 Good afternoon everyone. Today we'll have our modeling and data presentation. Secretary French will give an education update. Secretary Moore will preview winter sports and we'll talk vaccines. Just before I had my flu shot today I was on a call with White House officials and other governors and here's what we heard. CDC director Dr. Walensky and Dr. Fauci both talked about the importance and effectiveness of boosters which we'll all talk about more today. They were asked about rising cases in the UK and Dr. Walensky encouraged the group not to look just at cases but to look at the low death rate in the UK pointing out that their rise in cases was a result of less severe cases and younger people who were less vaccinated. The CDC and administration are prepared to roll out vaccines for five to eleven year olds upon approval and will use a similar distribution plan for the adult rollout but are adding in more pediatricians for those parents that would prefer to go through their trusted doctor. Next as you know as of Friday booster shots have been approved for all three vaccines. If you've received your second Pfizer or Moderna shot more than six months ago you're eligible for a booster and if you got a J&J more than two months ago you're now eligible as well. As you heard us say we're being very liberal and broad on our interpretation of eligibility. We want as many people as possible to get their booster as it gives you the most protection. This is especially true if you're over 65. As we've seen this variant continues to impact older Vermonters more than we had hoped with studies showing of waning immunity for these populations so getting a booster is critical. Although Vermont has been a leader administering them demand hasn't nearly been as high as when we first rolled them out and that's something we need to change. So again please go and get your booster especially if you're over 65. It's free safe and easy and you can sign up with a pharmacy your primary care provider or visit healthvermont.gov slash my vaccine to make an appointment. Secretary Smith and Dr. Levine will go into more detail in a few minutes. As we discussed last week it's still up to all of us to help make sure we keep older and more vulnerable for monitors out of the hospital. That means making smart choices like wearing a mask in crowded indoor settings or getting tested before getting together with people you might be at higher you know might be at higher risk. Simple common sense approaches can make a big difference. As we transition from pandemic to endemic we need to manage this virus in our daily lives. To do so we can make simple proactive and protective decisions like getting tested before you visit your grandmother for a birthday party or taking a test before and after you go to a concert. This will be part of the future for quite some time. As a reminder Vermont does more testing than almost any other state. They're free and available. So take advantage of it because it too is part of our management strategy. I'll now turn it over to Commissioner Pechuk who is on the line. Thank you very much governor and thank you Jason and thank you governor and good afternoon everybody. So starting with the national picture and update as to where we stand today compared to last week. You'll see that across all of the major metrics infections hospitalizations and deaths that the U.S. continues to see improvement cases and hospitalizations that prove it continues to be pretty steady and significant fatality rate has slowed down a bit but with cases and hospitalizations improving certainly a good trend across the country. Also a good trend across the country that cases are improving in almost every region of the country which is a good sign in past waves we've seen outbreaks start regionally and then grow nationally or grow to other regions. But at the moment for the most part across the country cases have been receding in all regions. When you look at New England we see here on the next slide that cases are similarly seen slow improvement here improvements not as significant as other parts of the country. Of course our peak has not been as high as other parts of the country as well but you do see slow and steady improvement across New England over the last three or four weeks including this most recent week. When we go to the next slide we see that Vermont has also seen improvement in its case count down 15% over the last seven days down 7% over the last 14 days. So this certainly is a favorable sign but again remember that cases are elevated. This is coming down off of a high point of cases and also remember that at least twice during the Delta wave our cases have improved only to have those trends reverse. So it is certainly a good sign but certainly a note of caution there both of those points as well. Another item that is a favorable news in terms of this downturn in cases over the last seven days on the next slide you can see it's not an artifact of testing going down. In fact testing has been steady and increasing over the last week. That has driven our positivity rate down over the last seven days. So as we said a few weeks ago that is what you'd want to see is our testing staying steady or even increasing while our cases are falling it would give you a sense that it is a more of a reflection of where case growth is moving rather than a test anomaly or fluctuation. So that is certainly a favorable sign as well. When we look at the rates between those who are not fully vaccinated and those who are fully vaccinated we have a very similar story here. That difference is still 3.8 times greater and we see that fully vaccinated rates staying lower and actually decreasing this week while that not fully vaccinated rate has increased 9% over the last seven days. And again on new hospital admissions a very similar story. We see the same differentiation there 3.8 times difference so that not fully vaccinated rate is 3.8 times greater than the fully vaccinated rate. And similarly we see that not fully vaccinated rate increasing although slightly. And we see that fully vaccinated rate decreasing again albeit slightly but continuing to see those who are not fully vaccinated going to our hospitals and much greater frequency. Looking at the regions of Vermont we see some slight improvement in the Northeast Kingdom but the Northeast Kingdom continues to stand out much more significantly in terms of its recent case counts and its active cases compared to Southern Vermont, Chittenden County and Central Vermont. You can see pretty steady numbers of the last week in the other regions but again the Northeast Kingdom really stands out. When we look at the county by county map you can see that Orleans County had some improvement this week but the other parts of the kingdom are still high as is Orleans as well. On the next slide we did an analysis of you know what does the vaccinated versus not vaccinated rate look like in Orleans County. And we found a picture that looks similar to the statewide numbers in that there are many more people not fully vaccinated on a rate perspective getting the virus than those who are fully vaccinated. And that's been a consistent theme over the last three weeks. But in Orleans County that rate is greater. The statewide number was 3.8 times greater in Orleans County. It currently stands at 4.8 times greater. So a similar story but even more of a significant gap and difference there between those who are fully vaccinated and those who are not fully vaccinated. Going to the Vermont higher education update you can see that our numbers for fall of 2021 have been pretty steady. We have 65 new cases this week compared to 63 last week. But when you look at the semester as a whole we've had just under 400 cases for the fall semester of 2021. At this point during the spring semester of 2021 we had 671 cases. So cases are about 42 percent lower so far on campus and again really driven by that really high vaccination rate that we're seeing on all higher education campuses. Looking at our long term care facility update we see that we have 10 current active outbreaks. That's one additional outbreak from last week. But overall the case counts are stable if not decreasing with 150 total cases this week compared to 164 total cases last week. On the statewide hospitalization numbers you will see that in terms of those who are