 Good morning everyone. Today we'll hear from Commissioner Pichuk for a weekly modeling update and then a health update from Dr. Levine. As you'll see across our nation and across our region and in Vermont we're still experiencing concerning trends sporadic case counts with hospitalizations and deaths on the rise. But even with vaccinations underway and the light at the end of the tunnel in sight it's more important than ever to follow public health guidance to protect the most vulnerable and our health care system in general. Every day we vaccinate more elderly Vermonters protecting those who are least likely to survive if they get COVID because they're more at risk. And I believe we have a moral obligation to take care of them first. That's why each of us must do our part to ensure as many of them as possible have the opportunity to be vaccinated. Now is not the time to let up on our work to slow the spread of the virus. The actions we take like wearing masks and avoiding gatherings will directly impact how many Vermonters we can save as vaccines make their way to these most vulnerable amongst us. As we've discussed in previous briefings this is why we're taking an age-based approach in the next phase of our vaccine rollout. Because as the data and science show the older you are the more vulnerable you are to severe risks and death from COVID. Saving lives must be our priority. It's why we sacrifice so much over these last 10 months. As we work to get shots in arms as quickly as possible we know having a clearly defined flexible easily understood and accessible vaccination plan is critical. With our based on age plan we'll see the number of deaths decrease even if the number of cases remain at the current rate. This will allow us to begin reopening the economy again and start making our way back to some sort of normalcy. But again now is not the time to let up and I'm hopeful Vermonters will understand why this strategy is so important and continue to do all we can to help. Switching gears as you might know when Congress finally passed another COVID relief package they also extended the paycheck protected protection program known as PPP and made it more flexible. Last spring in summer PPP was an important program that helped keep businesses open and Vermonters employed now Vermont lenders made over 12,000 loans many forgivable that total over $1.2 billion. The SBA has now opened initial applications for both first-time applicants and employers in need of a second loan. It can be found at SBA.gov. And just like the first time around the lending itself is being managed by banks and other lenders not the state or federal government. It's important to note as of today the SBA has launched the program only for specific lending institutions. So most employers won't be able to submit their applications just yet but we hope later this week the rest of the banks and lenders will go live. In the meantime it's important to be ready so fill out your applications now. We recommend that employers contact their bank or credit union to see if they're planning to participate in this round and start pulling together the needed financial information so you're ready to submit as soon as your institution starts accepting applications. Because remember these funds are first come first serve so be prepared. Tomorrow at three o'clock at 3 p.m. the agency of commerce community development will host a webinar to go over application details and also provide a demonstration on how to fill it out. You can get more information and find out how to join at accd.vermont.gov. And with that I'll turn it over to Mr. Petschek for this week's modeling presentation. Thank you very much governor and good morning everyone. The COVID-19 pandemic continues to intensify across our country breaking records on a near continuous basis. Today cases have never been higher in the United States with the country averaging close to a quarter million new cases on a daily basis. Hospitalizations continue to rise with more people being treated for COVID-19 than in any other previous time. And most regrettably U.S. deaths from COVID-19 continues at a tragic pace continuing to be one of the leading causes of death in our country and now averaging over 3,000 people dying from the virus every single day. Looking at our regional data we are unfortunately seeing some similar trends. This week the Northeast reported over 200,000 cases 17 percent rise in new cases compared to last week's total and also the single largest week of cases so far during the pandemic with many of the states around us seeing the impact from the holidays on their case counts. However we did see a considerable increase in regional testing this week as testing returned to a more normal pre-holiday level. Even with the increase in cases the considerable increase in testing did drive down the regional positivity rate although it is still above the 5 percent level recommended by the World Health Organization. Hospitalizations across the region are also high and trending higher. The seven-day average is higher than at any point during the recent surge with close to 13,000 individuals hospitalized across New England and New York. Here in Vermont we're also seeing cases increase yesterday passing the 9,000 case threshold since the start of the pandemic and this week we recorded 1166 new COVID-19 cases here in Vermont about 400 more cases than we did last week and a record number throughout the pandemic. To help put the recent case growth into perspective and also put the current risk into perspective imagine that over the last five days Vermont has reported more cases than it did for the entire months of May, June, July, August and September combined. We have also seen our case growth accelerate during a period that would suggest we are experiencing a holiday surge. Looking at the period following Christmas and comparing that to two previous holidays, Halloween where we did experience a surge in cases and Thanksgiving where we did not see a surge you'll see that that 10 to 17-day period following Christmas is tracking very closely to Halloween with the only major difference being that Christmas started at a higher level of cases. Turning now to what this all means for Vermont's forecast in the weeks ahead we are now forecasting a trajectory for cases that will continue to rise until early February possibly even approaching 300 cases a day on average but again as we have emphasized many times before and as the governor emphasized in his opening remarks the decisions that we all make today both large and small following the public health guidance and doing all of those things to protect ourselves and our families and our communities will help ensure that we beat this estimated forecast. Importantly we remain confident that even with the recent increase in cases and the projected growth in cases over the next few weeks that our hospitals will have the necessary resources to treat those who need care. First I want to show the type of sustained growth that might actually challenge our hospital capacity even though we're trending higher in cases averaging about 166 on a current day on average we would actually need to be averaging close to 380 cases a day over a 14-day period of time so not 380 cases in a single day we've never approached that number but 380 cases a day over a 14-day period to approach the level of ICU capacity here in Vermont. Again that's growth that's far beyond what we're experiencing today and it's beyond what we expect to experience if our forecasted trends continue. Again showing our hospital forecast we can see again with even that increase in case growth in higher cases forecasted were projected to remain within our current hospital capacity and although much of the information we discussed today might be encouraging to some I again want to remind Vermonters that your sacrifices continue to have a major impact when you measure our pandemic response across key indicators Vermont remains in the top three states in the