Thread by @GovSisolak

Good afternoon. Thank you for being here. You can follow along today's press conference on YouTube here: youtube.com/channel/UC3DFs…

Today, I am glad to provide you all with an update as we prepare for a COVID vaccine, which we anticipate may be available in the next week or so in limited doses. There is hope on the horizon, but it will take time to make sure everyone has access to the vaccine.

Federal officials have widely reported that we won’t see largescale vaccination throughout America until the spring. So we need a bridge to get there. Here in NV, that bridge between today & the day we have large scale vaccination must be built by all of us.

The tools we have to build that bridge are the same public health measures we’ve all heard on repeat over the last 9 months: avoid gatherings, limit exposure by working from home and staying home as much as possible, wash your hands, wear your mask.

As of today, that bridge is shaky based on our current trends. We have a lot of work to do, and it will take ALL of us to recommit ourselves to turning things around before a vaccine is widely available. Here's a quick update on NV's current COVID situation...

We are currently not seeing a downward trajectory in any of the metrics we track. In fact, we continue to experience increases across the board. As of today, 16 of our 17 counties have been flagged for elevated risk of COVID-19 transmission.

According to State health officials:
-COVID cases are growing at a rate 2x that of the previous peak in July
-Daily hospitalizations are at an all-time-high
-14-day test positivity rate is the highest we have seen
-the number of daily COVID deaths to COVID-19 are on the rise

The wildfire of community spread continues to grow out of control, and most concerningly, our numbers do not yet include any surge from the Thanksgiving holiday.

Nearly every day we’re breaking previous records. I am concerned. State health officials are concerned. And if that’s not enough, I’d like to share the recommendations and input that was sent to us from the White House Task Force this week:

“We are in a very dangerous place due to the current, extremely high COVID baseline and limited hospital capacity; a further post-Thanksgiving surge will compromise COVID patient care, as well as medical care overall.”

“The rate of COVID spread is increasing in Nevada. Engage local leaders to demonstrate the effect growing cases will have on hospitals and overall patient care if Nevadans don’t change their behaviors.”

“All states and all counties must flatten the curve now in order to sustain the health system for both COVID and non-COVID emergencies.”

“New orders put in place by the Governor should result in a rapid decrease in transmission if compliance is high.”

To summarize: if directives and mitigation measures were followed over Thanksgiving and continue to be followed, the White House believes we should see a decline.

Again, this input is from the White House. So, if you aren’t inclined to believe me, listen to them. If best practices were not followed over the Thanksgiving holiday, these numbers will no doubt increase.

As I mentioned last week, if we do not begin to see a change in our trajectory, and if this crisis continues to get worse, we will be left in the unfortunate position of having to take stronger actions – something I have been desperately trying to avoid

We have been working hard to balance the public health impacts with economic impacts -- but I’ve been clear since the start: we cannot overwhelm our healthcare system and put countless lives in danger.

Again, there’s hope on the horizon – but we must strengthen that bridge between now and the day we have widescale vaccination.

Back in October, the Nevada Department of Health and Human Services submitted our state “playbook,” for COVID-19 vaccine planning, to the Centers for Disease Control and Prevention (CDC).

Since then, Nevada’s vaccination planning document has been adjusted as the overall vaccine response has continued to develop and change. While there are still some unknowns, we certainly know more than we did the last time we gave an update.

We are expecting to have our 1st allocations of a COVID vaccine from the federal government very soon, potentially by the middle of December. This timeline is still being determined by the federal government, & we are still awaiting what NV's first allocation of a vaccine will be

Once an allocation is sent to Nevada, our State team is ready to take on that allocation and begin redistributing it.

I am proud of this team for maintaining close relationships with our county and Tribal partners in the State to ensure that allocations are distributed as quickly as possible with as much support as the State can provide.

The Tribal Nations in Nevada have all elected to receive their allocations directly from Indian Health Services, which will be separate from the allocations sent to the State overall.

Nevada, in addition to some of our other western state partners, joined the COVID-19 Scientific Safety Review Workgroup, which is independently reviewing the safety and efficacy of any vaccine approved by the FDA for distribution.

The goal of the Western States Safety coalition is to provide Nevadans with an additional layer of confidence when it comes to the COVID-19 vaccine.

This verification process is happening in lockstep with the federal approval process and is not anticipated to cause any delay in getting a safe vaccine to the residents in these participating states.