currently in the hospital that number has been going up over the last seven days. I will mention as we noted earlier that hospital admissions have come down over the last week which is a good sign. But the number of people in the hospital continue to be elevated over the last week. Again most of those people 73 percent are from those who are not vaccinated compared to those who are fully vaccinated. On the ICU side you can see that the numbers have been improving over the last few days but a very similar story in that 66 percent of them that are requiring critical care are coming from the population that's not fully vaccinated. Looking at our CDC model and this is a model for fatalities which obviously is a good indicator of where hospitalizations and cases are going as well. We still see a great degree of uncertainty that confidence interval is quite broad but for the first time in a while we are also seeing some indication that the modeling is anticipating fatalities and then of course hospitalizations and cases as a result to improve over the next few weeks. So again still great degree of uncertainty but there is some improvement in terms of some more you know belief that that the case numbers and the hospitalizations and the death numbers will start to subside here per the ensemble model. Turning over to vaccinations we can see that we continue to have a pretty good clip of people getting vaccinated on a daily basis given how many people in our state have already been vaccinated. We're up to 89.6 percent of our population that has received vaccination. Another about 2,300 people started vaccination this week so we certainly want to thank those people who have made the decision to come in and get vaccinated. We really need them and others to continue that push. For the first time this week we're also seeing a glimpse on the next slide of where the country stands in terms of booster doses and where states are sort of comparing to each other where they are ranking. You'll see when we look at the percent of the fully vaccinated population who is over 65 and what percent of them have a booster dose. Vermont is ranking second on that metric behind Colorado so again as the governor said this is certainly a good start but there is much more that we need to do in terms of spreading the word and getting people who are eligible and those who would like to getting their booster dose. Although we are second in the country you will see that that percentage is just about 27 percent of those who are fully vaccinated over 65. Now of course this is taken mostly Pfizer. Moderna and Johnson and Johnson just came online but there is a great deal of room there in terms of the number of people that still need to get their booster dose and then finally looking at the vaccine scorecard you'll see that on doses administered the percent of our population fully vaccinated and those over 65 Vermont continues to be number one in the country. We are near the top in terms of those who are have at least one dose those who are fully vaccinated per the eligible population and those who have started vaccination among the full back the full population. So with that I will now turn it over to Secretary Branch. Thank you Commissioner Pichett good afternoon. Last Thursday we released our revised contact tracing recommendations these new recommendations. We'll make the implementation of our test-to-stay testing program a lot easier and enable more students to stay in school. Our mitigation recommendations for schools included a recommendation that masks do not need to be required in a school where the student vaccination rate is 80 percent or greater. We had pushed back the implementation of this recommendation twice due to elevated case counts from the Delta variant. We have decided to push this date back again. The new date will be January 18th which is the first day of school after the Martin Luther King Day holiday. We are pushing this date back for two reasons. The first reason is we expect the emergency use authorization for vaccinations children ages five to 11 to come out at any time and we want to make good progress with vaccinating these children in the coming months. This vaccination effort not only will keep our kids safe but also be I think a game changer in terms of our operating elementary schools in particular and managing the cases at the younger grades. Now secondly we want to get through the holiday period utilizing our current mitigation recommendations. Holidays bring increased opportunities for gathering and traveling so we think it's prudent to wait on the implementation of a change in our masking recommendation until after the holiday period. Our districts continue to make good progress with implementing test-to-stay. We are now shipping antigen test kits the testing technology that's involved with test-to-stay to 19 supervisor unions and 12 independent schools throughout all regions of the state which means they they could be starting at any moment. As I noted previously families will hear directly from the schools when they're ready to start the testing and what the specifics of the test-to-stay will look like in their district so families should still be patient and wait for word from their schools as to when the program will start locally. As much as our state level teams have been working hard to design and implement this new program we've also been working simultaneously with individual districts to respond to their needs. We broadly call this kind of testing response testing since it's deployed in response to a specific situation or situations. I thought I would highlight several of the situations that have occurred in the last few weeks give you a sense of what the response testing looks like from a state perspective and when we've received requests specifically on test-to-stay from districts who reached out to us and said they'd rather implement that sooner rather than later. I mentioned last week Canaan. I thought I'd further describe their situation. Canaan had several cases and was having difficulty getting their PCR tests to the lab so we decided and this was in the early phases of designing the test-to-stay process we decided to try to deploy that to Canaan that worked very well. We worked directly with the school's nurse and the administration of the district to arrange Canaan to implementing test-to-stay on an emergency basis. We also stood up a PCR response testing for them including the use of lamp tests which I mentioned last week kind of similar to PCR but they're also able to be implemented on site as opposed to shipping kits out to the lab. Another situation I want to highlight was at Orleans Southwest Supervisor Union. They had a fairly high number of cases at the Hardwick Elementary School caused much of the school to be in quarantine. Within 48 hours we worked to arrange a PCR response testing event for them using EMS provider and staff and we also used our new response testing registration consent process to rapidly register the students and their families for this clinic. Recently we had Maple Run School District. Maple Runs in St. Albans. They had an evolving situation there where they had a high fairly high case count in the St. Albans Town School. The superintendent reached out to us and asked if we could deploy test-to-stay quickly for them. We were able to onboard them within a matter of hours since the process is now is fairly well refined and then yesterday we sent them a large number of antigen testing kits so they can begin implementing test-to-stay this week for their children. Again goal of keeping them in school as opposed to some of our testing other testing technologies. These response efforts occurred against the backdrop of our testing team continuing the important work of onboarding all of our districts and troubleshooting problems identifying resources, supports for the program. This morning the team was working on the disposal of the medical waste as a result of the testing and we worked out a solution in that area basically following up with each district to ask them if they wanted to manage that on their own. Some districts said they would prefer to manage the waste from the testing on their own but we also had the ability to deploy services under a state-level contract for those districts who need that support. But this is a fairly small group of individuals