 Good afternoon, everyone. Today's briefing will focus on our weekly data update, vaccine boosters, plans for quickly vaccinating kids under 12, and use of rapid tests and contact tracing to help keep kids in school. But before we dive into those updates, I want to define more clearly what I mean when I ask for monitors to think about personal responsibility at this point in our COVID response. I see this as a key to moving forward, because what we did for 15 months before vaccines was necessary, but isn't sustainable or good for our well-being. Specifically, I want to talk about the connection between personal responsibility and keeping those at greatest risk, meaning the oldest people in our lives, especially those with underlying conditions out of the hospital. And how by making some easy choices, we can also help regulate case counts that can lead to hospitalizations and transition from pandemic to endemic. So what do I mean by personal responsibility? First, it means if you can, please get vaccinated. The good news is vaccines remain incredibly effective. The data shows they've significantly reduced cases among the vaccinated, with less than 1% of vaccinated Vermonters becoming a case. And importantly, only three tenths of a percent of vaccinated Vermonters have been hospitalized. It's also reducing the overall case fatality rate, which is now below one half of 1%. Also, some studies are now suggesting that those rare breakthrough cases may be much less infectious to others than scientists originally thought. Next, if you're choosing to not get vaccinated, it means understanding the risks to yourself, your friends and family, and your community. The data is clear by not getting vaccinated. You're much more likely to get sick from COVID and you're much more likely to spread it to others. At this point, there's no doubt that if you're unvaccinated, the virus will find you and it will continue to circulate among the vaccinated at a rate that slows our progress and stresses our hospitals, nursing homes and schools. Here's the data. About 61% of all of our cases in July are among the unvaccinated, even though there are only about 133,000 Vermonters, about 30% of the total population who remain unvaccinated. Keep in mind, some are eligible, some are not. This proves yet again the vaccine's work and when children under 12 become eligible, parents need to step up. Additionally, with the unvaccinated making up about 75% of our COVID hospitalizations and of those in the ICU, hospitalizations are still being driven by the unvaccinated and mostly adults who are eligible to get their shot. This is putting pressure on our healthcare system. Now to be clear, we're seeing more and more people stepping up every day and I appreciate those who are doing so because it doesn't come easy for them. And we need to accept that a small number of Vermonters are going to remain unvaccinated for one reason or another. And as frustrating as that is, it does no good to shame them or get angry. In fact, it's counterproductive and does nothing to persuade them. But I do hope those who haven't yet gotten their shot will think long and hard about what all this means and their role in all of this. Finally, personal responsibility is about recognizing that COVID is still a real concern for the elderly, especially those with underlying conditions like heart or lung disease. If they've been a heavy smoker or if their immune system is suppressed because they're being treated for cancer. Dr. Levine will review the list of these underlying conditions in a little more detail. But if you know someone who has one of these conditions and they're elderly, they are at high risk of being hospitalized or dying from COVID. Each of us, whether vaccinated or not, need to step up and do our part to protect the old and sick in our lives. So what is stepping up look like? First, once again, get vaccinated and get your flu shot. Second, if you're over 65 and eligible, get your booster shot as soon as possible. The data tells us the older you are, the more important it is to get a booster. Third, take a little time to think about how you can reduce the risk of exposure for the elderly in your life. For example, if you're going to visit elderly parents, grandparents, or friends, think about avoiding high risk situations in the week or two before you visit them or take a test before you go. And if you've got unvaccinated kids in school and doing after school activities, have them take a test a few days before you visit those family or friends. And one more thing, if you're unvaccinated, wear a mask when around others or in a populated setting. These sort of simple, common sense steps can go a long way to protect our loved ones and preserve hospital capacity. And I want to be very clear, if you're one of the Vermonters who is never going to get vaccinated, it's even more important that you do your part to avoid spreading COVID to someone who is at risk or putting your children in a position where they're out sick from school. Because not getting vaccinated, taking no precautions at all and carelessly exposing an elderly family member, neighbor, customer, or patient is selfish and it's dangerous. So hopefully this clears up what I mean when I talk about personal responsibility. Because the reality is, with each of us taking upon ourselves to do simple and reasonable things to reduce risk, we can make a big difference. I realize this has been a stressful 19 months for all of us. And this transition from pandemic to endemic is going to take months. So the fact is, it's going to be a bumpy ride. With ups and downs and just to complicate things, we have flu season just around the corner. But I want to be very clear, we are making progress. And we can make a difference. So with that, I'll turn it over to Commissioner Pichek for the data update. Thank you very much, Governor. Good afternoon, everybody. I wanted to start this week just with a highlight of the national data. The steady and sustained trends that we've seen across the country have continued this week. You can see that cases, hospitalizations and fatalities are all down about 10 percent, a little over in some cases. So those trends continue to be favorable throughout much of the country, particularly those areas of the country hit hardest and earliest by Delta. Looking at the next slide, you can see that, again, those states that were hit the hardest, they saw the most significant increases in cases, hospitalizations and deaths. They've now seen the most dramatic decreases in all of those. But the states that are the most vaccinated had a much more mild experience as we've talked about in the past. And their trajectory downward is also much more slow compared to those states that saw much more significant outbreaks. You can see Vermont on this line just for comparison. On the case side, you can see that we have deviated pretty much for the first time during the Delta wave in terms of the trajectory of our cases versus all of the most vaccinated states. And on the hospitalization side, though, the trend continues to be steady and consistent with Vermont hospitalizations being very low compared to our peers. And the fatality rate falling very close to those most vaccinated states as well. Across New England, the cases were dropping a little bit more quickly, about a week or two ago. This week, they're a little steadier, but still declining down 6% over the last seven days, down 3% over the last 14 days. Again, visually, you can see that cases were dropping a little bit more significantly, like I said, really more two to three weeks ago. But again, the trends are still moving in the right direction around us in New England. On the next slide, you can see that the case numbers are lower this week compared to last week. We did adjust for the holiday last weekend, Indigenous People's Day weekend. So the numbers actually were higher last weekend for many of the states around us. Vermont, we were able to report throughout that weekend. Our numbers were consistent. But it did result in some of the cases being shifted to last week. But in any event, the cases remain steady across New England. You can see some of the states here seeing improvement week over week. Rhode Island, Maine, Massachusetts, New York, and Quebec as well. While Vermont, Connecticut, and New Hampshire saw their cases go up week over week. Looking again at Vermont specifically, you can see over the last seven days, our cases are up 10% on the seven day average. When you go back over the 14 days, which basically picks up that low point where we were a couple of weeks ago, our cases are up about 39%. So about 39%, but increasing more slowly in the last week. Turning to our vaccinated versus not fully vaccinated slide, you see here again the continued difference between the vaccinated and the non-vaccinated rate. That non-vaccinated rate is going up visually much more significantly. But when you look at the numbers and how they fall, you see that they're both going up at a pretty good pace. Now, the fully vaccinated rate is coming up from a lower point, but still it's up 30% over the last seven days compared to 21% for the not fully vaccinated rate. Similarly, when you look at the hospitalization admissions, those that are fully vaccinated and those who are not, again, still a great disparity between those who are fully vaccinated. But that rate has stayed pretty stable that not fully vaccinated rate down about 2% over the last seven days, while the fully vaccinated rate is up about 9% over the last seven days. Looking at the next chart, just to mention, I think it's important that our testing has remained stable throughout this entire period. So it does appear like we are picking up an accurate picture of what's happening in Vermont. So the numbers have been stable for us, but Vermont continues to be one of the top states in the country in terms of per capita testing. This week, number two in the country only behind DC in terms of the per capita testing. So certainly a sufficient amount of testing going on to picking up what's going on across Vermont. Looking at our age breakdown, you can see that the zero to nine-year-old age bracket continues to be the highest in terms of the per capita cases that we're experiencing in Vermont, followed by those other age bands that are not as well vaccinated, those in their 30s, in their 20s, and then those in their teens as well. And our most fully vaccinated age groups continue to be on the lower end of those most, you know, those ages with the most cases, which certainly is a good sign. And with some of those more vulnerable populations, seeing cases come down a bit this week, which is also certainly a good sign. Looking geographically, you can see a similar story. The Northeast Kingdom in particular has their case rates have continued to go up. They are much higher than the rest of the regions of Vermont. You can see that Southern Vermont is pretty stable, while Chittenden County and Central Vermont have continued to see their numbers rise as well. But again, Chittenden County and Central Vermont much lower than Southern Vermont and both are all three of them much lower than the Northeast Kingdom. So we talk a lot about the different rates of vaccination between states and how states with lower or higher vaccination rates like Vermont have avoided some of the worst outcomes in terms of the total number of fatalities and hospitalizations. But even within a state like ours that's highly vaccinated, you can see different outcomes based on the geographic location and the vaccination rates of those communities. So we took a look at the last 30 days and compared the top seven vaccinated counties in Vermont to those counties that were at the bottom seven of the vaccination rate, looking at those who are fully vaccinated. And over the last 30 days, you can see quite a big disparity here in Vermont in terms of the number of cases that we're seeing on a per capita basis with 33% less cases in those counties that are the most vaccinated, a 23% difference in terms of those counties that are most vaccinated in terms of hospitalizations, and a 40% difference in terms of those counties that are the most vaccinated in Vermont compared to those that are at the bottom end. So again, all the more reason for those in Vermont who live in communities with higher transmission to protect yourself and your families and get vaccinated and get your booster shot as soon as you're able. Another piece of data that we wanted to show this week is an update on the mobility numbers that we often have shown throughout the pandemic. This one is showing out of state visitors to Vermont hotels. We wanted to show it because it picks up much of last weekend Indigenous People's Day weekend. And it's also somewhat noticeable because it is the highest point in terms of hotel visits throughout the entire pandemic. So the point that we see here that was again midway through last weekend, the number of out of state visitors to Vermont. That's the highest number of visitors we've had to hotels since February of 2020 prior to the pandemic. And you can see through much of the last two or three months, the hotel numbers have been much more close to the baseline compared to the rest of the pandemic. But we also wanted to point out that when it comes to out of state cases throughout the last four months, the numbers have stayed very steady. You can see that about 91% of our cases through this whole period of time have been from Vermont residents with about 9% coming from out of state residents. And that's even during this period of time where we've seen higher hotel visits, higher out of state visits. So again, not showing in the data that tourism or out of state visitors are driving up Vermont's case counts. Just wanted to make that point as well. In terms of the higher education data, you can see this week was a little bit higher compared to others. 