fatigue that many of us are experiencing would take away from its importance. But the fact is we really do know how this virus works and what works against it. And that's what you already know, wearing a mask, keeping six foot distance, avoiding travel and gatherings, and staying home when you're sick. And unfortunately, the news of a more transmissible variance of the virus in the U.S. only should give us more reason to redouble our efforts. As of yesterday, the list of states that reported the variant included Texas, Connecticut, and Pennsylvania joining California, Colorado, Georgia, Florida, and New York, just across our own border in Saratoga Springs. Some people in which the variant is detected have reported travel to the appropriate places in the U.K. and Ireland, but others have no travel history suggesting that the variant is already circulating here. As I mentioned Tuesday, I do expect we will see it here in Vermont as well. It may mean more people will get COVID-19 and need medical care, and more of the population will need to be vaccinated. But it won't necessarily mean you will get sicker with this variant than with the virus we've been living with for some time. And some very preliminary news from Pfizer indicates that the U.K. and Saudi variants of the virus do seem to be effectively dealt with by the vaccine. It's early news, it's encouraging, but we need to have it confirmed and have more peer review of that. In another bit of preliminary news, in addition to the U.K. variant, Dr. Birx has been talking about the fact that she feels there may be a fall winter variant prevalent throughout the U.S., but as of yet, there's no really firm sequencing data to support that. The same concerns pertain to this variant as with the U.K. variant. It's associated with asymptomatic transmission, increased asymptomatic transmission, increased hospitalizations, and a reversal in some states of what had been declining case counts. To mitigate it, same lure suggestions. Proactive testing, especially in youth, to protect the most vulnerable. Proactive therapeutics, usually those given by infusion, like the antibodies, but those have had about 25 percent uptake by most states thus far. And then, of course, vaccinations, using a strategy like we are using with the highest risk by age through community immunization sites. Speaking briefly of vaccinations, as you've heard, we now have 21,000 people vaccinated. And in a report that should be very reassuring, the CDC has reported on allergic reactions, especially including life-threatening anaphylaxis after the receipt of the first dose of the Pfizer vaccine during the latter half of December. They reported a total of 21 cases after almost 2 million doses were administered for a rate of 11 cases per million. The majority of these occurred within the standard 15-minute waiting period, and they occurred in people with a history of allergic reactions. So, in these first immunizations weeks, anaphylaxis did seem to be a rare event. I do want to again remind everyone that we are still learning how long it takes for immunity to develop following vaccination. So, once you receive a vaccine, it is still important that you follow the precautions to prevent exposure and transmission in the coming weeks and months after that. And finally, I wanted to share one more bit of news and proudly highlight some data from our own Health Department scientists published yesterday in the CDC's Morbidity and Mortality Weekly Report, where once again Vermont has helped shape national policy. You'll recall since May, we've allowed people who are in quarantine due to recent travel or exposure to a COVID-19 positive patient to end their quarantine on honor after day seven, assuming they remain free of symptoms and have a negative test at that time. Our analysis demonstrated that this policy has had a minimal impact on further spread of the virus, with only 3% of people identified as close contacts testing positive on day seven. These data support recommendations like those recently proposed by the CDC to shorten the quarantine period. They've also benefited the overall COVID-19 response by identifying asymptomatic people earlier in their course of illness through the increased availability of testing. I'll stop there and I believe we start the question and answers now to whomever they be directed. Thank you, Dr. Levine. So as you mentioned, we're not really seeing any widespread cases because of the one trusted household rule over the holidays. I'm wondering if, you know, we'll continue to use this data and potentially use it to loosen restrictions, make this going forward. I know as of right now that has been banned, right? Right, that expired on January 2nd. It'd be premature to try to set policy today. We don't have complete information from Christmas and we still have to get information from New Years. So I wouldn't want to even conjecture where we would go with that at this point in time. Obviously, we're seeing a higher caseload in general, which may or may not have any relationship to the question you answered, but we're going to have to watch the data closely and I would not want to even hazard a guess before 14 days post New Year's Eve had elapsed. Secondary questions for you and maybe for Secretary French as well. So last night, Governor Scott said that he hopes to have students back in the classroom by April. You know, we're still seeing increased case counts. And as Secretary Smith said, you know, we're doing well in getting the vaccine in Vermont's arms, but we're still seeing increased case counts and were, as you mentioned, still seeing supply chain issues. I'm wondering, you know, how realistic that goal is. Yeah, I'll say my first few words. You heard the surveillance testing positivity rate, which again, is just totally remarkable. And I have to believe that everyone who works in the school environment takes this so seriously that they are being really careful in their lives. But the fact is, when we do see these cases, even the newest ones that have come in, they still are very much isolated cases within a household, within a worker at a school. And we're not seeing the kind of spread through the school environment that would really make us want to really reanalyze this whole situation. We've done very well for the entire first half of the school year. And we'll have to keep tracking the data now. But at this point in time, you know, with vaccine coming in as slow as you indicate, and it's not going to make a big difference in the lives of most of the state right away, because we're getting it out as fast as we can to the priority populations. We have no reason to change our stance on the schools, because they continue to enjoy really, I think, good progress. I'll let Secretary Fentz talk more about the future planning he was alluding to in his comments. Yeah, thanks, Calvin. I think, you know, certainly our ability to do in person is predicated on the conditions, you know, and I think through our credit as a state, I think one of the things we've done very well, largely with the leadership of the Department of Health, is to craft our guidance based on our conditions