Good afternoon everyone. Focus of today's briefing will be on the expected approval this week of vaccinations for Children between ages five and 11. But before we talk about that, we'll start with this week's presentation from Commissioner P check and then I'll come back with further thoughts before moving to our other speakers today. Thank you very much governor and good afternoon everybody. I wanted to start this week just with an overview of where the modeling stands. We haven't necessarily shown a lot of modeling slides recently. It's been really indeterminate as of the last four or five weeks and just wanted to level set and say pretty much where we are continuing to be at in terms of the trajectory in the weeks ahead. You can see from this ensemble model that shows the fatality forecast for Vermont that things potentially could improve significantly on that downward end of the confidence interval. They could get worse as well. So it continues to be a very uncertain picture in terms of the trajectory that Vermont is heading at the moment and wanted to just mention that up front. Looking first though at cases across the country, did want to again mention something that changed from the trends that we've been seeing over the last six or seven weeks. When we look at the infection rate across the country we do see a flattening out of cases. It's up just a little bit this week .4 percent. So something we'll want to keep an eye on. Hospitalizations and deaths continue to track down. Of course those are a lagging indicator and when we look at where the cases are coming from across the country we see that cases in the south continue to be very low. Cases out west have shown a little bit of an increase this week. Cases in the midwest have seen a little bit of an increase as well and the northeast has ticked up just in the last few days also. So again something we'll want to keep an eye on. Regional national cases can certainly impact us here in Vermont. Talking about the region we'll see that New England is seeing a slow and steady decrease in cases over the last seven days and over the last 14 days down about five percent. But you'll look when you see some of the individual states that there is a little bit of a disparity there in terms of some of the states in the northern part of New England, Vermont, New Hampshire, Maine, and those southern New England states and you can really see that on the slide on the right hand side of the graph that the case rates in the states that are in the northern part of New England are higher than those that are in the southern part and that follows with hospitalizations and fatality numbers as well. So we've been like this now for about seven weeks. New England overall is improving but again that's led by mostly those southern states. Connecticut in particular has seen their cases come down quite a bit over the last couple of weeks. Getting to Vermont we can see that on the 14 day average the cases are down about eight percent although this week we saw a little bit of a tick up about 12 percent so really not too much of a change over the last few weeks from where we were. On the next slide we showed this last week I think for the first time mentioning that we wanted to see cases go down, we wanted to see testing go up and that would drive down our positivity rate. This week we are seeing cases go up a bit as we mentioned about 12 percent over the last seven days. We did also see testing go down six percent over the last seven days so again we rather see that inverse obviously but that's what we're seeing this week and the positivity rate ticked up a bit over the last couple of days. Looking at the breakthrough data infections it's a very similar picture you know the the percent in terms of those who are not fully vaccinated obviously much higher than the percent of those that are fully vaccinated that's something we've known for some time and you can see the increase there just up a little bit in that fully vaccinated rate although the actually the fully vaccinated rate rather is steady and still going down a bit while that not fully vaccinated rate is relatively steady but trending up. On the hospitalization side you can see admissions for those that are not fully vaccinated actually have come down a bit over the last week or so while those who are fully vaccinated have remained relatively steady but that gap between the not fully vaccinated and fully vaccinated rate is a little bit tighter than we've seen in recent weeks so again one of the reasons for that when you look at the age breakdown of those in the hospital those are more vulnerable by age underline condition ending up in the hospital even if they're vaccinated so really a reason to get your booster shot and get that full protection if you're in one of those categories. Looking at the regions of Vermont we'll see that the northeast kingdom still is elevated in terms of their case counts they did see some improvement this week coming down a bit but you can see how much different they still are compared to central Vermont the Burlington Metro area and southern Vermont which generally have been pretty steady with each other and pretty flat over the last few weeks. Breaking that down a little bit more in terms of the infections that we're seeing and what the differences are in those that are fully vaccinated and not fully vaccinated this is taking a look at basically the month of October going through October 30th and looking at the average ages of those who were infected who were fully vaccinated not fully vaccinated same with the hospitalizations and same with the fatalities as well and what you'll see from the data is that those who are infected with the and who are also fully vaccinated have a much higher average age than those who are not fully vaccinated and infected that makes sense the the vaccination rates for those in their 30s 20s are lower than the rest of the population and those under 11 or under 12 are not able to be vaccinated and we've seen some really high case rates there which we'll get into in a minute which is certainly good news relating to the potential opening of vaccination age groups this week. You'll see with the hospitalizations that age different is there as well and also there for fatalities. A little bit different story on that front basically it shows us that those who are higher in age are still more vulnerable to hospitalizations and fatalities again a reason to get a booster shot to get that full protection but it also shows that those who are not fully vaccinated the range of risk is a much broader one for those by age people in their 50s 60s and 70s are dying that are unvaccinated and those that are not vaccinated are ending up in the hospital among those who are fully not fully vaccinated at a younger age range as well so more of a risk there for those who are unvaccinated. For those that are fully vaccinated again age is still of vulnerability important to get your booster shot. Turning to the age bands again talking about those five to 12 years old being able to have vaccination available to them hopefully this week that's certainly going to be good news when you look at our data which is consistent with national data but over the last two weeks that age group in particular that five to 11 year old age group has been the highest per capita consistently higher than those that are adults and higher than other adolescents as well so that will be certainly good news as we can protect that age group which has been seen higher rates. Looking at higher education things are pretty stable on campus 53 cases this week right about where they've been for the last few weeks nothing too noteworthy to point out here. Similarly with long-term care facilities things are pretty stable as well when you look at the totals and the number of outbreaks that are currently active. When you look at our hospitalization numbers you know you see that the overall hospitalization number on the seven-day average is trending up. The same trend is also true though that most of the people still although coming down just a bit are those who are not fully vaccinated 75 percent of recent stays have been among those not fully vaccinated and the same thing on the ICU side you can see the numbers fluctuating a bit there in terms of their trajectory but the thing that's remained consistent is that 75 percent of those who are not fully vaccinated have made up the recent stays within the ICU. Turning the vaccination we're not showing all of the slides that we usually show there's some information that we want to understand and reconcile with the CDC in terms of new vaccination doses but we do want to show where Vermont stands in terms of booster shots per the CDC data. You can see that Vermont is near the top or at the top in terms of the percentage of those 65 or older who are fully vaccinated who've also received their booster dose so that's about 35 or 36 percent of the Vermont population which certainly again off to a good start. And then finally when we look at where we rank in terms of some of the other states everything pretty stable here relative to last week Vermont at the top or near the top on all of the vaccination categories so certainly continuing to show strong uptake of the vaccine both in terms of initial doses and also in terms of booster doses as well. So with that I'll now turn it back over to the governor. Thank you Commissioner Petschek. As I mentioned today we're focusing on vaccinations for those between the ages of five and eleven which we expect to be authorized very soon. The CDC's advisory committee is meeting today and we anticipate they'll recommend moving forward and then shortly after the CDC director we anticipate will approve. Giving us the green light for vaccinations potentially even as soon as tonight. If that's the case we want you to know Vermont is ready. If approval comes tonight registration will launch tomorrow at eight a.m. for parents and guardians to sign their kids up which means we could begin vaccinations as soon as Thursday or Friday. This will be an enormous step forward and a significant opportunity to protect as many people as possible. As a parent myself I know protecting our kids is the most important thing we do and I'm sure that while this will be an easy decision for some others will have questions. For example I've heard from some parents that COVID doesn't seem to affect kids as much so they're hesitant to sign them up. With us today is Dr. Rebecca Bell the president of the Vermont chapter of the American Academy of Pediatrics and of course Dr. Levine who will go into the why getting kids vaccinated is so important and safe. I also want to remind parents of the enormous educational and social benefits as well. Vaccinating kids reduces the need for quarantines after potential exposures which will keep your kids in school learning from teachers and being with their friends and reduce the challenge of finding child care and staying home with them as well. We know from recent experience how important in-person instruction is for our kids and by getting them vaccinated you're not only reducing their chance of getting COVID but you're taking an important step to keep them in school improving their education and all the social and mental health benefits that come along with it. Obviously this decision is up to parents but I hope you'll consider these critical benefits and listen to the experts like Dr. Bell or your own pediatrician because top health agencies like the FDA and CDC and top pediatric doctors would only recommend this if it was safe and the right thing to do for our kids. So you don't have to listen to me but please listen to them and get your kids vaccinated and I'm hopeful most