Thread by @JaneLindholm

Okay, ready for another press conference thread? (If the answer is no, feel free to mute me!) 95 new cases reported today. Nearly a quarter of the state's total cases have come in the last two weeks alone.

"As you've seen, our cases have continued to grow," Governor Scott says to begin his remarks. And says that because of this growth, new steps have been enacted. (The ones he announced last Friday.)

Scott says private gatherings are what the data shows is driving transmission in the state, and that's why he put a prohibition on multi-household gatherings. Says he's going to address the reactions/response he's been hearing and explain why restaurants etc. are still open.

Says he understands it may feel counterintuitive that restaurants are still open but you can't have friends over for dinner. But he reiterates the statistic that 71% of outbreaks since Oct. 1 have been traced back to gatherings, both in private and in public (like bars).

Says the state isn't seeing outbreaks connected to restaurants, salons etc. So the rules seem to be working. So they're trying to address where the rules/guidelines AREN'T working.

Also says schools are not driving transmission, and keeping kids in school (in person) is one of the state's highest priorities. So when he looks at "needs vs. wants" he says social gatherings are wants, but slowing the transmission and keeping schools open are needs.

(ME: I know that some of the "gatherings" between and among households are not purely social, and might be--on an individual case basis--a need. The state is addressing this at a population level, not an individual level.)

Scott says he also knows that people are saying "the state can't make me do this," and they're right--they can't force Vermonters to comply. But he's asking people do to it anyway, for the good of everyone.

Scott says it's adults who are driving the spread, by getting together, drinking alcohol, bending the rules, and then going to work or sending their children to school and spreading the virus.

SCOTT: "I hear the anger out there, the frustration, the anxiety, and the sadness. And I get it. So if you need to take it out on someone, send it my way. I can take it. But what I can't take is seeing this virus continue to grow."

Scott: "So you can question our methods, but I'm asking you to please do your part to help." He says the state will offer more clarity and an update to the new rules on Friday, to help address questions they're getting. (Me: maybe a change to the rule prohibiting walks?)

The state is also stepping up testing and tracing. Will be opening 5 new testing sites that will run 7 days a week. I didn't catch all 5 of the towns, but he says 2/3rds of Vermonters will now be within half an hour of a 7-day testing location with these new sites.

New contact tracers are being added to the state ranks, including some from the Vermont National Guard.

AHS Secretary Mike Smith now, with new rules around health care visitation. I can't type fast enough to get all the new guidelines/restrictions down here, but I'll search for a document. Basically, they're trying to restrict the number of people who can come in with patients.

Here are the towns with the new testing locations. Thanks, Lola!!

https://twitter.com/loladuffort/status/1328736418076758023

For anyone who is allowed to visit a patient in a hospital, they will be screened and there will be a log of everyone who comes in, so they can be traced if needed. They'll be restricted in their movements around the hospital, have to wear masks, sanitize hands etc.

The guidelines are restrictive, but not as restrictive as have been in the past--doulas are allowed, for example. One adult can be with a child. And end-of-life visitation is restricted but not prohibited.

Adult day programs, which were being planned for reopening, and some of which have already reopened, will now be suspended. Tele-health and "flexible service options" are available, but no in-person day programs will be in operation for the time being.

There are about 37 facilities that are what used to be called "nursing homes" in Vermont. Smith says visitation is very complicated as they try to work through rules for these facilities.

Working with Rutland Health and Rehab to contain an outbreak there. Also managing an outbreak at Four Seasons, a residential care facility in Washington County.

Working on getting surveillance testing of staff at all types of residential care facilities to try to get a handle on outbreaks before they spread. Says the state will be providing these tests at all the state's facilities.

Smith says long term care administraters have been advised of flexibility in considering their approach to indoor visitation in order to protect residents and staff. Says he understands that residents are missing their families and loved ones.

But also recognizes that the highest priority is to protect everyone in these facilities, and that means taking as many precautions as possible to protect vulnerable residents.

Modeling report now. Commissioner Pieciak says there won't be much that's positive or optimistic in his modeling report today, but Vermonters have the ability to affect the future and bend the curve.

Another million cases on the US since the last modeling report. In VT, it’s only taken 23 days to go from 2000 cases to 3000. Vermont has the second highest reproduction rate of the virus in the country right now!

National data here.

71% increase predicted in the nation over the next 6 weeks.

Regional data shows similarly significant increases. Approaching the peak from the spring. And the cases are rising significantly faster.

🚨Regional forecast predicts a 153% increase in the next 6 weeks. (Not sure what’s going on with that slide.)🚨

Vermont-specific data. And a look at the potential that Halloween may have had an impact on driving transmission—a cautionary note as we look at holidays to come, Pieciak says.

Look at the 2nd yellow box—that’s where we’ll start to see any impact from the new restrictions.

More VT data, including our state’s projected increase over the next 6 weeks.

And here’s the education update.

We turn now to health commissioner, Dr. Mark Levine. He starts with an update: 95 cases reported today, with 17 people hospitalized, one in the ICU.

The state is monitoring 156+ situations. Special attention being paid to Washington and Orange counties, which account for ~40% of cases in the last 2 weeks.