in Vermont, and arguably our guidance is some of the more restrictive and comprehensive than many states in the country. So, you know, we're looking forward, we need to look forward, we have to do that planning. And that's sort of the education side of it. We have, we know students have been significantly impacted by this emergency. We, thinking forward, if we could project forward based on what we know today, we would expect to return in the fall, you know, to quote unquote normal or something like that. But the point is, I think, with this emergency, we can't afford to wait to the fall to begin to address the needs of students. And every week that goes by that we don't do that, there's risk involved in that as well. So, we're optimistic based on what we know of, you know, the advent of more vaccine coming and certainly conditions improving, warming, warmer weather and so forth. But our ability to do more in person is certainly predicated on our analysis of the conditions. Steve? Actually, Dr. Levine or Mike, whichever. Just wondering, I've gotten a couple of questions about as we move forward with the with the age brackets and everything, and we get to the general population. Obviously, the federal system, the, the inoculations are happening in the healthcare facilities. Where are people going to be able to go to get these? You know, and is, you know, who's going to administer them? If you go to the drug stores, you've got that 15 minute wait period, things like that. And they, they were wondering about how much training is going on for these folks to, to get that done. Yeah, if I, if it's to the general public, I think there's going to be several avenues by the time we get to the, the general public. And I think there's going to be several avenues throughout this whole process as we move forward. You talked about pharmacies that may be one area because the federal government has a phase two where they're going to just ship directly to pharmacies with their vaccine. But I think you're going to see district offices, district health offices, these pod, these sort of these community vaccination sites that will have up through a variety of people using personnel at the health department, using personnel that are trained personnel at the, at various other state agencies that are trained. You'll see EMS probably be involved in this and you'll see National Guard probably involved in this in these community vaccination sites that we talked about. You'll also see hospitals involved. I'm, I'm, you know, as we're putting this together, I think hospitals will play a role here, not only getting it out to the primary care physicians, which also will have a role here. But, you know, we're, it's going to be multiple players involved at multiple locations so that you don't have to drive more than 30 minutes to get a vaccine. That's what that's what we're looking at. And it will be as well publicized as you can imagine. So folks will literally be able to walk in pretty much. Or do you need to, there's going to be a registry, yeah, there is going to be a registration system because there has to be when you have age groupings, you're going to have to have a registration system. So there will be a registration system that will be announcing shortly. Good morning. There is some new reporting this morning that President-elect Biden will release all available vaccine doses and not hold back supply for a second dose. And I'm wondering, Dr. Levine, what you're thinking is about the pros and cons of that. And could you handle a doubling or, you know, at least a sharp increase in the pace of vaccinations? Thanks for that question. And that is truly, Stuart, you would agree, breaking news since it just kind of came across this morning within the last hour or two. So we don't have the fleshiness of the details yet, fleshing out of the details. But what you said is essentially what I know that there will be more first doses available to be deployed across the country because of the fact that the current administration, the minute they send a dose to Vermont, they hold the dose in reserve so that in three weeks, if it's Pfizer or four weeks, if it's Moderna, that same person can get their second dose injected. What President-elect Biden has proposed is to not hold that in reserve and just keep sending vaccine to the state. Part of that means the state then has a little bit of more work to do, I would think, understanding how many doses they need to get in to give to people for their second dose while they're still trying to have an accelerated pace of injecting their first doses. So it's going to be challenging. I do like philosophically getting more vaccine in at an early time as much as possible, but I would like the comfort of knowing that the manufacture and quality assurance processes are matching that so that we'll keep getting more vaccine in to inject to people, but we'll always have that second dose. Because I don't think we want to do what England has done, which is basically say we don't know when people will get their second dose. It could be months and months later, but we're willing to do that so that everybody gets their first dose. I'm not convinced that's a wise path to take. It doesn't follow the data and the evidence of the studies, and there is no study that tells us how much further out you can get your second dose and still get the biggest bang for your buck, if you will. So we'll have to wait and see when more details are forthcoming, and when they start talking about the questions I've talked about, which will be the first ones everybody's going to ask, trying to have some secure knowledge that they can accelerate their pace of the first doses, but still comfortably tell people they're going to get their second dose in a timely way. Okay. My second question, I'm not sure to whom this should be directed, but we have been getting a lot of email about that bus load of people who returned from that protest on Wednesday, and the images that showed no one wearing a mask because they were getting off the bus. Are you doing anything to ensure they are in quarantine? Can you assure Vermonters that they are? Yeah, so let's start in the beginning. Clearly, I would probably say that the Facebook posting has gone viral, at least within Vermont, and clearly it indicates lack of compliance with the guidance that we traditionally talk about with regard to distancing from people, capacity within the bus, wearing of masks, et cetera, and we know that from footage of what happened in Washington that none of those rules were abided by very well, by a larger population. So certainly a high-risk enterprise. We certainly made sure that communication went out to everyone on the bus at the time they arrived, indicating that we recommend very strongly quarantine testing because that's really what one would do, just like if one had a gathering at Christmas. We told everybody you need to be doing testing for that regard as well, but we feel it very strongly about the quarantine issue. Unlike if there's a positive case who we would tell to then isolate, we don't really have regulatory power to enforce somebody being quarantined when