will. Vermont currently leads the nation in many vaccination categories with one of the most important being youth vaccination. About a week ago we were the first state to cross the 80 percent vaccination threshold for kids 12 to 17 with over 70 percent of them being fully vaccinated. And these numbers are growing every day but we need just as strong of an uptake for those five to 11 as well. While we know this will won't eliminate all cases it's another big step forward and could be the key to accelerating our transition from pandemic to endemic. Vermont has shown the nation how it's done from the start and we need to do it again. As I mentioned Dr. Bell is here to go into more detail on the significance of this and help parents understand the benefits. Secretary Smith will discuss many of the clinics we'll have available and the logistics for the next phase. Deputy Secretary Boucher will talk about schools and of course Dr. Levine who will summarize and tie up any loose ends. I'll turn it over to Dr. Bell. Well I am thrilled to be here today on behalf of Vermont pediatricians to discuss the really wonderful news that children ages five to 11 will soon be eligible for the COVID-19 vaccine. This has been a long awaited and much anticipated development and we are so excited for younger children to have the opportunity to be protected from COVID-19 illness. So for those not following the minute by minute developments like we are I can catch everyone up. Last week the independent advisory group to the FDA voted overwhelmingly that the benefits of the Pfizer-BioNTech COVID-19 vaccine outweigh its risks for the five to 11 year old each group. They voted after reviewing the clinical trial data and risk benefit analysis for this specific age group. The FDA then authorized emergency use of the vaccine for this age group last Friday. Today an advisory committee to the CDC is meeting to discuss clinical recommendations for the vaccine. Then the CDC director will give final approval and after that as you heard children ages five to 11 will be able to start getting vaccinated throughout Vermont. So a few notes about this vaccine. The dose will be one-third the dose of the vaccine for those 12 and older and this is because children tend to have a more robust immune response so the trial for this age group actually started back with a phase one dose finding study to find the smallest dose that would elicit an equivalent immune response with minimal side effects. This smaller dose needs to be diluted more and so a separate product has been developed and this is what has been studied. These pediatric vials have been shipped to Vermont. The timing of doses is similar to those of adolescents and adults so it's two doses three weeks apart. So the FDA has authorized use and the CDC is weighing in now on everyone's minds what do Vermont pediatricians think. So we unequivocally recommend this vaccine for every Vermont child who is age eligible. We believe the benefit of this vaccine will provide protection for every Vermont child. So how do we know this? Well there's a randomized placebo controlled study in this age group and the data are very convincing that this vaccine is safe and effective. The trial includes 4,600 children ages five to 11 of which two-third received the vaccine one-third received placebo. The study showed that the immune response in this age group was similar to the immune response in older children and young adults. Vaccine effect efficacy was shown to be 91 against COVID-19 infection. Importantly these data were collected during the Delta surge so we know this vaccine is effective against the Delta variant. So what about side effects? Local reactions like pain at the injection site and swelling in redness are as commonly reported in this age group as older folks who received this vaccine. What's interesting and maybe not surprising because the dose is lower is that we're seeing fewer systemic side effects reported for this age group. So many of us after our second dose of the vaccine had had systemic effects the next day so fever, chills, fatigue, headache. Children ages five to 11 in this trial reported those effects at a much lower rate. They reported them to be mild and they all went away within a day or two. There were no serious adverse events related to vaccination. This includes zero cases of anaphylaxis and zero cases of myocarditis. I want to really underscore for families that the recommendations for use were made specifically looking at the risks of COVID-19 illness in children in this age group which we know to be less than that for adults but still exist. So those risks were looked at and studied and compared to risks and benefits of the vaccine and the data are clear that the vaccine is beneficial. So the other thing that Vermont pediatricians are reassured by are all the data we have on the millions and millions of people who have received this vaccine already. If we're talking just about the Pfizer-BioNTech vaccine in the U.S. alone over 100 million people are fully vaccinated with this vaccine. That's a lot. Of that 12.6 million are fully vaccinated adolescents with this vaccine. A lot of data points. In Vermont 31,012 to 17 year olds have been vaccinated with a Pfizer vaccine. Those are our patients and we have been so grateful that they are vaccinated and protected from serious illness. I'll share with you that throughout the summer and the fall, Vermont pediatricians watched as unvaccinated adolescents in other parts of the country were hospitalized with severe illness at an alarming rate and we have been so thankful for our high adolescent vaccination rate here in Vermont. We do continue to be concerned for our unvaccinated adolescents here, some of whom have experienced severe illness. What we're learning is that it's impossible to predict which children may have serious illness. Many children who end up with severe disease have no underlying conditions at all and others have very common conditions. We want all children and adolescents to have the benefit from vaccination so that their immune system can be prepared for an eventual exposure to the SARS-CoV-2 virus. This is what vaccination does. It prevents information to our immune system in a controlled way so our bodies can prepare. When the immune system is unprepared it can over respond in its attempt to control the virus. Much of what we do for hospitalized patients revolves around suppressing an unprepared immune system response. So this is why pediatricians love vaccination. It doesn't change anything about the way the body works. It doesn't modify a pathway in the body. It just primes it with information and lets it respond in a way that it normally would. In many ways this is what parenting is about as well controlled preparation. We tell families in our clinics and our offices that we can't shield our children from everything that life might throw at them but we can prepare them in the same way we can't shield our children from ever being exposed to the SARS-CoV-2 virus. They will be exposed likely many times over their lifetime. Vaccination will prepare them for that eventuality. Although many people experience immunity post infection the response is variable and it's not as long lasting as vaccine induced immunity and people have to get sick to get that immunity. The most reliable and safest way to achieve immunity is through vaccination. Pediatricians and other medical professionals who care for children use a shared decision-making model when we work with our patients and their caregivers. It is families who make decisions but it's our job to provide context to the choices families are facing. We do that by describing what is known and what is uncertain and there's always some degree of uncertainty in every choice we make but the degree of uncertainty can vary widely. It's important for us to convey where the greatest magnitude of uncertainty lies in a decision and in this case it is without a doubt with the virus. Pediatricians worry about the uncertainty that the SARS-CoV-2 virus presents to our children. We worry about the long-term effects on a previously healthy adolescent with severe COVID pneumonia and signs of lung damage. What does their exercise capacity look like a year from now? How will their lungs weather future respiratory infections? And what about the school-aged child with MIS-C, multi-system inflammatory syndrome in children? This is a rare but serious complication from COVID-19 infection and over 5,000 children in the U.S. have been diagnosed with this. This can lead to significant myocarditis requiring ICU stays and cardiac support. What does recovery look like for that child? And what of the children who have persistent symptoms months after COVID infection? How does that affect their health and development? There is so much we still need to learn about the long-term impacts of COVID-19 illness. The good news is that for this age group these conditions are now vaccine preventable. So when it comes to kids and COVID and vaccines yes there is uncertainty but that uncertainty lies in the virus and how it behaves and how it will affect our children long-term. We know that families often prefer to receive immunizations at their child's pediatrician or family medicine office. This is what they're used to. These practices will likely be receiving vaccine shipments in mid-November. For those eager to get vaccinated right away, community sites will have the first available vaccine. School-located clinics will also be available to families as well as some pharmacy sites. Please choose the option that is the most convenient for your family and allows your child to be vaccinated as soon as possible. Many families will have questions about the vaccine and pediatricians are ready to answer them. The Vermont chapter of the American Academy of Pediatrics will be hosting twice weekly virtual family forums with local pediatricians to answer questions. They will be held in the evenings and recorded for those who cannot make it live. The first four forums have been scheduled. Monday, November 8th with Dr. Leo Castello who practices in the South Burlington area. Wednesday, November 10th with Dr. Liz Richards from Brattleboro. Tuesday, November 16th with Dr. Josh Cantrowitz from St. Johnsbury. And Thursday, November 18th with Dr. Ashley Miller from South Royalton. We will continue to hold forums throughout November and December. Please check our website aapvt.org for more information and a schedule. I'd like to end by saying that pediatricians like to say that we would never make a recommendation for an intervention that we wouldn't take ourselves or give to our own children. This COVID vaccine is no different and we can see this play out during this pandemic in real time. We are vaccinating ourselves, we are urging our loved ones to be vaccinated, and now we are vaccinating our own children. My oldest is six years old and he is now eligible, will be soon for the vaccine, and he will be vaccinated as soon as possible. For those with children in their lives who are not yet eligible, I feel you. I also have a four-year-old. He will have to wait just a story of his life, but he will benefit from his older sibling getting vaccinated and from higher rates of vaccine protection in the community. And speaking of community, I have not even mentioned all of the public health benefits to vaccination and that's because my role as a pediatrician is to make recommendations for my patients on an individual personalized level. The benefits of vaccination are clear in this age group, even without taking into consideration the added public health benefits. Please reach out to your child's medical provider with questions or attend one of our family forums. We