Dr. Levine now talking about one of the state's contact tracers, to illuminate what that job is like. Reading from a Facebook post she wrote (with her permission).

The post talks about ways people can avoid being considered a close contact, by not getting within 6 feet of others for more than 15 minutes, if they don't need to be. Acknowledges that some people need to be in contact with others: health care officials, teachers.

Post continues: We don't need to be at bars, hunting together, gathering etc. Tracer says if people don't want to have to get a call from her and have to account for every minute of their time over the last several days, they need to stay away from others.

Tracer continues by saying that before people get "all angsty" about out-of-state plates, she wants to be clear that it is Vermonters driving transmisson within their own communities because of their own decisions.

Dr. Levine concludes his remark by talking about the good news about vaccines currently in trials, and entreats Vermonters to make the sacrifices they have to during these upcoming holidays so we can all have good holidays next year.

Question time now. First one is about what data points the governor would need to see before he'd roll back the restrictions. He says he'd need to see basically what we had before the spike. A slight rise over the early summer, but not the significant increase we've been seeing.

On the new state testing sites in Burlington, Middlebury, Waterbury, Rutland and Brattleboro, those are just the first 5. The state hopes to have a total of 14 soon.

I *think* AHS Secretary Smith is saying these 5 new testing sites will increase the state's testing capacity by about 30,000 tests. (But I would like confirmation on that.) And, again, tests will be conducted 7 days a week.

Levine says the striking difference between this spike and the previous one is the "rapidity" of the increase. Says it takes 2 incubation periods to see the real impact of any mitigation efforts. Says he hopes to see progress after the first incubation period (14 days).

He'll also be looking at the lagging indicators--hospitalizations and deaths, which usually peak after the case numbers peak and start to decline.

New beds are being added to the field hospital at the Champlain Valley Expo. 50 beds available now, with an additional 200 being added by the VT Guard by next week. They'll be in multiple pods throughout the Expo.

On a rumor that he was planning a party for his inauguration, Governor Scott says having a party would be "completely inappropriate" and isn't something he has considered at all. He says it's not even in the "want" category of "needs and wants."

.@EPetenko asks how the hospitalization forecast compares with the capacity for hospitals and when we might hit PPE capacity.

@EPetenko Pieciak says we have "north of 40 ICU beds," well within a comfortable buffer of anticipated case growth, where the prediction is for ICU bed utilization low teens. Also predicting to be well within capacity for non-ICU beds.

AHS Secretary Smith says the state gets daily updates on hospitalization and PPE usage. Says 246 ventilators are available. 2 are being used today, he says. (Deleted this post and reposting because I had the total ventilator number wrong.)

Public Safety Commissioner Schirling (whose line is bad) says the state has more than 70 ventilators on order. Doing pretty well with most PPE, but it sounds like the state is still trying to get the number of N95 and nitrile gloves it needs to feel like it has enough.

Schirling's summary for the state's supply of PPE: "we're in reasonably good shape" but there are areas of concern and a lot of it will depend on the "burn rate" as/if cases continue to clime.

Question about why Washington and Orange Counties are seeing such a significant number of the state's cases. Scott says he wants to be "blunt" in his assessment: cases in these counties started with the ice sports outbreak and continued with Halloween parties.

Commissioner Levine says the case rate in Washington and Orange counties is 3 times and 2 times the state rate, respectively.

.@WCAX_Cat asks if the state would characterize this as a second wave and if they think it will be worse than the spring. Scott says he thinks it's already worse than the spring, in many respects. Not sure if he'd characterize it as a second or third wave or not.

@WCAX_Cat Dr. Levine says the term "wave" kind of lacks any meaning at this point.

@WCAX_Cat Levine says he wouldn't characterize it as worse or not worse than the spring because the situations are so different in terms of the state's ability to do widespread testing, to have PPE, hospitals and field hospitals ready, and to address sick patients' needs with treatments.

@WCAX_Cat Levine says the state should be receiving some supply of a monoclonal antibody treatment that should help moderately sick patients stay out of the hospital. (But he doesn't want to raise too much false hope.)

@WCAX_Cat Cat says she's also seeing a difference in how people seem to be reacting or feeling about the virus, and that it seems like maybe they're not taking it as seriously or seeing it as such a critical time.

@WCAX_Cat Levine says there's no concern about labs running out of collection kits or assay materials, and that the state has a significant stockpile. The thing they want to make sure of is that the labs in the state can turn around test results quickly enough to be most effective.

Have a drink of water or a snack, folks. This is going to take a long time, I think. We're only about a third of the way through the reporter questions. @vermontedition will begin with Deputy Health Commissioner Tracy Dolan after this ends--share your questions for her with us.

Governor Scott says he thinks "we're a victim of our own success" because Vermonters had done so well in surpressing the virus but then "let our guard down" or got fatigued. But he believes we can get back to where we were.