they're not yet a case. So we have to be very careful about that in terms of how much authority we can exercise, but we've been very strong with the information about quarantining and with obtaining a test. Thank you. Follow-up to Calvin's question to Secretary French. This April date for students returning in full. How confident are you with that actually happening? Is this an aspirational goal or is it realistic? If teachers aren't vaccinated and it doesn't sound unless they're in the older age bands that they would be, and obviously the virus may still be around in the community, how confident are you that that can actually happen? Well, thank you. It's certainly an aspirational goal, but it's informed by a real assessment of our conditions and a projection of what those conditions will be like in April as much as anyone can do that. But it is also important to acknowledge, as I mentioned, there is some educational need for us to address this issue. Also, it's an acknowledgement that it takes some planning to point the education system towards this work. So I don't think it's time lost for us to begin that planning. Honestly, we had tried to do that planning in October, and then the conditions worsened. So we've sort of put it on the back burner because we knew we had to get through this challenging sort of holiday period, if you will. But we think the time's right now to start doing that planning and to give people a sense of when we think we'll start to see some real progress in terms of implementing that planning. But all that could change based on the conditions. But it's important to identify that sort of timeline for the system so we can begin to do the planning and to allocate our resources accordingly. And thank you. And then maybe a question for Dr. Levine regarding the Addison County numbers, which have just been going way up. And this church Christmas Eve gathering, was that the victory Baptist Church, can you say, and were occupancy requirements exceeded for that gathering? You named the church correctly. I'm not aware that occupancy limits were exceeded, but I can't definitively say that. Thank you. I did want to add one other comment to my previous comments regarding the bus. And that's only that, you know, what we're really asking for is what we've asked all Vermonters to do from the beginning, not only abide by the guidance, but be altruistic and look out for one another. So the act of going into a quarantine after such a bus ride and the enhanced risk is really to protect themselves, their own families, their communities, and Vermonters in general. So if anyone didn't really get that message coming off the bus, I'm voicing it to you now in that spirit. Thank you. Yes, this is likely for Dr. Levine as well. For the bus company, has the state been in contact with them, considering it doesn't appear like they were adhering to the state guidance? I'm not Dr. Levine, Mike Scherling from Public Safety. Public Safety was in touch with the bus company. The restrictions are on travelers, interstate operations for transit are still functional. So folks responsibility is personal to adhere to the quarantine guidance. Does that mean that buses full of people are still going in and out of the state? Interstate transportation remains uninterrupted. So whether it's an airplane, personal car, bus, to the extent you can get a ferry right now, those modes of transportation are all still functional. Okay, thank you. Thanks for back. Secretary Smith, thanks to you and to Governor Scott for restoring police and firefighters to the list of essential people that need to be near the front for the vaccine shots. I've received several emails and calls in the past few days asking me to thank you for protecting emergency first responders. And I know the governor was missed that they were sort of pumped out. And I understand Bennington police where they had an outbreak has already started to receive their shots. So I'm just passing along the thanks of many people. With that said, how many police in Vermont have tested positive for COVID? And I'm told this morning, there apparently is a large number of people associated with the state police barracks in Rutland. And there may be a quarantine down there. Do you know anything about that? Good afternoon, Mike. It's Mike Scherling from Public Safety. Again, we don't have a full count of the number of first responders that have tested positive. But I think anecdotally, I would say that number is in the 10s, probably in the low 10s, 20 or 30 that we're aware of. Relative to the Rutland barracks, we did have an event where there's an exposure to a shift so that we have a number of folks that are in preventive isolation as a result of that with testing pending. Can you define a number of people? The last count I had, I think, is eight or nine. But that evolves. How many on a shift? That is the entire night shift for that barracks, as I understand it. But I should say that number is potentially malleable as contact tracing occurs. And the question I had asked was, how many police, I know you gave 20 to 30 maybe first responders, but how many in the state police have tested positive for COVID? You must have a number of your own department. Again, I don't have a firm number because we don't always know the health, unless it impacts work, we don't always know the health status of an employee. But that number is probably in the, it's in the single digits, but I don't know exactly what it is. I would guess six or seven. Okay. And my other question, probably for Secretary Smith, this comes on behalf of a retired 26 year retired military person who has lung issues apparently due to his service in Vietnam and Agent Orange. He is 70 years old and is scheduled for an infusion for his lung or lungs on February 3rd. But has been told he will need to wait another six months until the fall before he can medically get cleared for a COVID vaccine shot. Yet on the other hand, if he were to get his vaccine shot soon, he would only have to wait six weeks for the much needed lung infusion. So it's six months or six weeks. Is there anything that the state can do in this case to help this retired army veteran? Let me, I won't even hazard to give an answer on that given my background. It's not medical. I'm probably going to ask Dr. Levine to take that question. Dr. Levine. Do you have an honorary degree here? Obviously this is complex. It would be premature to give any kind of answer at a podium with the details that you've provided. I think 70 years old is in the second group of the age banding. So it's not like six months away. It's hopefully six weeks away in that timeframe. So if you would like to have that individual or through you get us details, I can at least make some comments on the situation. But otherwise, you know, I have to say there are going to be potentially 600,000 special situations. And that's not going to be a coherent way for us to run a large vaccination campaign to get the most vulnerable in the state taking care of first in a methodical way. But certainly I'm willing to hear something out that you can provide me. Very good. Thank you very much. I'll get you. I'm sure