have your child's best interest in mind and we are happy to work with you. Thank you. I'm going to hand things over to Deputy Secretary Boucher. Thank you Dr. Bell. Good afternoon. I want to update you on a couple initiatives that focus on Vermont's education recovery. You may recall that in preparation for turning toward recovery from the pandemic, AOE launched a planning initiative to guide districts and schools in addressing the impact of COVID-19 on students. We focused on three areas, hopefully you'll recall, student engagement, social emotional learning and well-being and academics. On Friday, Governor Scott announced new state plans for achieving universal after school and summer programming built on the success of our recent summer matters campaign. Last summer, Vermont used part of our SR state set aside to fund grants, expanding access to fun and engaging programs for kids across the state. This was designed to address the first area of our education recovery plan, helping children become re-engaged within their communities after several months of pandemic management. Summer matters contributed to over 9,000 children participating in summer programs this past summer, with 67 percent of those programs serving youth with special needs, and 46 percent of the programs offering youth employment opportunities for adolescents in our state. In looking at the map of summer offerings, it was clear that there was something in for nearly every region or county in the state. In addition, as of mid-October, more than 90 percent of our school districts signal that they have used or are planning to use their local SR dollars on after school and summer programming. Governor Scott's new vision includes the creation of a formal inter-agency after school task force, charged with developing a statewide system offering universal access to safe and rich and comprehensive options for after school and summer programming for Vermont youth from pre-kindergarten to grade 12. Chief among the strategies for this work are leveraging public-private partnerships at the state and local level to expand existing programs and capitalize on what is already in place. Also focusing on programming for all age groups, because we understand that high school students are often the most difficult to engage, and developing a baseline for safety and quality statewide so that all after school and summer programming in Vermont fully meets children's and family's needs. This new task force includes members from state agencies and departments including education, mental health, DCF, voc rehab, fish and wildlife, and labor, as well as Vermont after school. In addition, on Friday the governor announced a second grant competition to fund summer 2022 and school year 2023 after school programs. And more details about these funds will be released as the task force begins its work in the coming weeks. I'm also pleased to announce today a new state tool designed to help address students' social emotional learning or you might hear it called CEL or SEL and their well-being. And this is of course the second focus area of Vermont's education recovery plan. CEL refers to activities like self-regulation, recognizing and understanding our own emotions and those of others, and applying tools to manage stress. Research indicates that it is critically important for students to have a strong foundation in CEL skills and both mental and physical well-being to be able to attend to and learn academics successfully. Yesterday we officially launched CEL VT, a free virtual platform with resources for understanding healthy social emotional learning and building core CEL skills. The materials on CEL VT are intended for students, for parents supporting their students, and for teachers and administrators to use an instruction and education recovery efforts in school. And I'm pleased to show you some examples of the kind of materials that you'll see on the platform. I believe, yes. Here is one for second grade. This is actually an example showing that Croc has been too impatient to wait her turn and she keeps interrupting everyone. And so this is a whole lesson around for the younger kids, second graders in this case, to be patient, to learn how to wait their turn to not interrupt. Next slide. Seventh grade. This is one example embedded within a lesson for seventh grade that is about managing hard-to-feel emotions, such as anger, sadness, and fear. And so here you can see that the module is bringing in a little bit more developmentally appropriate, more complex ideas here. So actually talking about how the brain is involved in emotion regulation, but it's still at the level of a seventh grader. And then eleventh grade. Here is one that is putting a lid on stress, very helpful for seniors as they think about things like SATs and finishing on their courses to graduate in time and so on. And this one is about telling them how it is very common to feel stressed out in one's junior year. And then it talks a little bit about some ways to actually think about what's happening and then help them juggle that stress in the context of everything else. So these are just a tiny, tiny snapshot of what is in this set of curriculum materials, but I wanted to give you a flavor of the range that is very developmentally appropriate all the way from kindergarten through twelfth grade. Hopefully as you can see it's meant to be a very engaging material, a lot of cartoons and cool pictures and interactive videos so that hopefully we're enticing students and their families as well as teachers who will use this in their classrooms to really engage with the material. And again why we're investing in this at this time is because it is so critical after having navigated and continuing to navigate the pandemic that we really focus on social-emotional learning for our students and make sure that they're mentally as well as physically of course as they can be so that they can focus on learning and the typical reasons why we're at school. I wanted to point out that I have some information for folks to be able to access CELVT so parents and educators can register at sel.education.vermont.gov and when you log on to that site more information can be found there and can also be found if you go through the agency of education website there is a CELVT page and when you get to that landing page for CELVT you'll see an overview and registration walkthrough videos for both educators and for parents. So we're pretty excited about these two initiatives both focusing on universal after-school and summer programming and the new CELVT platform because we think they're going to be really very critical for helping our students get back to a sense of well-being, a sense of fun, a sense of safety as we hopefully continue to turn the corner. Finally to tie this work in with what both Dr Bell and Governor Scott said it's imperative that all K-12 students get vaccinated when eligible. When students are vaccinated they can remain in school, they can focus on the critical cell and well-being work that is so important to their recovery as I've noted and they can access supportive relationships with adults friends and classmates that help them achieve their academic learning and success. So I implore all parents to check with their pediatricians and their pediatric primary care teams and to ultimately ensure that their eligible children are vaccinated as soon as possible. And I'll now turn it over to Secretary Smith. Thank you Deputy Secretary. Good afternoon everyone. As the governor and Dr Bell mentioned the FDA has recommended providing the Pfizer vaccine to children ages five to 11 years old. The CDC is meeting today and tomorrow we expect that they'll approve the recommendation by the end of the day or sometime on Wednesday. The morning following the CDC approval starting at 8 a.m families will be able to go online and make an appointment for their children to get vaccinated. You can go to healthvermont.gov backslash my vaccine. You can also call<PHONE_NUMBER>. We strongly encourage people to make an appointment to get their shot. In addition to our state-run sites pharmacies and primary care providers we're setting up school-based vaccination sites. The Department of Health would support from EMS and other health care providers will operate 96 school clinics in near covering 112 schools across the state over a six week period. Many of our schools of our school clinics are in place in places where there are fewer pharmacies or other ways to get the vaccine. We're also set up in areas where we know families may struggle with transportation. Our goal is to get as many doses as possible into students arms before the holiday break at the end of December. That's first and second dose. Children will be eligible to receive their second dose 21 days following the first shot. Most school clinics are set up for vaccinating children not adults. With that said parents, guardians, and family members are of course welcome to accompany their child to the appointment. We expect 6,000 pediatric doses by the end of today coming into the state. However, Vermont expects to receive a total of 23,400 doses for children by the end of this week. Of that amount the state will receive 15,900 doses. The remaining 7,500 will be allocated to pharmacies and health care partners and we expect more doses to become available after the initial allocation. To give you some context, there are approximately 44,000 children in Vermont between the ages of 5 to 11. Now turning to vaccines and boosters for adults, obviously we continue to urge everyone eligible to get a COVID-19 vaccine. Keep in mind that if you've already gotten your vaccine it may be time to get your booster. It is especially important for anyone 65 or older to get a booster. You should also get a booster if you're under 65 and feel for any reason at risk of getting COVID-19. Just remember that you must be 18 years or older and have received your second dose of Pfizer or Moderna vaccine at least six months ago or the Johnson & Johnson vaccine at least two months ago. To get your booster or your initial vaccination you can make an appointment again at healthvermont.gov slash my vaccine or by calling<PHONE_NUMBER>. Last week the governor Dr. Levine and myself visited North Country Hospital in Newport. We went there to encourage residents of the northeast kingdom to get vaccinated and get their boosters. Many of you I saw there. While we were there the governor and the members of the Orleans delegation got their booster shot. Since we held that event almost 500 people in the northeast kingdom have gotten vaccines or booster doses. Thank you to those folks for doing their part and looking out for each other. We're planning another barnstorming effort in the northeast kingdom this weekend with a special focus on Essex County just to give you this just came in to me just to give you some idea of what's going on this weekend. On Wednesday 11-3 the Glover ambulance station will be holding a clinic from nine o'clock to one o'clock. On Thursday 11-4 the Newport ambulance will be holding a clinic from nine o'clock to two o'clock. On Saturday at the Orleans fire station there'll be a clinic from eight o'clock to two o'clock. On Sunday at the Brighton fire station there'll be a clinic at nine o'clock to 13 to one o'clock. Each of these clinics will have Pfizer, J&J and Moderna available for booster or original vaccination. This weekend's clinics will be walk-in only. I also want to add on a different type of clinic on Saturday. North Country Health System that's the FQHC up there is adding a 100-person clinic on Saturday in Island Pond from nine to three. There are no walk-ins you have to register. This is not a pediatric site. This