63 cases this week, still pretty low when you look at the full entire semester. So things continue to be going pretty well on campuses across Vermont. Looking at the long-term care facility data, you can see that we have the same number of outbreaks, nine outbreaks this week compared to nine outbreaks last week. Two outbreaks were removed from the chart and two additional outbreaks were added week over week. And there are now 18 higher, 18 more cases in terms of the active cases associated with an outbreak compared to last week, standing at 164 of those nine facilities. Looking briefly at hospitalizations, you can see that the numbers have gone up again. Last week, the numbers were coming down in terms of hospitalizations. We anticipated that the numbers would go back up based on the number of cases that we had started to see over the last seven to 10 days. The numbers have started to go back up. But again, as the governor said, 70% of those that have been in the hospital over the last seven days are among the unvaccinated. Same with the ICU numbers. You can see those numbers going back up with the case counts going up. But again, 75% of recent stays among the unvaccinated. Looking at the number of fatalities that Vermont has seen and looking at the forecast into the future, we're in a similar place as we have been for the last two weeks. The confidence intervals on the models really have a wide disparity between them, showing almost every likelihood that's possible cases and hospitalizations and deaths improving staying similar or getting worse. So again, it's really an uncertain forecast at the moment in terms of the trajectory that we're on. You can see that by the confidence intervals and the directions that we possibly could head. So we just need again a little bit more information, a little bit more time to understand that trajectory. Turning to vaccinations, Vermont is at 89.2% of all eligible Vermonters who have started vaccination. So up another half a percentage or point or so from last week, that's an additional about 2000 Vermonters who have started vaccination. You can see on the next slide that we continue to be on most categories, the national leader, if not near the top in terms of our vaccine rankings. And again, one of the most important, the percentage of our population fully vaccinated now at 70.6%. So with that, I'll now turn it over to Secretary French. Thank you, Commissioner Pichek. Good afternoon. We continue to work with our schools and implementing the new Test to Stay initiative. Excuse me. Under Test to Stay, schools can enroll their students in a seven-day antigen test screening process with parental permission. And we think Test to Stay is going to be a very promising approach that'll not only help keep our schools safe, but also help keep kids in school more frequently. The onboarding process for Test to Stay has several steps, including obtaining the waiver, as I referred to last week, the CLIA waiver process. Also, there's a new reporting system for reporting the data for that type of testing and also participating in some training. As of yesterday, we had 17 independent schools and 62 school districts, which I believe are all our school districts plus our tech centers. Some of them are independent school districts themselves. 17 independent schools, 62 school districts have all expressed interest in participating in Test to Stay. 12 of the 17 independent schools have completed the waiver process. 40 of the 62 school districts have done so. The 12 independent schools have completed the setup process in the reporting system, and 13 school districts have registered in that system. So in summary, as of today, we have about 10 independent schools and 13 school districts that are ready to launch Test to Stay. I'm talking with my team this morning. I expect several of these will go live this week with Test to Stay. I did want to mention that last week we did deploy Test to Stay in Canaan. Canaan was having some trouble getting shipments of their response PCR testing to the lab, so we worked with them intensively over a period of several days to get them set up to do Test to Stay with something they desired to do. I understand that process went well. They created several new template forms to collect data on the results and to monitor the student participation, and now they're sharing that experience with other districts around the state and the nurses association. We have had a number of schools who have decided to continue with our PCR surveillance testing. To date, we have 35 independent schools and 23 school districts participating in the surveillance testing. We have de-emphasized the use of the surveillance testing for a couple of reasons. Firstly, we know there's a lot of virus in our communities from our other testing programs. As you heard, Commissioner Pechak said we have strong participation in that program statewide, so to a certain extent the data we might obtain from a separate surveillance program in schools might not be as useful as it was last year. We also think the response PCR testing that we're deploying in the Test to Stay will be more useful in the long run and would prefer schools focus their limited capacity on implementing those programs instead. I have been communicating to our schools that we're working on revisions to our contact tracing process, and I thought I'd highlight some of those changes that we're planning to make. We have been working with our infectious disease experts, pediatricians, school nurses, and school leaders to make changes to the process, so the things I'm going to highlight today are the result of that collaboration and their support. A major change we'll be adopting is no longer recommending contact tracing in outdoor settings like playgrounds. Our intention is to focus contact tracing on indoor activities almost exclusively. I will say school buses have been a very challenging environment relative to contact tracing, and our experience indicates that the risk of transmission on a school bus is low, particularly if there's good air flow on the bus. If a student is found to be infectious on the bus, we'll recommend restricting contact tracing to the students' immediate seatmates and not isolate all the students on a bus. We will be reducing the distancing standard for contact tracing from six feet to three feet in classrooms where students are wearing masks. Previously, a close contact was defined as a person who was within six feet of an infectious individual for more than 15 minutes. Three feet has found to be equally effective standard for schools in other states, including Massachusetts, so that's where we intend to go as well. Our focus here is to make contact tracing more precise and also less labor intensive, but on the other hand we want to be cautious about making any changes in the process in the context of heightened case counts as a result of the Delta variant. A good example of the balance that we're trying to make between the safety and making this process more precise is our change to the whole classroom approach, which largely affected elementary classrooms. Students are usually more active in elementary classrooms than those of the upper grades. As I mentioned, the definition of a close contact is tied directly to the amount of time students spend in close proximity to one another, particularly an infectious individual. Under our previous approach, we recommended a whole classroom be quarantined if they spent more than four hours together, but precisely because we had difficulty determining to what extent students were close to one another when they're moving around, particularly at the lower grades. As you might remember in a typical elementary class, you spend the bulk of the day together in one room. This is particularly true in the primary grades. We're going to continue to recommend this approach when students are very active in a classroom, but we're also going to recommend a three-foot 15-minute standard in situations where there's less movement in a classroom. We think this will help reduce the number of students who need to quarantine at the elementary level. The use of the three-foot 15-minute standard will be recommended when students are wearing masks. We are working to finalize the revisions to the contact tracing process and intend to publish them later this week. We've also been working on our recommendations for winter sports. Secretary Moore has been leading this work in cooperation with our stakeholder groups, including the Vermont Principles Association. As we did last year, we intend to coordinate school recommendations with the recommendations for the rec league sports, since our students participate in both. And right now it looks like we're going to publish our recommendations for winter sports next week. We've also been working with the Agency of Human Services to set up vaccination clinics in anticipation of the Pfizer vaccine being approved for emergency use for students age 5 to 11. Secretary Smith will have more information on these preparations in his update in a minute. As our schools prepare to implement test-to-stay and revisions to contact tracing, we will be prioritizing the vaccination of this new age group. Vaccination not only plays a critical role in keeping our schools and students safe, it also impacts how we implement testing and contact tracing and can greatly simplify both of those processes. For example, individuals who are vaccinated and asymptomatic are by definition not identified as close contacts and are ineligible for test-to-stay. So I strongly encourage parents to get their children vaccinated in the coming weeks. It will be very helpful for stopping the spread of the virus and for ensuring our kids can stay in school in the coming months. Thank you. That concludes my update. I'll now turn it over to Secretary Smith. Thank you, Secretary French. I have a lot of information to cover today. It's going to take a little bit of time. I'm going to start off with vaccination and vaccine boosters. As of this morning, over 39,000 people have gotten either their Pfizer booster or an additional dose for those individuals with weakened immune systems. It's important to get a booster, so please make an appointment to get yours. Boosters of the other two vaccines are moving through the FDA and the final CDC approval process. We expect approval as early as the end of this week. Late last week, the FDA advisory panel supported a Moderna booster administered six months after the second dose was given. The FDA also supported a booster for the Johnson & Johnson shot at least two months after those individuals got their initial J&J dose. Before they can be made available, Moderna and J&J boosters will