It is 6 p.m. on Monday, May 15th, so I will call to order this meeting of the Winnowsky City Council. Please join us in the Pledge of Allegiance, led by Deputy Mayor Thomas Reiner. A Pledge of Allegiance to the flag of the United States of America and to the Republic for which it stands, one nation, under God, indivisible, with liberty and justice for all. Thank you. Any agenda review? Any concerns about the order this evening? No. Okay. Next up is public comment. Public comment is space for any attendees who aren't here for an agenda item. If you are here for something on tonight's agenda, please wait for that. Is there any public comment this evening? Okay. There's no one online. We have our consent agenda. I'll take this into votes. First is the City Council and Ligger Control Board minutes of May 1st, 2023. Any concerns about it? No. Do I have a motion to approve? Second. Motion by Bryn, second by Aurora. All those in favor, please say aye. Aye. Those abstaining? Oh, abstaining. You were gone, right? Yeah. Okay. Okay. And then the rest of the consent agenda, we have our payroll warrant, April 16th to 29th. We have a motion to approve. So moved. Second. Motion by Charlie, second by Bryn. All those in favor, please say aye. Aye. Motion carries. Thank you. We will move on to council reports. Can you kick us off, Charlie?  Uh, no significant updates. Thank you. Um, I also attended a meeting on behalf of the mayor. It was the finance commission meeting. Um, the director of downtown Winnowski was a guest at the finance commission meeting, and it was really kind of just a level setting a meeting where they were getting to know each other and, um, talking about like a general out way of what downtown Winooski does. I was happy to be there because I was able to fill in some information that the new director didn't know due to being very, very new, but we didn't take any action. No votes were taken that night either. Thank you. I'd like to provide an update on my monthly housing round table meeting where I meet with partners in our housing community and school district. We continue coordination around trainings for tenants, tenant information, and bringing those from the Champlain Valley Office of Economic Opportunity into Winooski. Also heard some progress with the Vermont Home Improvement Program. So this is the state-funded program that provides grant funding to bring houses, vacant houses up to code if they are rented at affordable levels. So there's, some more houses have been identified that might have like three or more bedrooms in them in the area, so not immediately happening, but some progress there. And then just for the public awareness, we had our annual strategy and priority session. Leadership team and city council got together on Saturday to discuss priorities for the upcoming year. That'll come back on a future meeting agenda for a public discussion and approval. Great, thanks. The airport commission met on May 3rd. A lot of us just updates, no action items. Looking at early stages of reviewing the noise impact map. Selecting a consultant will be a lot more communication, public outreach on that as it gets underway. So just look out for updates and I reach from the airport on that. The noise insulation progress is moving along, but it hasn't reached Winooski just yet. So again, seeing some momentum there and more information will be coming out as it reaches our city. The Municipal Infrastructure Commission will be meeting this Thursday at 6.30 at the pool and we'll be reviewing the LaFountain and Dion Street Scoping City as a primary topic for that meeting. The Safe, Healthy, Connected People Commission met on May 9th. We spent the time doing some detailed review of the community services program needs slash interest survey and also some focus group questions. So that will be coming out to kind of gauge, make sure that we are providing the city and residents with the program that they most need and want. And there's no inclusion in belonging, commission meeting this month. This is one of the off months. All right, thank you. City updates? Yeah, so there are seat vacancies. The city of Winooski is searching for engaged and dedicated residents to serve on our boards, commissions and committees of applicants with related experience, skill sets and interests are encouraged to apply. And council and staff will welcome diverse voices. So if you've never served, we will do our best to support you. Current seat vacancies include the Finance Commission, Inclusion and Belonging Commission, a brand new youth member position with the Winooski Memorial Library Committee, Winooski Valley Parks District Board of Trustees and the Chinnin and Seldo Ways District Board of Commissioners. You can learn more about these positions by visiting the news updates section of WinooskiVT.gov. And on a similar note, the city will have an announcement in the coming weeks advertising our annual Board, Commission and Committee term expirations, which are right around the corner on June 30. A Memorial Day Parade, that is returning to Winooski. Join us in partnering with the Winooski Vermont, I'm sorry, the Veterans of Four Moors and the Regular Veterans Association on Saturday, May 27th. The parade starts at 12 p.m. at the Winooski School District, travels down Main Street and ends at the VFW. Following the parade, please join the ceremony to honor our fallen veterans and enjoy community barbecue. Volunteers and participants are needed. The parade welcomes all groups, local businesses, creative vehicles and floats. If you're interested in participating or want to volunteer, please call the VFW at<PHONE_NUMBER> or show up early on the morning of the 27th. And finally, there is a blood drive at the senior center. The Winooski Fire Department is hosting that blood drive in partnership with the American Red Cross at the Winooski Senior Center on Friday, May 19th, from 12 to 5.15 p.m.  Visit the news update section on winooskivet.gov to learn more. Thank you. We will move on to our regular items. And so first up is our presentation on flavor tobacco products bill in the Vermont legislature. Mariel or Heather, do you wanna bring us up? Good evening, everybody. I'm Heather Nguyen and I'm a former Winooski School District teacher and now working for Winooski Partnership for Prevention as the youth coordinator. And I'm here with Reina Chase, a fifth grader at JFK. And we're gonna be talking to you about what you see on the tray over there. So I'm gonna pass it over to Reina. Hi, my name is Reina and I'm going to be asking you guys some questions about what is in front of you and what flavors are in the snacks. What flavors do you notice in the snacks? Watermelon. They're all very sweet. It's like a baseline, not to be particular. They all look very delicious. Colorful. What other flavors do you see in there? Blue raspberry. Blue raspberry. Vanilla. Well, birthday cake. Oh, birthday cake. Oh, birthday cake. Sour apple. Winter green mint. Strawberry. And cinnamon. Who do you think likes these kinds of snacks the most? Kids. I like them all, but I have a child-like palette. Where can you find, where can people find these snacks? Grocery stores. Gas stations. Convenience stores. I'll just do these flavors in the snacks, or mind you. They're all very nostalgic to childhood, particularly the blue raspberry. Like blue raspberry ICs are like big core kid memory for me. I think they're all vape flavors. Yes, that is correct because we're focusing on how we should go with the flavor band to save people's lives. So, you figured that out pretty quickly. Obviously you have some experience thinking about this before. When we asked students at the school before, they were not as quick to make those connections. But when we showed it to them, they were pretty surprised. It's clear there's marketing that's directed right to children. And those things are readily available in our stores in Winooski. So, we're going to turn the floor over to more of our ATI students. We have Talia Bennett, who is an eighth grader, and we also are blessed to have with us again Lucas Suarez, who is a senior and our longest standing lifetime ATI member. We'll switch spots and let them take it from here. Thank you, Reena. Yeah, thank you. Hi, my name is Lucas, I'm a senior. I'm currently at the Essex Technical Center and I've been associated with ATI in Winooski partnership prevention for about eight years now. I'm Talia. I'm currently an eighth grader and I've been with Above the Influence for a couple of months. Welcome. Yeah. We get first four months, I just want to say hi. Thank you for having us. I appreciate it. And very happy that you could be meeting us today because the topic we're going to be talking about pertains to a lot to our youth health in Winooski and in general. So, I'm very appreciative that you guys could talk with us about it. As some of you may know there's currently a bill, S18, the Vermont House that