is an adult site and it's boosters only at the Northern County Health System in Island Pond. One of the things that I just want to mention is I want to take a moment here to say a special thanks to our EMS personnel in Vermont. They've stepped up and done an incredible job helping vaccinate people in their own communities. We saw the great work that they did in the Kingdom over the weekend and continue to do over this upcoming weekend and the next few days happening. This happens all across the state. That includes at our long-term care facilities and many of our community vaccination and testing sites. They've been doing this work throughout the pandemic and it's certainly not letting up and we will roll out the boosters as well as vaccines for children using EMS. Often they respond at a moment's notice when there is an urgent need. So thanks to the EMS personnel for supporting our communities. In other areas non-COVID related just a quick and brief mention that yesterday our open enrollment began for Vermonters seeking to sign up for or to change their healthcare and dental insurance. This year many Vermonters will be able to purchase healthcare insurance at significantly lower costs due to increased federal subsidies through the American Rescue Plan. To see if you are eligible for a more affordable plan you can go to info.healthconnect.vermont.gov. And one last thing here. Last week we held the first public virtual session to hear from Vermonters who have experienced long wait times to get medical appointments. Thank you to those Vermonters who participated and who contributed their stories to support the investigation. Just wanted to give everybody a heads up. We're holding a second session this Thursday, November 4th from 12 p.m. to 2 p.m. We encourage anyone who would like to participate to do so. Please sign up at dfr.vermont.gov under the topic wait times. If you prefer to share your story anonymously you can submit a written description of your wait time experience at the same website. Now I'll turn it over to Dr. Levine for a health update. Thank you Secretary Smith and Governor. I don't think there's a lot of loose ends so I will do some brief reinforcing and make a couple other important points. I'd like to add my thanks to Dr. Bell for being here today. Her expertise and experience in the field of children's health has been a key part of our success in helping keep kids safe in Vermont. We all know how important it is for parents and caregivers to be able to reach out to the people they trust the most when it comes to their children's health. They're pediatricians and family medical providers and I know that Vermont parents are much like other parents around the country. Their trusted source of information is their own physician or their child's physician and not something they just picked up on the internet. I want to thank all of the providers and practices who are getting ready to vaccinate their younger patients when the time comes and for answering questions about vaccine and understanding that these decisions for parents are not always easy. This is what these clinicians do all the time and I'm always impressed by how well they put both kids and parents at ease. So if you are a parent or a caregiver I hope you'll think about all the benefits this vaccine can have for your child. Not only protection from COVID-19 itself but freedom from the worry that comes with it like needing to quarantine if you're a close contact or spreading it easily to others. It also means more freedom for Vermont kids to be kids, to see friends and family, travel and stay in school and it will help protect against the risk of long-term effects of COVID which can affect children as well as adults and be serious in last months. The rate of the so-called long COVID syndrome in adults we fear is somewhere in the 10 to 35 percent range. In children the data is early yet but it could be in the 4 to 5 percent range. I want to thank parents for considering all these factors so you can have confidence in the decision to vaccinate your child because when it comes to your child safety the threat that COVID-19 poses to their health will remain with us for years to come. As I've said many times and I'll reinforce what Dr. Bell said this SARS-CoV-2 virus is going to remain on the planet long after we get through this delta surge long after we stop recommending mask use and gathering size cautions. It will join the other vaccine preventable viruses that circulate and that your child will almost certainly encounter. Over 414 million doses of COVID-19 vaccine have been given in the United States. For perspective that's 82 million more doses than there are people in the entire country and it was done under the most intense safety monitoring in history. Serious problems with safety are rare and according to a recent study published in the CDC's morbidity and mortality weekly report there is no increased risk for mortality among COVID-19 vaccine recipients. In short the vaccines are working and the data continues to show vaccines are safe and working very well against the most severe outcomes. Now one thing I've been asked frequently here and elsewhere is why you need a vaccine if you can get immunity from having been infected with COVID-19. Well another new study of patients hospitalized with COVID found that vaccination can provide a higher more robust and more consistent level of immunity to protect people from COVID-19 illness requiring hospitalization than infection alone. The data continues to show that cases among unvaccinated people are still happening at far greater rates than cases among fully vaccinated people. Among people who are hospitalized with COVID-like illness the CDC found that those who were unvaccinated and had a recent infection were five times more likely to have COVID-19 than those who were recently fully vaccinated and did not have a prior infection so it also found that vaccination after infection significantly improves protection from reinfection. Coming back to Vermont I know Vermont still has higher case numbers than we want to see nonetheless the success of vaccines themselves and our high vaccination rate are clearly pointing us in the right direction. I'm pleased to add that this is not just my opinion. A short while ago I spoke with Dr. Anthony Fauci about Vermont's situation. Someone whose perspectives, pragmatic science-based approaches to medicine we should all admire. Dr. Fauci told myself and state epidemiologist Dr. Kelso that he agreed that our current mitigation and vaccination strategy which emphasizes getting boosters out quickly to high risk Vermonters while providing the remaining now 53,000 unvaccinated adults with easy access to vaccine and now hopefully starting very soon vaccinating younger children all of these things should help turn things around for our state. Lastly I want to congratulate those Vermonters over age 65 who have already made Vermont a national leader in the response to getting a booster and while boosters along with children getting vaccinated are priorities it's still critical that everyone continues to take the other important actions to reduce spread right now while Vermont and the majority of the country remain at high levels of transmission.  Thank you Vermonters for doing your part to help protect yourselves and one another. I can't imagine there's any questions after such a detailed presentations but we'll open it up anyhow. Starting with folks, the lead number is typing. Once you have 43,000 more children who become eligible to be vaccinated is that going to change how Vermont calculates its percentage of total population that is vaccinated? I don't see the Secretary Smith nodding. I'm sure we'll use the eligible population but please repeat check. Yeah Wilson so there's about 550,000 Vermonters who are eligible now the 43,000, 44,000 you know five to 11 year olds will make that percentage larger increase the denominator so that will go up to about 590 you know 4,000 so that will change our percentages you'll see that percentage which is just at 90% now probably go down into the mid 80s and then hopefully work itself back up as more and more of the five to 11 year olds get vaccinated. Governors, US Senate confirmed Beth Robinson last night. You endorsed Beth Robinson's nomination. Most US senators were Republicans voted against her. What do you know that they didn't know? Well obviously they didn't work with her. We've seen her in action here in Vermont for a number of years and have a lot of faith in her and I think it was a great step forward. I thank the Senate for confirming her and I thank the Republicans who did vote in favor but but I think they'll see in the future that she'll make she's a great choice for federal judge. Also in politics this weekend the Republican Party will choose a new chair. Do you have a preference? Will you be involved at all? Do you support Paul Dain? Yeah I haven't been involved in this process at all and but I know Paul. He served in the house I believe when I was possibly in the Senate or soon after becoming Lieutenant Governor but had the opportunity to work with him. We don't agree on every single issue obviously but but I think he'd do a good job in that role so we'll see what happens this weekend. I won't be attending but but I think he'd be a good choice. Governor I want to ask about the general assistance program. I know you've made your position clear. Piers as though as of yesterday the speaker and the pro tem are both in favor of expanding it not just of people currently as taking Vermont's experiencing homelessness into the program. Has that changing your your thinking thought process at all? Well it hasn't changed my thinking obviously it's changed theirs they had voted previously in favor of ending that program so they must have come to a different conclusion since we came you know the legislature weighed in on this decided to end the program and we did so. So we're obviously willing to work with the legislature on this they'll be coming back into session in January and I'm sure this will be a topic of conversation. Maybe I'll I'd like to have maybe Secretary Smith weigh in and I'll come back to your next question. Calvin we've been obviously talking with leadership about the program we'll continue to talk about them. They sent me a letter this week with some questions we're going to answer those questions we're going to meet again. We're always looking at ways to further enhance the program just remember that we will be implementing soon the adverse weather conditions. What that does is open up the program to more individuals during that time period because it gives more flexibility to the program during that it's usually implemented it's not new we've done it before and we'll do it again and we'll talk with the speaker in the center pro tem about this in terms of opening it up but it loosens the eligibility requirements for the program. It also will run from probably towards the end of this month or you know the third week in this month to March or April depending on what the weather is like. So it will enhance the opportunities for various people for various people who are homeless to have shelter over the winter. So that those those discussions are continuing as well as you know the the issues that we talked about before in terms of the program and what we're doing with the program. One of the things that I just I want to emphasize none of this none of this works without the investment of 249 million dollars of permanent housing and you know it just we won't get to where we want to go without investment investments into housing in order to permanently house those are homeless in this state. I guess going to take number nine