I'm not going to make it if I don't get some food, myself. It's out in the fridge in the VPR cafeteria! So bear with me; I'll try to keep tweeting, but will have about 20 seconds where I'm out of earshot while I'm walking!! :)

Mike Donoghue asks about a situation where a child was considered a close contact of a positive case and has been in quarantine. The parent had the child tested after 7 days, but is still awaiting results 4 days after the test. 1/

Says this is causing significant consternation and financial issues for the family. Parent says this is unacceptable turnaround time. Dr. Levine says this parent should get in touch with the health department for help, but also 2/

two labs out of state where tests are being sent are experiencing an increase in the turnaround time for test results, which is an issue. 3/3

AHS Secretary Smith says labs that VT providers use have different turnaround times, so there's some variability in when test results come back. State lab results come in in less than 2 days. But labs in other parts of the country are starting to be inundated and taking longer.

Smith says people should ask their provider where they are sending the tests in order to get a better sense of what the turnaround time might be.

.@StewartMyNBC5 asks for an update on the hazard pay program, and which big companies have now applied, noting the deadline has been expanded. Pieciak says Shaws has applied. Walmart, CVS, Walgreens, Lowes, Costco have all now applied. *Not* Home Depot yet.

Wilson Ring says he can't tell if the governor sounds frustrated or angry about the spike in cases; asks the governor to pick one. Scott says more frustrated than angry.

Says he knows Vermonters are trying to do the right thing, but also that the state has been trying to warn about the potential for problems and their warnings weren't heeded.

Wilson also asks if the governor will think about instituting fines for noncompliance. Scott says he's still hoping people will comply voluntarily and "take this a little more seriously than they have." (But sanctions aren't off the table.)

Governor Scott says "the contact tracing teams are overwhelmed right now," and then immediately backtracks--says they're not overwhelmed, but are at capacity, and could be overwhelmed if cases continue to rise.

Dr. Levine says most people are complying and are responding to contact tracers' outreach. More than 80% of contacts are being notified within the first 24 hours after a positive case is identified. And all close contacts are supposed to be contacted within 48 hours.

On the surveillance testing for school staff, Dr. Levine says the testing being done before thanksgiving should a good baseline reading and help the state understand the spread after the holiday.

.@VPRDillon notes that the governor has been forceful and has invoked the idea of patriotism to fight the virus, but how can he reach those who aren't getting the message--either because they're literaly not getting the info or because they're willfully disregarding it?

@VPRDillon Scott says that's the real problem. But in his response, Scott sticks to the message, but doesn't really address a strategy for how to actually get to those people. So Dillon follows up--how should Scott shift the message, Dillon wonders?

@VPRDillon Scott says we need other people to step up. Yes, like the contact tracer Dr. Levine talked about, and like (WDEV owner) Ken Squier, who went public with his case recently. Scott says people need to be honest and vocal about what happened to them when they let their guard down.

@VPRDillon We've been talking about this in the virtual VPR news meeting, thanks to a question from @AJEvancie, who sparked the discussion. 1/

@VPRDillon @AJEvancie We talked about what the state's strategy is. Or could be--like are there "influencers" the state could be roping in to deliver the message to communities that have less compliance, or are less up on the news? What would that look like? 2/2

Question from @LisaVermont about why background checks for possible school subs continues to take as much as 8 weeks, and could that be shortened to get more substitute teachers in more quickly. Ed Secretary Dan French says yes, that's a significant bottleneck.

@LisaVermont Both he and Gov. Scott say they'd like to help speed that up. French says some of it is controlled federally, and the state wouldn't be able to address that part. But they'd like to speed up what they can.

@LisaVermont Lisa also asks about the possibility of sharing sub lists across districts, for substitute teachers who are willing to work in more than one district. French says that's a good idea and he'll look into it.

.@katie_jickling asks about the data on why the state isn't allowing outdoor masked gatherings. Scott says that's what he's been talking about, that's where the spread is occurring. (ME HERE: I think Katie and the governor are cross-communicating. 1/

@katie_jickling We'll try to address this on @vermontedition with the health department soon, but I think the thing that's frustrating a lot of people is about certain specific activities, like walking with a neighbor, and if THAT is associated with cases. 2/

@katie_jickling @vermontedition Basically, why is the state using a hammer instead of a scalpel. Why it's banning ALL social gatherings instead of ones that are specifically associated with spread, like where food or drink is present. Again, we'll try to get into that on the show. 3/3)

.@averynpowell asks Dr. Levine to expound upon the idea of quarantine and what it means for returning college students. Levine says this means staying in their own room, eating meals separate from the household, having own bathroom if possible.

@averynpowell Levine says people in quarantine can go for a walk outside in the woods, alone. And, if they don't develop symptoms, they can get a test after 7 days. (Also, the state is recommending ALL returning students get tested at the end of their quarantine if they do the full 14 days.)

Steve Merrill says he's been tracking case counts on websites that show there's no correlation btw cases and mask mandates or shutdowns. Scott says he fundamentally disagrees with this assessment. This is the most forceful Scott has been in response to a Steve Merrill question.

We're getting close to the end here. I may miss some things--I have to get things printed and ready for @vermontedition, coming right up. I hope you'll tune in, we have the health department with us and it's essentially YOUR briefing/Q&A.