country and when we look to the vaccine administration we continue to see that Vermont stands out on the pace it's administering vaccine. New data released yesterday by the CDC ranks Vermont first in the northeast tied with Connecticut on doses administered on a per capita basis and we're currently tied for sixth in the country. Given the sobering information that we talked about in today's presentation and also the great hope that the vaccine gives to end the pandemic it's critical that every Vermonter continues to step up and goes and gets the vaccine when it's your turn to do so and at this time I'll now turn it over to Dr. Levine. Thank you. I'll start with our case update this morning. While yesterday we reported 109 cases today we're reporting 167 cases and two additional deaths. Our positivity rate is at 2.7 percent and as you saw that is best in the nation. There are currently 51 people in the hospital 10 in the ICU. The range we're seeing in numbers of hospitalized patients continues to be higher recently but as Commissioner Peach Act just noted in his presentation we continue to remain within our capacity and we are monitoring the situation in our hospitals very closely. As I said last week we've seen our daily case counts show some effects from the holidays most notably post Christmas when more people were more likely to travel and gather with others. We saw this uptick in counts on days 8 to 14 after the holiday. We are still waiting for more data to determine whether New Year's Eve had any significant impact though we're just a few days shy of the 14 now. I had also mentioned that our contact tracing teams have identified several multifamily gatherings that had potential for further spread but so far we are still not finding evidence of significant outbreaks tied to the types of small gatherings that were allowed for the holidays. We see far more evidence of abundant isolated cases that have come from the community. We're currently investigating or monitoring 44 outbreaks and investigating or monitoring 344 situations 42 of which were added yesterday with the majority being in long-term care facilities that we have already been sharing with you and in non-healthcare work sites. We need to remember that when we don't see people who seem sick and we are going about our daily lives more people do have the virus in our communities right now and that means it can show up at workplaces schools health care facilities. I have oft quoted science that indicates that asymptomatic transition transmission can occur in up to 40 percent of cases. Well now some believe in our reporting that the true number may be as high as 50 percent that's half of the cases. So my words of wisdom to you are be careful be safe and be alert at all times. That's why everywhere we need to go we need to commit to looking for masks on faces six foot spaces uncrowded places. We still need to avoid travel and getting together with anyone that we don't live with. We should always monitor ourselves for symptoms literally take a moment and think how you're feeling and be sure to get tested after any gathering or possible exposure to someone who has COVID-19. Now none of this guidance I've just stated is new but it's even more essential as we keep an eye on developments around this new more transmissible variant of the virus the so-called B117 that has now been found in 10 states including Connecticut and New York. In looking nationwide we see a percent positivity average of almost 14 percent deaths that are up 19 percent in the past week and the seven day average for hospitalizations as up 6 percent. Many believe the variant is already circulating and we should expect to see it in Vermont. I've been one of those though we still do not have any confirmed cases of it here. Our state public health laboratory continues to work with the UVM laboratory on developing ways to more rapidly perform genome sequencing and be a little bit ahead of the CDC who are only randomly sampling some of our specimens. Current estimates are that this variant the so-called UK variant is 50 percent more transmissible than the current virus. It won't make you necessarily more sick but it may mean more people will get COVID-19 and need medical care and more of the population will need to be vaccinated further stressing this early stage of vaccinations. The other significant world variant the South African has yet to be seen in the United States. On the vaccine front our teams continue their hard work planning for the next phases of vaccination as they expand by age grouping and high risk conditions. We plan to have more details to share later this week on these and on how Vermonters can register for appointments when they are eligible. In addition to health department communications we'll work with partners such as healthcare practices, pharmacies, employers and local news media and depending upon the metric used as you saw on the slides just now Vermont remains among the top states in the country for the percentage of doses administered and we currently are almost at 25 doses administered for just the first dose plus an additional number of people have already received the second dose. This is all the more the reason why we need to keep taking all the same steps to protect ourselves from the virus and keep it from spreading as we wait for the vaccine to become available to more and more Vermonters. Now you've heard me say that we're watching hospitalizations very closely and you've heard me talk in the past about monoclonal antibody therapy as a means to prevent a subset of high risk outpatients from ever becoming hospitalized patients. The therapy has support from one major study but has not been widely endorsed as a standard of care due to a lack of full endorsement by some medical research and clinical organizations including the NIH and the Infectious Disease Society of America. The therapy also requires specialized infusion centers for patients who are COVID positive which is admittedly a heavy lift for some hospitals nonetheless about half of our Vermont hospitals have requested and already administered doses of monoclonal antibodies from our federal allocation. Perhaps others will gain interest at this delicate time in the pandemic when hospitals are admitting more COVID patients should they feel that the risk benefit ratio seems appropriate for the patient at hand. And along these same lines a small randomized double-plined placebo controlled trial in Argentina indicated that early plasma therapy may be of benefit in older patients with mild COVID disease. This is so-called convalescent plasma presumably rich in antibodies against COVID-19. This plasma during the early stage of the pandemic led to a significant reduction in the rate of development of severe respiratory symptoms in those who were treated. There were no significant adverse effects of the therapy. The researchers concluded that high-titer convalescent plasma can reduce progression of COVID-19 in older adults with mild illness if administered within 72 hours of symptom onset. We'll see how much impact this has on practice in the U.S. I mentioned these treatments to let you know that there are still advances being made in the treatment of COVID-19. Treatments that can still have a significant impact not only on hospitalizations but on real people while we wait for the slow process of vaccinating on a large population level in a time of scarce vaccine. I'll turn it back to the governor now. But that will open up to questions. All right we'll start in the room with Calvin. Thank you governor. The FBI state and local police as you know are tracking potentially armed protests in all 50 states including here in Vermont. I guess first off are you concerned about this and what is your message to Vermonters that may want to attend this weekend? Well first of all I'm concerned obviously about the safety of Vermonters every single day and this potential gathering of this protest that is being planned is something that has our attention. I've