years for that that housing to come online but I guess the the other point I was hoping to ask the governor is advocates said that they've called hotels around state and they say that they've taken stock of about a thousand they say hotel rooms from hotel owners who are willing to participate in the program and take in new Vermonters. So I guess I'm wondering. Well just one misnomer that I just want to make we haven't ended this program right now there are 1500 people who are housed in 962 rooms throughout the state. So we never ended this program. One of the things that you know we call all the time on on unavailability of hotels. If those advocates want to give us those names of those hotels we'll certainly use them. So I guess at this point we shouldn't it be up to the hotels or whether they want to participate in the program. Well we'll look at hotels I mean we've got to make sure that the hotels are adequate in order to house people in various things that are late. It's not up to the hotels to decide it's it's up to us to make sure that the hotels are capable of of doing the things that we need done in order to to house people and they may be available I don't know but they may be available this week. We need a longer term commitment. It's worth noting as well this wasn't a perfect system and when we have as Secretary Smith had said a number of people 1500 people now which is probably three or four times what it was pre-pandemic. So we've we've enlarged this program even today by at least three or four times what it was then and when I say it wasn't a perfect system as we've we've stated before the solution is permanent housing. A hotel motel program had its challenges in a number of different ways. They weren't getting the services they needed. They were more isolated than in different settings. We also had thousands thousands of law enforcement calls to hotels and motels. Rutland as you remember shut down one or two motels as a result of all of the activity that was happening within those that hotel motel program. Some there were some bad actors that were taking advantage of this program so it wasn't perfect and we're just trying to do whatever we can to make this better and take care of people. The last follow-up question I mean if the cold weather rules aren't going to take over for another three weeks or so you mentioned it means this week it's supposed to dip into the 30s so I guess what's the plan to help out people that I think we are freezing conditions already. I think they're already being helped out right now. I mean with 1500 people in hotels and motels now. I think I'm not sure there's a gap there but Secretary Smith. We'll monitor the weather. That's one of the adverse weather with that conditions that we look at. We monitor the weather. Just remember Calvin there's not only 1500 people in hotel motels there's 500 people in shelters as well. We are trying to expand the shelter capacity and right now we're looking at facilities where we can expand that shelter capacity as we move forward. So there's a lot of activity going on in terms of the homeless especially with talking with leadership about how we how we implement the adverse weather condition provision, how we expand the shelter provision. Like I said they sent me a letter I expect to send back the letter. I hope to meet with them this week and you know working together but particularly working together to get housing bill I think is going to be critical in all of this. Just remember we've been able to place through new through housing initiatives 500 500 people as we move forward. So there's been a lot that's been going on but there's a lot more that needs to be done and it's all in solving the problem through permanent housing. Again if this program is open back up to the emergency level that we were at maybe a year ago I think we'll be hearing you'll be hearing from many communities who have great concerns that this is being opened up in the way it was before. Governor there's a state championship soccer game that's going to be played tonight and it is closed to the public and closed to the press. What are your thoughts on that do you think the vpa did the right thing or do you think it's kind of a violation of the first amendment? I wasn't involved in the decision on that obviously I had heard it but I believe they've reversed part of that decision in allowing the press in but who is there someone on the line that can or is that Secretary Boucher? Hi I received a memo this morning from the executive director of the Vermont principal's association that said Winooski had agreed to have the press at the event so that was the latest that we actually were aware. With kids 5 to 11 being added to the eligibility list does this change recommendations for Thanksgiving and what is guidance this year for the holidays? Unfortunately the kids even if they got vaccinated early next week would only have received one dose and not had the usual time go by so first dose 21 days later second dose two weeks later you're considered fully vaccinated so they'll be on the way which is great but they won't quite be there yet gathering size is still going to be a consideration for Thanksgiving just like Halloween. Secretary Smith are we receiving the same doses like for the adults is it one dose or are we going to wait until later to receive the second dose? When we receive an allocation it it's an allocation there's no remember before when we did it it was we got an allocation and then the the federal government held back an equal amount that's not going to happen this time they're going to they're going to give us the allocation we're going to administer the allocation and the way that we have planned out if we get future allocations the way that it's coming that we think will be coming in although no guarantees there will be no second dose issue as we move forward. All right we'll move to the phones starting with Lisa Lumis at the airport. Good afternoon I have a question about contact tracing um I was in contact with a local woman who tested positive on Sunday called the Department of Health and left her close contacts and she did not those close contacts did not get contacted by the Department of Health until Wednesday what's the typical turnaround time for that? Secretary Smith we do look at those statistics almost twice or three times a week in terms of turnaround times I do know that we have 150 full time 156 full time equivalent contact tracers that are on that is not the typical turnaround time that we're looking for we're looking for within 24 hours at most you know the 48 hours so I would like to get that namely so I'll have somebody reach out to you and just find out what happened. Okay that's great I also have a question about rapid antigen testing these are the tests that are being used in school are those tests available to the public anywhere through the state? Yeah I'll um Dr. Levine wants to chime in on the contact tracing but I'll let Dr. Levine talk about the engine testing as well is is that okay or because? Yes that's fine with me. With regard to the um contact tracing first one very important point and I think we've done a really good job with educating Vermonters and they're very familiar with our website and the process when they know their close contacts the best part of what's happened in Vermont is that people know to talk to the close contacts and actually give them the information that they need to have that's really important because that will always be the best early warning system for any individual Vermonter so God forbid people would wait with close contacts and anticipate someone else will get a hold of them to always best that they if they know them obviously contact them quickly as this woman sounds like she knew who these contacts were and can provide the names with regard to the antigen tests the tests being done in the schools do require a a machine I'll leave it at that to read the result of the test and so it requires a special waiver called a clear waiver it's something that a person wouldn't just have in their home for this particular type of point of care rapid access test however there are tests that you can obtain either online or going into your pharmacy that would be similar antigen tests that are approved tests that would allow you to do the test at home without any special equipment if you will and access that the state at this point in time hasn't been making those available in fact there's a supply chain issue as with many things in the country now regarding those tests that is a strategy though that we in the state firmly believe is the strategy for the future and the federal government believes that as well so we're waiting for things to sort of sort themselves out in terms of the government perhaps providing not only abundant tests that they've purchased but the ability for most of the population to have them at low or no cost and we in the state are trying to sort of keep that in mind but make sure we don't wait so long that it will take too long for that strategy to get developed so that's sort of a look at what the future of testing is going to look like thank you and i want to just follow up with something you said about Thanksgiving a moment ago when you said the size of the gathering is going to matter are you providing any recommendation we're not giving a specific number obviously no but at the same time we know that obviously as gathering sizes increase a number the likelihood or the potential for virus to be transmitted at those gatherings at a time when the community level of transmission is still high is a very real phenomenon obviously families that want to be very careful about things of that nature should look for vaccination status should consider the kind of testing we've just talked about prior to the holiday so that people are aware that they are safe if you will at that point in time so there'll be more guidance coming out in the future and we'll see what our level of community transmission looks like later in the month as well thank you Greg Lamero good afternoon governor as you know members of the media push back against a media ban by Winooski high school and the vpa regarding coverage of a high school soccer event later today the good news is that you know the the media ban was lifted whether that was forced by a pending lawsuit or not and in wiser heads prevailed but it kind of brings back around the topic of the vpa governing high school sports and you know in an editorial yesterday in the caledonian record it I kind of want to quote it here they said we don't think anyone who decides to diffuse a controversy by removing independent third party observers should be in the position to make important decisions so governor I'm wondering if you agree with that statement by the caledonian record editorial staff and more of an overarching issue here has your view of the vpa administering and being in charge of high school taxpayer funded sports changed in the last few weeks well it appears that they arrived at the correct decision in the end so I think their first mission obviously is to protect the kids make sure that they have their day to play the game and to compete and trying to de-escalate the situation that arose a couple of weeks or a few weeks ago so I understand the challenge they were facing and but I think again they came arrived at the correct decision at this point in time so I don't believe you know obviously there's there's improvements that could be made but I think there will be a lot of self-reflection at this point but again the bottom line is how do we how do we provide a safe atmosphere for our kids to play in these situations without repeating what happened not so long ago that