will have a very powerful impact on public health of past. The bill prohibits flavors and tobacco products. We think passing this bill would have a very big difference for people our age because it would ban the very enticing and delicious sounding flavors. In our schools, in our communities, we know people who are using nicotine products are mainly using vapes. And we know the vape flavors that they're using are things like bubblegum, candy, cherry and watermelon and stuff of the sort. I personally am choosing to stay away from these flavors and things of the sort because I know it's dangerous for my health and I know that they're only doing this because it would keep me addicted for life and they don't care about my health. Other cities and states including Massachusetts and California have already decided to prohibit flavors in order to stop the tobacco industry from targeting youth and people of color in their states. Prohibited flavors would prevent new smokers from ever starting in the first place. The tobacco industry is targeting US teens and even kids by having these flavors. When kids my age, these flavor products in the local stores, flavors like popcorn and cinnamon, reminds them of movie theaters and holidays. The tobacco industry wants us to be attracted to these flavors. They want us to start using e-cigarettes so we can get addicted. They want us addicted because it gets them a lifelong customer and they make a profit off of us. We want you to help our Winooski youth by keeping these flavors out of our state. We know we'll have better lives if we don't vape or smoke because an addiction can run your life better than you can. Thanks for letting us share with you today. We hope you'll take time to learn more about this important bill and help us stay safe. Here's Marielle to tell us more about how to take action. Thank you for sharing. Thank you. Yeah, thanks again to our students for sharing. It's awesome to hear the message in their own words. So, you know that the legislature just broke their session and now we're in between two sessions and it's actually a great time. I've learned to network with legislators on things that are gonna get carried over to the next session. Restricting flavored tobacco products is the best practice for public health. It also is expected to have really important impacts on health disparities because flavored products are part of what perpetuates disparities in tobacco use including specific targeting of the black community and specific targeting of the LGBTQ community by menthol products and other products. And we also know that most smokers start before they turn 18. I was one, started when I was 12 with a flavored product and among those who start young, 97% report using flavored products and that flavored products are a main reason for their use. Also, most smokers are looking to quit. About 70% of, I shouldn't say just smokers, but tobacco users say that they wanna quit using tobacco and restricting flavors actually helps ease that quitting process, particularly for menthol. Menthol has characteristics about it that make it easier to smoke and harder to quit. So I just wanna advocate for this for protecting public health, protecting our youth and protecting our community as a whole. We do have this bill in the legislature right now, but even if there weren't, this would still be a best practice that I would love to speak with you all more about for future sessions. But I think because this, we have an opportunity right now, it would be a great thing if council is willing to reach out to our representatives and tell them that you would support a flavor restriction to protect the community. That would really mean a lot for health in Waduski. So thank you so much for your time and please let me know if you have any questions. Well, I would like to follow up by sharing that. We, last year in the fall, we created like a priorities list of things we wanted to share with our representation in the state house. And so this is certainly something that we can add to that in the future and reach out to you for language funds or even like maybe get some quotes from our local youth who are involved. Great. Sounds good. Does anyone else have any questions? I have a question. So you mentioned California and Massachusetts as statewide bans. Do you know if there have been any municipal bans? Actually in both of those states, they started as municipal bans. It is unclear at this point if Vermont has the authority to do a municipal ban that is being discussed from what I understand by VDH and the state lawyers. It's better practice obviously for protecting public health to do it at the state level. And honestly, it's often preferable for retailers to do it at the state level as well because it's easier to manage from a business perspective. Sorry, when you said who was looking into it, can you just reiterate that again? VDH, the Vermont Department of Health and the state lawyers. Is VLCT the Vermont League of Cities and Towns? I don't know if they're looking into it. That's a good question. Great, thank you. Yep. Anything else? No, just thank you. Yeah, I appreciate you all coming in, taking the time to share with us. I've got a sweet tooth going now. But also, this is really useful data. I didn't know that menthol was specifically even harder to equip than unflavored, so very helpful. Actually, sorry, I do have a question, but you just reminded me of, I recall previously menthol had actually been more damaging to people's lungs. Is that still the case? Yes, and I have a video that I will make sure to send on to all the counsel. From an expert in this field, Dr. Phillip Gardner who works for the African American Tobacco Control Leadership Council, I got it. He's out in California and he explains the science behind that really well, but basically because of menthol's cooling effect, your lungs open a little bit more and so nicotine penetrates more deeply, thus making it easier to smoke and harder to quit. Thank you. Okay, well thank you again. We're gonna move to our next item, which is an update on the O'Brien Community Center. Please feel free to stick around, but also don't hesitate to exit if you're done for the evening. Yeah. If you walked in without signing in, please do so for minutes. Thank you. Elaine, would you like to kick us off? Yes, so just for some context, hopefully counsel has a sense that the city manager has been driving this conversation to potentially sell the O'Brien Community Center to Champlain Housing Trust. At this point, we are made enough progress that we're talking about programming the space in terms of like the physical space. So that's why I've asked Ray to be point from going forward, of course I'm still involved, but now we're getting to the nitty gritty that's why I raise up the table instead of me. Yeah. So yeah, I think tonight I'm really hoping to lay some context, some groundwork for the conversation, hear a little bit about what we've talked about over the last year with CHT, and then look to counsel to sort of give us a sense of direction and support for direction moving forward. So I think just a little bit of table setting on the history. So O'Brien Center opened in 2008, near as I can tell financially, never really penciled for the city. And so it's been something that we've been sort of wrestling with over the years, I think had finally gotten with full tenancy a few years back to a pretty stable place, but admittedly a place where we weren't bringing in additional funds to seed a capital budget for the building. So we were covering the operational cost, paying down the debt, but weren't adding to a capital reserve for the facility. So I think as much as that was positive, there were still some concerns for us long term there. And then I think there's an operational piece too where we've I think said this in public session before cities are not always great landlords. And I think we are not equipped or staffed necessarily to manage a public facility with rental spaces that we're leasing out. So I think in acknowledging that, wanting to do right by the community, wanting to really stay true to the vision of a community center that serves residents with consolidated human services in one space that's accessible and comfortable. We began a conversation with CHT who has expressed an interest in retaining the building moving forward as a community center. So I think I'm gonna leave my table set there and pivot to Mike and ask maybe if we could talk a little bit about some of the things we've discussed over the last year and where we are today. And then we can field some questions from y'all. Thank you. And I have a little bit of hay fever, not a cold, not a cough, not anything. I've been testing myself. So Michael Monty, I'm the CEO of Champlain Housing Trust. And first of all, thank you very much for this opportunity. I think what we have in front of us is something that's a great