exactly what to call the second thing, but I'm going to do that first. I received an email from one of our readers who says that her organization, which is in a group of educators, are noticing major impacts on families, housing and utility bill needs as they wait for new COVID support money to come through. And this woman says the problem is causing a lot of stress and people are losing housing in the kingdom. And I guess the question is, does the state have some kind of way to provide alternative ways to support these people while they wait? Secretary Curley might be able to speak to some of the, I know we have rental assistance programs. Here also the PUC recently reinstated the moratorium on utility disconnections. So there are a number of resources. I wonder if Secretary Curley could speak to a couple of those, but I know there are quite a few resources in place. Yeah, I think that there's a lot to unpack in that question in terms of the variety of things that people may be experiencing. And as Rebecca said, their moratorium on disconnections is extended to hopefully people aren't losing their connectivity or their power or whatever they be. I would just say if you're willing to reach out to me offline, we definitely can connect you with the housing and community development commissioner who can talk about our rental programs and make sure that people aren't losing housing. We do have several dollars still to help in that arena. So I would love to hear from you and, or I can try to reach out to you after, but let's make sure people are taken care of. Thank you. I have one other question. This is for Dr. Levine. There's been a lot of discussion about the new variant of COVID and it's frequently stated that it's more easily transmissible. What does that mean exactly? Is that, would that be seen, for example, in instead of 15 minutes being a contact, a shorter period of time being a contact, or am I misunderstanding what that means? Yeah, so practically speaking, what it means is that the person that you might contract COVID from might have a higher load of virus in all those nasal and oral secretions that they're spewing out when they cough or when they yell at you or what have you. So more virus available to infect you from an individual who has the virus. And it has to do with some changes due to mutation, changes that occur in these spike proteins that impact the way they bind with the receptors in our nose and other places. And so that's kind of what it all fits together as, without getting too detailed. Should the appear and spread widely in Vermont, would you anticipate that would change the recommendations or people's behavior at all? The only change would be to redouble their efforts. There is no other real public health guidance or behavior change that would go beyond the current, but it would only be to redouble your efforts doing all of the current. Because again, with a higher transmission rate, you may find you're encountering more people who put you at risk. So if you're not keeping a distance from them, if you're not wearing a mask in their presence, if you're not avoiding your congested indoor space, you may be more readily able to pick up the virus than you would have with the former version. With the governor somewhere. Mike Smith, I was struck by the numbers you were providing on vaccines distributed. And a lot of the places that are getting very high rates like Vermont are actually have relatively low, relatively low case counts and deaths. And I'm wondering if, maybe those vaccine numbers, those vaccines should be going to the places that are having much more difficult times, Arizona, California, Florida, the Atlanta, Georgia area. I'm wondering if that crossed your mind at all. No, Tim, that hasn't crossed my mind at all. And I'll tell you why. I mean, there are lots of doses going out to those larger states. And I know that they are trying to administer them as quick as possible. We are doing a good job here in Vermont. I think, you know, we have seen an increase in our death rate in the last month or two. And, you know, it is imperative to me at least that we try to get those that are most vulnerable, those that are 65 and up vaccinated as quick as possible. Even with the dosages that we're getting. Just think about this. We're getting about 8,800 a week. We have about 125,000 of the most vulnerable we've got to get to. We haven't got to that phase yet. When we get to that phase, you know, we're looking, as I said, to spring to get this done at the pace that we are at the beginning of spring, at the pace we're going. So, you know, I would say not to cut back anything in coming to Vermont. Let's get the most vulnerable vaccinated and let's and we have been doing that in a exquisite way. And I just want to keep that up. All right. Great. Thanks, Mike. Yeah. I just wanted to flag in addition there, it's Mike Scherling from Public Safety. The nature of that question actually goes all the way back to April relative to Vermont's good performance and our efforts to ensure that whether it was PPE, ventilators, testing supplies, and all of the things that have been critical through the response, the federal government has been very receptive to our argument all right along that good performance should not penalize our ability to continue to respond. So this is just the latest example of those change to the extent that they have been viable being consistent regardless of performance. Thanks, Mike. Good morning. I should direct this question to but I'm wondering about the reversal on the policy that now is going to allow first responders to get vaccinated, which obviously closely aligns with the CDC guidelines. Who in state government first made the suggestion not to have emergency responders get vaccinated and instead distribute those vaccines on an age-based system? The EMS category was always in 1A. What we have done is basically just expand the EMS category because we realize that many of these first responders as I talked about are actually the first on the scene that are giving medical attention to these individuals. So we included them into that sort of brought that EMS definition because that's what they do. We did not include into this definition patients such as people that are at desk or clerks or administrative leadership into this. So once we realize in terms of the 911, how 911 medical calls, how responding to accidents really happened, it was an easy call. EMS and these first responders are doing similar things to help patients that in some cases vulnerable patients. I understand that, Mr. Secretary. I'm wondering the original advice from CDC, the guidelines from CDC were to have all emergency responders get it before the general public. I'm wondering who in state government who had the idea originally bypassed those policies? Greg, I'm going to take some exception to that because I don't think there was any intention to bypass these first responders. I think what we should have done out of the gate is make sure that we broaden the EMS category on this. We didn't do that. Oh, I guess let me make it a little more direct because I have two people there, Dr. Levine and