been briefed on it. I'll have Commissioner Sherling provide some remarks on this as well. My message to Vermonters who want to participate obviously it's your right, First Amendment right to gather and protest and make your feelings known. But I would say don't be plagued. Don't be used as a pawn by some of these extreme groups that are planning these protests throughout our nation to undermine our democracy to overthrow the government and they're using some of those who have strong feelings but not the strength of those who are planning these uprisings. They're using them as pawns. They use them in Washington and they'll use them in the next few days. So I would just ask them to be aware of their surrounding and don't be used. Commissioner. Thank you governor. I think the governor hit the high points. We're in close coordination with federal state and local authorities to plan for any eventuality. At this point there are no specific indications of disruptions anticipated in Vermont. But as the governor said, there are those who clearly demonstrated last week their intent on an insurrection and we don't want as Vermonters to fall into a trap of coming and inadvertently supporting that. So while we don't script where and when folks should exercise their First Amendment rights, we would ask that people think twice about whether these two days that have been identified the 17th and the 20th are the right times to do that and maybe rethink exercising those rights at a different time. Governor, have state leaders on a frequent basis received threats? In recent weeks leading up to now, have you received more threats than you do? We don't typically comment on threats that I receive, albeit there are threats that commit, but we don't comment on that. And then the last question, having to do with the vaccine, you know, as you mentioned, you were still on track to vaccinate group 1A by the end of the month. What concrete or I guess how exactly will the next group of people, the 75 plus, how will they know? What will that outreach look like when it's their turn? Yeah, we'll be able to present that plan to you. I believe we're going to do it on Friday. I made ask Secretary Smith if that's correct. Are you planning to unveil that plan on Friday, Secretary Smith? Yes, Governor, on Friday we'll do the outlines of the plan for the next phase in terms of 75 plus. Yeah, it'll be fairly simple though, Calvin. I mean, in terms of the age banding, that's what makes it so unique in some ways that anyone 75 and over will be able to receive the vaccine and it'll be on a number of different platforms. And that's what Secretary Smith will lay out on Friday. All right, we're going to move to Steve, but just a note that there are 24 folks in the queue, so please keep your questions below. Mine actually will be quick. I think it probably is for the doctor, but have we seen any adverse reactions to in the state so far to the virus itself or to the virus, to the vaccine itself? So yes, I've heard of several people who have to be transported to an emergency room. I don't know the details of those, but the answer is yes. Seriousness of those? Not a very small number compared to over 25,000 doses. Right. Treatment would that be or? Not aware of the details. Okay. Very good, thanks. But that is the reason we have a 15-minute observation period and 30-minute observation period for anyone who's had a history of anaphylaxis. Hi, morning, everybody. Dr. Levine, I've asked variations on this question before, but I'm curious now that people are starting to be vaccinated, especially in the long-term care facilities, are you starting to see a tailing off of cases in those long-term care facilities that would indicate the vaccines are actually working? So the simple answer to that would be that it's too soon to see that happen. Because even after a dose is administered, it's going to be a 7, 10-day or plus period to build up the immune response to that first dose. So if we look, we're in the second week of January now, and a lot of this happened late December, and it was continuing through January. So it's a little soon for that to have an impact. It's also why we don't state that vaccination is a remedy to an outbreak in a facility. Once it outbreaks occurred, there's a lot of transmission that can be asymptomatic that occurs. And though it would seem to make sense that vaccinating everybody quickly would help, the problem is the body's immune system doesn't understand that and still takes time. So it's usually not a great response to an outbreak. I can say, though, that when you look at our table of outbreaks, you're not seeing significant growth in many of the facilities. Many of the facilities are on there because we follow them for two incubation periods after their last case, and that means 28 days, which is a long time period. But you're not seeing a tremendous amount of growth in most of the outbreaks that we've had recorded previously. So that happened, I have to say, a little ahead of the vaccine, as well as while we've been vaccinating. So that's favorable news. And if we can prevent new facilities from becoming added to that list, because of the haste with which we're trying to address all of the long term cares, the skilled nursing facilities, the assisted living and the residential care, then that will have been a great success. So if this is, you know, and hoping it will be successful, wouldn't you expect within, I don't know, how long it would be, but those cases in the long term care facilities would drop down to, I don't know, almost zero? How long do you think that should take? Yeah, eventually. But again, knowing that you get your first dose, you build up a certain immune response, three weeks later for the Pfizer vaccine, you get your second dose, and then you need to build up the immune response to that. We're talking still six, eight weeks after your very first dose. So that would be, you know, through the month of February and later. But yeah, I like your optimistic tone. And we should keep with that with regards to what we're doing here. Well, I'm seeing, looking for some data to back up the optimistic tone. Thank you very much. We've seen reports out of other states that some vaccine doses had to be tossed because they couldn't get them into people's arms fast enough. Has Vermont had to discard any vaccine? I'm not aware of any that we've had to discard. Dr. Levine? Yeah, I don't have a firm piece of data on that, but I'm not aware of any. And in fact, you know, we have weekly and several times a week discussions with our hospital systems. And they make every effort at the end of a day. If there's vaccine left over, they literally will run the vaccine up to one of the floors in the hospital from their clinic and say, who hasn't been vaccinated yet? We've still got some doses left over. So all efforts are being made to use those doses. And you're right, we should have literally no doses being thrown away because of lack of use or spoilage because they exceeded their time out of the free the frozen state. But I'm not aware of hardly anything in that category. That's good to hear. I was running some numbers last night off the CDC website it appears that we're about 48% or so of our distributed vaccines actually making it into people's arms. And last week we were at about 58%. What is the reason for the drop in the percent of it back vaccines administered? Not sure I can give you a reason. Unless Secretary Smith has one that he's aware of. Because what we've done with the long term cares is accelerated the rate with which they're getting vaccines into arms. Unfortunately, we can't always accelerate the rate of reporting. And they are, you know, with their contract with the federal partners can have up to 72 hours to report those doses. So some of it may be a lag in reporting. Otherwise, I know that when they are administered by the healthcare facilities, the report is within 24 hours for short. So I can't give you an explanation, though fortunately, as you saw in