revitalization of the O'Brien Center. Our work really is as property managers and as developers and as real estate holders. In this context, we actually have about 140,000 square feet of commercial space at different times, types. So it isn't like we're, this is new to us. Certainly over the last few years, you might have seen or heard of the Old North End Community Center in the former St. Joe's School and the transition of that building. And that really turned that building into a great use for the Old North and a really collection of individual uses coming together in a way that I think is pretty exciting. So with that in mind and conversations, we see that there's an opportunity here as well. Kind of a different set of players. Some folks have been fairly secure in their positions in parts of the uses of the buildings and ongoing conversations with those organizations about their participation and how strong they can participate in sort of this revitalization. I frankly think that this is taking too long, but I'm just impatient. But nevertheless, probably we're taking, we're going slow enough so that we can go quickly at some point, yeah, is that little saying, which I think is useful in this case. We wanna make sure what we have is the program that is correct and right. The parts right now are the, I always think of them as Vermont Works for Women. Actually, it's Vermont Works for Women, isn't it? Yeah. But they had a prior name, because I was a part of sort of getting that organization started. But Vermont Works for Women is still there. A real revitalization and utilization of community health centers of Burlington and dental clinic, a real expansion and really, I think, Class A services, Class A offices and healthcare in that location. Revitalization, I think, a step forward from the University of Vermont in terms of their facility as well. And then sort of continuing with the gym as an event hall, the kitchen as sort of a very important community space. A library, I think, is the one program that we could settle in on and be clear about. Some additional community spaces and a range of different organizations who wanna use them. And then finally, the real sort of conversation now is do we do a gym or not do a gym? And how do we do that? How does that work? We've had different iterations of designs. Yeah. And would it be helpful if we can Sure, sure, yeah. Paul, would you be able to share that document that I shared with you earlier with a few of the designs? And as Paul's queuing that up, I just wanna remind Council of what was in the cover sheet, which is that it isn't, this is potentially gonna get into the leads here, which isn't the intent. The intent is to ask you for general blessing that we're heading in the right direction still, but with the sale to CHT, and also just the idea that would be having different types of service providers in the space. Like that level is what we're looking for, that continued confirmation that that's correct direction. I think too, just to build on that a little bit. Again, these designs have, work has been put into them to be clear, but these are still, I think, fairly conceptual in nature. So I think, again, we didn't wanna get into like, oh, I think the library should be here instead of here. It's more to look at the masses and the volumes in the space that we have to work with. So the first iteration is option A, which is really was that the University of Vermont Medical Center was not gonna be in that space anymore. They have indicated though that they wanna be there and they wanna continue to serve Winnieski and to face forward into the community. So we've had several conversations with them and we continue to sort of urge them to be, in fact, forward facing, shall I say, and be a community resource. This is option A, assuming that they would have left, it would have created a large space or a library and also for the gymnasium. I think this one option is off the table at this point. So let's go out to option B. Yeah, option B. So you could sort of see then option B is really just the medical center. Excuse me, you don't see steps here. It's, as you know, it's sort of tagged onto the building and there's not much considered, it's not steps, excuse me, Vermont works for women. There's not a lot of work that's gonna happen on that location. Some work will happen, but not as dramatic. If you're less familiar with this floor plan, they're off to the left. Yeah, and sort of in that lower corner of the CHC medical center. So here you see the community health centers in Burlington, medical facilities, the dental facilities. Again, a kitchen connecting to the community room, University of Vermont Medical Center, big lobby connecting all those medical facilities. And then off to the side, again, a city library with some community spaces. This is option B. This does not have really a gymnasium. That's what that X is across it. If you go to option C, who's doing this, by the way? Paul. He's remote. There's no one to look at. Option C, is this option C? Yes. Okay. Then what we see here is a little bit more and a second floor, a second story with the gymnasium being a major part of the sort of the program and the activity. Each of these iterations goes from like 12 million to 15 million to 18 million dollars. It's not a small project, okay? And I think the distinction and difference, that we did the Old Northing Community Center about three to four years ago. And that was about eight or nine million dollars, but we really just left big classrooms for everybody to bounce around in. We had a gymnasium that was already existing, a fairly inexpensive, we don't have to create that space. And it was already set. So this one has, because it has some new buildings, and because the internal activity in each one of these options, there's a lot of space going on. If you look at the CDC Medical Center, and we have plans for that, you'll see a rabbit's nest, which makes a lot of sense, of spaces for individual doctor's offices and patient care and all that stuff. So we're close, I think, to being able to sort of make the decision about what to do next. I think there's some conversation still with the YMCA to sort of see they have express potential and interest in this. What we really want to be able to do though, is when we do this, is to sort of have folks who in individual organizations have long-term commitment. And not to be five years or 10 years, but really to be long-term. This will require quite a bit of work in terms of raising funds. I think the CHCB has already hopes to have an earmark. We think the City of Manuski-Ultra will have an earmark as well for this.  We're gonna have to do a capital campaign of sorts to raise money in the community. There'll be some debt in here, the least amount of debt, the better it is from an operating cost, right? And we'll have used new market tax credits, which is a form of utilization of a federal tax credit program, which we have used a few times now, which essentially takes all the money, throws it into this new partnership of cooperation, takes advantage of the credits, and then we'll pay a big chunk of this, not probably about a 25% to 30% of that, of those dollar remains. And we're beginning to explore who might be a tax credit syndicator working with us. Housing Vermont now, Ever North does that work and we've had conversations with them. They did the work with us at the Old North End Community Center. So, lots of money to be raised. A final program needs to be developed in order to determine what the final budget is. We're prepared to, we've been asked a question whether we want to, or whether we can purchase the building sooner, and do that, and we're still considering that. That all depends upon whether we can find what would be fairly low-cost money in the short term, which we can then put into the property. But I want to make sure that we can do this in a way that doesn't leave money on the table for the tax credit utilization. It's tricky at times to sort of, to make sure you don't close the door behind you. So, we'll take a look at that. We appreciate that up, that the city wants us to do that and we're going to still explore that. So, but this is not a, this is not me coming saying, sell this building, we'll give you the money tonight as much as we hope that we'll come back in a couple of months with a final program, or pretty close to it with a budget, with an understanding of what needs to go, and how it needs to go forward. With the clarity on our part about what we have to put together from a campaign perspective in terms of raising funds in the community. You know, with, we won't at that point have all the materials necessarily to really go out and raise the funds, but we'll start to develop those as well. So after that, I'm going to, I've made some things up, but I think mostly they're true. And I'll be glad to go ahead and have questions. Yeah, and I think just a couple