Secretary Smith. Was it either of your ideas to not administer this to all emergency responders first? This is a hard question because I don't, there wasn't any sort of, there wasn't any sort of pre-planned to exclude them. There was, it was just who do we include into the EMS category and I don't think there was any discussion of who to exclude. We thought we were including everybody that does sort of these medical emergencies. If anything, it was an oversight. And here's, I'll have Mike Schirling talk a little bit more about it. Yeah, thanks for the question. To the extent there's a perception that the first responders were skipped over, I think that is just a perception. There was, what was communicated was the overall community strategy to go by age band while we were still contemplating what the nuances of what is now happening in 1A and the eventual clarification of the EMS responder was. And I think I've clearly communicated that to all the police and fire chiefs that were in that cohort of folks that received the clarifying guidance. Well, I was just trying to figure out who in state government had the idea to change the policy from what was first. I think you answered that question. Do you have another one? Thank you. Hi there. I'm hoping to find out if you actually do you have a list of everyone who was on the bus to DC and is that how you contacted them? So Mike Schirling from Public Safety again, we do not have a comprehensive list of the folks that were on the bus. We were able to make contact with the bus company while the bus was still en route from Washington back to Vermont. And the bus company graciously agreed to make an announcement to all of the folks that were on the bus to reinforce the quarantine requirements. Okay. And and is that a list that you are trying to trying to get in order to kind of make sure that that people are quarantining? It is not. Again, by and large interstate travel remains an open mode of transportation. The key is that for people who are choosing to use interstate transportation, again airplanes, buses, boats and and cars that they adhere to the public health guidance that has been laid out both by executive order and by the health department. Okay. But is is it the case though that that the bus was over the capacity that that Vermont you know that that social distancing public transit capacity? We don't actually have a restriction on distance on public transportation. So for example, airlines have the ability to determine their capacity and then passengers have to determine what the correct you know safety footing for each individual person should be. But that said, if you're with if you travel at all, notwithstanding the fact that there's an increased risk as a result of the lack of masks and the close distance that these folks were to each other, you still have to maintain yourself to adhere to the quarantine requirements that we have in place. I would just say and defer to Dr. Levine if he has anything else has anything else to add. There's certainly enhanced risk as a result of the proximity and the lack of masks. Okay. Thank you. And at the very least, because they've traveled out of state, our guidance in the state of Vermont is you must quarantine when you return. And so that message was made very clear. And a question on vaccination plans for teachers. Is that going to be a prerequisite for that goal of moving back to full in person that that teachers are vaccinated by that kind of April goal. Hi, this is Secretary French. It's not directly tied at the moment. Certainly an assessment of the conditions is really what we'll be looking closely at and vaccination factors into the overall conditions. Yeah, I mean, currently we've been pretty steady at about 75% are in hybrid. We certainly saw a doubling of in person instruction at the elementary level after the initial reopening period. But we keep on a monthly basis, keep an eye on that data. We'll see how it plays out. Yeah, we have quite a bit of in person going. Yeah. But but as far as that goal of full in person, the vaccination is not going to be a prerequisite. To the extent that vaccination will help us improve the conditions it is, but it's not tied directly to vaccinating the school staff themselves currently. Okay. Thank you. You're welcome. Just going to add a clarifying or correction on one of the things I said a moment ago. Agency of Commerce has has texted that charter buses do have a 50% restriction. So technically that that charter should have only had 50%. And and is that does the state have enforcement capacity in that regard? We will reach back out to the to the bus company and have a an educational conversation on that. Thank you. Hi, this question is for Secretary Smith. I want to follow up on a question raised by Mike Donahue on Tuesday about the appropriateness of ski controllers receiving the vaccine and you said you would look into it and I'm wondering what you have concluded and I'm wondering how you could conclude that ski controllers or anything other than EMS first responders. Thank you for the question because I I didn't conclude anything other than they are first responders. Many of the cases you will find that they are in fact EMT or EMS qualified and have all the certifications for that and in many cases they actually operate as EMS in other sort of jurisdictional or work environments. So the the the information I really thank you for the question the information that you just said that many are qualified and do fall under the EMS qualification. Thank you very much. I'm happy to hear that. Greg, Bennington Banner. Hello and thank you. My question is about this might be for Secretary Smith with regards to the Department of Corrections officers testing positive for for COVID. I was wondering if you could tell me where officers are testing positive. What's the current status of inmates testing positive throughout the state correction system and are any testing positive at Marble Valley or Southern State? Yeah I don't Greg I don't have the precise numbers this is sort of I put it in because the Department of Corrections is going to be doing a press release this afternoon. I will say the bulk of the positives the vast majority of the positives are staff and is and it is in all facilities in terms of small numbers one two that sort of numbers in all our facilities except St. Johnsbury and and ironically at least through the last testing period Mississippi and and then and then in terms of incarcerated individuals like I said it's very few and if they and it's it's predominantly a lot less than than the than the five or six or seven correctional officers that we're talking about here. Okay so I'm a little puzzled then as to what we have a full lockdown at Marble Valley since I'm not hearing that that's the facility closest to us here in Bennington. Yes I'm not hearing cases of guards or inmates there yeah so I wonder if you can if you have any more detail on why that's gone full lockdown. Yeah there are two at least one case and at least one suspected case waiting for results. Has any type of administration made any determination as to whether when if and or when inmates will