does it not concern you the the attempt to censor media and and that it took the threat of multiple lawsuits and you know pending momentarily almost filing lawsuits before before the vpa would would come around and in your words do the right thing well again I think the bottom line is they arrived at the correct decision in time to have the game and so at this point in time I don't know if it was the threats you often I I don't know how they came to their conclusion but whether it was the threats of lawsuits that were made by many media organizations or they just came to the conclusion this was appropriate for the kids at this point in time I just don't know that's that's a question for them okay thank you governor that's it for me br angle smith bt digger hi I have a question about vaccination clinics um it sounds like the health department is really sort of gearing up for the vaccinations of children ages five to eleven and I wonder where it leaves us with previous efforts for like for example holding vaccine clinics in shelters and in you know others have had to reach areas sir Chris Smith yeah I just thank you for the question I just haven't emphasized that this week we haven't given up on other vaccination efforts as well I mean we are well I mentioned the school effort because it's a new effort this week but we aren't giving up on other efforts and we will you know like we've done through the pandemic we've through the entire pandemic we will reach out whether it's homebound or those in um in shelters that are eligible for boosters or vaccinations we will reach out and continue to reach out uh as we move forward I just haven't mentioned you know the the number of clinics uh that we're having this week in general I I am assuming it hasn't led up at all which is quite substantial around the state quick follow up to that um I spoke to at least one large provider in the state that said that they were told by the health department they won't get stopped coming in uh to you know from the state for vaccine boosters uh in in homeless shelters and um they have to sort of make other arrangements is that sort of a one-off thing or is it something that yeah or they're like yeah I I haven't heard that I'm and I'm befuddled by that sort of situation so let me uh take it offline and try to figure out what's going on I if anything it was a miscommunication but uh Dr. Levine have you heard anything in that regard no in our local health offices that's one of the primary roles yeah as Dr. Levine said that you know our local health offices that's one of their primary roles is what um what you just mentioned so let me look into that to find out what's going on hey seven days hi yeah commissioner pjack alluded at the beginning of this press conference to um some conversation that the state is having with the cdc about our booster data could you just elaborate on that a little more what exactly are we looking at thanks for pjack so Colin what we've seen in the data over the last five or six days is that the booster data potentially could be under counted and those starting their initial vaccinations could be over counted so if anything the booster data is under counted we're still number one in the country on those categories we showed today but what we want to confirm is whether there's any over counting on the on those starting their initial vaccination some other states have reported seeing that it's not something unique to Vermont it's something we believe it's on the cdc's end so we want to confirm that before you know making announcements about our new people starting vaccination got it thanks and then i had a second question i think this is probably for the governor the Atlantic came out with a story i think this week that was pretty much arguing that america has lost its covid compass that we don't really have a clear set of goals to what we want and that's making it difficult to drive our policy decisions and i think looking back really on in Vermont at least it was very clear that our goal was to prevent deaths and hospitalizations i'm wondering for people who might not be following these every week if you could give them an update on what you think our current goal is obviously our strategy is vaccination what is our goal in your mind right now at this point in time i don't think our goal has changed i mean we always have tried to protect our health care system hospitalizations and deaths has been a priority and we're continuing to do so and again we're at a higher level of hospitalizations over a longer period of time than we like but it's it's been flat in some respects higher than we want but flat and in our health care system is is challenge but but not broken so we're continuing with the same goals that we had previously that will be anything to add to that as the governor is aware we have a restart team that you know began many many moons ago with reopening vermont so to speak and we've continued to meet because we're trying to chart out a course to the future when pandemic becomes endemic so the goals the governor stated remain the goals obviously we've also had the consistent goal all along of keeping kids and in-person education as a primary goal to drive us as well but those those remain sort of the the compass if you will Joseph Gresser Martin Chronicle to Pete Hirschfeld vpr thanks Jason sorry for the delay um governor i'm sure i want to make sure i understand uh your administration's policy approach to the issue of folks who are unhoused right now living in campments living in the streets um secretary smith uh seemed interested in the fact that advocates had spoken with motel owners so that they had rooms available to provide emergency shelter you talked about concerns with motel housing and i guess what i'm wondering is if if there is motel capacity right now for people who are currently unhoused uh is your administration interested in pursuing that opportunity um to get people under roofs that aren't under them right now secretary smith i talked about hotel motel capacity because think about this we are um talking about the conversion to an 18 month program in in january and we are currently on pause until the end of december here um and then talking about converting to an 18 month program that's away from the ga that means still people are eligible in that program for hotel motels so we are still interested in hotel motels as we move forward in that program secondly adverse weather um when we impose the adverse weather conditions it will open up not only shelter um and that's why we're looking for shelter capacity around the state but it will open up the need for a hotel motel space remember the hotel motel space isn't static we have people coming into the program as well um that um meets some of the qualifications of the program now so it isn't static as we move forward so there isn't an inconsistency between what um what we're saying in terms of hotel motel and lastly the hotel motel program isn't the ideal program um for anybody that's homeless permanent housing is and one of the things that we keep driving at is the need to fund the permanent housing proposals um that we have before the legislature and that's that's where we're driving at but peter the the hotel motel um capacity is a is an issue and we look at it you know there may dcf does a very good job of scanning the hotel motel landscape on an ongoing basis because they know more than anybody how much we use that program right now and i don't i don't think you know if we if we're seeing something if we're not seeing something that the advocates are seeing um i'd be more than happy to sort of look at it but at the same time there are certain things that we're going to need we're going to need consistency in that hotel motel program we're going to need some sort of service level at the hotel motel um that we're looking at but if that capacity exists then your policy would be to avail yourself of it at ahs and provide that motel housing to people that currently don't have it and are eligible we we are going to do that when you implement the adverse weather policy we immediately increase the eligibility for for entry into the hotel motel program we've done this for uh for years now in terms of the adverse um weather policy there's no difference than what we've done for years in addition to what i'm saying is that when we convert we're going to be when we convert out of the general assistance program to the rental assistance program the option is there i i would hope that we would do more apartments and other things but the option of there is there to use the hotel motel program so that doesn't go away and then thirdly like i said this program um continues we'd like it to continue in a in a manageable fashion back to the original size but at this point it continues at a higher rate um last follow-up i promise um if you send out the capacity and this is sort of a a philosophical question if you have the capacity to house everybody who needs it when cold weather kicks in um why not provide that housing when cold weather isn't an issue because one of the things that we're going to because it isn't a permanent solution as as one thing it isn't a permanent solution secondly we're lucky we're fortunate right now that fema is paying for this program this program without fema and wide open would be close to a hundred million dollars a year so you tell me what programs you want me to cut to fund this program at a hundred million dollars a year there's this is a program that's unsustainable after the fema funding rolls rolls off we have to make this sustainable as we move forward in in the future and i think that's what we're doing we're moving people from the general assistance program that's fema funded right now that won't be forever on to a funding mechanism and a program rental assistance that gives them 18 months of rental assistance where they can use either a hotel motel or an apartment and then roll that into permanent housing i i think that is the logical way to move this and to um and to make sure that we don't have this issue again thank you phraser nickles the value reporter uh yes hi my questions are related to school sports i'm wondering first off uh in a situation where a school that requires masks is hosting a team that does not whose policy will supersede uh i don't know if uh secretary moore is on or deputy secretary buchet i am we'll start we'll start with uh governor secretary moore okay this this is secretary moore uh so the the recommendation is that masks be worn uh throughout the winter indoor winter sports season and so it would apply broadly and irrespective of what is going on in a particular school once we get past that martin was their king holiday date where the the require or the recommendation that all students mask may be reconsidered okay and in a situation such as in water barrier in our area um the local hockey teams play at a town rank in that situation would students still be required for a mask even if the town facility does not require it the recommendation extends to all school sponsored sports activities and in addition uh secretary curly and i did hold a conference call with leaders from the recreational youth recreational sports community at the end of last week shared the school-based guidance with them um and asked for their consideration in following the same recommendations for recreational youth sports leagues okay thank you like don and you the islander thanks jason uh governor wondering what is the latest uh that you've been told as far as uh core gate and the ongoing problems the department of public safety has had converting to a new workable emergency dispatch center for police fire and rescue all across the state uh