The work group has been charged with staying abreast of vaccine candidate(s) trials, evidence of safety & efficacy, and other info to independently provide recommendations to state vaccine planning efforts as well as ensure public confidence in vaccine safety & efficacy

It is natural for the public to have questions about a new vaccine and I remain committed to transparency regarding vaccine planning and expectations

Today, I am joined again by two of our experts on the vaccine planning team: Candice McDaniel who serves as the Health Bureau Chief for the NV Division of Public and Behavioral Health & Shannon Bennett, Immunization Program Manager, Division of Public and Behavioral Health

Candice: So, a 95% efficacy indicates a 95% reduction in disease occurrence among the vaccinated group, or a 95% reduction in the number of cases you would expect if the group had not been vaccinated.

Even with promising efficacy percentages, a vaccine will not be released for use until it is deemed safe and effective.

The FDA Vaccines and Related Biological Products Advisory Committee is set to meet on December 10th and from that point we anticipate things will move quickly.

Staff for the Nevada State Immunization Program are prepared and will be on standby to accept initial shipments and for redistribution when a vaccine is received.

Since our last update we have continued with our planning and preparation for scenarios we may encounter during the vaccine rollout. From these exercises we have developed a more comprehensive process for distribution.

The Nevada State Immunization Program is receiving regular updates on both vaccines and how they must be shipped, handled, stored and administered. Each have their own specific challenges and parameters we are working with

We told you previously about the ultra-cold storage needed for the COVID-19 vaccine. The Pfizer vaccine will require ultra-cold storage, but the Moderna vaccine will not. Both vaccines require two doses be administered with a set timeframe in between.

We continue to work with our partners statewide to share this information, ensure vaccinators are enrolled and initial orders are submitted.

Allocations of the COVID-19 vaccine will be made based on population and we will use the tiered approach, in alignment with Advisory Committee on Immunization Practices guidance, to ensure our front line medical providers receive the first doses.

Shannon: As Candice said, Nevada’s playbook outlines the tiered populations that will receive the first doses of the COVID-19 vaccine.

It is important to remember that when a vaccine is approved for use and allocated to individual states, the tiers we developed will outline who is eligible to receive the vaccine.

Our framework of priority populations begins with those at highest risk for contracting COVID-19 and those who we are all depending on to take care of us -- our critical infrastructure workforce in hospitals and medical facilities.

Tier One also includes other medical provider types, correctional facility staff and law enforcement.

Of this first vaccine allocation, a portion will also be set aside for CVS and Walgreens – our pharmacy partners -- who will vaccinate members of our vulnerable population who work and reside in long term care facilities.

We are working with all Nevada counties to finalize their plans to vaccinate their Tier One population. An important consideration when vaccinating medical facility staff is the potential for anticipated side effects.

As with other vaccines, a low-grade fever and a sore arm are indications the vaccine is doing its job, but it may impact our medical workforces ability to do theirs for a short amount of time.

As we have planned for vaccine rollout we are working with our medical facilities to ensure only a portion of the staff receive the vaccine at one time in order to not create a potential staffing shortage.

The COVID-19 vaccine will not be released unless it is deemed safe and effective, but these common side effects are an important consideration while we all work to protect the health of our communities.

Once a vaccine is approved, we anticipate weekly allocations and each county is able to submit their request for the vaccine. These requests and the monitoring of vaccination and distribution will run through Nevada’s Immunization Information System, Nevada WebIZ.

The NV WebIZ system is widely used by Nevada’s immunizing providers and Nevada state law requires that all vaccines given must be entered in the system.

This is the system that the immunization program uses every day for the influenza vaccine and the Vaccines for Children program. We are able to keep updated on how much of the vaccine has been used and how much is still on hand.

The program is working hard to be prepared to get the vaccine to our immunizing providers once it has been approved and we are updating Nevada’s vaccine playbook with additional details as they are thoughtfully planned to support this response.

Thank you to Shannon, Candice & their entire team for their tireless work on this vaccination rollout plan. This rollout is unlike any other, and I am proud of the work they have done to engage with state and local officials to be prepared for this moment.

I want to conclude with one more quote from this week’s White House report – an important message that must be heard by all Nevadans:

The COVID risk to all Americans is at a historic high. It must be made clear that if you are over 65 or have significant health conditions, you should not enter any indoor public spaces

….where anyone is unmasked due to the immediate risk to your health; you should have groceries and medications delivered.

If you are under 40, you need to assume you became infected during the Thanksgiving period if you gathered beyond your immediate household.

Most likely, you will not have symptoms; however, you are dangerous to others and you must isolate away from anyone at increased risk for severe disease and get tested immediately.

If you are over 65 or have significant medical conditions and you gathered outside of your immediate household, you are at a significant risk for serious COVID infection;

...if you develop any symptoms, you must be tested immediately as the majority of therapeutics work best early in infection.

Thank you for tuning in today. In order to avoid a scenario where NV experiences devastating loss & an overwhelming of our healthcare system, our bridge to large scale vaccination must be built upon a foundation of vigilance, not complacency. We can do this, Nevada.