be vaccinated. No that has not been determined if it's in the age band as you know our our inmates our inmate populations fairly there are some people that would fall in the age band at the at the get-go on that but there has been no determination yet other than the age the age grouping that would determine any sort of coming out of priority from the age group grouping system that we've talked about. So if you're 75 plus an incarcerated you will get vaccinated if you're 25 plus you'll have to wait like everyone else so far. And if you might indulge me I just wonder if there's any update that that Mr. Shirley might be able to offer on the investigation into Trooper Hall in the Chasbury barracks. Like for example as as the determination reads or as are there any updates that you can announce into the into that investigation. Nothing substantive at this time it's only been 24 hours but we do anticipate having that concluded by very early next week with updates to follow. All right thank you very much I appreciate it. Yes thank you good afternoon this is for Secretary French as you know local school boards across the stator in the process of finalizing the budgets to be presented to their voters at top meeting. I'm wondering how challenging do you think this environment will be for schools to get budgets passed and are any of the recovery monies available for normal operating budgets that might take some of the pressure off of property taxpayers. Yeah thanks for the question I you know it's always a challenging year with school budgets for a number of reasons but I think in particular based on my experience as a superintendent I think the the increases we're seeing just out of the gate projected to the Ed fund are going to make it especially challenging. I think then you factor in the uncertainty about next year and what the operational costs will be make it very challenging and there's the general anxiety among taxpayers among about their own personal financial condition is going to make it especially challenging. But in terms of the federal dollars I think you know there there are protections built into how those funds can be used they can't be used essentially to supplant I'll say quote-unquote regular expenses but to the extent those expenses are qualified as being COVID related then they are eligible for reimbursement through many of the programs that have been established so I know many districts are leveraging those funds to their maximum advantage so that should be of help. Okay and for Dr. Levine or perhaps Secretary Smith I'm wondering have you determined the metrics for when you would consider a phase for instance phase 1a or a particular age band completed especially since you know the assumption is not everyone is going to accept the vaccination or will you target a certain percentage or the the opportunity to offer everyone a vaccine but I guess I'm wondering how do you know when it's time to move on. When we're finished we're going to have overlapping bands it's just going to happen as we as we move forward but when we think we're substantially finished for example in phase 2 which is 75 plus we know there's approximately 50,000 people within that within that age bracket here living here in Vermont when we get near to that that number or we have some analysis which we hope to have in terms of what the uptake is in that age group we'll know when to move on to the next age band that doesn't preclude anybody that misses their age band to come and get tested because basically what we want them to do every time we say a next age band for example the first is 75 plus the next thing we'll say is 70 plus we're not precluding anybody that 75 plus from getting getting their vaccine so that is did I did I miss your question. I want to know I was I was just you've answered it pretty well I was just curious whether there was concern about there being sort of a lull in the in the transition between the brackets sounds like you're taking steps to try to avoid that. Yeah we are and I don't think there's going to be a lull as we as we make sure we're not going to get down to zero in one age band before we move on to the next age band we don't want that low low by the way if I could amend something that I said earlier I had mentioned there may have been inmates there are no inmates that are positive now in our correctional facility. And if there's time I would like one question of Dr. Levine with a couple of days over 200 is there any possibility of tightening restrictions in the days ahead. Just to add on to Secretary Smith first the vaccination program relies on registration so appointments and it will become evident when one phase has less people making appointments so that will be another sort of safety net if you will allowing us to have good insight quickly into the fact that we can open up the next phase because there's less demand in the previous phase so there'll be a variety of ways for us to get at that with regard to your question I I'm concerned that we've had two days in the very low 200 range but certainly we wouldn't use this just that experience post holiday to do anything dramatic in terms of our policies right now so I would I would ask you to indulge a little time because we do want to get through the post Christmas and post New Year's time frame you know you'll recall when we had the larger increase in cases related to our central Vermont outbreak and the timing around that it didn't necessarily mean that the solution was to become more restrictive across the board right away so sometimes one needs to just let these events play out if you will a little bit before you intervene in a very strict way clearly I do want all of our monitors to know that in this post holiday time we are seeing more cases and they need to be really not letting their guard down as they proceed in their daily lives and to continue to follow all of the guidance that they've been trying to so strictly follow all along and not let that lapse now okay thank you everyone hi um Commissioner Shirley we know that about 50 people travel down to DC from the Chittin County area in that bus are there any law enforcement agencies investigating whether um these are were involved in a riot that erupted outside the capital and inside the capital building or do you know is anyone investigating that thanks to the question and well we don't comment on active investigations I can tell you generally that the state police our intelligence center and any law enforcement in Vermont are are actively cooperating with federal authorities as they explore all avenues and all potential tangents to what occurred in Washington on Wednesday there were reports that someone from southern Vermont entered the capital building but this is just a report and have you heard anything like that again we don't discuss active investigations as they unfold but if there's something substantive to report we'll certainly get it out as quickly as possible would you characterize this as an active investigation I would say we're actively cooperating and assisting federal authorities as I think just about every state is at this point so that's probably the best way