obviously it was taken offline uh when it fell on its base several weeks ago it was supposed to be sounded like it was going to be quickly fixed obviously it hasn't i heard from troopers and some other people here recently that a test failed miserably so uh is there any thought to punt and try to find a new system maybe go back to spellman system which hartford and some of these others are using and investing in that seem to have worked through the years alcore gate must be something that you made up i hadn't heard it referred to is that um in terms of i am aware that we had a test i wasn't aware of the results of the test but that's what tests are about right to make sure that the system can can stand up on its own before we implement that was what we learned from the first round so if that is the case and i don't know that it is um we're still working on it we decided as a as an administration with the public safety to move forward with val core system and again it's about a 5050 split some like it some don't um but we think it's has an enhanced capabilities and we'll continue to try and merge towards that i might ask if commissioner shirling can is on and maybe or somebody from ads uh agency of digital services might be able to give us an update on this but i know i i do know that they uh they put a um a test together but i'm not aware of the results good afternoon governor thanks for the following mike uh the test was conducted late last week in the reports i got from the test team both inside public safety and digital services together with some third party other agencies that were present indicated that things went actually very well there are a few additional items on a punch list that are being worked on now but i think exceptional progress has been made since the first first live test that occurred a few weeks ago what is the target date since it keeps moving the goal line keeps moving here uh during this project yeah great follow-up question um we never set a particular target date what the instructions were from both ads leadership and dps leadership was to just work through the issues identify them fix them and be ready to go live when it's ready not to put an artificial date on it we do anticipate that uh things should be ready uh without any uh additional things that come up uh sometime in the next few weeks but i mean you must have some sort of target date are you looking six months what's a year two years uh in the next few weeks is the is the current target okay and and you have not heard any negative feedback about the tests that supposedly did not go well according to some of your own troopers and chiefs and sheriffs run the state now if there are folks that have feedback to that effect they should send it directly to me the reports from the teams that are working on this where speed was was very good and like i said there are a few punch list items but there are always punch list items even with our pre-existing uh system so that's not unusual maybe maybe offline you can share your share your sources mike with uh commissure serling i don't think he has enough room for a moment we'll we'll bring in our consultant that may be true bill pelichek uh to determine what we do next that's a delusional proposition thank you both very much andrew mcgregor caldonian record uh yeah thank you good afternoon first like to thank greg for reading and referencing our editorial much appreciated probably for secretary smith these questions he mentioned over 500 kingdom residents receiving vaccines since your visits to newport just curious if you do have a breakdown on those uh first versus second doses or boosters um i realized given commissioner p checks uh answer a few minutes ago that might not be cleared to have it yeah i i don't have the precise breakdown but most of them were boosters okay uh and i am curious um early on in the vaccination effort uh there were a number of events in the kingdom that used the johnson and johnson i think the first barnstorming throughout six county was j and j as well as some of those uh early drive-in clinics at the part in fairgrounds do you have any sense of what portion of vaccines were used in the in the kingdom whether they're you know whether it skews more heavily towards j and j than other parts of the state that's a good question i don't have the answer for you right now um but i will try to get the answer i i i am let me try to get the answer for you okay and then uh a final follow-up to the childhood vaccines um i think you said that they're starting once they become available they'll be starting by appointment but is there an intention or any availability for walk-in uh vaccinations for the five to eleven year olds early on we're trying you can probably check with your pharmacy but at the state clinics and at the school clinics we're really encouraging uh registration it just allows us to distribute the vaccine in a in a really equitable way across the across the state okay thank you very much chris roe newport daily express chris roe we move to erin botanco vt digger all right hearing reports of um potential covid outbreaks happening among on-house population is that something that the state actually tracks and how do you track it when you mean the homeless population is that what you said erin yes we actually have teams that will jump on to something like that if we hear about it we have both teams that will jump on um congregate living sort of situations um as well as long-term care that include long-term care um corrections um those those areas where we have um people in hotel motels for congregate living or shelters so i have we have a specialized team that will do that and i is there a specific question about a an outbreak that you have and i'll see if dr levine or myself can answer it for you well i guess my question was do you know how many or if there are any ongoing outbreaks at uh congregate facilities like how much help there is at this point yeah i i don't have that information right on me i mean we do have outbreaks across the state in long-term care facilities as as commissioner p check had talked about and in other locations but i don't have that precise uh number i to to be honest with it doesn't ring a bell as we're talking maybe dr levine has something that he can add but it doesn't ring a bell right now but let me check for you and make sure that i've got it right here yeah and also when it comes to encampments obviously those are often kind of informal arrangements that aren't really falling under like a specific organization um are you guys doing any outreach or kind of covid specific outreach to encampments in the state yeah i mean we've done outreach in the past we'll continue to as i said in a previous answer we'll continue to do outreach for people that are homeless those people in the bipoc community those people that are new americans as well as that are here under temporary visas for example some of the farm workers and others that are that are going i i would imagine that you'll start seeing those as we go forward we've continued throughout the pandemic to do that we'll continue to do that when we believe there's people eligible for their boosters as well if there was an outbreak at an encampment would the state have the capacity to put those people into emergency housing i i would we have a facility specifically for covid positive um people that are homeless it's it's up in burlington we would put them into that facility okay that's all thank you and dr levine has uh some additional uh information erin this is not the final answer but i've done a very quick scan of all of our recent outbreaks and uh there's really no outbreak that i can localize to the kind of setting you're talking about um just to answer the final question we do have a very rich history of reaching out to individuals who live in these kinds of settings like encampments that you're talking about as i think we are all aware we have had issues with mental health issues with substance use and infections that can be transmitted within those settings so we've had a pretty rich history of reaching out especially on the immunization front to try to make sure that the appropriate vaccinations are delivered or at least accessible and available and the education behind that is provided to the populations who who live there um i can tell you uh that as of the end of this end of october 44 cases associated with homeless shelters over time okay so not anything right this moment that i could tell you about but uh over time so a very very small percentage of total cases okay thank you Tim McQuiston from our business magazine hi governor i had a couple of labor related questions you know we're coming up coming up on the tourism heavy tourism season here and you know commissioner harrington's recent report was we're down 25 000 workers from before the pandemic which was already tight labor market and the ski resorts are usually have a lot of foreign workers as well is there anything the state can do to to help out this vital industry we have many many sectors rail vermont that are in need of a workforce have workforce shortages whether it's in nursing whether it's in the business community retail i mean all across construction all across the board every single sector has been impacted so we're doing all we can we need to focus on this i believe this is probably one of our most critical issues of this upcoming legislative session how do we encourage people to come to our state how do we grow the workforce so that we can grow the economy so this is going to be a topic of conversation it's been a topic of conversation for me over the last five years but it's going to be intensified now we're we're seeing the effects of a long-standing reduction in our workforce and the pandemic has exacerbated that so we are we are really going to have to get creative we're going to focus on this and again try to attract more people into the state is the answer and we one of those the needs that we all know is as having affordable decent affordable housing so we need at least that 250 million that i proposed to put into housing both for the homeless population emergency housing and so forth for long-term needs but as well decent affordable housing for the workforce now the other thing that caught my eye with the revenue report that came out at the same time of the employment report is that personal income is is doing very well and it seems like it kind of an odd situation where the labor force is down but the personal income is up what do you what do you make of that inflation yeah i mean i think wage i think wages have increased they've been propped up in summer guards over the last year by supplemental income from the federal government this may not be something that's going to continue over time unless we are able to to put people in those roles and fulfill the the the needs and the workforce so we'll see but but i think i think we've seen the rise in income supply and demand at this point okay great thank you tom davis compass vermont tom davis we'll move to michael dordy vermont digger hi thank you i just wanted to ask briefly about the numbers in long-term care facilities uh commission of p-check had said in his presentation that those numbers were holding pretty stable and and while it seems they haven't changed that much from recent weeks they still remain high and at this point i think are the highest that we've seen during the delta wave and i just wanted to ask kind of what what's the thinking behind why we're not seeing more movement with that metric at this point we've had boosters out for more than a month um you know we've learned a lot more about the risk to uh you know people particularly in the 80 plus