quick specific city operational points that I wanted to bring up, because obviously that's a big part of your purview as well. I think as the city has approached this conversation, in terms of priorities, the library and improving services within that has remained pretty front and center for us, as has the availability of public space for resident gatherings and events. I think those two pieces have been really central to what we're looking to try to accomplish here. As Michael mentioned, you know, the gym I think is something that we would love to have. I think we feel confident would be well utilized. And I think the financing of that has proven to be a little bit stickier to figure out. So the other thing I think you just want to say is that from an operational budget perspective, we are trying to work within the budget that we currently have and not upfront, not add cost to the city's general fund budget. So as of right now, we are carrying an annual deficit on the O'Brien Center building and are trying to build any future lease arrangements within that set amount of money. So essentially instead of a deficit on the current situation, that money would be pivoted into lease costs moving forward. So trying to be thoughtful about the long term, I think as Michael said, we want to build a program here that's going to last and not be on thin ice. I think we're trying to learn that from the first time around. Two other things I guess I would mention, as you mentioned, we sort of established a budget for this from what we need to go raise based upon what we believe is a very low cost to the entities who are here. So if this was a private sector thing, I'd say this is going to cost you $20 a square foot plus all of the expenses in operating and lights and utilities. And we're trying to get it down to a very low number. And therefore then we have to go raise money because what the private folks do is they leverage equity, which usually has a return, they also do debt. And we're going to need to do that as little as possible. Our equity has to be free and our debt has to be low cost. And that gets us to the number is $12 a square foot all in for all the entities. And that's been our target and we sort of build off of that. It's like doing affordable rental housing. You say here's the low rent. How do you get to a place where you can make sure that that rents can be that low?  So I think that that's sort of a key piece of how we're proceeding here. Well, this has been under discussion for a long time. Yes. It's been slow, but something that previous iterations of this council have really supported. I think your initial description of this as a revitalization is what we hope it can be to and is very exciting to see a successful sort of developer and manager of these kind of spaces step in. And while this isn't like a time for action, as you say, right, yeah, I appreciate having the opportunity to see where, get an update, see where we're going because it's been kind of slow moving and now we can also share this with the public and give a little more picture to the vision that we're hoping to achieve here. Yeah. I'm generally supportive, but questions or thoughts from counselors? I think it's a great plan. I'm envisioning ribbon cuttings already. Oh, good. That's great. One question, and maybe I dropped this, but. Was there ever a discussion to put housing above to build up and do housing or is that? No, nothing to worry about. I think structurally going up on that building would be really complicated from what I understand. So we have not talked about raising the current height of that building. I think there was a conversation once upon a time to maybe put some housing on the corner of the lot, like not to continue with the building. And after discussion with CHT, it's not feasible. And so at some point I'd come to council and ask if you're okay with not doing that. And you didn't say that you wanted it. So we've proceeded without that in the plan. That was a part of what's taken so long. We looked at a building on that corner, multiple stories, both in terms of housing or even for the community health centers of Burlington and it turned out to be just too difficult. Elevators, people getting in and out, where is the parking going to go and sort of like jamming too much into one space. We would like to, I would like to make that corner more inviting, but nevertheless, not necessarily build on it. Great, thank you. I guess a question I have, and this might be jumping the gun a little bit, is thinking about as we're a little further along, have some firmer floor paint lands, just connecting with community members, especially those who might face barriers for attending council meetings of just kind of, I assume there'll be a plan for that. Yeah, certainly. And we've talked a little bit about it so far, but I think as we get into the weeds on design, I think certainly on the city side of things, we will want to be out talking to community members, thinking about a new library. We want that to be a space that responds to what the community wants and needs. So that's definitely on the radar for us heavily. Wonderful. Very excited to hear the libraries being prioritized. From additional engagement that we've had this past year, the Winnowsky Tent and Winnowsky Housing Authority, some of them have expressed interest in having a local gymnasium. It seems like the school really isn't an optimal community to access. So I am just wanting to share that in reflection that it's been some feedback that we've received from some of the senior community members. There will be, in the back, there is an event hall and there's an opportunity to program like the seniors in particular. So the gymnasium is the full court basketball court back and forth and I can imagine that that event hall can still be used for a variety of uses. So cross functional? Yes, absolutely. And really looking at how we could pull things into a storage area and pull them out for different uses. So that's how that back gym would be used in the future. And so we have some of that kind of thing going at the Old Norfolk Community Center, it works really well. Really the conversation is do you need a full-size gym with full basketball court and all that work and that's another question I think still. And really it's really about the cost of operating it and the cost of development. The cost of development, secondarily, in some ways, even though it still raises the cost of it, but how is it gonna operate? And it's just who's gonna pay for it? And how is it gonna be programmed? That becomes really the question really, more than anything else. Right, if you think about $12 a square foot and how much the city has budgeted currently, it's a hard number that we can afford an FY24. So in order for us to say yes, CHT should build this, we need to make sure that somebody else can pay all that rent. Essentially is what it comes down to. Without committing the city to future budgets that we don't want to do. Do we have any user data about the event hall and slash gym? So the gym would be harder for us. We don't have currently an indoor recreational facility. The gym we have is used exclusively now for basically events, community gatherings. What I will say, I don't have numbers right in front of me but I will say that I just looked at the calendar last week with Zara and we have had six weeks in a row with one to two weddings down there on every weekend. So I think as a snapshot, and this is with zero advertising or promotion. So I think that as a snapshot, there's a real pent up need for available, low cost, comfortable space for our community to gather in. And I think again, if we started putting the word out and really promoting that, I think we'd be busy both nights every weekend, all year long. And I think, you know, Brockton I think would attest to and then Old Norfolk Community Center is busy as well with that type of thing. Kind of building on the cross functionality of space is they're seeing these designs tonight so haven't had a ton of time to kind of process or think about the thinking that went into the options. How do the options account for like adaptability over time and transition of community interests and needs? I mean, I think a few of them will be a little bit less movable parts, right? Like a gym is a gym, but as we've talked about, I think could also be parlayed into a function hall, voting space, bigger community gathering space. And then I think a lot of the office space, similar what's down there now will be pretty flexible. We're also within the community gathering space trying to look at some different tiers of size. I think one of the things right now we've struggled with is we've got two pretty big rooms down at the community center that are available for the public. And those tend to be in some cases a little bit too big for the small thing and too small for the big thing. And so trying to have a few, you know, if you've got a social worker looking to meet with a family of two or three and they're sitting at a table in the community room, it's awkward, right? It's not an appropriately sized space. So looking at between public spaces, library meeting rooms, having some different sizes that could be flexed for that type of thing. So I think we are trying to be thoughtful about not locking ourselves into specific uses. Great, thank you. And our architect would say that those are not plans you should completely rely on. Sure, design ideas.  