to characterize it all right thank you so much you've been muted to unmute yourself press star six vice education one two prisons um for secretary smith uh as far as northwest correction you're no longer muted a couple cases there went on full lockdown is this announcement uh are there any additional cases but over and above those two as part of this latest announcement we somehow muted ourselves uh so could you I apologize for this but could you repeat the question no no worries uh so as far as um the prison's question uh as far as northwest state goes I know a couple weeks ago there were a few cases there um I was wondering if this recent announcement are those these are there any cases over and above what was reported a couple weeks ago and um what about correctional officer vaccinations uh are they in the current phase of EMS or is there any consideration for bumping them up in the queue the um these are new cases and and there are new cases I don't I don't have the exact account I think corrections will have that for you later on this afternoon in terms of their press release but um so these are in addition to what you were describing a few weeks ago uh like I said five of our facilities have new cases this week and uh northwest obviously is one of them because the only one that doesn't is st johnsbury um in terms of correctional officers in terms of any group and grouping we are going as I mentioned before with this age grouping um concept because it is the most simple it is the least divisive that one group gets it over another um as we come out of 1a and go into phase two um and it also protects the most vulnerable so if those correctional officers are in 75 plus 70 plus 65 plus they will be the first um uh priority as we move into phase two uh in going um in vaccinating those who are likely to die uh from this virus and that's what we're that's our primary objective here is to prevent death and so that is uh that's the reason for the age grouping as I showed you on the graph you know once you get below 65 um your chances of dying from this virus are greatly reduced I'm not saying you can't but they're greatly greatly reduced as opposed to those over 65 so there isn't any sort of plans other than the age grouping plan right now um for any special special groups okay um and then my final question late to schools um sir secretary french I know discussions are early at this point but has there been any discussion as far as vaccination of students um would this be mandatory or treated like other vaccinations where exemptions could be applied um has there been any discussion on that so dr levine here going to answer your question if we if we continue to only have the Pfizer and Moderna vaccines they are only uh able to be given to individuals age 16 and 18 and higher which would exclude a tremendous proportion of the school age population if you will we're still waiting to see if there will be a future platform uh whether it's AstraZeneca or who knows what uh that would potentially be licensed and um have an age range that would include any any age in grade school or high school so no strategy around that because we we can't actually give the vaccine to the majority of students in vermont all right thank you jolly local 22 hi um i just wanted to know um approximately how many more people need to be vaccinated in 1a and is it safe to say that uh phase two will begin um by the end of the month at the earliest the end of the month is probably a good um sort of to put a pin into that aspect in terms of when we'll be going to phase two um in terms of the uh we only have the total number of vaccinated which i gave this week it gave today as 21 000 um i don't have precisely the uh the number on that but but we're indicating just by monitoring what is going on with getting through the long-term care facilities and getting through the uh the medical personnel we think uh that putting a pin on the end of january probably is is a good good way of looking at it and then just a question for uh secretary french um considering that the state has taken great steps to keep children in school uh and to meet april's in-person schooling goal um has there been any consideration for um possibly altering the community's um vaccination strategy and bumping up teachers prioritizing them in the queue yeah thanks the um yeah just to reiterate i think you know the um the goal for april is really you know firstly it's based on an assessment of where we think the conditions will be in vaccination uh you know my view functions as one of the key tools in our toolbag to help improve the conditions but certainly i think the the broader strategies around vaccination have you heard both secretary smith and dr levine speak to um there's a lot of unknowns and it's also largely predicated on federal policy federal logistics at this point so um certainly we'll we'll keep an eye on that but right now our projection for april is based on uh a conclusion that we think conditions will be improving and it's also informed by our um our priority to get kids back in school because we know that's the best thing for them thank you questions for dr levine last night in his inaugural address governor scott said that they hope to have us reach a point where life would begin to feel normal again by this summer possibly earlier in your mind what does that mean what does feeling normal look like to you in terms of all the precautions that we're taking right now to combat the virus thanks cat that's a great question um i think most people in the country feel that normal means not wearing masks hugging one another not having to worry about who you gather with uh not needing to avoid crowds distancing being a phenomenon of the past if that's that's like the big picture normal um you know i don't think uh most people think that the summer will be that normal however there's a lot more within that context that would make life seem like it's a lot more normal like we wouldn't have restrictions on some of the things we have restrictions on now from a policy level in terms of the size of gatherings in different places the number of people who can be at an event indoor versus outdoor um the um perhaps restrictions on uh parties at restaurants the number of parties at a table and uh how much of capacity could be uh you know exceeded or not so you know a lot of the things that are part of the executive order uh that get renewed um as the conditions uh warrant might be able to be uh lessened so that kind of normal is a lot different than saying we're not going to wear masks we're not going to worry about you know the close contact with people etc etc i think most people in public health feel that we still have a ways to go for those kinds of things um probably more towards the late summer fall but i don't want to be held to dates like that because there's so much to uh rely on with allocation of vaccine and things of that sort but i think it's much more you know those kinds of things that are built into emergency orders that um are certainly warranted at times of major virus prevalence and virus transmission across communities but that could be relaxed in a in a