need to be endorsed by the CDC. The CDC starts deliberation on October 21st. More information on who the CDC recommends gets a booster will be available after they meet. As I've said often, we've mentioned this before, Vermont has taken a liberal interpretation of who qualifies. If you're over 18 and have waited the prescribed interval between your last dose of vaccine and the booster, you'll likely be eligible for a booster, so please get your booster. As these boosters are approved, we're ready to roll them out through our network of vaccine clinics, pharmacies and health care partners. Now to the issue of mixing different types of vaccine. As of today, the CDC still recommends that people get a booster or extra dose of the same vaccine that they received the first time. However, the FDA and the CDC are looking at recent studies of what is called mix and match boosters and they may authorize mix and match for those who wish to switch vaccine types. So we'll continue to monitor closely what is decided in regard to mix and match. We will also update our registration system to accommodate mix and match if it is approved. These updates may take a week to implement. Now regarding vaccines for children, next week the FDA panel will meet to discuss the Pfizer vaccine for those ages 5 to 11. The following week, a CDC panel will consider the FDA's recommendation. We will be ready to administer Pfizer to those ages 5 to 11. However, it's a different dosage than that for adults and it will be sent to the state in weekly allotments. Vermont is slated to receive 15,900 doses for children over the first three-week period after it's approved. Additional doses will go to pharmacies. Just for a reference, the number of kids between 5 and 11 in Vermont is just under 44,000 children. Now I want to turn to the health care system more broadly. As you know, we are leading an investigation into what is causing some people to experience long wait times for health care services. I mentioned this investigation today because the team running the investigation wants to hear from you, from honors who have experienced long wait times for medical care. The investigating team will hold two public virtual listening sessions. The first is Wednesday, October 27th from 5.30 to 7.30. The second session will be Thursday, November 4th from 12 p.m. to 2 p.m. Registration for both sessions will be soon available online through the Department of Financial Regulations website. The website, actually, it is live now. The website is dfr.vermont.gov. Hearing from Vermonters is a key part of this investigation. If you've been affected by long wait times for medical services, please tell us your story by joining one of the two public sessions that I just mentioned. It's clear that our health care system, as the governor mentioned, and our health care workers are under stress. As I've said before, this is not a direct result of people infected with COVID-19. Instead, it's a combination of factors with COVID being just one of them. These factors include people who have delayed care and present more acute conditions as they arrive at hospitals or their primary care settings, and people presenting at emergency departments with mental health needs. It's also because we don't have enough staff, subacute beds available for patients to be discharged from hospitals. As we work to alleviate these stresses at our hospitals, long-term care facilities, and other locations, we must leverage all the tools and science that we have. Last week, Dr. Levine mentioned monoclonal antibody therapies for COVID-19. These therapies can reduce incidences of hospitalization and death, particularly among seniors and those who are likely to get sick from COVID due to other medical conditions. This past weekend, with the help of EMS, Northwestern Medical Center, and others, Dale and VDH, helped organize the administration of monoclonal therapy to residents of a long-term care facility experiencing an outbreak. The hope is to treat COVID-positive patients with this therapy before they need hospitalization, and thus relieving the pressure on hospitals and staff. A health alert will be going out from the health department this week, encouraging the use of this treatment option for monitors who have COVID can call their health care providers to see if they're eligible for this treatment. In addition, the Department of Disabilities, Aging and Independent Living, Dale, has paved the way to acquire staffing to open nearly 80 subacute beds at long-term care and rehabilitation facilities. This will allow the transfer of patients and relieve some of the census pressure on hospitals. Working with the Department of Mental Health, the Brattle Ball Retreat opened an additional 21 beds. However, in the past few days, these beds have been closed due to staffing challenges associated with an outbreak and staff leaving employment because they refuse COVID vaccinations. The state will continue to work with the retreat to get these 21 beds back online and perhaps six more as soon as possible. But the main point I really want to make here is that across the board, our health care workforce is under stress. With that said, day in and day out, we see them going above and beyond to care for their fellow Vermonters. So I want to take a moment today to thank them, to sincerely thank them for all that they do. Turning to vaccines to protect yourself, your family, and your friends, you can get vaccinated or get a booster at many of the locations, including your health care provider. This week, there are more than 80 state-run vaccination clinics across Vermont. It's almost impossible not to run into a vaccination clinic as you travel across Vermont. Make an appointment at healthvermont.gov slash my vaccine. You can call 855-722-7878. However, I do want to mention something of a troubling event that was brought to my attention last night. On Monday, we had an incident at the Double Tree Hotel in South Burlington, a vaccination site, a state vaccination site. People protesting vaccinations confronted those trying to get a vaccination or a booster. Nearly 90% of eligible Vermonters have received at least one dose of the vaccine. Although I encourage people to get vaccinated, those who choose not to shouldn't interfere with the overwhelming number of Vermonters who want to be vaccinated. And one last point before I turn it over to the Health Commissioner, Dr. Levine. The governor through his Department of Children and Families and the Department of Housing and Community Development have put forth a housing proposal that has two fundamental goals. Number one, move people who are homeless as expeditiously as possible to permanent housing. To accomplish this, we need to make the $249 million investment into housing that the governor has called for. And number two, protect the most vulnerable with an interim solution as housing stock is built or rehabbed. Commissioner Brown and Hanford are on the phone today if there are additional questions regarding this proposal. Now, Dr. Levine will provide a health update. Good afternoon. I will create a full circle and get back to some of the comments that the governor raised and talk about how we can help ourselves and one another. So we've spoken many times here about our high vaccination rates in Vermont and by being highly protected against severe illness, hospitalization and death, Vermonters have been able to live more normal lives again. Seeing friends, family, going to work and school, taking vacation, generally getting back to doing the things that we love. These connections and routines have undoubtedly helped our mental health and likely even our physical health too. We all know that unfortunately the Delta variant changed the course of the pandemic and our road to normalcy. Knowing that this variant of the virus spreads much faster and more easily. This has caused more cases and increased the chances that any of us can come into contact with it whether we're vaccinated or not. This is what we mean by community spread or to use a seasonal metaphor when it comes to the virus, what happens in deer camp might not stay in deer camp. Again, the virus is moving from person to person. To many people, we often don't know how a person was exposed. Our recent contact tracing data tells us just this. 50% of our current cases didn't know where they got COVID, had not been to any large gatherings, but many had indeed been in a crowded indoor space where there was little mask wearing. 30% of people had been in close contact either with a household or friend who had the virus. 15% were associated with one of our outbreaks. Five percent had travel noted in their history with no other cause that was more likely to be the cause of their infection. So as I've said, if you're vaccinated, you're highly protected from COVID's worst effects. But if you're unvaccinated or you're at higher risk due to your age or medical conditions, you are vulnerable. This means we need everyone's help to protect those at higher risk right now while spread is high in our communities. While you may not be able to control the virus itself, you can control your own actions. Actions that we know will help to prevent further spread of the virus and the cycle of increased cases, outbreaks and illness. You remember that last year around this time, we traced the beginnings of the winter surge to Halloween, crowded indoor parties and events attended by adults. This is what we need to avoid right now while we wait for cases to go back down again so we can gather safely during the upcoming holiday season. Remember that a gathering is not just a party or a large event. Any get-together such as friends at your house, a dinner or other social activity can pose a risk. So in the spirit of Halloween is not canceled, here's a guide for everyday planning that all of us can and should do right now to help us get to the other side of the Delta surge. As always, number one, get vaccinated. And if you're already vaccinated, arrange for your booster shot to obtain the most protection possible and encourage higher risk family and friends to do the same. We have over a century of experience that vaccines work. Two, if you feel sick, stay home. You'll feel better and you won't spread your germs. Three, get testing. In fact, have a testing strategy. If you take part in activities that could put you at risk, such as attending large social or mass gatherings, being in crowded or poorly ventilated indoor settings like a bar or traveling, get tested three to five days after. You might also consider getting tested a couple of days before an event to protect those around you. For instance, if you and your family comprised of children under 12 who are not yet eligible for vaccination are indeed going to celebrate grandfather's or grandmother's birthday, this may be a good strategy to employ several days ahead of time. Four, wear a mask indoors when in public settings or around people who may be at higher risk. Five, gather safely. The smaller the group, the better. And if you feel better knowing the vaccination status of guests or request them to wear a mask like many wedding planners have done recently, this is your right. And we hope everyone will be understanding considering the times we're in. And lastly, get your flu shot. Just like the COVID vaccine, this will keep us all healthier, reduce how serious the illness could be, and helps keep our health care system from getting overburdened at a time when multiple respiratory viruses may be circulating. You can get flu shots right now. There's no need to wait before or after you get your COVID shot. All this information can be found on our website healthfermont.gov slash COVID-19. Thank you for helping protect yourself, one another, and those who are more vulnerable as we navigate this pandemic together. I want to close with a few additional points about monoclonal antibody treatments, which is really the only really effective and science-based treatment for COVID for those outside the hospital. These treatments are powerful and highly effective against COVID, reducing the chance of being hospitalized by 70%. But again, they are not a substitute for vaccination. Vaccination is still your best approach to minimizing the chance of getting severely ill in the first place. Who are these treatments