who've been doing this hard work across several state agencies and really I think it demonstrated the best efforts on the part of state employees to support our schools and our communities. I want to you know express my gratitude for them and their ability to not only help our schools get response testing going but also to provide that sort of direct assistance on a literally hourly by hourly basis to design specific solutions to our schools and our communities. Going forward schools will have a variety of testing tools at their disposal to respond to these kinds of situations in real time. I think that's what we're seeing the future of the testing technology evolve to. But we'll stand by ready to respond to situations as they come up into troubleshoot with schools and provide them direct support. That concludes my update. I'll now turn it over to Secretary Moore who will outline our recommendations for winter sports. Good afternoon. With school-based fall sports moving into play-downs and championship meets the attention of Vermont student athletes will soon shift to winter sports. And while the practices games and meets associated with school-based fall sports largely took place outside with the exception of volleyball winter sports will shift decidedly indoors. School-based winter sports typically offered here in Vermont include basketball, bowling, competitive cheer, dance, gymnastics, hockey, indoor track and wrestling as well as Nordic skiing, downhill skiing and snowboarding. And fully appreciating the important physical and mental health benefits school-based sports provide for student athletes. A guidance memo will be released by the Agency of Education later today recommending several mitigation measures to ensure student athletes are able to enjoy a full winter sports season. These include first asking all eligible student athletes to get vaccinated. Getting vaccinated not only protects the individual but the team and vaccinated individuals will not need to quarantine should an exposure occur. We saw several instances this fall where teams needed to forfeit one or more games while unvaccinated students completed a seven-day quarantine following an exposure. And while as Test to Stay becomes more widely available it will allow unvaccinated students to continue to participate in team-based practices during their quarantine. Athletes will still not be able to participate in interscholastic games, meets or competitions. Second, masks should be worn by all student athletes, coaching staff, referees and spectators during indoor practices, competitions and games regardless of individual vaccination status with limited exceptions. These exceptions are athletes participating in running events and athletes participating in events where inversion could cause masks to pose a safety hazard, things like wrestling, gymnastics, cheer and dance. As Secretary French noted during his remarks, the state's recommendations for in-school masking are being extended through mid-January. The recommendations for student athletes, coaching staff, referees and spectators to master indoor winter sports are currently anticipated to remain in place throughout the winter sports season. And finally, unvaccinated student athletes and any athlete participating in activities where masks cannot be consistently worn for safety reasons, such as wrestling or running, should participate in weekly testing. Spectators this year may be permitted at indoor winter sports games and competitions if the host school's policies permit them. Spectators are expected to observe all mitigation measures adopted by the school, including but not limited to those related to masking. Similar recommendations around vaccinations, masking, testing and spectators are being shared with recreational youth sports organizations offering indoor leagues and programs this winter. In closing, we know that sports have and continue to be such an important outlet for youth and adults throughout the pandemic. Personally, I'm excited to have the opportunity this winter to watch in person my younger child play high school hockey after having watched his games via live stream last year. And the best way to ensure that practices, games and competitions are able to take place without disruption over the months ahead is by observing these simple mitigation measures. Thank you and I'll turn it over to Secretary Smith. Thank you Secretary Moore. Good afternoon everyone. As you know, both the FDA and the CDC have approved boosters for all three vaccines available in the United States. That's Johnson and Johnson, Pfizer and Moderna. They've also approved mix and match boosters for those who want to switch vaccine types when they get their booster. People can already get mix and match boosters at pharmacies and their local health care providers and starting Monday November 1st you can sign up for mix and match at our state-run vaccination sites. As of this morning over 52,000 Vermonters have gotten either a booster or an additional dose which is what those with weakened immune system can get. 3,411 people currently have appointments for boosters at our state-run vaccination sites. This does not include people who have appointments at local pharmacies or with their primary care providers. We're recommending that anyone who is 18 years and older and who received a Moderna or Pfizer six months ago or longer get a booster. In the case of Johnson and Johnson, it only needs to be two months since their shot. But we are strongly encouraging that those 65 and older make it a priority to get a booster. To get a booster or get your initial vaccination, you can make an appointment at healthvermont.gov slash my vaccine or you can call 855-722-7878. This week we have more than 80 vaccination sites available across the state. We're also hoping that vaccines will soon be approved for and available for many children. Today an FDA advisory panel is meeting to consider approving the Pfizer vaccine for children ages 5 to 11. Next week the CDC will make a final determination for approval. We're finalizing the process to vaccinate children anticipating this approval. They will receive a smaller dose than what is being given to adults. We will have school-based clinics for this vaccination effort as well as at pharmacies, pediatricians office, and at other state-run sites. Now turning to our network of healthcare providers, I'd like to repeat something I said last week. We're investigating what's causing some of the some of Vermonters to experience long wait times for medical appointments. As part of that effort, our team is holding two public virtual listening sessions. The first one is tomorrow, Wednesday, October 27th from 5.30 p.m. to 7.30 p.m. The second session will be on Thursday, November 4th from 12 p.m. to 2 p.m. If you've experienced long wait times for medical services, please join us at one of these two sessions to tell your story. You can sign up online to participate at dfr.vermont.gov. I also want to provide an update on our efforts to make mental health beds available in the state. At the Brattleboro Retreat they recently closed 21 mental health beds due to staffing shortages caused by those employees losing their jobs for refusing to be vaccinated and a COVID outbreak. However the retreat is slowly increasing the number of staff beds over the next few weeks. We're also working with the VA hospital in White River Junction to see if they can provide some additional beds for adult mental health needs. This is a short-term solution to relieve some of the stress in our mental health system, particularly how it impacts hospital emergency departments. I can't say enough how supportive the leadership at the VA hospital has been in assisting the state. I really appreciate their professionalism and their assistance and much progress has been is being made to move subacute patients and hospitals to either long-term care or rehabilitation facilities. As I mentioned last week we offered financial assistance to staff up to 80 beds in this area. As of last night 44 beds are now online across three facilities with 18 emissions at this point. Now I'll quickly turn to vaccines. In Orleans County we've seen the rate of vaccination up take is much lower than in other parts of the state and new COVID cases are disproportionately occurring in that area. Orleans has the highest rate of any county