So I think there's still opportunity, certainly, I mean, certainly opportunity for the city to sort of say, I mean, no, a little bit of this, a little bit of that. So I think there'll be more chances to have that conversation in the community and with you all. Thank you. It sounds like we're pretty restricted to the existing footprint. No, so what we're... Oh, do you want to? No, we're gonna expand a new construction to December. Okay. Yeah, so if you, in your mind's eye, if you picture the area where the current library sits and then the greenhouse to the north of that, that's the footprint that we're discussing. So essentially the current library would be replaced with what's there now. So it ends up being about, I think it was about 11,000 square feet per level that's available to be placed there if we sort of maximize that part of the lot. Great, thank you for that clarification. It would have been an 11 million dollar project without the new construction. Right, right. We're definitely adding here. I think it's got it. Thanks. That's it for me. Anything else? Can we give our general approval for where this is headed? Definitely. Definitely. Excellent. Looking forward to it. Excellent, that's great. Thank you. Thank you so much. We'll spend more time and energy on it then. Yeah. Please. Thanks, Mike. Thank you. Oh, yeah. Sorry, what? Oh, yeah. Oh my God. I didn't even invite it. Yes. Yes, public comment is welcome. I don't know if it's before or after you agree. It's, we do it during the item but I totally just based on it. Oh, I'm Jess Wignell. I'm a member of the library committee. Oh, yeah. So we've been able to hear some of these updates on our previous meetings. I just wanted to come and express basically my encouragement for council to support this. I think this represents a once in a generation opportunity to partner with a group like Champlain Housing Trust and to really be kind of using their strategic investment to build really important resources for our community. I think both the library and the gym that's being considered to be incredible value ads. And really, I know that they're working really hard to keep the price per square foot very affordable. And that we as community really need this investment. So as they start to approach budgeting discussions and really start to envision what this final program is gonna look like, I just encourage the city and council to encourage that kind of big picture thinking for our community. That's awesome. Thank you so much for sharing and for being bold enough to make sure that I invited public comments. Absolutely. Thank you. That is the key phrase once in a generation investment. It truly is. Yeah, yeah. Thank you. There's one Zoom attendee too. So any public comment? This may just be staff. Okay. Now let's move on to item C, which is the introduction of Jasmine Hurley, our new housing initiative director. Can everyone hear me? Yes. Hi everyone. Great to see you all. As most or many of you already know, I am Jasmine, the new housing initiative director for the city. I'll just say a little bit about myself. So I am a macro level social worker. I have previous work experience in housing case management. I used to work at COTS. So familiar in some way with the housing landscape in the area. I also have experience working in food and security policy. I've done research on childhood homelessness. And then I also did substance use prevention work within a municipal setting. And I recently moved back to Vermont after finishing graduate school. So I'm very excited to be here. And I am looking forward to working with you all and looking at these broader macro level housing issues in Winooski. Yeah, so for those of you who aren't familiar, I'm sure most of you are, or all of you are, COTS is Committee on Temporary Shelter, if I have that right. And so just overall, the housing initiative director's role is at the systems and policy level, not at the case management level. Many specific issues that folks are still dealing with and what their housing would be going probably to the code enforcement team as it is now. Jasmine is tasked with developing an annual work plan to quote unquote, ensure a mix of quality housing that maintains and enhances Winooski's unique sense of place and supports the needs of the entire community. That's the statement from Winooski's master plan. The work plan might include policy, might include research and collaborations. She is consulting with housing organizations and people, anyone with a perspective on housing that would inform that work plan. So if anyone is interested in shaping housing Winooski, you're welcome to reach out to her at<PHONE_NUMBER> or J. Hurley, J-H-U-R-L-E-Y at Winooski-V-T.gov. And this Friday, congratulations are gonna be in order because Jasmine is going to be graduating officially from her master's of social work program. So that'll be very exciting. Pre-congratulations. Thank you. Well, thank you for, we're very excited to have you on board, have support added back to our housing commission besides the University of Virginia and work with us towards probably the highest priority issue that we hear about from residents. It's great to have you introduce to the community as well. Any questions or comments from council? Welcome. Cool. Really, we're just welcome. I'm really excited that you're on board and I'm looking forward to working with you. Thank you. Maybe a question more for the city manager. Obviously the work plan is probably more operations than not. Is it something that will be shared? Certainly with the housing commission. So the housing commission liaison could certainly then share it back to council. Great. I'd be interested to see it. I'm sure. Thank you. Is there any comment from members of the public? Okay. Thanks again, Jasmine. Well, you're probably gonna sit in the background still but either way, have a good evening. Yeah. Okay. We are on to item D. This is on for discussion or approval, introduction of ordinance update for chapter 28 fees. So we looked at these at our last meeting or the one before. Angela. Yep. So you did see these at your previous meeting. We just are bringing them back before you for the formal introduction and setting of the public hearing. Minor amendments were made based on your feedback from the last time to the dog licensing section and effort to make it clearer as to when those fees were due. I appreciate that. It does, it is clearer when I re-reviewed that section. Do you have a proposed public hearing date? Ideally, your first meeting in June would give us time to do that public hearing. They would then have the fees would be in effect just after the start of the new fiscal year. There'll be a few days where the new fees will not be in effect. So it's 30 days from the date that have your public hearing and approval for the fees to be inactive, activated. Okay, thank you. So that would be June 5th. Any questions from council? Yeah, councilor, deputy mayor, runner. Since you were not here and you had some recommendations, I just want to make sure. I see them not reflected in the document so I'm assuming you all did not agree. Maybe I'm incorrect on that. I'm not sure if you know, but perhaps I forgot to. We did discuss, your recommendations were on, shocks what was right. Well, the pull fees. The pull fees, which we did one increase, yeah. And we wanted more data, more seasons of data. Ray suggested having like three seasons and we only have two so far. In addition, we've already started selling cool passes for the current season. So there you go, a little chicken before the agri-vice versa. Yeah, I mean, I completely understand not wanting to raise fees. As we all did, sat through a budget season where we're clearly in need of finances and the library, especially being a place where we had to cut things. That was my thought on introducing some fee, nominal, small fees there. But if I was out disagreed, I'm not gonna fight it. I do have an administrative question falling up. So obviously one of the reasons why we're not increasing pull fees is because we've already started selling passes. If this comes up again, will we not be faced with the same timing situation? We could always introduce it earlier, so that it's in time. Yeah, this one doesn't come on a specific schedule. It has appeared when staff has recommended updates or in this instance, we requested