for? They're not for everyone. They are meant for people who are at the highest risk for a severe course with COVID. Those who are over age 65 or no matter what age have one of the many high-risk medical conditions I've discussed here before, which include conditions that compromise your immune system, obesity, heart disease, lung disease, kidney disease, a whole host of conditions. If your doctor doesn't know you have COVID, they can't order this medication for you. So when you get your positive result, even if you're not feeling too badly, tell your doctor at that time. Do that even if you feel pretty good because the treatment is meant to prevent the worsening later in the course, and it works best when administered in the first five days. You only need to have mild to moderate symptoms to qualify in addition to being high risk. This means perhaps just cold symptoms or loss of smell or fevers or chills, even shortness of breath. Now hundreds of hermoners have already received this treatment and they have not been reporting significant side effects. The medication can be given through a vein or by a needle prick under the skin at a hospital infusion center. Please accept a pulse oximeter, a device that you put on the end of your fingertip to measure your oxygen level from the health department when you hear from us. This can help you monitor your condition and see if your oxygen levels are staying up where they need to be. And lastly, to my clinical colleagues, expect to see another health alert message in the next few days. This will also draw your attention to the possibilities of having cases found in nursing homes and long-term care facilities treated much as we have recently done and as Secretary Smith described, at their residence with the capable assistance of our EMS teams. I'll turn it back to the governor. I'll now turn it over to questions. As you opened up the press conference talking about personal responsibility, what's your reaction to the incident Secretary Smith mentioned with people supposedly getting a booster being confronted in Burlington? Yeah, again, really unfortunate. I mean, I believe that people should exercise their right to protest, to advocate their positions, but to confront people who are doing what they think is right, just unnecessary and not helpful to either cause. Questions about the housing plan that you released yesterday? There are some policy advocates right next door at the State House who are disappointed that the hotel program doesn't go further. They'd like to see it extended through the winter when the cold weather is most dangerous. They would like to see it opened up to people who have previously been exited from the program, and they think that it's not really feasible that we're going to get permanent housing short-term. They see that as years away. So I wonder what your thinking is around their concerns and also whether there is more that could be done to help the most vulnerable who are currently being served by that program? Well, again, I'll let others weigh in on this one, but from our standpoint, we've done a lot in terms of the during the emergency during covid in terms of trying to help out the homeless, putting them in a hotel motel situation. We thought was the most expeditious way to help, but it doesn't serve them in the long term. And it's it's not something that's sustainable. We we had worked with the legislature, as you know, and developed a time frame when we were going to end the program. But things have changed a bit since then, admittedly, as well as the funding associated with that, which appears to go at this point in time. It wasn't it isn't ending is going till the end of the year, which opens up our options. I put a pause on things so that we could collect information, work with our partners and try and do what we thought was right in the long term, because I believe that the best thing for our homeless population is permanent housing, not temporary housing, not rent by night each night. It's permanent housing. We put a plan forward. I talked about this in the last legislative session. I think 250 million dollars is appropriate that and maybe we need more to be perfectly honest with you. But I think 250 million at a minimum is something that we think is necessary to help both the hop homeless population as well as to provide housing affordable, decent affordable housing for the workforce. So to carry out these initiatives, we're going to need to work with the legislature. The policy advocates that I listen to are inside the building and will be working with them both after the first of the year, but until the first of the year. This gives us an opportunity to narrow and hone what we think is best and acknowledging that we want to work with our partners in the legislature. Anyone else want to add to that? Secretary Smith. Yeah, I'll call on Commissioner Brown and Commissioner Hanford in a minute. I just want to reset the table here and think about what we're talking about. It's my belief that Vermont was the only state that did what we did. We put everybody into hotel motels that were homeless in in that in a time period when we didn't know what was happening with COVID. At the same time, the governor has recommended an investment that I've never seen in the state of Vermont, 250 million dollars investment. We aren't after the first after the first of the year, we aren't eliminating providing assistance to people that are in hotel motels. We're switching the funding mechanism that they will be using because we're unsure what the funding mechanism will be, but we aren't we aren't eliminating a funding mechanism for them. We're just switching it and we are, you know, we concentrate on an expanded definition of what qualifies for the program and that continues. So the most vulnerable, those that parents would fam with kids, the disabled are still going to be looked after after the first of the year. We aren't discontinuing that. We're just using a different funding mechanism using the same definition that we have right now. Commissioner Browner, Commissioner Hanford, do you have anything to add? By the way, we did we are exiting people from this program and putting them in permanent housing and I'll let Commissioner Hanford take it from there. Thank you, Secretary Smith. You're right. We have been successful in rehousing over 500 families exiting homelessness to date. Also just want to give a few other numbers here. Since the beginning of this pandemic, we've brought on over 720 new units of housing, over 350 of those dedicated to those exiting homelessness. There's a lot more to do. There's more that'll be coming online by the end of this year and even, you know, another 550 or more in the pipeline to be completed in 2022 with over 360 of those units serving the homeless. Clearly, we have more to build into the next few fiscal years. We need more funding to do that. We need to signal to developers and those wanting to help this need, address this need that they should be doing pre-development work, getting projects lined up, locations and there's more funding coming. And I would just second what Secretary Smith said, that there is a new source of funding that can continue to support temporary housing for individuals. It's just switching the source, but the real solution is more permanent housing being built. Governor, do you think that those who receive the stipend and fluid should be barred from the Motel program this way? Could you expand on that just a little bit? I might have spent the money on something other than search for new housing, but we're now asking for Motel access. Yeah, you can see Secretary Smith wants to answer that first. I'll ask Commissioner Brown to fill in anything that I haven't addressed. We found actually just the opposite, that they didn't blow it, that they used the stipend that we had provided to go ahead and find housing in different ways. And we'll continue to monitor that, but from our sort of research and from what we've heard, they really did use the stipend to try to find permanent housing out there as they moved on. Commissioner Brown, can you elaborate on that? Yeah, you are correct, Mike. We heard from many of our partners that we're working with these households as they moved on from the Motel program, that they really used it to meet their short-term needs, to establish themselves in new situations and to meet their needs, and that it was used appropriately and it was an essential source of funds to help them get back on their feet as they were leaving the Motel program. Can I ask a health question? Everybody I know is talking about the spike, especially over the weekends in the next 600 cases, I mean it's huge. How can it be that we are the most vaccinated state and yet we're seeing our worst case count ever? Yeah, no it is frustrating in a lot of different regards. There are a number of theories out there. I'll let Dr. Levine again answer the question from a health care perspective, but remember Provincetown, what we saw there, mostly vaccinated, but there was a spike in cases for whatever reason. So there's some different theories revolving around that. I've read some of the articles that give some substance to maybe some of these cases aren't as infectious, or they're as infectious, but maybe they're not the same as the first time getting COVID. So that's one theory. Again, we were from the beginning. We were one of the last states to get COVID at our doorstep. Before the variant, we were one of the last states to evolve off from COVID, the original COVID. So we're lagging a little bit behind most other states. So hopefully again, as I mentioned last week, this will get through in the next couple of weeks and we'll start our downturn to what the rest of the country is doing. Dr. Levine. Believe me, we ask this question every day because we do want to make sure we're not missing anything. The bottom line is this is Delta. It is a highly contagious variant. We're dealing with a time with the population being highly mobile and interacting a lot with one another. I think there's been some national news lately talking about Northern states having more of a burst in cases lately, but they're referring to non-New England Northern states in the Midwest and in the West. And talking about the cold, and though it is indeed chilly today, I think we'd all agree we've actually not had severely cold weather throughout September and October. So that hasn't really had an impact to say the least. I again take solace, if you will, in some of the slides that you saw where the sort of significant plateau in cases that we've been experiencing continues without necessarily a severe downturn, especially compared to the other parts of the country. The bottom line is we have not experienced the height of cases that anywhere else outside of the Northeast has been experiencing. And though we continue to go up here, it's really a very different trajectory. And there's some thoughts that the more highly vaccinated population you are, the longer it takes to sort of burn this out. And we're just going to have to see. I would encourage again Vermonters to use our data. Our data shows that the four lowest vaccine uptake counties in the state are paralleling the higher caseload parts of the state. I'd like nothing more for people in those areas to find even more protection and consider vaccination because I do firmly believe that there's only a small percentage of them that are truly vaccine resistant, vaccine skeptical, and will never ever accept a vaccination. And we're seeing that phenomenon occur every day when we show you the data that shows we're now over 89% people getting at least one dose. Hundreds of people keep doing that all the time. It's just a matter that they're getting to that point. Yes, I wish they would have gotten there earlier, but at the same time, I'm hopeful that they will still continue along that continuum. If you had originally gotten the J&J vaccine, would you hold out for a mix and match or get the J&J plan to prove Friday? Yeah, so I think what we will find on Friday will guide my answer to your question. So I wouldn't want to prematurely answer it without seeing the data that they are going to be able to show us they've looked at. But all indications are that they are going to show that you get a much