in the state at 1,531 cases per 100,000. That is almost three times over the statewide average. I want to be clear this is not intended as finger pointing at any one part of our state rather it's a reflection of the data that we see roll in nightly. So we recently met with legislators, Dr. Levine and myself, met with legislators from Orleans County to discuss this and we will be focusing on this county to create more opportunities to get vaccines and boosters to the folks in that area. As Commissioner Picek said nearly 90% of eligible Vermonters have received at least one dose of the COVID vaccine and we are at 70.9% of the entire state population being fully vaccinated and remember some of the population can't be vaccinated. Even during the recent upsurge in cases Vermont still had one of the lowest positivity rates in the country. According to the CDC, Vermont is one of the states with the lowest positivity rate in the nation at lower than 3% and according to John Hopkins, Vermont is the 11th lowest in the country. Today's seven day average positivity rate is 2.6%. So let's work together, let's keep our friends and family safe and healthy and our state, the leader in the nation in our response to COVID-19. Get your vaccine and when it's time get your booster. Finally, Halloween is just around the corner please go out and enjoy it with your family but when you're out please follow the guidelines and common sense to protect yourself and your loved ones and take extra precaution if you're coming in contact with those who are vulnerable to COVID such as elderly family members. Dr. Levine will have more to say on this so now I'll turn it over to him for a health update. So we will soon need to be indoors even more on the cusp of the holiday season when everyone will be looking forward to gathering once again. As always this also unfortunately times with the start of flu season and we know COVID-19 spread is high right now which puts older Vermonters and those with medical conditions at higher risk of getting sick with the virus. But there is good news as we head into winter in Vermont. We can enjoy the season because we can still make a difference in the impact of illness to protect the most vulnerable and those who cannot yet be vaccinated. Not only do we have a vaccine that's highly protective against severe illness we have the experience of working together to slow the virus spread throughout the pandemic. What we all need to do right now simple familiar and very important. First get vaccinated including your children when they are eligible. Second get your booster shot. Third if you're sick stay home and get tested. Fourth wear a mask indoors and finally keep gatherings safe. And if you or a loved one do get sick and are at higher risk be sure to ask your healthcare provider about monoclonal antibody treatment as soon as you get your positive test result. The treatment works best in the first five days and can reduce the chance of being hospitalized by 70%. Now our high vaccination rates are still helping us do very well compared to the rest of the country seeing the lowest rate of hospitalizations and deaths. We were so effective and efficient as a state and reaching a high rate of vaccination that now summer monitors may be experiencing waning of their immunity. Not leading to serious outcomes but making it possible for them to get a milder infection or transmit the virus to others. And the last thing anybody wants is for themselves to be contagious especially to someone who may be at higher risk for a serious outcome like hospitalization or death. So if we can reduce spread even more it will keep us all safer. We have even more reason to be hopeful with boosters now available for all vaccines to give remoders the most protection possible against COVID-19. So again if it's been two months since your Johnson & Johnson vaccine or six months since your Pfizer or Moderna vaccine and your 18 or older we encourage you to get that booster shot and if you're confused or not certain that it's for you to speak with your health care provider. And as you've heard children ages five to 11 are expected to become eligible for the Pfizer vaccine in the coming weeks. We're actively planning clinics and working with pediatricians as we wait for federal regulators to review the data. If authorized the COVID-19 vaccine will help keep these young Vermonters safe and healthy. Protect those around them and help them live their lives without the disease or any future complications like long COVID syndrome. Having our children vaccinated will also help avoid interruptions to learning and the burden of being exposed to the virus. And because children can have such a high rate of asymptomatic illness this also helps protect the adults in our society especially older people in their world as well. Let me talk directly to parents and caregivers for a moment about this. I really want you to have complete confidence in the decision to get your child vaccinated. While I truly believe this is the right choice based upon the data I have seen to date and I say this as a doctor but also as a parent and grandparent I recognize this is a decision that's quite big for many and there's a lot of information out there both good and bad circulating. So I strongly encourage you to contact your child's pediatrician and ask any questions you might have. You will also find excellent information at healthvermont.gov slash COVID-19. This is all to say that we are still in this all together. The more we can remain united the better off we will be. Unfortunately I have heard from our COVID case investigators that some people are saying they will not follow health department guidance to isolate or quarantine. This concerns me for three reasons. One is the failure to follow these basic public health actions is a choice that can only keep community spread of the virus going potentially endangering people who are at risk. Two contact tracing is still considered a successful strategy to manage COVID-19 and the CDC has recently recently told us that we are one of the more successful states using that strategy. As much as we'd like it to be this pandemic is not over yet and we need Vermonters to help us provide information and follow guidance to keep others safe. And three our teams need to do their jobs. They are people they are sick of this pandemic too but they are dedicated so please just be kind. Finally to end on a cheerier note we are coming up on Halloween this weekend so let's get ready to celebrate safely. Now trick-or-treating of course is already outdoors so keep any other activities outside as much as you can whether they be campfires, costume parades, haunted hay rides, pumpkin carving, they're all great with an outdoor option. Keep groups small and help discourage large clusters of people. When inside be sure to wear a mask and not just your costume mask. Try to avoid crowded parties or other such gatherings. Both adults and children are at higher risk of getting and spreading the virus in these riskier situations. Contrary to public opinion you don't need to disinfect candy but do have kids wash their hands before eating any treats. And of course make sure you have flashlights and can be easily seen in the dark and have a happy Halloween. Thank you Dr. Levine. We'll now open it up to questions. Governor it's been almost a weekly question for you but I guess we'll ask it again if I don't somebody else will. Yesterday I'm sure you heard of the group that's saying you need to do more. You're going to reimpose the mask mandate, bring back the state of emergency. Is there anything that can be done beyond just weathering the storm we're going through until it gets better? Yeah I think we're doing everything that we should. I'm more hopeful today than I have been in weeks. We have the boosters that have been approved. They're coming online. People are getting more and more enthusiastic about the boosters. We're seeing the CDC and the FDA approving the pending approval of the 5 to 11 vaccines. And we're seeing our numbers start to decrease across the nation and here in Vermont. So the state of emergency is something that shouldn't be abused. I've said this before my message is no no different than it has been over the last few weeks. It shouldn't be overused and it should be used appropriately. Now there's a time and a place for a state of