the data, we're still one of the leading states. Sorry, did I cut you off? No. No, one thing you'll see as we make a transition from the 1A category to our next phase with the oldest Vermonters is that we will certainly not allow appointments to be left empty at the end of 1A and just wait to do 1B when 1A is completely done. There will be a overlap period where the finishing up of 1A is occurring while the initiation of 1B is occurring, because clearly we don't want to hold on to vaccine that comes into the state and not utilize it quickly. All right. Thank you. First, maybe just so we can get an update on our request that we made to the health department more than a week ago to get specific statistical reports like we've gotten in the past about where the outbreaks are and how many. Is there any, that report going to be forthcoming? Can you give us an update on that? Yes, I'm aware that the same process has to be gone through each time you get a report, but you're getting the reports. Well, we haven't gotten any, we didn't get any last week, we haven't gotten any this week, so I'm just wondering. You will be getting the reports. Any idea on the timeframe on that? I don't have that awareness at this time. No. Okay. So for today, we continue to get reports of Vermonters unable to get tested easily. Got another email yesterday of somebody from the reader in the islands that noted a close friend was working alongside a man that tested positive over the weekend, and the reader tried unsuccessfully to get tested. He was with a friend for three days, so she thought due to her age and situation and whatever, she called the health center to get tested and was told that because she did not have obvious symptoms on Monday, she could not have a test. She did have a sore throat, I guess over the weekend, but was better on Monday. She was told she could wait online, go online and wait two or three days for an appointment, and she just says, quote, just want you to know that it's not as easy as they make it sound to get tested. Is there any help for these kind of people? Yeah, absolutely. I'm not, you said she called the health center, so I'm interpreting that as a clinical setting. All right. Which is fine. And they probably said what they needed to say, which is they weren't going to order a test for her because she didn't have symptoms because that's what they would normally do. But that's only one phone call she made. We would much rather she had either gone on our website or made the phone call to the health department where there's a complete listing of all the facilities available to her in her catchment area, we'll call it, that she could travel to, and she could actually register for ahead of time and have an appointment. They would also tell her what day might be the most useful day for her because, depending on when her exposure was, it's not necessarily that same day or the next day later that would optimize her getting a test. It might be a number of days later after she's had a chance to incubate if she was going to be infected and then test positive before her symptoms developed. So all of that could have happened and is happening for thousands of her monitors every day. So I wouldn't want her unfortunate experience to be the model for what people think happens because since we've really launched all of the sites around the state, we've heard really very good feedback and been very receptive to the needs of her monitors to go to a test setting as an asymptomatic person, get the test done and get a result back within a 48 hour period. Okay, can I, I only got one question in that was no there was a follow-up, it was a follow-up from not reporting. That's a question. I had a quick question for Secretary Curley. There are 19 people left in the queue, so please if you have a question. I'll be quick. Yep, Bingo is Secretary Curley, I assume Bingo is starting apparently this week locally and ice fishing derbies are starting. What rules do you have for these kind of gatherings for these kinds of events? Those are great questions. We have a variety of guidance on our website. I'd be happy to try to walk through just with both. Bingos are a really tough one. Clubs are closed right now, so depending on what the environment is, we would be very concerned about people being properly faced. So big concern there, the ice fishing again, a little bit more comfortable outdoors and Dr. Levine's probably speak better to that, but as well, you know, we don't necessarily have something on Bingo and something on ice fishing, but the guidance can pertain to them, so happy to help if there's folks that are thinking about starting up an area. There should be no tournament, no competition, so that will create another hurdle for folks to think about when they're planning whatever they're... I don't want to call it an event because it makes me a little bit concerned, but I'm happy to help. Thank you very much. Joe, the Barton Chronicle. I believe this question is for Dr. Levine. There are two vaccines that are currently have an emergency approval and presumably more on the way. Is there a difference between them that affects who should be getting vaccines, a particular vaccine, and a mechanism to make sure that people are matched, the correct vaccine in that case? What were the last few words you said? People are... That people are... If there's a difference in who should get which vaccines, if they're matched accordingly. Yeah, so the two vaccines that are available are, of course, the Pfizer and the Moderna, and these two vaccines are very similar in terms of the technology that went into them. There's really not been any major differentiation of which vaccine might be preferable for one audience or another. The only difference is a two-year age gap where one is licensed for 16 and above, the other is for 18 and above. But if we ignore that minor difference, there's really no one that is best for one setting versus another setting. We've chosen to use the Pfizer and the long-term care settings due to the fact that the pharmacies were very well equipped with the appropriate freezer and the temperature that vaccine required. It is important, we still believe, and this has not been proven to be otherwise yet, so this is still what everyone should hear, that if you got dose one of Pfizer, you get dose two of Pfizer. If you got dose one of Moderna, you get dose two of Moderna, and there's no crossover. And then finally, potentially at the end of this month or into February, we may hear about one or two other vaccines that you had put in front of the FDA's advisory committee for potential emergency use authorization. But I don't want to over promise anything that's out of my control, but we're hearing late January, early February, potentially for another vaccine. I've also heard that there's a possibility that the new administration will be releasing much larger quantities of vaccines to the state. Will that present a problem to Vermont in making sure that they're used properly? That's a problem we'd love to have. It was just announced this morning that they may not withhold the second dose anymore, but send it all initially. We don't really have any real details on anything except that one line, so I can't say much more. We still believe that people who get a first dose should get the second dose at the right time, so it'll change the bookkeeping into what we do as opposed to what the federal government's doing. But if we got larger allocations, we would be delighted because the plans we have that you'll hear about later this week involve a variety of potential places for people to get their vaccine, some very large community vaccination sites, and in order to do justice across the state and to all of the different settings, you need enough vaccine to distribute. So I'll just say bring it on. Thank you. Thank you. Just a little deeper into the logistics of distribution, obviously it's easy to distribute to a hospital or a nursing home or home care facility. When it comes to