it. Okay. Yeah, just. Yeah, I mean, you can never raise pull fees if it happens after the fact. So that's a good point. This chapter can come to you at any time, so if that's something you want us to look at for a future season, it would be something that would come to you during your budget process. Exactly, right. That would be the obvious time to say, well, we'd want a plan for that. You wouldn't necessarily budget for it if you hadn't had it yet, but you could signal and then we could prepare it in time to actually institute. Great. We usually start selling pull passes in late January, early February. And I can't remember if something came up during the retreat or, I mean, if there was something that came up during the retreat. Related to fees? Yeah. Traffic and public safety impact fee perhaps? I think it was more something that would be included in this rather than an impact fee. But I may totally be, thinking of something else. Showing fees? What was that? Oh, I mentioned that because in the last meeting I had suggested increasing some permit fees, but because staff are working on changes already, that was also not appropriate to look at at this time. Okay, all right. That's what it was. Thanks, I'm not losing my mind. Any other questions or comments? Any public comment? Okay. What is the motion I need? Sorry. It's all for discussion approval, right? We need an introduction by a counselor and then a motion for the date of the public hearing. Oh yeah, see we're gonna introduce it, right, Bryn? Sure. I would like to propose that we move forward the fee changes in chapter 28 as presented to council and set a public hearing date for June 5th, 2023. So moved. Second. Introduction by Bryn, motion by Thomas, second by Aurora. All those in favor, please say aye. Aye. Motion carries. Thank you. Thank you. Okay, we are onto item E, Moonewski Small Business Loan Committee loan application recommendation. Well done, I was guessing seven and asked Lily to come at 6.45 so you all are doing great. Well done. Yeah, so I'm gonna do a little intro first if I, if you don't mind. All right, so just some background on this grant. I think several of you have probably not seen this before. So when I spend a little time for both for your benefit as council and for the public. So in 2016, the city of Moonewski allocated $250,000 for the purpose of establishing a small business revolving loan fund known as the Moonewski Small Business Loan Program. An agreement was made between the city and Opportunities Credit Union for the city to deposit the funds with OCU, Opportunities Credit Union and for OCU to service the program. The purpose of this program is to assist Moonewski businesses in obtaining financing for a wide range of business needs, including but not limited to equipment purchases, lease hold improvements and major repairs. The intention is to promote the long-term viability of Moonewski-based businesses, which in turn will stabilize employment opportunities, reduce commercial vacancy rates in the city and provide goods and services for citizens as well as contribute to the economic vitality of the city, which is one of our master plan goals. The maximum loan for this program is $75,000 and the minimum loan amount is $5,000. So the committee that reviews applications to recommend to council is chartered to comprise of the city manager, finance director, planning and zoning manager and two community members, there was a typo in the cover sheet. It is to be staffed by the community economic development officer, however we do not have that position at the moment. So without that position, the city manager is both staffing and serving on that committee or transparency purposes, just want folks to understand that. And so this new loan application eligible for the Moonewski Small Business Loan Program has been referred by Opportunities Credit Union for consideration by the Moonewski Small Business Loan Committee. The council appointed loan committee met on May 12th to evaluate that application based on the program criteria established in the policy guidelines in the city fund. So to clarify Opportunities is really the one judging the risk and the committee is just really black and white looking at the criteria and the guidelines. So the committee does recommend approval of the $37,500 loan for a 60 month term for Standing Stone Wines LLC to be located at 33 Spinner Place. So if city council, just to be clear, if city council votes to approve this loan as recommended by the committee, the loan program will retain at least $200,238 in some sense for future applicants. The at least is a, I won't get into the details unless you really want to know. Again, the ultimate disposition of funds is at the discretion of city council, not staff, nor the Moonewski Small Business Loan Committee. The applicant is here. So if you have questions for her that are not related to her business plan, financials or other information that should be considered confidential, go ahead, that doesn't leave much room admittedly. If you do have these questions though that you would need answered before you decide on the application, you can go into the warrant executive session. Thank you. Please introduce yourself. And if you want to tell us a little bit about your business. Sure. My name is Lily Sickles. I have been in the services industry and working with wine for about 30 years in New York City and I've been in this area for about 13 years now, almost 14. I love it here. So I want to open a, I am opening a wine store called Standing Stone Wines. It's named after my tribe. Oh, and I did, we have people of Standing Stone. I was diagnosed with lymphoma in 2019. I went through treatment and I was fine. And then I had a recurrence and I went through treatment two years ago. And when I came out of it, I knew that I wanted to start a business and I love wine and so that is really what I wanted to do. But I was, so many people were so generous and kind to me that I knew that I wanted to pay it forward in some ways when I started a business. And so that's why I chose, alcohol has not been great to the indigenous community. My own father died of cirrhosis of the liver. And so just to make money off of alcohol didn't seem great. So that is every month, based on sales, I'll be donating to a different indigenous cause. And that's a very important part of the business plan. At some point, you know, I have to get up and started, but I'd love to do stuff for the community as well, like have a bottle every month where a dollar per goes to a local charity. I love Winooski. I'm very excited to be a part of this community. It's really a wonderful place. And so I want a blind store and after, I'm also going to sell LGBTQ, BIPOC, locally made artisans, different crafts or an artwork, hopefully maybe have some art exhibits. Mary McGinnis from BCA is a friend of mine and has offered to curate that for me. I'm really excited about it. I think that I'm going to have great press. I've had a few stories from WCAX news about my cancer treatment and they are excited to do another followup when the store opens. So that's like invaluable advertising and I'm very excited about it. I think that the community will be excited about it too. I'm going to specialize in 10 to $20 bottles of wine, which is about half the price of what most of the fancy wine shops in the area, they start around 20. So I wanted to specialize in 10 to 20, but I'll also have cheaper wines and I'll have more expensive. And I want to have like a great selection of Vermont craft beers as well. That, so it's kind of a one shop stop. And I think a wine store is great in Winooski because the only other place to buy wine is beverage warehouse and they don't, they have an okay selection, but they don't really have anybody that knows about the wine to explain it to them, talk to people about it. And I'm hoping to teach wine classes too. So I'll need an in-house license, a first class. So, which I'm hoping to get like in January and then I'll have a small wine bar too. That's not going to be a bar. It'll be open the same hours as the store like 12 to eight or, and it's more so customers can taste wine before they have to spend the money on a bottle and they don't like it. But so that's basically my plan. Well, thank you for sharing Lily, thank you. Just for reminded I had a clarification I want to provide. So the committee also voted to clarify that the minority owned business enterprise and woman owned business enterprise criteria that are currently in the guidelines that those be a self-certification versus a formal registered certification to reduce barriers to access for that those points basically. With that, that's why that's contributing to the recommendation that this one be be approved. Thank you. Is that recommendation something we can act on now or we need to come back to that as like a warned item? Because we did do that for the COVID business grants. That's what I was