more significant rise in antibody levels after doing J&J and then an mRNA vaccine than you would if you got J&J and then another J&J. And they're showing that that impact, even though it's going to happen late this week and into next week, is something that if we had had the data earlier, the suggestion might have been to give somebody whatever second shot they would get a lot sooner than six months after their first shot of J&J. But again, this data is, if you will, test tube data looking at people's antibody levels. It's not really the real world experience of people who took one strategy versus another and see what happened to them because that data is just not in yet. So we're relying much more on just the marked increase in antibody titers, which is a really important part of our immune system, but it's not the entire picture from the immune system point of view. Dr. Luzin, in the context of waiting immunity for some of these vaccines and the timing that we're seeing with the Delta variant, as you know, Vermonter has stepped up real early and we rolled out a very effective vaccination campaign early on. I mean, do those two factors, could there be any correlation there? There could be a correlation there, yes. The reality is even with waning immunity, the part that's waning is your ability to get infected. So to test positive or to have some illness from it, the part that's not really waning significantly is will you get a serious outcome? So even if you get a mild to moderate illness from Delta, which we hope you won't, you probably won't end up in the hospital or dying, God forbid, have those serious outcomes. That part of the immunity doesn't seem to be what's waning. It's just the ability to get infected. So we'll see how that progresses. I would just add that most people, it seems from our experience with the booster campaign and from talking to people, don't feel a sense of urgency like they did when the vaccine was scarce and it was like I want a dose. But I would tell people again, even though you may not feel a sense of urgency, this would be the time to start really looking at getting the booster and don't sort of put it off further and further into the future. I guess that one last follow-up question with the general assistance program, maybe Governor or Commissioner Brown too. I just wanted to clarify, as you would address, why not open it up to you from authors that were previously exited? I mean, it doesn't seem to be a money issue right now. I mean, is it a hotel capacity issue because we are approaching stick season right now? Commissioner Brown? Yeah, we were able to house over 2,000 households during the pandemic because the economy essentially shut down and hotels were not serving travelers and tourists. That has now changed and as you heard, we had some of the highest motel capacity of travelers over one of the recent weekends in October and that's really reduced the number of available hotel rooms that we have available. We're now at capacity at around 950 households and motels, which is the reason part of our plan includes expanding emergency shelter capacity in the areas of the state this winter to make sure that those who are able to access a motel room due to capacity issues that we have a place for those individuals and households to go. How many hotels participated at the peak of the program and how many are participating now? We can follow up and get you that data. I don't have it right at my fingertips. Thank you. That's Stuart. I wanted to get back to you on one part that I left out and this is don't misinterpret this as an excuse. It's more of a fact. We do an incredible amount of testing here in Vermont twice per capita than what New Hampshire does five times what Connecticut does. So we capture a lot of cases that I think are slipping through in other states. So again, just keep that in mind. The high number of cases that we we test for surveillance testing and otherwise and people want to get tested on their own. So again, that could factor into the high case counts as well. And I was listening intensely to Richard Levine and the Johnston Johnson what to do with the second the second dose as I received the Johnson Johnson myself. So I'm going to listen to the experts first. I'm going to listen to what they come up with on Friday and then confer with Commissioner Dr. Levine. We're the third highest testing state in the country. The temperature now starting to fall. Is this situation expected to get better? Doesn't prior experience tell us it's going to get worse? Yeah, I don't know if we can go by prior experience because we've only been through this once before with a different covid versus the variant. And I'm not sure that any of us are very good at predicting what this virus is going to do. It seems to have ahead of its own as well as with new variants and so forth. I would have said and I thought this previously that we would have seen the surge that we're experiencing right now. I would have predicted that we were going to see that in November and December. That's when I thought it was going to happen, but it didn't. And we may as well. Some are predicting that we actually won't see an increase. These are national experts like Dr Fauci has said that that we may we may actually see a downturn going through the winter, which to me makes no sense. But with our high vaccination rate and continuing decline, the booster shots coming out, the second dose for I think it's 60,000 those who receive Johnson Johnson in our state possibly. I'm not positive of that number, but I think that in the 40s, in the 40s, it's higher. Well, one saying 40, one saying higher. So I'm going to stick with 60 for right now. But but with that coming out, all kinds of news, the the five 12 year olds probably will get approved as well. All of this is going to make a difference in in a positive way. So hopefully Dr Fauci is right. We'll see this downturn and continue to to meander our way out of this into from pandemic to endemic. What preparations or what expectations do you have for November and December, looking at what we have now, we are prepared every single day to continue to advocate for what we think is the best guidance again, getting vaccinated, first of all, getting your second dose, getting your booster, protect yourself, take some self responsibility, protect your others that you're in contact with will continue to advocate. If we do all of that, I think we'll be in pretty good shape. We'll move to the phones now, beginning with Lisa Raffke, the associate press. Thanks, Jason. I also had a question about the housing plan. I don't know if it's something Commissioner Brown or Secretary Smith could answer. Part of it would move those people staying in motels to longer term motel rentals possibly through the emergency rental assistance program. Would that be covered by ARCA funds? And do you know if that is something allowed, that program would be allowed to be covered by those federal rescue dollars? Commissioner Brown. Yes, we have consulted the Treasury guidance and our consultant and that is an allowable use of the emergency rental assistance. I think the state has received over $250 million in several different tranches of funding. And you know each household between the separate funding streams is eligible for almost up to 18 months of a housing rental assistance. And so this provides a longer period of assistance under this program that we will run within DCF. We are already running a similar program for families on the reach-up program that have rent payments and we're administering those funds and do a similar process for these households through our economic services division as well. Okay and do you have any idea how many of those households might be part of that program you know next year? You mean of the current households we're serving in the emergency housing program? Right, yeah. We believe virtually all of the families and households that reach their 84-day limit in emergency housing would be eligible for this rental assistance program moving forward. Okay, all right, thank you. Greg Lamaril, the County Courier. Good afternoon Governor. I wanted to follow up with a quick question with Secretary Smith. You mentioned earlier that there were monoclonal antibodies that were used in some nursing homes in the area. I'm wondering where they were used. What nursing homes were they used in? We've mentioned long-term care facilities where we've had outbreaks before. There is an outbreak in Franklin County at the residential care facility and that is Ave Maria and there may be another one but I can't remember which one it is. I think one other follow-up here. Governor, as far as the hotel motel program goes, you know multiple states did something similar in the in the throes of the pandemic, whether it be Illinois, California, whatever. I'm wondering if you've reached out to some of these other governors to see how they're handling ramping down the program and what you're maybe learning from other states? I have not reached out to any other governors on this issue but we're relying on my team, Secretary Smith and Commissioner Brown and Commissioner Hanford as well. Secretary Smith? There is no other program like this in the United States. We are the leader in how we did this program in the hotel motel program throughout the state. I mean the city of Los Angeles did something similar but no state in my review of what's happened out there did what Vermont did and continues to do what Vermont does in the hotel motel program. Commissioner Brown or Commissioner Hanford, did I express that right? You are correct, Secretary Smith. I think New York City did a similar program but I believe it was New York City itself and not the state of New York. Well you know state or city, wouldn't there still be something to learn if you could reach out to some of the leaders in those municipalities? I mean there's probably far more homeless in New York City than there are in. I would say our experience in Vermont would differ greatly from Los Angeles and New York City. We're a much different demographic and we're a more rural state and so our experience would be much different. Well I've certainly read on the programs in other states and the winding down of those programs in New York City and the impact it's had. So you know we are aware of those efforts and some of where they're at with those programs right now but really we're facing our experience on Vermont meeting Vermonters needs for our program. I did hear some opponents on on the idea of ramping down this program say that that it's really just unethical to kick people to the curb to make room for tourists. I take it you don't share that same view. We're still we're taking care of the homeless. We haven't kicked anybody out so to speak. We've given them options and but we're still continuing to take care of the homeless. Last thing here governor I've heard that there's been multiple outbreaks you know over over the last few months of COVID at the police academy fire academy courses are being affected by these COVID outbreaks. I'm wondering if the state has considered participate in either the police or fire academy that students must be vaccinated. Yeah I have not heard that. You may have information that I do not have. Maybe Mr. Schirling could could respond. Good afternoon. Thanks governor. Thanks for the question. There have been sporadic cases but this year I am not familiar with anything that has been substantively disruptive. The police academy has a masking program in addition to encouraging vaccine and I'm just not familiar with anything that's been a substantial disruption as I indicated. I'm told that you know many classes have had to move online which obviously in a hands-on atmosphere really does hinder some of that education. I'm just wondering if any considerations have been made and has just opted not to go with a with a vaccine mandate or if that hadn't been contemplated yet. Well the I guess a couple things if you could get me some information if you've got it on you know what has been moved online I know some of the courses that are able to be conducted online have been have been moved. In terms of a vaccine mandate there are folks employed by a variety of different organizations that attend the trainings that are supported by