emergency and I can assure you this isn't it. And I believe that we'll get through this with all the measures all the mitigation measures we put into place and doing all the right things and taking some self-responsibility. If I thought that the state of emergency would be helpful in this case I'd impose it. But it would not be from my standpoint and the standpoint of our entire team. So again we'll we'll get through this and I believe that we're all working to overcome this and and I'm hopeful with the numbers we're seeing. Just to be clear then you still are presuming you're still encouraging encouraging mask usage but not requiring. That's right okay. Is this a route that just doesn't understand or how can they just fundamentally misunderstand the same set of facts that you do? It's probably a better question for them. I think you've been through all of our press briefings over the last year and a half. We've told you we've given you good news, we've given you bad news, we've always been honest with you about what we're facing. And when we see an opportunity to make things better we move forward with that. Again I just want to reiterate that imposing a state of emergency at this point in time would not be effective. I think the majority of Vermonters would agree that we've been through 18 months or more of this pandemic. We're learning how to mitigate it. We've taken we've made personal decisions on our own at this point in time with the guidance of this administration and our team. So again if I thought that this would help in any way we would impose it but I don't believe it would. Ask you to follow up. We've been getting some calls from viewers who say is the daily case known? We've had some big numbers in 300 and some things lately. Is that a meaningful measure or are you really more focused on hospitalization and death? I mean we have close to 90 percent 90 percent was first dose and then some who have recovered who have some natural immunity. I mean that's really high. So should we be worrying about cases anymore? Well again we're not going to be over COVID anytime soon. This is going to be with us for quite some time as we move from pandemic to endemic. So we we need to learn how to mitigate it ourselves. In the case counts aren't aren't a good measure of of where we're at. I think from the very beginning we said our primary mission was to protect the health care system by watching the hospitalizations and deaths. And we are a victim I think Dr. Levine had spoken about this in his remarks. We're you know we're a victim of our own success in some respects. We are one of the first the leaders and and Vermonters doing the right thing wanting to get vaccinated and we did we did so early. So to see us and we have no track record with this vaccine so we're learning as we go. So it appears the vaccine the efficacy of the vaccine is is waning and we were one of the first to get the vaccine through most of our population. So we're one of the first to see this wane as well and to see return of some some case numbers but we're not seeing the the number of people with severe illnesses that we did before. And again when you look at and a still when you look at the the number of cases I think it was this morning there was 82 percent of the of the cases today were amongst the unvaccinated. So this is still a pandemic of the unvaccinated and especially again when you look at the numbers you know we have almost 500,000 Vermonters who've been vaccinated. We now have of the eligible we now have less than 60,000 50 something thousand people who are unvaccinated. So when you when you take the percentage of of the people who were who were vaccinated or unvaccinated and see what their case numbers are you can see the vaccine is working and the boosters is just going to solidify that. So so again I would urge them whoever the naysayers are to look at the data and and to talk to Vermonters. I think Vermonters feel as though we're moving in the right direction. How closely will you be watching those booster numbers over the next month? I know Secretary Smith mentioned that a lot of the numbers that we have right now are just from the Pfizer booster. So how important do you view that over the next few months? I know as we sort of talk about people going inside more and the benefits of boosters do you have a target in mind? I know for the spring time it was the big 80 percent number. Is there anything like that you're sort of I haven't put a target number. Obviously we'd like we've said that we are going to interpret the eligibility of the booster in a broad and liberal way. So effectively anyone who wants a booster should should get it. And we are going to continue to promote that. We think this is part of the answer. Again we're learning as we go the efficacy of the the vaccine is waning so we need to step up and make sure that we utilize the booster that is at our disposal. So we'll continue to watch. We are we're going to try different approaches to advocate. It was we're seeing the clinics get busier now the first week, two weeks, three weeks was a little bit slow. It was slower than we had anticipated but they have picked up dramatically over the last last week. So you get your flu shot today. Do you have plans to get a booster anytime soon as well? I hope to get a booster this week. I had the J&J so I'm hoping to get the booster. I've got to decide which one. The good news is all three are effective and so you can't go wrong but I'm always looking to get the edge in any way I can. So I'm going to do my homework and determine what is the best for me. But but I'll do that this week. Regarding the lower vaccination rate up in the northeast kingdom you know Secretary Smith mentioned that you're trying to have outreach over the next few weeks to get the vaccination numbers up. I guess what will that outreach look like specifically and if they have taken the shot already why would they take it now? Yeah I mean again I'll let Secretary Smith answer that as well but we're hoping again we're not forcing anyone who would be vaccinated but I think we can make a case for why it's a good idea just based on the numbers and we want to make sure that those those who have been vaccinated get their boosters. And we haven't you know we haven't talked about this a lot but with the the increase in cases in that region there's going to be some natural immunity. I don't know the numbers but there will be some natural immunity. How long that lasts I don't know but I we think it would be safer for them to to get become vaccinated. Secretary Smith. Calvin we had some success in the northeast kingdom with barnstorming so I think you're going to see a lot more of the barnstorming over the next few weeks with mobile clinics rolling into Orleans County and talking about you know us starting the conversation Dr. Levine and myself starting the conversation with legislators but that's not where it stops. I think there's going to be continued conversations with Orleans County in terms of what they can do and then opening up the opportunities from town to town on a barnstorming event. Those barnstorming events were successful in Essex County. They were successful actually all over the state when we did them. We may return to those in Orleans County. I have a separate question for the governor. Maybe Secretary Moore could chime in on this too. I wanted to ask about global foundry's proposal to become their own utility. I guess I wonder if you could explain what is happening to that situation and if you can address concerns from some that the employer that that global foundries may not be held accountable in terms of meeting its carbon reduction goals. We're going to let Dr. Levine answer the the previous question then I'll get back to that. That's okay. I'll be quick. I'm 100% unconvinced that the people in Orleans County who have chosen to not be vaccinated will never be vaccinated. They are so skeptical and resistant because we know across the state there's a not a fair number of people that are not totally skeptical and resistant. They're just either apathetic about it or they're not really tuned in to putting that in their schedule. They're still waiting to see how other people do. There's a whole host of reasons and they explain why we went from 80% to let's call it 90% now since mid-June. That's not a huge amount of time and look how