going to say, yeah, we did that. Yeah, I think you're, you know, we couldn't formalize it by... Could we put it on consent agenda maybe? Exactly right, yeah. Okay. So you can indicate that today and then we'll can put that on consent. Well, yeah, I love how much detail you went into. Very well thought out. Thank you. It sounds exciting to me. Any questions from council? One thing to that consent agenda item. Another thing we discussed was self-certification for LGBTQ owned and that was something that was part of the COVID relief funding as well. Other than that, I'm super psyched about your business idea and I could not wait for it to open. Me too. Yeah. Yeah, very excited. I needed a bottle of wine the other day and I forgot the commodities had closed and I drove there and so I had to get a bottle of wine at Charles and wasn't very happy about it. So I'm very excited when I can stop at your location and grab something. It's amazing. Yeah, super excited. Commissioner Daley looks really excited as well back there. Okay, hearing no more concern, well, there's no public comment, right? Just checking. Any public comment? No, no attendees on Zoom anymore. Okay, hearing no concern, do I have a motion to approve the recommendation from the Small Business Loan Committee? So much. So excited. Motion by Thomas, second by Bryn. All those in favor, please say aye. Aye. Motion carries. Thank you so much, Lily. Congratulations. Thank you so much. Thank you so much. I'm so happy. Thank you, Lily. We'll look out for the updates. Okay. Thank you. Hey, we'll be out there. I promise. Thank you. And so with that, we will not need item nine executive session. Oh, wait, that was, yeah, okay. 10A would have been the vote. So we're moving on. Item 11, we have worn an executive session pursuant to one VSA section 3132 about the negotiation of real estate purchase or lease options related to lot 70. I am looking for a finding that we should have this discussion in executive session as doing so in the public would put the city at a disadvantage. So moved. Second. Motion by Thomas, second by Charlie. All those in favor, please say aye. Aye. Motion carries. And so I need a motion to enter into executive session, inviting Elaine Wong and Angela Aldiri. So moved. Second. Motion by Thomas, second by Bryn. All those in favor, please say aye. Aye. We're gonna move into executive session to discuss this topic. No other topics will be discussed. No action will be taken this evening. When we return from executive session, it will be solely to adjourn the meeting. Thank you. Do you want us to move back there? Yes, sure.


Welcome back to the session on latex. In this session, we will customize headers and footers, change the page numbering style and reset the page number. As we have seen till now, the article class displays the page number in the footer, while the book class places the page number in the footer, where the chapter begins and then in the header. Well, we can customize this using the page style and this page style command. Some styles are empty, plain and heading. Let us see a demo. I am switching to text studio. So, we have our article opened here with some sections and random text. Let us build and run. As you can see, there is a page number, page number 1, page number 2. Let us increase for better readability. Now, we will write slash page style empty, build and run. You see the footer, the page numbers are not there in the footer. Well, now let us go to the second page on this page. The section 6 is title, I will right click it and I will say go to source. If you see, I reached this particular section. This is called as reverse search. This was discussed in one of the earlier sessions as a feature of an ID. Well, now let us write slash this page style and we will write headings, build and run. You see the page number 2 has appeared. So, page number 1 does not have any footer. Page number 2 is headings, which displays the page number 2 and again page number 3 is blank. Now, the set counter command is used to reset the page number. Let us examine this using a book class to just illustrate a proper example. Let us change the document class to book. We will add a chapter slash chapter overview. We will remove the page style or rather we will comment it out, so that you can refer to it at any point in time. We will again go here and we will comment this out as well. We will build and run. Yes, we got our chapter in a book format. Well, let me add table of contents slash table of contents, build and run 2 times. So, as you can see the table of contents starts from page number 1. Page number 2 is blank. Chapter starts on page number 3. Well, ideally a first chapter should start from page number 1. So, we go here and we write slash set counter, page and number 1, build and run. Yes, starting from page number 1, page number 2 which is blank, chapter 1 starting from page number 1. If you see, this was also reflected in our table of contents which starts from page number 1. Now, by default we use Arabic style for page numbers that is 1, 2 and 3 which we have seen till now. The other styles like roman, alphabets can also be used. Let us have a look. So, now let us do something wherein we have our contents page as roman page numbers rather than Arabic. So, we write slash page numbering and we write roman, we build and run. So, table of contents starting with roman number 1, roman number 2 which is a blank page and then again roman number 1 why is that so, because we have set our page numbering to roman. Now, let us switch it back to Arabic. So, we come here and write slash page numbering Arabic, build and run. So, we have a contents page on roman number 1, roman number 2 and then chapter starting with Arabic number 1. Now, let us add a chapter called annexure slash chapter annexure and we want the page numbering to be alphabets slash page numbering alphabets. And we also write a set counter to start it from page number a and we have some content. This is the annexure of my document, let us build and run 2 times so that I have it in my table of contents. Let us go to annexure, chapter number 2 annexure starting with page number a. Let us see the table of contents, chapter 1 overview starting with page number 1, chapter 2 annexure starting with page number a. And this is roman, this is also roman and others are Arabic page numbers. Well, so in this session we customize the header and footer, we reset the page numbers and we customize the page numbering style. Thank you, have a nice day.


Okay, so next we have Issa Sigourneke, who is going to be, well, it's a bit of a link between this session and the session before, so she's going to be talking about malaria treatment, well, during the Ebola outbreak. Thank you. Thank you very much, and thank you very much for giving me opportunity to talk to you. I would like to share with you some interesting and unexpected findings from one of our Ebola centers that MSF managed in Liberia. So despite this being the largest ever Ebola outbreak and lasting now for more than 15 months, we still have absolutely no evidence that any of the therapeutic interventions we are using makes any difference on patients' mortality. The treatment we are using today is still symptomatic and partially presumptive, so part of this presumptive treatment is also systematic use of anti-malarial treatment that is either given systematically to all the patients at admission or based on the positive results of malaria rapid test. In MSF, we prefer the first option, so to give anti-malarial systematically to all the patients at admission, also with the intention to prevent malaria during the stay in the Ebola center. In MSF, the first choice, the preferred choice, is the combination of Artemitur and Rumofantrin. So the data I'm presenting is coming from Foya in Liberia. As you can see in the map up, the Foya is a town in northern Liberia bordering Guinea, and in fact it's just across the river from Gakedo where the outbreak first started. The outbreak in Foya started, the first cases were reported in March and April, and then after a little break, the epidemic really started in June 2014, and then the number of cases very rapidly increased in August. On the right side, you see the treatment center. Further, there was just an isolation unit in the big building in the middle that was a former refugee transit unit that was set up to manage 10 to 20 patients, and then when the number of cases inside the center increased to more than 100, the center kind of mushroomed in a chaotic way around this original center. So during this very busy time of very fast increase of new admitted cases, the team experienced a shortage of first-line anti-malarial treatment. So during this time, the first-line treatment Artemitur Rumofantrin was replaced by another commonly used combination, Artisan Atamodayakin, for a period of 12 days. Artisan Atamodayakin is also the first-line treatment in all three