these two organizations so we haven't contemplated mandates that would cascade across you know hundreds of agencies. That's it for me today. Thank you. Chris Roy, Newport Daily Express. Yes good afternoon. One of the within the last few minutes here I received an email from a reader who's wondering those of those who received the AstraZeneca code vaccine if they can receive the Pfizer or the Moderna vaccine she's saying that she's two local pharmacies up here at Denider. Yes we are aware that some pharmacies have denied it but these people either got the AstraZeneca from being overseas and now coming to this country or more commonly from being in the trial and all those who have been to the trial and are looking for starting a new vaccine regimen with an mRNA vaccine can do so at one of the state sites. We've already cleared the way for that to happen. Governor you said nobody's been kicked to the curb as it relates to the Motel housing program. There were about a thousand households that were eligible for that program in Zoom and were told they were no longer eligible in July and had to leave Motel housing. I mean is it the verbiage that you take issue with or are you saying that those people didn't lose state subsidized emergency housing? Secretary Smith. Yeah I'll call on Commissioner Brown in just a moment too. Peter we did not remember when we initiated this program during the height of the pandemic we eliminated all eligibility requirements all eligibility requirements. Anybody that wanted a hotel motel room that said they were homeless could get a hotel motel room. What we did is institute in July some criteria to bring back it was expanded criteria and more more broader criteria in July to put some fencing around who was eligible in terms of coming in. A lot of people again just about a thousand I think it's about 1300 people were still housing about you know 900 rooms about a thousand adults 300 children. We did that criteria that we put in in July did impact some people that didn't qualify anymore but just remember that program had expanded criteria from the original program that we put in place and and it did allow more people to be housed. Commissioner Brown. Yes I would add that you know that was a new eligibility criteria was put in place through a process initiated with the legislature where they asked us to form a working group to propose what the program would look like for state physical year 22 that working group of housing providers a legal aid you know staff from the agency of human services came up with this plan proposed it to the legislature and was passed unanimously became law and so that that's the program we're working with now. Obviously we're continuing to work with the working group to propose what the programs look like in 23 and also it was the working group to help inform this new path forward that was just announced by the governor as well. And Commissioner Hanford I believe you said earlier that several hundred people were transitioned into permanent housing is that correct? Commissioner Hanford here yes the number that I'm aware of is over 500 households were transitioned into permanent housing. And am I clear that the policy decision not to include the folks who lost eligibility in July in the GA program going forward and the ERAP program going forward is based exclusively on capacity issues? Or is there something else? Is there another reason or not bringing them back into the fold? Commissioner Brown. Yeah I mean I think that there's multiple factors. One is motel capacity is a real issue and it has been for several years and it's something we've been highlighting. Try to work with the legislature and develop additional community resources to meet the needs and also it is those community resources that we want to further develop out to help meet the needs of those other homeless Romaners that are not eligible for this program. We want to meet their needs as well and we have a proposal to do that as well. And one last question I apologize for asking three. Governor you started out this presentation with a very clear articulation of how Romaners can use their own personal responsibility in ways that are going to reduce the spread of COVID-19 and in the context of masking you said and I'm quoting you here if you're unvaccinated wear a mask when around others or in a populated setting. And I'm assuming you chose that language very deliberately and I'm hoping you can explain why you wouldn't include vaccinated Romanters in that charge. Because the data is very clear the transmission rate amongst the unvaccinated is much higher than if you're vaccinated. So it's clearly in the data. It's clear. So you're not terribly worried about vaccinated Romanters not masking indoor settings. I think it's again I wanted to emphasize that if you're unvaccinated you should take extra precaution in those situations not to preclude anyone. And in fact our guidance has been if you're in those situations with a lot of people you don't know in a very condensed area that you should vaccinate or not wear a mask. But having said that again if you're unvaccinated you should take extra precaution. Thank you all. Mike Donahue the islander Mike Donahue. All right we'll move to Leora Engel Smith. BT Digger. Hi I think this question is for Secretary Smith. It's about the 80 sub acute beds that you guys are hoping to bring online. Where would they be? Where are they going to be available and you know how did you guys reach the number 80 and once all of those are open would that sort of alleviate some of the bottlenecks? Those are very good questions. Thank you very much for them. We developed the number 80 because we did a survey of hospitals through the hospital association to figure out how many of their patients were being not being able to be discharged because there were no sub acute beds. The number came up as 74. We went to 80 just to make sure we had more beds than patients anticipating if there was you know having some leeway if there was any growth. The places that we're looking at they call it a different name. I know it is Burlington Health and Rehab. Those beds will start coming online tomorrow on the 20th. The other ones will follow quickly thereafter and those are St. Albans Health and Rehab and Rutland and I'm struggling for the name but it's a Rutland long-term care facility and rehab facility down in Rutland and I'll get that name for you Leona because it usually comes right to the front of my of my brain and it's not coming there now. How many things are opening tomorrow? I think there I'll have to get the name the number for you but I think it's it's it's I don't want to give a number out there but it's certainly I think it's in the double digits and I got to figure out yeah I think it's 18. Thank you. Tom Davis, Compass Vermont. Tom Davis. Tom is probably on his way to Canada. We'll move to Lisa the Waterbury Roundabout. Lisa Waterbury Roundabout. All right we'll move to Aditi, Vermont Digger. Yep we got you. This is Lisa from the Waterbury Roundabout. Sorry the unmute was on a delay. Okay we'll go to you and then Aditi will come right back to you next. Go ahead Lisa. I think either Dr. Levine or Secretary French in terms of the reporting that's happening right now on the state website with the breakdowns for cases in schools. It's nice that we have that now that we can look at every Tuesday to see the current week and the running tally of cases school by school across Vermont. One of the things that I've noticed and I find I don't understand and I'm wondering if other reporters that are covering other parts of the state are seeing this as well is that the number of cases that our school district where I'm located which is the Harwood School District we receive notifications every time there's a case identified in a school that goes out to the community. We've had 10 cases reported. I know that's not very many but based on the breakdown that's reported on the state website there's only five. So there's you know entire schools that have had several cases three four cases of them are listed as zero. So I'm wondering what the discrepancy is and if others in other places might be seeing this difference between what the communities are being told from their schools and what the state is collecting on that running tally. Hi Lisa this is Dan French. Yeah we've heard that concern before I think it usually boils down to timing for the most part you know there's especially now there's a lot of case activity it sometimes takes a little bit to work work that out through the system and as you noted we're updating or the health department's updating the state data on Tuesday so sometimes that takes a while to sort out but I you know eventually the data the data do stabilize. I think that's a delay of more than a week or so because I've been watching this now for a couple weeks and the needle hasn't moved while our cases have been moving. Yeah I don't know I mean the other the other thing is where we have a lot more testing going on so you know a school might be reporting you know I've heard from schools saying you know parent used to take home tests and so forth and has a case it might might take some time before the health department identifies that finally as a legitimate case if I don't say illegitimate case but a case that's been verified through that process so you know we do our best with that we have a lot of small schools that are in particularly with Delta a lot of a lot of data that needs to be parsed out so try to keep it updated as possible. Okay one other one other question while I've got you in the in the queue here is the idea behind de-emphasizing the surveillance testing to shift over with the emphasis on this test to stay I'm trying to get my head around this too because it seems to me that the point behind the surveillance testing is to try to catch the cases that we don't know are there where there could be students that are asymptomatic and caring and potentially contagious so that they get caught sooner rather than later before it spreads and the test to stay seems to be testing that's being used once the case has happened and it involves the people that are around that person it seems like two different things. Yeah they are I think it's in the middle there there's this approach we're called response testing and I'll just draw the distinction between surveillance testing and response testing I think there's two variables there one is scheduling and the other is the technology so in terms of scheduling you know surveillance testing you know schools are enrolled in surveillance testing and that happens on a regular basis if you think back to last year pre-vaccination we didn't understand the condition in our community so it was helpful to have that sort of listening post out if you will to understand what the patterns are you know that kind of approach isn't necessarily helpful if you have cases emerging in your school and you're not scheduled to be tested for another week so response testing has emerged as a more I'll say responsive approach but it's using pretty much the same PCR type technology just to draw the distinction between antigen testing that's used in tests to stay so with response testing if we have a situation in school we're able to deploy testing to the school so that you know schools can get those tests in their hands more quickly and also then you know deal with issues of isolation quarantine more quickly and that I think the interesting thing there is there's a new technologies emerging all the time in terms of response testing so you know this is where the take-home kits become more prevalent we also have this idea of lamp testing which allows schools to understand you know identifies the virus being present as opposed to antigen testing and that technology can be deployed on the site and doesn't require being sent out to a lab so the the purpose again of surveillance testing I think was more useful in a situation where we didn't have a lot of vaccination and the case counts were relatively low I've heard very strong consensus from our epi folks that surveillance testing its purpose isn't necessarily that useful in this moment in time but then secondly what schools need to have which is more real-time data that really points to using response testing in conjunction