many people came aboard. So I'm convinced with barnstorming with other means of access and with further communication and public communication we can actually increase that number. The other thing I wanted to say on Devin's question was the people who have the most potential to have their immunity waned right now are those who initially got the vaccine way back in the beginning which are of course people who are in the over 65 age range people who have more serious medical conditions that have concerned them for why they might not have as good an outcome with COVID. People who are in higher risk occupations like working in long-term care facilities or health care facilities etc. So if we're going to be looking at some metrics Commissioner Pichek already showed you on one slide the over 65 rate. Those are ones we really want to focus on in this early part because they're the ones we're most concerned about. Far less concerned about a 25 year old who's completely healthy and may be ready for their booster and not so sure about it what have you they're going to do fine but I'm much more worried about the people who are much more high risk involved. Getting back to your questions about global foundries. Global foundries formally IBM is as I understand it the single largest user of energy electricity in Vermont. They use about 10 percent I believe of the energy that comes into Vermont. Them becoming their own utility is understandable with the amount of power and the expense surrounding that. So when we when they're comparing some of their entities located around the country in New York and the electricity prices they have to make decisions. So we want to give them a playing field that they can be competitive and we'll stay in Vermont but we do want them to be accountable for their carbon emissions. It's in the hands of the PUC Secretary Moore can add to this. Sure so part of the challenge comes in just the the construct of the way we're looking to achieve reductions. We talk about them in the aggregate we would like to be 26 percent below 2005 levels by 2025 40 percent below 1990 levels by 2030 and in the aggregate those targets make sense. The challenge at times is is downscaling them where there've been real changes in industry practices not only in global foundries industry but in industry writ large over that time and it may as you get a smaller piece of the pie that you're measuring against that aggregate baseline it gets complicated. Global foundries and previously IBM made significant changes in process to address ozone depleting substances over the last 30 years and that often involves substituting CFCs with HFCs. Good for the ozone layer not as great when it comes to their global warming potential and so part of the the question and the work that we're engaged in the Agency of Natural Resources is a party to the PUC proceeding that the governor described is is trying to figure out what that that right measure of progress is because those baselines don't necessarily make sense given some of the changes in their operation significant changes in their operation that occurred over that time period. For Secretary Moore or Dr. Levine the unvaccinated students who said that they if they are exposed to somebody with the virus they're supposed to quarantine but they can still practice can you explain the thinking on that if they're supposed to be isolated? So that would be true for schools that are administering a test to stay program the test to stay sort of benefits include being able to access educational instruction but also stay for school-based activities after school. It's limited to practices or after-school care or those those types of elements and is not intended to cover any inter-scholastic competition so it really is unvaccinated students that have been determined to be a close contact participating in a test to stay program can continue to practice with their team. Good afternoon. My question is for Dr. Levine. Could you please explain a little bit about the novel virus infected pneumonia and death and hospitalization rates in Vermont and how is it treated? Ed you might have to repeat that. It's breaking up a little bit. Okay I'm asking you about the pneumonia whether that's driving the death hospitalization rates in Vermont and how is it treated? So I think what you asked is about pneumonia from coronavirus and how is that driving hospitalization rates and deaths did I get it right? Good okay good so the natural history of a coronavirus infection in anyone often in the first few days to a week involves mostly their upper respiratory tract their nose and of course they'll get generalized symptoms perhaps of fevers or chills or achiness headache etc perhaps loss of smell that can evolve into damage to other organs and in this case we're talking specifically the lungs which developed pneumonia. Now if I may one of the reasons we keep telling people about vaccination and how effective it is is that transition from a simple cold like illness or flu like illness to pneumonia you are generally protected from by having had the vaccine. Your organs will do very well even if you do develop a cold. To get into a hospital because of COVID generally requires you to have a low oxygen level and to get an oxygen level low enough to qualify you most likely have involvement of your lungs so that can be a pneumonia that's related to the virus itself or it can be the inflammatory reaction the response of your body to having the coronavirus which causes your lungs to fill up with a lot of different kinds of fluids and inflammatory substances. Either way those obviously put you at much higher risk from the illness and so yes the answer to your question is it does drive hospitalizations and death if you evolve into having pneumonia from coronavirus. Is there any treatment? Yes so if you end up in the hospital you will generally have an antiviral drug and a steroid drug as well as possibly some other anti-inflammatory drugs so these are treatments there's not a specific antiviral drug for this virus specifically but there's one that has had some efficacy but again I want to overstress the fact that your weight into the hospital is much more enhanced if you don't get vaccinated. Those are you know that's 70 percent of who we're seeing in the hospital and in the ICU with pneumonia and lung problems from coronavirus. Joseph Gresser Barton Chronicle Barton Chronicle and move to Tim McQuiston from my business magazine. Hi Governor let me follow up on Stuart's question about whether we should be concerned about cases but looking at the workforce in general. Obviously there's been a lot of difficulty in childcare finding workers for child care parents have to stay home now with cases in schools kids might have to be quarantined at to stay home and you know thinking about Stuart's question is maybe why should we care if kids get COVID at all it's creating a lot of disruption for them it's you know obviously disrupting the economy. Cases and their symptoms are very low but there's a lot of efforts still going on still a lot of disruption I'm just wondering what your thoughts are on that. Well obviously cases lead to to spread and spread the disease to those who are more vulnerable than the youth so that's the main reason we want to keep the spread down to as limited a number as possible. Well and the point from Stuart's question is that you know especially the Delta variant and who it is affecting and who the the dangerous cases are going to it's not really younger people at all or people who receive the booster so it's do you see what I mean on the disruption on one place on one side versus you know who is who is at risk in the other. Dr. Levine. So if there's a case count on a given day of a hundred cases 15 maybe 20 of those cases will be under the age of 12 that leaves the majority of the cases still in the adults in the population so we have to be aware of that and as the governor said who are the people that those 15 to 20 come in contact with either because they know they're a case because they've been tested but oftentimes they can be asymptomatic and not even know they're a case so that's why you know that we still have to focus on that age range there are possibilities for kids in that age range to have a worse outcome though we have not seen that widely in the United States or in Vermont thank goodness