much more improved health environment and kind of a follow-up question to that there were many people who postponed some big life events weddings you know funerals major anniversaries etc from last year because it wasn't safe to have a larger party or they didn't want to have all of the prohibitions of masks and distancing and things like that given that those large events often require a lot of advanced notice and advanced planning and there are also industries that rely on those incomes in vermont what is your advice to people who are at the start of the year trying to think about okay can i have my 2021 wedding can i hold that belated memorial service that we put off from last year for a loved one yeah you know you've got me in a bad position here because people are going to put deposits down based on dr levine's advice and i'm not going to be able to give them that granularity of advice so i'll just start there um but again when you talk in public health circles again we're still thinking you know as the year evolves whether that means late summer whether that means fall whether that means end of the year that a lot of these restrictions may not be in place anymore because a sufficient number of people have been vaccinated because we've been able to suppress the virus by all the behaviors we're doing in the first half of the year and things may look very different so it's way more realistic to think about an october wedding in 2021 than it was in 2020 but having said that don't hold me to the date all right thank you afternoon everyone all of my questions have been addressed for today so so thank you thank you um steve any k tv hi can you hi can you hear me we can great thanks uh rebecca um dr levine uh i got a couple for you if i may um there's not only seven deaths in the in the u.s this fall uh attributed to the flu normally there's about 10 000 plus um the cdc says the masks uh and and hand washing um appear to be working for the flu um but they don't seem to be working for covid and um i was wondering if vermont is still testing uh people with flu symptoms for flu a and flu b number one yeah so you're really asking is the healthcare community testing because obviously as a state we're not doing the kind of testing we're doing for covid with large scale testing operations uh for that purpose so people with flu symptoms i have no doubt are getting tested for the flu um if you know if if the clinical picture looks right i imagine they're all getting tested for covid first uh because of the situation with covid but you do point out a good point that um we are seeing markedly less flu across the country and they did see markedly less flu in many places in the southern hemisphere during their flu season so uh commenting on the kinds of behaviors people are practicing as protective against another respiratory virus like the flu does make sense um my second question um with the with this m rna um technique or uh or vaccine um traditionally the vaccines have uh like adjuvants in them to uh jump start the immune system um like in the old days it was mercury and then they switched to aluminum and and uh i i don't recall what they've been using lately but do the uh to this m rna uh vaccines uh contain adjuvants to uh to to like jump start or spark the and and immune response yeah i don't believe they do i i don't i don't want to be a hundred percent authoritative on that but i don't believe they do um but you know people need to understand that though this is a new technology for vaccine it's not new just because it was invented when covid came around it's been around for a long time and been tested extensively in many other arenas it's just this is the first uh real disease we're using it for uh a vaccine for the population of large i can check into though if there is a specific adjuvant in there that would be great i would really uh i would really appreciate that um i guess uh i guess that's my two um yep thank you um thank thank you thank you all erin vt digger vt digger avery wcax all right thanks for coming back to me so how do health conditions fit into these next vaccine groups have you all set specific conditions that will allow people to get a vaccine earlier and can you clarify when in the lineup they can expect to get their shot so a 50 40 or 30 year old who's immune compromised when should they expect to get vaccinated or are they in the first date first age band yeah thanks for bringing health conditions back to the podium here because they they are important um and in fact this very day perhaps this very hour our advisory committee is actually talking about medical conditions the cdc as published on its website um conditions that um are important for adults who might be at increased risk uh for severe illness from covet so not necessarily getting covet but just if you get covet what's going to make you have a poorer outcome and um i've mentioned majority of these before but i'll just mention those again and a few others uh cancer chronic kidney disease copd which is emphysema heart conditions but serious heart conditions like heart failure problems with the muscle of the heart problems with uh the kind of heart disease that affects the vessels and leads to heart attacks and then um diabetes type two diabetes i think in mid december i got asked the question about down syndrome and said that people with down syndrome uh often have some of these other conditions like cancer or heart disease that would put them in increased risk uh but they weren't on the list well wouldn't you know it on december 23rd they got added to the list so that's now on the list as well and then any disease state as i've discussed before that compromises your immune system if you've had an organ transplant if you're on medications to suppress your immune system so you can maintain that organ transplant etc so those are the ones that we have talked about before in addition the cdc raises the issues regarding obesity especially severe obesity sickle cell disease which certainly belongs on the list and they also mentioned pregnancy and smoking so the way we have things outlined at this point in time and you've seen the data we're using to show the strong correlation between uh age putting you at severe risk for a poor outcome in this case the poor outcome being actually death uh we are going through the higher age ranges that were illustrated well on the slide and then after that uh coming to the population uh which in vermont is quite broad actually uh and we're determining the actual numbers now uh people who have many of the conditions that i just listed uh but they would come next in the stratification system we're using and i'm assuming when you say upper age ranges you mean is that 70 plus uh 65 plus for the three sets of uh age ranges and presumably of course many people with chronic diseases will already be in those categories but anybody under those ages who has these chronic diseases would then come in next and we're just discerning exactly how big that would be and exactly which conditions um makes sense for us all right thank you we'll be back on Tuesday and the governor will be joining that as well thank you