with tests to stay and contact tracing so it's that how to get that right mix is where we're heading to and I think you know the it's promising to hear about the new technologies that are being deployed all the time in testing but does it still mean that this response testing waits for a child to get sick or to have symptoms before that launches into motion where the surveillance testing is basically looking at everybody even if they don't think that they have any symptoms or they're not even sure they would be contagious yeah I get your point it's you know firstly we we're not seeing a lot of interest in the surveillance testing from the school perspective so that that idea of getting a broad sample isn't as necessarily being operationalized like it was last year but again we already know as you've heard today we have significant amount of testing going on in our community so we know the virus is there you know that was essentially the purpose of surveillance testing last year was to sort of do that public health surveillance if you will so we know the virus is present right you know it's a really operationalized how to keep schools safe comes down to getting that data in the hands of schools more frequently and I think here you know again response testing combination of response testing test-to-stay and contact tracing will really be sort of the the key ingredients to doing that okay thank you very much Audit PT Digger all right we'll move on to Andrew McGregor Caldoni record yes good afternoon thanks question for commissioner p check looking at slide 14 in your presentation comparing the seven most vaccinated counties to the seven least looks like the top seven counties are some of the larger ones that account for nearly 62 percent of the population in your slide is that differential in infections hospitalizations and fatalities on a per capita basis or is that the raw total number suggesting that the discrepancy is even greater when compared capital yeah no it's a great question I'm just looking at the slide on the tv and it doesn't say it anywhere but it is a per capita analysis so it's per 100 000 on all of those metrics so you are right that I think it's like 385 000 are in those top in those top counties and just over 200 000 are in those bottom seven counties but we did adjust it for a population okay and I know you've said projections are especially tough to make right now but considering this discrepancy there as well as the one that you routinely report on the states for geographic regions do you expect the kingdom will continue to have a starkly different experience than the other regions and and guess as to when the kingdom might see its peak in cases seeing as some of the other regions look like they're plateauing yeah so again it is hard to know with any certainty you know what the timing will be but just in terms of you know will the kingdom always have a different experience I think a the answer you know is no and even more likely to be no you know if we get the vaccination rates up a bit there as well when you look across northern New England some of the other states that have counties with particularly high case counts at the moment there are also some of their lower vaccinated counties like in northern Maine and Coas County in New Hampshire so it is something that is happening not just in Vermont but more broadly and I think the key is vaccination but of course we've also seen whether it's Louisiana or Florida or California you know Delta does run its course over time so that is also you know a likely outcome at some point it's just hard to say for a state that is as vaccinated as we are when that will be as we have seen. Any then probably not for you Commissioner thank you very much but for perhaps Secretary Smith as a governor any initiatives then focusing on the kingdom for instance to boost those vaccination dates I know there was a town-by-town traveling vaccination clinics early on just curious if there's anything that you guys are trying now. Yeah that's a good question we had put and we will continue to do so we have put vaccination mobile vaccination clinics up into that region of Vermont and we will continue to do so to promote vaccinations I don't have the list of the over 80 that we got going this week so I don't know where precisely those 80 are going but we have made efforts to place mobile units up in that area to increase the vaccination rates in that area and we will continue to do so as we move forward. Okay thank you everyone. And Andrew I think I have this statistic right but those who are unvaccinated are six times more likely to transmit than vaccinated as well as 11 times more likely to be hospitalized if they contract COVID so if that's any different I'll let you know but those are the two six and 11 I believe and that's what we have to keep in mind we'll do everything we can to continue to promote vaccines but you know it's difficult when people are unwilling to do so. Colin Flanders seven days. Yeah this is a question about vaccine uptake in particular about booster shots I'm curious I think it was Dr. Levine who had mentioned something about there is a less of a sense of urgency among the people seeking out these booster shots than might have been a year ago or earlier this year are the numbers where you would expect them to be would you hope that they were higher at this point a few weeks into offering these shots and if they are lower than you expected what are some ways that you can go about trying to encourage people to go get them? Yeah so the numbers are lower than we anticipated um we have abundant capacity to give shots same day that most of our state-run sites I do know the pharmacies are a little more stressed trying to do flu shots and COVID shots and everything else at the same time but there's plenty of access around the state for people who want to get a booster there is this phenomenon of people taking their time as you as you put it which is a little bit understandable because again we are saying and we mean that you are protected still even without the booster but again to achieve a much more high level of protectiveness and especially that protection against being able to um become infected or become ill even if you don't get a serious outcome nobody wants to have a moderate case of COVID I mean just think about last time you had the flu or what have you that's not necessarily what you'd want to invite onto your doorstep so I do think knowing the winter's coming knowing that there's still a delta variant circulating in our communities this would be the right thing to do in terms of strategies that's a real challenge because I don't think we have an understanding mainly because boosters just happened we don't have an understanding of what's driving people and what's not driving people with the vaccine campaigns it became evident over a couple of months exactly what person fell into what category they were you know just very very aggressively wanting to get vaccinated if they were on the total opposite end of the spectrum or if as was more likely they were in that area in the middle where they were just hesitant or they were apathetic about it or what have you I'm not sure we understand yet the the whole psyche with regards to the rest of the population so we'll have to be getting insight into that now but similar to our regular vaccine policy part of our policy if I could use the word is to be relentless and to make sure that we continue to educate we continue to demonstrate the differences as we've done pictorially for the population as we vaccinated each age band to show the decrease in cases and the increase in vaccination rate and how they correlated and we'll also continue to make sure that there's access to vaccine secretary smith mentioned you know the 80 odd places this week that are happening whether you want a booster or whether you are a first timer so we need to continue to do that and obviously we'll continue to do that as part of our overall pandemic response secretary smith I just wanted to add Colin we noticed out of the blocks it was a little slow and and I think there was some confusion of how this rolled out from the federal side I think there was confusion about who was eligible and who isn't if you're talking about a strategy we're we're fairly liberal here in Vermont in terms of how we are ministering this booster so if you're like I said before if you're over 18 and you've had the the interval between your last shot in terms of your regular vaccination cycle and this booster in most cases Moderna Pfizer six months J and J two months we're going to be we're going to be fairly liberal on who gets who gets it meaning we're going to we're going to try is to open it up to a lot of people here in Vermont for boosters so I think you'll start seeing this rolling my hope is you'll start seeing this rolling faster and we've seen that in the last few weeks we've seen us start to roll a little bit faster than what it did in that first week which was not what we expected in accordance to how we did the first vaccine with a lot of people showing up all at once when they were eligible I just want real quick follow up do we have any idea and I'm just might have been said at a previous press conference about how many people fall into our liberal eligibility guidelines how many people are we talking who are eligible for a booster shot of right now and I'm sure that's a moving target since we're talking about a timeline it is a moving target I will tell you that if we looked you know generally at the guidelines that the CDC had put out and then sort of looked at different groups that may fall in there it was about a hundred thousand that we're looking at but the way that we're looking at it I think it's going to be you know much higher than that number as we as we move forward thank you Michael Dougherty Vermont Digger hi thank you I wanted to pick back up on what Andrew was talking about with the focus on the northeast kingdom given that the per capita case rates in Orleans and Essex County are are so high I mean they're right now double what the statewide rate is or leans appears to be one of the top 10 counties in the country in terms of the highest per capita rate and I'm curious Dr. Levine had mentioned through contact tracing data getting statewide a little bit of a sense of where cases are coming from but I wonder does any of that data give us an indication of specifically what's happening in Orleans County I mean what is behind the much higher case rate that we're seeing up in that region I'm I'm going to just take a wild guess here and say as we've said this is a now a pandemic of the unvaccinated and I think that there's a number of people in that area who are unvaccinated and so this continues to spread and it spreads to both vaccinated and unvaccinated unfortunately when you have that much of a concentration in one area Dr. Levine I believe that Orleans County is the second least vaccinated county in the state so it does correlate with that I'm sure as the governor has said but you know if you look at places like Louisiana and other southern states there is another motivating factor that comes into play with time and it gets categorized as fear sometimes but other times it's just more awareness and I think you know we can hope that we will see that in our lower vaccinated regions of the state because the fact of the matter is there has been significant national uptick as a result of the Delta surge in vaccination rates we continue to have our steady uptick in Vermont and I think we can expect to see even more just related to the factor that people see neighbors friends family members getting ill possibly having worse complications and begin to reevaluate their situation so that that that would be my hope and the sooner the better for for those who do come to that realization to keep as well protected as possible with with contact tracing data more generally last year you were able to provide some analysis some charts that showed you know different environments that according to contact tracers that were indicating where people were getting infected is that something that you be able to provide again this year well I think you know in my opening comments I provided what we do know because you know most of these cases don't fall into