affected countries, including Liberia. It has been shown previously that Amodayakin has some in vitro activity against the Ebola virus. And on the left side, there's a picture that's a border crossing between Guinea and Liberia, and the team in Foya was, for most of the time, supplied from Gakedo through this way, and also the blood sample. There was a laboratory that was based in Gakedo, so the blood samples traveled every day across the river to them. So that's just another epidemiological curve showing you the confirmed and the number of new admitted patients per day. The confirmed cases are in red, and the patients that show not to be Ebola cases in green. And in the shaded area, you have the period of time where the only Artisan Atamodayakin combination was used due to the shortage. So we use this unfortunate opportunity of drug shortage to explore whether there is a difference in mortality between the patients that systematically received either Artemitur Lumifantrin or Artisan Atamodayakin. For this, we use the standardized line-listing, line-list data of the patients, very similar to what Francesco used to combine the analysis. But our data also included in this simple epidemiological line list, there was also the epidemiologist took time to also enter what type of treatment was prescribed. So that's just what the information we have, it's only about the treatment prescribed to the patients then. So if we look at the patient characteristics of the patients receiving either of anti-malaria combinations or those who were not prescribed any anti-malaria treatment were very similar in their baseline characteristics. However, the patients in the group of Artisan Atamodayakin and those that were not prescribed any anti-malaria treatment had a slightly lower CT value at admission, so that means higher viralated admission. And in particular patients in the Artisan Atamodayakin group, they were admitted during the particularly busy period, so there were an average 100 patients admitted in the center during that time compared to around 50 in the other two groups. And then we also, the last important differences in cases coming per unique home village in particular groups. So in fact, we tried to look, if there is a difference in mortality, because it could also be linked to the fact that a lot of patients would be coming from the same big families and there'd be genetically maybe a bit different and have different risk of dying. And we see that the patients in Artemata Lumafantrin group were more likely to come from the same village compared to the other two groups. The patients that were prescribed Artemata Lumafantrin had an overall mortality of 65%, very similar to those patients that were not prescribed any anti-malarial treatment. Our patients in the Artisan Atamodayakin group had 50% mortality. The risk ratio of dying for patients that prescribed Atamodayakin Artisan at compared to the Artemata Lumafantrin was 21% lower. In unadjusted analysis, and then 31% lower in adjusted analysis. So in adjusted analysis, we looked for different risk factors that were associated with mortality. So very similar to the previous analysis, those patients that were older had a higher risk of dying. And particularly the strongest predictor of that is the cycle threshold at admission. We also looked at the patients that were receiving or were prescribed IV fluids. And those had a higher risk of dying. That is probably just a proxy indicator for those patients that were more severely sick. That's why they were prescribed the treatment. And then the number of patients that were present at the day the person, the patient was admitted as a little bit of a proxy of quality of care that was provided. So patients that were admitted at the busiest time were also more likely to die. Then we did some sub-analysis. We thought maybe this effect that we are seeing of Artisan Atamodayakin on mortality, it might be just due to the patients having malaria and they have higher chances because we treat their malaria. However, when we look at the subgroup of patients that had RDT positive, so the rapid test confirmed malaria, this effect of there's no more difference between patients receiving either anti-malarial treatment. However, the effect is stronger in the patients that had no, that didn't have malaria at admission. We also looked at the patients that had a higher or lower viral load at admission because that's been a little bit directed in other treatment studies ongoing. So patients that had a lower viral load at admissions of higher CT values, the effect was of Amodiyakin Artisan Atamodayakin was much stronger compared to the patients that arrived with the high viral load at admission. So what we show in our analysis and what we observed in our group of patients, those patients that were prescribed Amodiyakin Artisan Atamodayakin had the higher chances of surviving. This study has many big limitations, first of all is observation and study. The only data we have is the data on what was prescribed, we have no idea which patients actually took treatment or not. So this is both anti-malarial treatment that were prescribed, our oral medications of the patients that are already sick and have nausea and vomiting might have difficulties taking the treatment and in the particular Amodiyakin is associated or is perceived to be associated with more side effects like nausea and vomiting. So it might be even more likely that patients prescribed Artisan Atamodiyakin didn't take it. The quality of data we have, it's limited by the conditions in the field so it was collected at a very busy times and we have a number of patients that were not prescribed any anti-malarial treatment and they were actually not really able to explain why this happened. For some patients probably because they had negative results and the team decided not to give treatment or because they were rationing Arthymeter lumifantrin doses when the shortage was foreseen. There might be other confounding factors that we did not think about and we could not control for and it's the sample size, the number of patients we had was rather small. There is alternative hypothesis to Amodiyakin having a positive effect on the survival is that the combination of Arthymeter lumifantrin might be harmful for the Ebola infected patients. There is some rationale on it because lumifantrin is a drug slightly similar to the Halofantrin that has been very much associated with the sudden deaths linked with the QT prolongation that might be more especially in patients that have hypokalemia or hypoknesemia which can be the case potentially in the Ebola affected patients so there might be a link to that as well. So what you do with this information so within the discussions we had within MSF and with the malaria working group is that it might be wise to change the first line anti-malarial treatment at least for our patients since the both drugs are similarly effective and it seems that there might be potential benefit of the combination of Arthymeter and Amodiyakin. We absolutely need more data to confirm this findings and to try to understand how the drug if at all works how this could be done so I think the first thing would be to look at any possible data that exists on the use of Arthymeter and Amodiyakin in those countries. Unfortunately it seems that majority of the centers not just MSF but also all the other centers prefer to use the combination of Arthymeter lumifantrin or just injectable Arthymeter and the other option might be to try to see something into this mass distribution of anti-malarias that were described earlier and then in parallel there should be pre-clinical studies both in vitro and animals to confirm the mechanism of action and to try to see if the drugs actually works and how would that happen and this is planned and we'll hopefully start seeing them. So I would like to thank everyone in the field for collecting the data the Ministry of Health to all the people to contribute it to discussions and brainstorming around this analysis and to all the patients and population in FOIA. Thank you very much. Thank you, Isis. So I think we have time for a couple of very quick questions. We don't really have time but we're going to have. At the back there. Or at the side. Thanks. Is that the alasri from MSF? Thank you for the presentation. Do you know if the drugs were given to the patients for them to take or if they were given on a daily basis? In some of the centres the bag was just given to the patient upon arrival. Yeah so they hear the for the it might have changed at the very end where the numbers went down but for the most of the time the treatment the presumptive systematic treatment was prescribed added mission and the treatment was pre-packaged for patients and it was up to them to take it so we have absolutely no idea if they actually took the treatment or not. Any others? If not we'll thank Isis again for a fascinating trip.