but at the same time there's still evidence that some of the chronic things that can happen after COVID like long COVID can happen no matter what your age so again we need to still be aware of those cases because of their potential impact to themselves or to those who are more vulnerable around them does that get what you're asking uh generally yes thank you doctor I appreciate it thank you thank you governor. Michael Doherty Vermont Digger. Thank you I want to jump back to this call we heard from lawmakers yesterday asking for an indoor mandate mask mandate or some other statewide mitigation measures and one big difference from what we've heard from from them and from your administration is about public opinion these lawmakers were saying that they're getting hounded by constituents who are asking the state to take action here you and others in your office have said flat out that Vermonters would not accept or comply with any new measures and I'm curious just to how you're making that designation that determination what evidence do you have that there's not an appetite for new measures among a majority of Vermonters? Probably the same evidence that they're using public opinion people I'm coming in contact with I get around to a lot of different entities we have a constituent services as well we're just not seeing it not hearing it. I wanted to ask also Dr. Levine had mentioned that there are people who are telling case investigators that they were refusing to comply with quarantine guidance and some of the same critics critics that we were hearing from yesterday had suggested that you know previous rhetoric about personal responsibility you know individual decision making was connected to this overall level of non-compliance that that people are observing what's your response to that? I would say that there has been this non-compliance since the initial outbreak of the COVID cases I mean this has been prevalent you know a small minority but prevalent over the last 19 months so this isn't since I've spoken about personal responsibility which I very much believe that we have to take personal responsibility both individually collectively in terms of the mitigating this virus because it's here to stay for a while we can't go have a state of emergency and perpetuity and we can't abuse the state of emergency it could be overused I mean just think about the number of crisis crises that we have the number of challenges we have are we going to have am I going to declare a state of emergency when we have a housing shortage labor shortage climate change mitigation I mean is that what we want to do being a constant state of emergency we have to deal with these issues on a day-to-day basis and there is a time and a place as I said before there's a time and a place for a state of emergency and this is an it thank you Colin Flanders seven days hi um well I believe last week there was a slide in the presentation about the percentage of cases split between vaccinated and unvaccinated and I believe it was only for the month of July I was just curious do you have updated statistics or if not estimates of what the vaccinated versus unvaccinated breakdowns are as far as percentage of cases goes during the delta wave Mr. P check yeah thank you governor thank you Colin so you know on a daily basis Colin the you know the percentage of the rock count could be you know anywhere between 20 25 30 35 percent of the cases even 40 percent of the cases among those fully vaccinated meaning the rest are among the unvaccinated we usually show it in terms of the case rate because those two populations are very different the fully vaccinated population is more than twice as big as the not fully vaccinated population so through much of the delta wave the difference has been you know between three to four to five times greater among that not fully vaccinated case rate compared to the full vaccinated rate and we can we can certainly send you information or a slide on that gosh thank you guide page from our daily chronicle how many instances have there been of a vermonter having full-blown highly symptomatic COVID recovering and then at a later date redeveloping full-blown highly symptomatic COVID I have no idea official edine so what you're referring to is called reinfection someone who at one point in time has an infection well over three months go by and suddenly they present with a similar infection so let me tell you about the challenges of measuring at first because the way you accurately measure it is to know this the genetic sequence of the original virus and then the genetic sequence of what came next to see if it's the same virus or if it's a different genetic sequencing so we only have that data for the most recent part of the pandemic because states haven't been doing whole genome sequencing for more than several months like since the summertime so I don't have the precise number today but the last time we reported on this number and looked at it it was under 30 so under 30 cases and I think we're talking now 35,000 cases of COVID over time so very small number but again very difficult to get precise about it except most recently because of whole genome sequencing being available to us all now in this part of the pandemic so it is known that it can happen this phenomenon of reinfection but again at least during the current pandemic it doesn't appear to be that common in event are we talking about people who were really sick I mean not just you know quote-unquote tested positive but didn't have symptoms therefore maybe bringing into the testing but people who were really sick both times yeah I I don't think I'd have to qualify it with the word really sick I would just say symptomatic because I don't I don't have a handle on every case but the reason they got tested most likely was because they had symptoms on both occasions but hard to tell you they were really sick don't know that okay also I once again in the slides I don't see any updated fatality figures for October as I missed it and and I would like to ask you again for breakdown what those numbers are and for the fully backed non fully vaccinated and unvaccinated I did get that information last week from your staff I just wonder if you have it now yeah I don't have it and I don't know if Commissioner Pichek has it in front of him either but we can get that to you it's not going to change dramatically from the previous time and our debts for the month of October and our debts for the month of October are currently significantly below that of September but obviously we have another week to go in the month Michael Smith, V.T. Digger. Hey um some questions about the bed the additional beds at the VA hospital um these are mental health beds if I understand correctly how many beds are going to be added and then is that just for veterans with mental health needs there's just going to be like sort of a general catchall sort of bed situation for to help us stabilize. Secretary Smith thank you for the question the VA has 12 beds we have worked with them and the sort of agreement is whatever is available at that time so if there are some available beds we'll use those available beds I don't have a count on what's available right now today it is general population adult so and it's only for a very limited amount of time so you know within 30 days as we're working through this again we need to work through some things with the VA but I just I really want to just thank the VA for all their cooperation in what they've done here so are the beds online already or are they going to be online they're going to be online I think within the next 24 to 48 hours wonderful thank you yes thanks good afternoon for Dr. Levine circling back to Orleans County in search and cases aside from the unvaccinated are there any other commonalities to these cases such as age group or how the cases are being spread I don't have in back in my mind an age group distribution to give you there has been one recent outbreak associated with cases which accounted for about 40 cases but that's but a fraction of all of the cases that we've been seeing over these weeks in Orleans County one thing that we do know from the demographics of Vermont we are of course the three new england states in the northern part of New England the oldest states in the country and we vie for position number one amongst the three of us