seniors who are at home and they're affiliated, for example, with the home health care agency, are they going to get the vaccine through home health care? If a person is, say, 60 years old and they have some serious pre-existing conditions, how would they know when they're eligible when you talk about 75 age group plus? Is their family doctor's office going to notify them they're eligible? Can you just give you a little more on the logistics of how people are going to know and have access to the vaccine? Yeah, Ed, you're about three days too early. We'll have those details on Friday. So Secretary Smith will be going into some of those details. Hopefully flush this out a little bit more so that it becomes clear for those who are interested in when they might be able to get their vaccination. So wait till Friday. Okay, I'll have to check back in then. All right. Thank you. Thank you. Hi, Lillian, could you quickly clarify what you mean by changing your keeping in Vermont? Are you saying that even if they release all these vaccine doses at once, intended to vaccinate more people with a first dose, Vermont would just continue on with the first dose, second dose strategy? I think what Dr. Levine had said that the CDC and the Biden administration had come out with new details about what they were going to do, but we haven't received all those details, just the headlines. The headlines aren't always exactly what happens. Okay, but in general, does Vermont believe that they should kind of keep with the philosophy of making sure everyone gets the second dose, you know, in the regularly scheduled time? Again, I'll let Dr. Levine answer from my perspective. We had committed to Vermonters that we're going to have a second dose ready for them at 21 or 28 days. And I believe we should follow through on that promise and the strategy that we rolled out to begin with. So we don't know what flexibility we'll have, but hopefully we'll have the flexibility to do what we think is right. I think giving the second dose is what would be the right path forward. And I'll go on record as agreeing with that. I don't have much more to say about it. The fact of the matter is it follows the science. If we're going to believe in the efficacy of the vaccine, we should use it the way it was used in the studies that we're using to use it in the first place and not be experimenting on the state of Vermont's population. Okay. Also, so contact tracing seems to show that family gatherings aren't responsible for the latest surge. Scott, do you think that your listing of the band had any part of the latest case numbers? Do you have any theories as to why this surge is happening now when it didn't really happen after Thanksgiving? Well, obviously, there were more people getting together. We had, I think Dr. Levine had said earlier that we are seeing some multiple family gatherings that have been part of the concern. And we've contact traced this to some of those, but the single family gatherings with one other trusted family hasn't, we haven't seen any connection there. So obviously more people are getting together at Christmas and New Years than they were during Thanksgiving. Okay, now I understand. So what you're saying is, you know, two family childhood gatherings like you allowed for were not responsible. It's more that there were families that defied even those restrictions and had more people. That's, that's what we're finding. We haven't been able to contact trace back to any that I know of, of one other trusted family. But there is more community spread, as Dr. Levine has said. Dr. Levine. Yeah, in addition to all of what the governor just said, we did have a modest outbreak in the Bennington area we've talked about before that seems to have run its course, I would think, certainly not adding tremendous cases there. And we did have the Addison County Church Services. That outbreak is still growing. The number is close to 100 now that are affected by that outbreak. So we have a few that we can actually say occurred related to people gathering during the holiday period. But we don't have abundant data to say that there were a lot of people going outside the bounds of the guidance that was provided during the holidays. As Commissioner Pichek stated, as Commissioner Pichek's data showed us on the slide, we are we began Christmas at a higher baseline level, much different than Halloween when we were just coming out of the summer and early fall and the level of the state was much lower compared to where it was right before the Christmas holiday. Okay, thank you very much. Hi there. Just to follow up on the vaccination, the federal policy on vaccination questions. Do these forthcoming recommendations on just vaccinating everyone who's over the age of 65, change anything or might they change anything about how the state is going to approach this age banding plan? At this point, we want to continue with our approach, 75 and over. We'll get more details. Dr. Levine said that this was just released this morning. So we don't have all the details from the CDC at this point, but it's our hope that we'll continue to do the age banding from 75 and over, starting I believe sometime next week. But we'll go into more details on Friday. And does it change to not holding back those extra doses, give the state more flexibility to kind of speed up the process? And is it possible that we would reach future phases faster? No, you know, and again, I'll let Dr. Levine answer this, but these the vaccines were implemented with two doses to get the highest effective rate. So if we disregard that, the science doesn't tell us that it'd be all that effective. And we don't know how effective it would be, actually, because I don't think they did any testing on that and did any research on what a single dose would do. So that's why we would like to, if we're able to, continue to advocate for everyone that is within the time frame to get their second dose, because it'll be more effective at that point. So Dr. Levine, anything more? I guess I'm just curious about whether the sort of state versus federal managing of those logistics will change, sort of how fast the state is able to administer. Yeah, no, we obviously, as the governor alluded to, we just don't have any of the fine details. All we have is a headline at this point in time for both more doses coming in and the government not withholding the second dose early on and for the over 65. Keep in mind, though, from last week's slides where we showed you the case fatality rate by age, and it's still true that if you're over 75, your case fatality rate is significantly higher than if you're 65. So again, the goal for everyone, whether it's one set of guidance or another, is to save lives and do that as quickly as possible. So we have a method of doing that that will outline for you on Friday. It's not any different than what the government is saying. The government is just saying basically, make sure you get older people done as a priority because we want to save lives. And we have a methodical way of approaching that. And do you know anything about next week's shipment volume yet, and whether you'll be getting the expected amount of doses or whether that will change? Yeah, we usually don't at this time, but I'm going to ask Secretary Smith if he has any awareness that I don't have yet. No, Dr. Levine, I don't. We usually don't have it until about midweek. An insight into what's coming in next week. Thank you. Again, having said all that, if they start ramping up and giving us the more supply, first of all, we'll have enough for the second dose for those folks there within the 21-day period or the 28-day period. So it might be a natural type of evolution to the second dose. So we'll have to just wait and see what they're planning, but hopefully we'll receive a much larger supply in the future and it'll continue to grow so that we can put more shots in our arms. That's our goal. We'll be able to ramp up for it as well with a plan we're putting into place on