age group uh why aren't we seeing more movement there yeah i don't think i mean the boosters might have been available for the month but we haven't been able to get them into the arms of those who need them um and and and there hasn't been the uptake that we had hoped so we are focusing on that at this point in time so uh again we are um i know uh our team has discussed long-term care facilities in particular and trying to make sure that we uh where we relied on the pharmacies previous to this um we are going to be using our own forces to to go in and make sure that we provide the boosters that they need secretary smith yeah we looked at this very question last week and and came to the conclusion that we need to we needed to intervene a little bit um into this issue and so as of this morning we've contacted 185 out of 195 long-term care facilities um eight needed assistance clinics because they hadn't scheduled it a ninth is being scheduled today um all other clinic uh facilities either noted that residents have been offered all eligible booster vaccinations are noted that they have a clinic planned in the next week uh 10 facilities haven't responded to us yet to our outreach despite three calls and two emails and teams are en route to each of those locations those are ems teams to hopefully confirm any person needs in uh people we just want to make sure that everybody is uh boosted in those long-term care facilities and making every effort through our ems as I congratulated in and uh them uh earlier um making sure that we make every effort to make sure that they are boosted it looks like um there's a pretty robust booster program going underway and we're augmenting it to make sure that people are boosted in these long-term care facilities we're hoping that with everybody boosted we'll start seeing those numbers start to decrease thank you secretary and one quick follow-up on that a couple weeks ago there was talk of using long-term care beds uh as a lever to kind of alleviate some of the pressure on overcrowded hospitals and I'm curious how how does having an ongoing outbreak impact your ability to do that you know we've got 30 40 50 cases at a given facility are are those beds being uh are you still you know reshuffling hospital patients or or is that impacted at all by these ongoing outbreaks yeah we're um we are using um long-term care facilities we're using three long-term care facilities one in Burlington one in St Alvin's and one in Rutland um we have online 67 beds uh for sub-acute patients for rehab and long-term care um and we are I think there's about 40 of those beds being used but I'll talk to Dr. Levine or I'll turn to Dr. Levine about the use of those facilities so we we've learned a lot during the pandemic on this go ahead yeah thanks um Mike just so people don't get the wrong perception most of the long-term care facilities are not drowning in cases um you've seen the ones that have the most cases on the slide that was shown and I would still submit that even the largest of those which was in the 50s but most of them are teens 20s 30s that's a far smaller number of cases than they would have seen pre-vaccine in this pandemic so uh the the ability to sort of contain the infection uh has been I think rather successful during the delta phase even though it's still distressing to see cases in those settings when it comes to a hospital discharging patients what Secretary Smith was describing isn't integrating these patients into the nursing home population it's usually a wing or a floor that has gone completely unused and in that facility those are essentially just unoccupied beds very segregated from the rest of the population who in theory and I think in practice could have caregivers that are also dedicated to them and not cross crossing over into other parts of the facility so it shouldn't really create a huge impediment for our desire to decompress the hospitals as much as possible and get patients who are just waiting for placement in these types of facilities actually into those beds does that cover most of what you asked I guess it does thanks so much Devin Bates local 22 local 44 Barbara Newport Daily Express question is about the uh the subsidized housing program back in March uh a rule was changed where the landlord no longer had to apply for the rent the tenant was put in charge of that now there's tenants basically dead beats he explained the book what was changed so the foot be controlled the representing the hand through the tenant yeah we didn't I didn't get all that but uh I'm wondering if Commissioner Hanford is on no uh Ed if uh if it's okay I don't have the answer for you could uh could I have Commissioner Hanford reach out to you directly yes absolutely okay we'll do that okay okay very good thank you guys page from our daily chronicle uh governor uh why didn't you sign the letter signed by the 26 other republican governors protesting the biden administration's southern border immigration policy um you know at that point in time if you remember guy we were trying to negotiate with the federal government about opening the northern border and making some headway the southern border while it's a situation that is uh was something that was impacting that region uh dramatically uh thought they had it well in hand and from my standpoint it was more about focusing on the northern border and and why would i want to send the letter when i was trying to encourage them to open up the northern border to open up the economic opportunities for this region new england in particular so it was just a strategic decision on my part not to um not to close the door on any opportunity we might have to open up the northern border which again we were successful in doing true uh governor sununu didn't seem to have that that problem i guess he i guess he relied on me uh to make sure that we could open up the northern border so okay good tag team um also uh thank you governor also uh Paul say that uh more than a third of parents won't let their children age five eleven and get vaccinated and remand has zero childhood fatalities from COVID-19 i understand what dr bell said about vaccination being beneficial absent any public health benefits you know all in its own but is it also fair to say that reducing potential transmission to adults is the most important reason for the state progressive push to vaccinate young children i'd say it's a combination but dr levine dr bell i'd agree there are multiple reasons and i think we both cited reasons why it would be good for the kids themselves why it would be good for the parents of the kids and the family unit and yes additionally there are public health benefits in reducing transmission which is often from an asymptomatic young kid about 40 or 50 percent of the time from some literature um to adults um and keeping the virus from spreading throughout our communities but you know i i would not want anyone to get the impression that there's one reason and that's it and one one one reason trumps another reason because these are all important reasons and i'll let dr bell pipe in as well yeah i would say the important thing about this is that they are really complementary so there are great public health reasons to vaccinate and there are great individual reasons to vaccinate and um for sure we pediatricians have really worried about some of the other harmful effects on children that the pandemic has brought loss of a parent or another caregiver um to COVID-19 illness the disruptions in in-person learning um the isolation that has occurred all of that is hugely problematic and affects children's health and well-being but what parents want to know is my child who lives in vermont who's between five and 11 years of age should they get the vaccine and i want to be very clear that they should that the benefits of vaccination outweigh any risk and that although the severity of COVID-19 illness in children is lower when you compare it to adults it still exists and we want to prevent it and we don't tolerate serious illness or death in children when we can prevent it so i just want to be clear that from a pediatrician standpoint we give very personalized and individualized recommendations and this would be my recommendation for each child in this age group in vermont and then in addition dr levine can talk about all of the other great public health benefits that vaccination has as well so they complement each other thank you um guy if i could go back to the previous question about the canadian border um i was maybe a bit flippant with uh with new hampshire and i should just say that um you know we we enjoy a good relationship with our neighbors to the north it's very important to us it's our largest trading partner our border is much larger than in miles than new hampshire i don't think it's as important to new hampshire as it is to us here in the states in the state of vermont so again this was a high priority for us from a tourism standpoint but just from an economic standpoint in trying to get back to attracting more businesses from from canada and we've made a lot of ground over the last five years and we think it's part of the answer in the future as well so again i'm sure it was important to governor shenunu but maybe more important to the state of vermont thank you all right thank you all very much we'll see you next tuesday


Dear students, in this topic we shall discuss the role of ion channels in self-excitation. The basis of self-excitation of pacemakers is the inherent leakiness of sinoatrial nodal fibers to sodium and calcium ions. This leakiness is due to the presence of three types of ion channels in their membranes. These are the fast sodium channels, slow sodium calcium channels and potassium channels. These channels activate and deactivate at a pace that keeps the resting membrane potential much less negative that is only minus 55 millivolt as compared to minus 85 to minus 90 millivolt in other cells. It also keeps an unstable and rising resting membrane potential due to continuous influx of sodium and calcium ions. Dear students, the fast sodium channels open immediately as the membrane potential goes less negative than minus 55 millivolt after an action potential when hyperpolarization occurs. They remain open for only few milliseconds because as they open they let the sodium ions to immediately move inside the cell. This sodium ion influx prevents developing a stable and more negative resting membrane potential. These channels become inactivated and blocked above minus 55 millivolt. Dear students, minus 55 millivolt and above the level per slow sodium calcium channels open. These channels are comparatively slowly open and that is why sodium ions start leaking through them slowly. As a result, membrane potential gradually rises. This rise prevents to establish a stable resting membrane potential. This way, even at minus 55 millivolt, the resting membrane potential does not become stable but gradually rises. Rising membrane potential at minus 40 millivolt, this is the threshold level at which the sodium calcium channels become activated maximally. So the influx of sodium and calcium ions starts rapidly that triggers an action potential. Dear students, the rise in membrane potential is slower in the range of minus 55 to minus 40 millivolt. So the sinoatrial nodal action potential is slower to develop. As compared to the action potentials of ventricular muscle fibers, dear students, now we shall discuss the role of potassium channels. Considered the action potential, the potassium channels open slowly. Their opening causes the return of membrane potential back to its negative state. However, owing to their slow activation, duration of sinoatrial nodal action potential is longer.