from month to month but the bottom line is I know that those counties in Vermont are also some of our older citizens and that's why we're especially eager for those who may be more vulnerable just by virtue of age to make sure that they understand vaccination and if they wish to access it have access to it okay in terms of the vaccination outreach you're planning up there I see by the dashboard that the lowest vaccination rates by age group in Orleans County is among the 12 to 18 year olds and it looks to be probably the biggest deviation for Orleans County from the statewide numbers what's your takeaway from that and what's the message that you're going to hope to deliver yeah well I think the message is going to be far more general not isolating out one age group versus another but I think what you recognize is important because we've actually had tremendous success across the state in getting that 12 to 18 year age group into the mid to upper 70% range for uptake of vaccine so that's really quite extraordinary already and is continuing to increase so I think we can call it out so to speak and emphasize it and especially now with what you've heard about sporting events in school and testing in school and what have you our efforts to keep students engaged in in-person education is really paramount so anything to that we can do to support that including vaccination of a susceptible population is certainly worth talking about so we will be messaging that and then quickly a last question somebody who received the Johnson Johnson vaccine last spring recently had a breakthrough infection uh is there a waiting period before they should seek out the booster shot yeah generally what we've been saying is once you've totally resolved your infection and are feeling well again you can get your next vaccination on Davis comes from i i think these questions are for secretary more more to follow up on the winter sports guidelines that you provided first question is just clarifying that these are recommendations just like your recommendations for vaccination and masking at schools but they're not mandated is that correct that is correct second follow up on that is so each school has the ability to decide whether or not it wants to post spectators or not some schools can say we're going to play the game but we don't want we don't want spectators that is correct okay so they have that jurisdiction uh lastly you've talked about the sports that are exempt from masks um and i know there are some dangers to get in common equipment uh or getting over somebody's eyes but i thought i heard you say the word in version yes and if you could elaborate on that sure just any sports that requires upside down movement so gymnastics tumbling that may be part of of competitive cheer or dance programs um as well as wrestling are all opportunities where a mask that could be properly worn at the beginning could accidentally slide over someone's eyes and impose a real safety hazard you don't see that the same thing with hockey given people getting checked no i i i don't think we had any particularized concerns expressed about hockey last season when athletes were playing mast okay thank you then also sorry one more the um and the unvaccinated athletes that are playing how often will they be required to be tested the recommendation is for weekly testing for weekly testing but that's up to the school to enforce correct correct all right that's it thanks very much thank you erin tanko vt digger i just have a question for secretary more um as well uh just to clarify unvaccinated students can still participate in interscholastic games as long as they're not currently under quarantine is that correct that that is correct as long as they've not been a close contact of someone with confirmed covid they they are able to participate fully with their team okay um you know the the guidance seems very similar to um the rules for all students last winter uh which you know strikes me um as a reminder of the department of health conclusion that um winter sports was responsible for numerous outbreaks you know cases among students who are not directly participating in sports a lot of law school days um you know particularly for schools with a lower percentage of vaccinated students how do you think this year will be any different well certainly at the high school level that that uh leads us back to the first and foremost recommendation that student athletes um become vaccinated and that is that is the the key difference i think between uh the current school year and and past school years um that said beyond that you're correct it's it is many of the the same mitigation measures tools in our toolbox but vaccinations really being an incredibly important addition well i mean this does also apply to you know schools that don't have very high percentages of vaccinated kids maybe even you know schools where the majority of the sports um you know participants are not able to be vaccinated at this point um and even if they are approved for it won't be fully vaccinated for another month and a half so are you concerned about those particular schools so the the vast majority of high school students should be age 12 or older and therefore able to to access vaccinations certainly there the younger athletes um in our our middle school and elementary school programs in particular um will need to to be cautious but we believe that this is a balanced approach um and and think that it will sort of take full advantage of the the emotional and health benefits that sports provides to many young people while at the same time being protective of current conditions on the ground okay thank you please saloon us the value reporter good afternoon this is probably a question for dr levy do you have any data on whether there have been any cases of covid covid hospitalizations and or deaths among the people who've received booster shots boy you know we've been giving booster shots for fizer for two weeks maybe so um can't really tell you i have any data on that at all yet um i do have just the usual data that we have on if people have been vaccinated or not having said that we are going to be looking at this issue of boosters but i think you're just a little too early in the game yet um and i hope the implication isn't that there's a potential danger from getting a booster that we would uncover very quickly because certainly none of the clinical trial data or experience worldwide has said anything about that i think my question was in part about the people who were able to have the five very specific immunocompromised conditions who were able to get boosters somewhat earlier than two weeks ago i thought they were getting that in okay at the end of august mid-september uh that sorry to uh have that uh confusion but you didn't pick up on our vocabulary lesson which was that those are now actually considered boosters those are considered third shots and people who'd already had the first two parts of their primary series so those are just a normal three-dose series for those people um that i don't know i don't know if we have much data on that so that's something for me to go do some homework on that is a very high risk population regardless so just to give you that caution they're getting that extra dose of their primary series because they're at such high risk and their ability to mount an immune response to the vaccine is less than those who have a less compromised immune system thank you very much i think um dr levine you can correct me if i'm wrong but we all have to keep in mind that even though you may receive the booster we have the fully vaccinated plus a booster doesn't mean that it's a hundred percent there still will be cases amongst those who have had the booster so we just have to prepare ourselves now that the likelihood of that are reduced dramatically with the booster but it's still there it's not a hundred percent correct and it will still protect against those serious outcomes and obviously we we get the vaccine in general and the booster specifically to again enable us to avoid the serious outcomes of getting into the hospital or of death chris roye newport daily express chris roye to chris mays rattle borough former hey thanks jason i'm all set for today but thanks thank you chris that's it all right thank you all very much and we'll see you again next tuesday