Friday. It's easily, we're easily able to ramp up from there. So I'd like to ask Secretary Smith and Secretary French about their responses to January 8th release from the Vermont NEA that questions like ski controllers engaged in a, quote, leisure activity, unquote, we're getting vaccines before teachers. I'll take that first because I answered the question from you last time, Lisa. I said if those were medical personnel that were, fell under the category of EMS or first responders, then they were, they could get vaccinated. What has, I thought it got a little bit twisted because if those people are going to get vaccinated anyway because of their qualifications and as the fact that they are providing medical services. So I answered it the way that I think it should have been answered and I thought it was, I think it's appropriate that these are medical personnel that are providing medical services and have certifications to prove that they are medical personnel and they are entitled to the vaccine. Thank you, Secretary Smith. To be clear, the words leisure, engaged in a leisure activity were not mine. They came from the Vermont NEA. Secretary French. Yeah, I would just back on that that as first responders, obviously, they're like more likely to encounter individuals who might be contagious. So in that perspective, it makes sense to me in terms of their certifications. Thank you very much, Lisa. Lisa was a bit misleading the statement in some respects because these, some of these ski patrol are EMS first, you know, and they might perform other duties on the weekends and so forth, but they go through other training. They are already, their other jobs might entail being on the the emergency transport or first responders in their own communities. So it's just unfortunate that it was characterized in that way. Did anyone at the state level respond to the Vermont NEA in its January 9th release? I didn't see that, Lisa, but I'll ask Secretary French or Secretary Smith if they responded or know of anybody who did or whether it was a question. Maybe it was just a statement. Governors, Secretary French, we did not respond to it. The agency of education did not respond. And Governor neither did I. Okay. Thank you all very much. I appreciate it. Tim, Vermont Business Magazine. Governor is going to ask an exciting financial question, but let me follow up on what Lisa was saying. You know, at the end of last week and that Friday's press conference, there's a lot of questions related to who's going to be in the second group. And I know you're going to release this information on Friday in more detail, but there's a lot of lobbying going on and a lot of questions and reasonable questions about if someone has underlying health conditions. And so it's not just the teachers. It's other other groups or other people who might think they are reasonably able. And I'm wondering what you would say to these other people in these other groups who think they should be in the second wave and how it, like Mike Smith, was also asked about people with underlying health conditions and about firefighters, et cetera, et cetera. And what do you say to people who want to jump into that group? The underlying conditions, we are going to be able to describe who would be in that grouping. There will be some with underlying conditions that will be in phase two, along with the 75 and over. I would just point back to the data. The data tells us who's most vulnerable, who's at risk of dying if they get COVID. And those over 75 are at much greater risk of dying from COVID than those over 70. Those over 70 are much higher risk than those over 65. And those over 65 are at much higher risk than those under 50, let's say. So, you know, if we want, we can make an argument, I think, for almost anyone. Everyone is essential in some manner throughout Vermont and the careers, the jobs they have on a daily basis. But we know who is susceptible to dying. And that's our goal right here, is just to make sure that we prevent as many deaths as possible as we get through this. If we have more of the vaccine, we will get them in the arms of everyone. If we had enough, we would line people up and make sure that they had vaccinations, but we don't. We have a limited supply, so we have to prioritize. And I would say those at risk of dying come first. We have a moral obligation to take care of them, like they took care of us. Thank you. Yep. Sorry about that. This question, I think, is for Commissioner Schirling. While there hasn't been any that you've made aware, any possible arm demonstrations at the State House, if there are any, how do you go about protecting and making sure people have the right to protest, but also make sure that everyone is safe, especially if the calls are for a possible arm protest? Thanks for the question. I think all you have to do, assuming nothing like last Wednesday happens, is to look back on how Vermont has handled these in the past. It's not uncommon or unheard of to have protests that relate to Second Amendment rights where people are armed, other types of protests where people are armed but are peaceful. And there is a well-established playbook for how to handle that in terms of responding specifically to how we'll handle any eventuality, both this weekend and beyond. That's not something that we're in a position to discuss the details of for obvious reasons. Okay. And another question I had is, we're hearing reports that gun sales are up in the States. And I believe you said yesterday that you heard about a possible Second Amendment rally on Sunday. Do you have any concerns about the increase in gun sales in the state and the possible the rally that could happen? No specific concerns relative to gun sales. As I mentioned yesterday on a media call, that's not uncommon with a change of administration in Washington. That's a typical uptick that happens. Although I am not familiar with specific statistics around gun sales in Vermont, if they do exist, this is not information that I have at this point. The sale of weapons, possession of weapons is something that has a long history in Vermont. And, you know, sportsmen have long demonstrated responsible gun ownership. It's when you see guns used for nefarious purposes and crime that we get concerned. So it's how they're used less, the fact that they were sold. Great. And then, any, either for you, Commissioner Furling or Governor Scott, are you aware of the National Guard been called to Washington DC at all ahead of inauguration next week at all? No. The answer, Vermont National Guard, no. Thank you. Thanks, the county courier. Thanks, Rebecca. Good afternoon, Governor. I understand that the legislature is not funded requests for right year in body cameras for Capitol Police in Vermont. With the recent insurrection, do you think that this policy needs to be changed? You know, we're reviewing body cameras and we'll be presenting our budget next week or the week after. And, you know, we're contemplating, we'd like to see body cams on all law enforcement in Vermont. As far as riot gear, I'm not sure that there's a need for riot gear with the Capitol Police. Okay. And just a quick follow up. In recent weeks, you've been pretty outspoken about this not being the time to increase revenues in Vermont. Are you committed, as you were in your first term in office, not to increase taxes and fees, at least during the recession or maybe even during the pandemic? I just want to clarify, I'm all for raising revenue, just not by increasing taxes. I'd like to grow it organically with economic growth, so we have more revenue. And I believe that we can do that. We had started down this path before a pre-pandemic. We were in a fairly good position. In fact, probably the best position we've been in in decades. So it's just this pandemic that has caused us some economic harm. Thankfully, the federal government, Congress, Senator Leahy, Senator Sanders, Congress and Welch have been able to assist us in obtaining more resources so that we can backfill some