the outbreak category 85 percent of them don't fall into an outbreak category so the majority of people unfortunately are in that 85 percent so 50 percent are they're not sure how they got it and they may have attended a gathering there may have been poor masking but it's unclear because they didn't know anybody there who was infected it becomes a real challenge to give more granularity to exactly what their experience was different than if they report travel as a strong factor report a household contact as a strong factor and again in our situations you know our situations in the state again are being driven by the usual kind of situations whether it be a school-based one whether it be a long-term care facility a variety of workplaces without you know really one defining type of workplace except sometimes a theme of people who do work much more closely together as part of the job that they hold or are facing customers a lot more frequently but again it's hard to get so specific that a person could take that information and protect themselves more than we already tell them how to thank you and I had one other question for for the governor related to your opening remarks and this idea of personal responsibility and you know it strikes me that perhaps the people who most need to hear that message are probably not tuned into this press conference and have maybe in a lot of cases kind of checked out from the pandemic or just not taking COVID seriously anymore and I wonder you know how can we rely on people who have effectively moved on from from the pandemic to hear this message and and much less act on it to kind of get it safely through the holiday season. Well we certainly you know I understand your point but as we again look at the number of people who are vaccinated those who've received at least one dose we're we're getting to 90 percent so I would have to believe that there's another 10 percent again by the numbers the data that have not been vaccinated. Something we don't talk about a lot and I'm certainly not promoting this but there's going to be some natural immunity at least in the short term we don't have the data to know how long this is going to last in order we on any of the the vaccines for that matter but but that's going to become a factor before long so again we can only hope I don't I mean there's a number of media folks here in different areas of the state and have a different outreach I would say that it's a mix that that I think we can still make a difference with those who are unvaccinated to make the case not force them to but get make the case to why it's a good idea for you to become vaccinated at this point so we'll continue to try I know those who are here who are listening and are going to be reporting this will make the case for us as well because it's a fairly fairly small number when you think about it again when you have of the eligible population almost 90 percent who are willing you only have to get to that 10 percent at this point thank you Tim McQuiston Remind Business Magazine I had a couple of data questions for Commissioner Beechek what is that the cases have been down the last few days should we read anything into that or is it just a matter of timing or just is there just not a big enough sample yeah so Tim we we always look I mean the almost the shortest duration we look at is the seven day average you know we also look at the 14 day average as well so like today when you have you know 132 I think cases it was it's replacing a day where last week we had 130 so the average actually went up just slightly so you know I think you want to keep a close eye on that you know over the last week I think the seven day average was up 10 percent you know not as much as last week but still up so you know slowing down potentially a bit but I would recommend looking at it you know in a little bit longer range rather than day by day and how many fatalities have there been so far this month it's a little hard to calculate that just eyeballing it yeah so for October we did report a fatality today so the number is 19 for the month of October great thank you guide page from on daily Chronicle governor can you hear me yes oh great I can even see you guy oh I wonder so the slides today although I guess I just heard that there have been 19 fatalities for the month of October can you or commissioner give us the brand down on those fatalities and fully vaccinated less backed and unvaccinated I think we only have two categories first of all I mean it's either you're you're fully vaccinated or you're not fully vaccinated or not vaccinated at all so there's only two categories um yeah we can we can look at that we don't don't have it at our fingertips a guy but we can get that to you thank you you know I've I've been asking uh the spokespeople for this information and has been forthcoming and I think that's you just commented on you know why the 10% and I can say that the 10% often feel that they're not getting all the information that they need they answered no questions a lot of my readers are among the 10% so some sort of engagement there would be very helpful yeah and I would I would I'm going to ask Dr. Levine the comment on this because again when as as someone who might look at those numbers and see that the let's just say it was 50 50 and they might lead to the conclusion that that the vaccine doesn't work that's just not looking at the the data properly that's not doing the math properly because again from a percentage standpoint it'll be much much less of a percent or percentage of those who are vaccinated than those who are unvaccinated when you take the whole population as well there are a number number of cases where there are compromise health conditions so whether they've been vaccinated or not that the the actual underlying conditions played a factor in their demise Dr. Levine it's pretty much exactly what I would have said and there was some comments in the press today actually regarding the boosters and all of that but bottom line was the reflection was that nationwide we're seeing more people who are in the vaccinated range who are dying but the fact of the matter is as a percentage of the vaccinated population that's still a much smaller number and it turns out that when you reach a certain stage in life whether it be age or more commonly medical condition related all it takes is a mild to moderate case of an infectious disease to tip the balance in the wrong direction and we just have to understand that that's the way things have been going for centuries with the whole variety of viruses we know a lot more about than we do the SARS-CoV-2 virus. Commissioner in a nutshell could you describe the treatment protocol for patients who are admitted to the hospital for COVID-19? In a nutshell it's yeah in no review. Sure. Sure. Usually you don't get into the hospital unless there's a problem with your ability to maintain a good oxygen level in your blood so there are criteria for that from the get go and you usually have to have some element of illness beyond COVID that would probably get you there because you're in a compromised state but probably the primary modality of treatment I would list as oxygen given a variety of ways the least common way is because you're ventilated by a machine because so many of the ways we can administer oxygen now help prevent you from having to get on a ventilator so that's a whole bunch of intensive care unit and medical floor kind of protocol that I won't over detail here. Medication wise most people who are getting hospitalized aren't on their first or second day of illness they've had the COVID for a while at least five seven days and that's the point in time when they're starting to deteriorate not necessarily related to the virus but related to the inflammatory response that the illness has produced in them their bodies trying to fight off the virus and all kinds of inflammatory chemicals are being released within their bloodstream to try to do that. So some of the therapies are actually to reign in control of some of that overzealous response on the part of the body and that's why things like corticosteroids are used in that setting. There are also antiviral medications not the one that Merck is trying to get approved now that's a different one but some older ones that are used to work on the virus part itself. So it's a whole host of interventions to support people's ability to breathe and have a good oxygen level without being on a ventilator hopefully to rein in the inflammatory response and to address the virus itself. Is Remdesivir one of those antivirals? And Remdesivir is one of those antivirals. Okay. Thanks for your time. It is the one of those antivirals in terms of the one that would be chosen for the appropriate patient who meets the criteria. And are you using the monoclonal antibodies too? So most of the time someone would have gotten into the hospital either too late to use the monoclonal antibodies or the cats out of the bag so to speak. So you know this this therapy is used early in the course to prevent you from getting in the hospital. So it would be the less common person who's actually admitted to the hospital who would still qualify for it because they may have passed that point in time when it would be useful. Thank you. Guy we'll do our best to get that information. I see no reason why you shouldn't have that information on vaccinated versus unvaccinated deaths. But I would ask we'll provide the number of people who are vaccinated the number of people who aren't so that you get all the information and then you can report all the information in terms of a percentage of of those who have died with COVID who are vaccinated versus unvaccinated. Glad to do it. Thank you. Aaron Tango from Montdigger. Well we've received some questions for readers about the Motel housing stipends the $2,500 that people can receive. Specifically there's some confusion about under what circumstances people can receive it. One of our readers was told that they you know are having an extension to their their motel stay but if they say they're potentially corefitting the $2,500 that they receive and since they're still looking for permanent housing when they can they're kind of confused and you know don't understand like what they should do. So it would be great if you guys could clarify how people receive that $2,500 and you know if they will lose it if they stay at motel. Yeah I don't believe that's the case but we'll go to Commissioner Brown to get the get that clarified. Correct those funds are are available to help households when they do find other living arrangements whether permanent housing or or or someplace else to live. Those funds are available to help with the transition so whether you know it's when they reauthorize or two weeks later those funds are available for a household when they're moving on from the program. However they are currently funded with Corona relief funds which need to be spent by the end of December or that when they're no longer authorized under the federal legislation and so those funds will just through that process this program be winding down and we're not proposing a new essential payment however our plan does include continuing the rapid resolution funding which is available as well which provides even more resources for a household to move forward. Okay so what happens if you know you're you're getting a housing situation lined up you know you replied maybe you're you're just specifying the lease and landlord backs out. Do you you know do you like lose the 2,500 you have to reapply if you you know are staying in the motel and you get another opportunity and another like four weeks. You know what does that process look like? Yeah households don't apply for the payment it is available through a matter of when we're working with that household if they are tell us they're transitioning out then we make that payment available. If that falls through and they remain in the program and then two weeks later that they have another plan to move forward with those funds would still be available to that household. Okay so this person you know even if they stay at the motel for another two weeks they're not full or fitting the $2,500. Correct. Okay thank you. All right that's it thank you all very much see you next Tuesday.