of the impending needs that we have. This latest package is going to be advantageous to Vermont. I believe we can get through this without increasing any taxes. So I'm just as committed as I was the first year to that will be the last resort. We should not, what we need is more taxpayers, not more taxes. I'm just as committed today as I was four years ago. Thank you, Governor. Have a great afternoon. Thank you. Stuart, NBC 5. Good afternoon. Governor, you've called for the president's resignation or removal. Do you support impeachment? Yeah, I stand by what I said. I believe the president should be held accountable for this insurrection. I believe he had a hand in it. And I think we just have to look back through history as to why you have to follow the through. This isn't obviously, this isn't something that we should be condoning undermining our democracy. And I believe that, again, he was had a hand in this, if not a major role in this insurrection. And if I could ask whether any of the situations that Dr. Levine described are yet associated with the bus trip to Washington last Wednesday. I don't believe that we've contacted Chris anything back to the bus trip last week. All right, thank you. Governor, more than 40 senators and US senators, including Senator Leahy and Senator Sanders, are calling on the Trump administration to have a more comprehensive COVID vaccination plan. Do you feel that the federal government needs to have a more comprehensive plan and what would your administration like to see out of that? You know, what I think we need is we just need more vaccine. We need more supply. We can, at least in our state, we're comfortable with a plan that we're committed to. I believe that we have a plan in place and we'll be evolving over time, where we get the shots and arms of those in need. But we just need more of the vaccine itself. So if there's something that they could do to encourage the manufacturers to produce the vaccine in a more increased way, that would be most beneficial to the states. But I don't need, you know, we're too far down this path in some respects. We've got a plan in place that I believe will work and all we need is the supply. So for them to come in midstream and then turn this on its head wouldn't be advantageous to Vermont. Thank you. Yes, this is for Dr. Levine. For these two new variants that have shown up, are the vaccines available still effective against them? So the early word with the UK variant is that the vaccine will still be effective, but that's very early word and preliminary. It's all been very promising. I don't want to consider it 100% definitive yet, but we should be encouraged. With regard to the Saudi Arabia variant that there is no awareness yet on that one. So I can't comment on that one. How concerned are you that since we are seeing variants now that we may see one that the vaccine doesn't work against and we'd essentially have to start from square one? Yeah, you know, that's a mild concern right now, but no longer time goes on that could become a more major concern. And that's why the whole issue of rapid deployment of the vaccine is critical. It really is a race against the clock in some sense, because we know the current vaccine and what it is effective against. And we want to have more people vaccinated at a time when the virus is what the vaccine was made to be effective against, even with the variant that we'll start to spread around the country here. So viruses do mutate, and we know that the longer things go on, the more likely it could be that other mutations occurred that could become more prevalent. So the faster we can actually suppress this virus by vaccinating people and by making sure that everyone obeys all of the guidance and efforts to not spread the virus from person to person, the faster that goes, the better. Okay. Thank you. I was wondering if there was any data or information about how many people in this first phase of vaccinations have refused to be vaccinated? Yeah, Dr. Levine. Yeah, we don't have more than anecdotal data right now. Unfortunately, I know that the uptake in the residents of the long-term care facilities is quite high. I don't know as much about the staff that work in those facilities. Anecdotally, those in healthcare facilities are pretty pleased with the uptake of the vaccine, but again, we don't have the numbers yet to really give you. I'm hoping those will be forthcoming. It'll be a little bit challenging to get them from such diverse groups, but that's what we're hoping to get. But can't say much more. As I've been reading the national data, again, it's mostly filled with anecdotal reports. There were some spots in the country that actually looked quite alarming, like three and 10 of the healthcare workers were saying yes, and they would prefer to wait three or four months and see that things were fine before they started taking it. And then other parts of the country where it was literally nine and ten were taking the vaccine. So it seems very regional and challenging to really get at official true data as opposed to just anecdotal reports. But that's what we have at this point. Okay. And then I wanted to shift gears over to the Governor and Commissioner Sherling up to the comments both being made about these potential rallies or events that are being planned. Both of you sort of laid out that people's First Amendment rights to gather, but Governor, you've spoken out pretty strongly against sort of the beliefs and sort of the disinformation and sort of the message that these people are gathering to talk about, which is that the election was somehow a fraud. So, you know, kind of moving aside from the First Amendment considerations, do you think that these people should be gathering right now? I mean, do you agree with what they're doing and the actions that they're sort of there to raise awareness or that they're saying they're raising awareness about? You know, it's not clear to me exactly what the message is. I think it started out as a Second Amendment rally, to be honest with you. But then there are these extremist groups that have started infiltrating and are using it for other reasons, multitude of reasons. And my fear is that they're using law-abiding citizens of Vermont and other states who believe in the Second Amendment, which I do as well, and are using them as pawns in this scheme to cause disruption and to tear apart our democracy and to overthrow the government. And that's my biggest fear. I just want them to be aware of what they're doing and the reasons they're being asked to do it. And I think that that's, from my perspective, that's my biggest fear, is that Vermonters are being duped into participating in this rally for the wrong reasons. Well then, should they be showing up then? Well, you have a right to do it. You know, again, I'm advocating for them to be aware of why they're doing this. What's the reason? And again, I just want them to go in with their eyes wide open. Obviously, there have been other protests throughout Vermont over the last year that have been peaceful in nature. And hopefully, if they do gather on these two dates, that it will be a peaceful rally. Thank you. This is for Commissioner Levine. We've heard some kind of anecdotal cases around the country of folks getting the first dose of the vaccine and then testing positive for COVID afterward. I was wondering if there has, I guess, A, have there been any such cases in Vermont that you've heard of? And B, if that does occur, does it have any impact on the effectiveness of the vaccines? Yeah, thanks for asking that question. So yes, we have known of a few cases in Vermont and it gives me a great opportunity to tell people that just because the needle went in your arm on a Monday doesn't mean you can't be standing next to somebody with COVID on a Friday, not wear a mask, be too close to them, be in a crowded room with them and get COVID. So it does happen and it's completely compatible with what we know about our body's ability to mount an immune response to the vaccine. So though I don't have widespread events like I just described, it has happened here. Generally, once you get COVID, we tell people you should wait a period of time to, someone's going to need to go on mute. We generally tell people to wait a period of time to resolve that so that they'll be able to mount the best immune response to the vaccine. So it's a little bit of a changing landscape when it comes to having already received one dose and wondering about when you get the second dose. But we'd want people to certainly be out of that period of time when they're symptomatic and still fighting off the infection. And there is a little bit of flexibility. There's a little bit of flexibility in when one can get a second dose. It's not a magical thing about the exact day of three weeks or four weeks. So when it comes to people's lifestyles and convenience and when they can get to a vaccine location, they could be a day or two ahead or a day or two behind, and that's not going to be the end of the world. So if someone finds themselves in that instant, would you recommend a quarantine and then just get the second dose as usual? Or I guess what would you recommend for someone in that situation? Yeah, I think a lot of it's going to depend on exactly what their course was and what happened. So it might be more of an individual decision to make with their health care provider. Okay, thank you. Yes, good afternoon. Thank you. Dr. Levine, this is a bit of a continuation of what Liam just asked. A local hospital administrator here has estimated that the total number of their employees that have signed up and will be vaccinated by the end of the first phase is going to be somewhere around mid-60s percentage-wise of their hospital staff. If that holds up at the vaccination rate, and especially translated to the general population, doesn't that drop as short of achieving herd immunity? And what would be the consequences of falling short of those goals? Sure. So part A is if it is in the mid-60s, what we've seen already is there are healthcare workers who have waited to the end of this 1A group to actually step forward. In the beginning, they said they were hesitant. And now that they've seen over a number of weeks' events unfold, they're willing to take it. So I wouldn't say that our resting point is at the mid-60s for the group you've talked about. It could actually go higher just because of human behavior. The second thing is we don't actually know the herd immunity number. And even Dr. Fauci has sort of gone from 70% to 90%. And that's a fairly broad band. And it's because we don't really have a good way of assessing that, except use of past experience with other viral diseases and epidemics. So obviously we want to shoot for the highest that we can get and be realistic about that. We also think that even as the pandemic continues on, people will change their behaviors just like some of these healthcare workers in the first phases. And as they see over months and months, things evolving, their comfort level with receiving the vaccine might as well increase as well. So that's about all I can say. I think I answered all of your phases of the questions if I didn't be happy to. What has been our most successful vaccination rate for, say, flu shots in any given year? Yeah, flu shots, probably the most successful would be in the 60% range at the most, which isn't bad. But obviously, you know, some of our very time-honored vaccines, polio, measles, mumps, rubella, you know, we're way into the mid and upper 90%. So clearly, we can achieve those numbers. Okay. And if I may, of Secretary Smith, I understand AHS has put out a request for proposal for vaccination partners with a deadline of January 25th. Just curious how this RFP process fits into the bigger picture and what the January 25 deadline means for a timing on rolling out the larger vaccination effort. You're going to have to tune in on Friday there. I think that is going to be part of some of the announcements that we're making. Understood. Thank you. Guy Page. Guy Page. Yes, Governor. There's a lot of social media buzz that tune on one of the groups supposedly planning these state house protests predicts President Trump will declare martial law. If he does, will you and the state of Vermont police cooperate? I don't believe that President Trump will be declaring martial law. Okay. Let's say he does. What would you do? Yeah, I don't want to play that game guy because I don't believe it's going to happen. Okay. Thank you. Can you hear me? We can. Governor, under the title, there's a few in every crowd. In the fall of 73, I went to a grateful debt show in Boston and a bunch of people without tickets had trashed the music hall. The rest of us came out after the end of a great concert and wound up being clubbed by police on horseback like baby seals. I watched that whole rally that they held and the President had specifically asked for peaceful and patriotic protests. How can you blame someone? Could you blame the grateful debt for putting on a concert? I mean, he didn't specifically ask for violence. Yeah, he did. As far as I'm concerned, he did. I mean, just take some of the comments that he had made and Giuliani had made and Don Jr. had made pre-rally. I would say this was more than a rally when they break down the barriers to the Capitol, break into the Capitol, break windows, and overwhelm the Capitol Police, killing one officer in particular. Oh, I saw it. I saw it. So I'm not sure that that I'm not sure that's a peaceful rally. And I don't think that those statements that he made were made until afterwards. Before, I didn't hear that out of his mouth. I beg to disagree, but I want the whole thing to be started. Why don't you send me that clip where he did that before the rally? If he had asked for violence, wouldn't that be like those clips beyond the news every night? Yeah, I think I would advocate, Steve, watch the impeachment trial. And some of those clips might come out. Oh, good grief. I guess we'll have to agree to disagree. I will. Now, speaking of media, I've got to have one for Dr. Levine, if I may. Dr. Levine, are we still using the ICUs to isolate people? I would say in general, the answer is no. There may be one or two specific cases. I don't have an awareness on the 10 patients I mentioned today. I would hope the answer is almost always no, but maybe occasions in some of the smaller hospitals where that might occur. But like I said, it would be the minority of the people in the ICU. And with Moderna's vaccine, they say they have a 84% success rate for people over 65. And with the number of patients that have like allergies and stuff, and the higher number of people who get anaphylaxis or have anaphylactic shock after taking the vaccine, wouldn't it be better to recommend that the vaccine be administered in a hospital setting where, you know, in case somebody doesn't have like an epi pen or something on them? Yeah, so, you know, we're going to be very strict with how it's administered in Vermont. So it doesn't have to be in a hospital setting necessarily, but clearly it has to be in a setting where there are personnel available who could administer an epi pen or any other treatment needed. Admittedly, this is a rare event, but rare events can still happen. So we have to be prepared for anything. But one would want to have the very first intervention done at the site of the vaccine, and it doesn't have to be in a hospital, but clearly there should be ability to transport the patient to a hospital if they did have a life-threatening reaction. And that's the way things will be done. Thank you, Rebecca. This is Tom here. Good afternoon, everyone. My questions today related to potential monitoring, contact tracing related to the Trump rally bus trip last week, and also to the proposed rally at the State House this weekend. So all my questions have been addressed. Thank you very much. Thank you, Tom. Okay. Well, thank you very much for tuning in, and we'll see you again on Friday.