Thread by @GovSisolak

Today, I am pleased to once again be joined by Candice McDaniel and Shannon Bennett, from the State’s immunization program. You can view the live stream of my updates here: youtube.com/channel/UC3DFs…

Before I begin, I want to take a brief moment of silence to honor the Capitol Police officers who lost their lives as a result of the mob that stormed the U.S. Capitol building last week. These men spent their lives protecting the halls of our democracy.

As I said last week, the chaos that erupted at the U.S. Capitol was the opposite of patriotic. It was undemocratic and un-American.

The divisiveness and lack of leadership have resulted in the lack of a unified national strategy to combat a deadly pandemic. It has pitted state against state on the open market trying to secure personal protective equipment and testing supplies.

All of the challenges we face as a nation are combined and intertwined. And the United State is best when we come together, putting aside our differences, to reach a common goal.

And right now, our common goal must be to reach the end of this pandemic so that no more families mourn the loss of a loved one to this terrible virus and be able to transition to the full strength of our economy.

I wan to make one more thing very clear: I know there are many folks around the State and the country right now reading a letter written by the Nye County GOP chairman. It is an embarrassment to the entire State. Do I condemn it? You bet I condemn it.

Language from party officials & community leaders that incite insurrection & violent uprisings & promote blatant falsehoods are dangerous at a time like this. The false allegations against the integrity of the election, which lack all evidence of fraud or wrongdoing, need to end

As you’re going to hear today, we’re trying to get out the largest vaccination in the state and country’s history. We have healthcare works overwhelmed in hospitals. Most importantly, our children are watching- they're internalizing this. We owe it to them to do better.

Now onto COVID updates: I want to talk to Nevadans briefly about extending the State’s current mitigation measures in place to help slow the spread of COVID-19. What the trends show right now is that the State is still experiencing very high levels of disease burden.

Our HHS team predicts it’s likely that we won’t see the full impact of holidays and gatherings in December until around 2 weeks from now and we likely won’t see the full impact of New Year's Day until the end of the month.

It’s for these reasons that we will be continuing the mitigation measures that are currently in place. At this time & for planning purposes, we are looking to keep these measures in place for another 30 days.

At the time I announced these measures, I called it a “Pause,” because I truly hoped they would only have to last for a short period. However, we remain at an all time high and due to Christmas and New Years, our case numbers are likely to increase over the coming weeks.

In order to not add an increased burden on our hospitals, we must remain under these strict mitigation measures & change our behavior immediately. Like I’ve said many times, there is hope on the horizon, but full-scale vaccination will not occur until further into the year.

We are past the 10 mo mark since our first case in Nevada. Over time, it’s easy to become numb to the daily numbers, but we can’t allow ourselves to do that. Now is not the time to give in, it’s the time to double down for the future of our State. It’s the only way we’ll recover.

Now onto vaccines: I want to talk high level about our State’s goals when it comes our COVID-19 vaccination efforts. 1st, we are focused on a science & policy-based distribution model. That's reflected in every version of our playbook and will be reflected in these updates.

Our team has recognized the importance of prioritizing our senior population & we are developing plans w/ partners to help with this effort, but one notable change is that the top priority under General Population is 70 years and older – previously it was 75+.

Secondly, our primary goal is to ensure we don't let any doses go to waste. We want to maximize every dose that comes into the State – and avoid expired or unused doses.

The immunization team kept that goal in mind as they developed updates to the Playbook. They listened to those at the local level who expressed the need for additional flexibility to adjust to real-life situations on the ground.

Additionally we want to ensure that vaccines are distributed equitably across all populations, including historically underserved populations. We know this pandemic has had a disproportionate impact on our communities of colors & our plans must have a strong emphasis on equity

Since vaccines arrived in the State a little less than a month ago – the first doses of the Pfizer vaccine arrived on Dec. 14 – we have been in close contact with the local health districts and hospitals who have been administering the vaccine to the our health care workers.

Counties are making great strides in finishing up vaccinations for health care workers. Everyone has been working hard, but similar to every other state who has been tasked with running the largest vaccination program in history, there have been challenges

Instead of ignoring or denying the challenges we face, we will be committed to identifying them and finding solutions. We will course-correct as necessary and remove any obstacles to get more shots in the arms of Nevadans.

In this vein, and after the first few weeks of vaccinations, I asked the best logistical leaders in our state to review what has worked so far, what challenges we are facing, & what we can do as a State to resolve any issues moving forward.

This group includes the Division of Emergency Management, the Nevada National Guard & our Immunization Team. This is the same group who worked with our local health & emergency response leaders to address the challenges we faced with COVID-19 testing at the start of the pandemic.

I am confident they will work to identify challenges, develop solutions, and implement on the ground.

The team is working w/ local partners on standing up vax centers for our State’s most populous locations, looking into expanding who can physically give a vaccine, breaking the data entry backlog issue, and so much more. I am committed to using every resource available.

Fortunately, the latest stimulus package included more funding for state vaccination programs. And while this money will come in the midst of this operation rather than prior to it starting, we will gladly put it all to use to assist in our efforts.

We all share the common goal of getting Nevadans access to the vaccine faster. We are limited by certain factors out of our control – including how many doses are allocated by the federal government.

I know the number one question people ask is “when will I get mine?” -- and trust me, there is no one who wants to provide you with that timeline more than us.

Unfortunately, the federal government only provides our allocation amounts for one week ahead, putting states and local vaccination teams in an impossible position to predict exactly when prioritization groups will be able to get vaccinated.

I am hopeful that the incoming Administration will quickly implement a unified national strategy and deploy additional vaccination assistance to the states to reflect the urgency of this operation.

Until then, we will be relying on state and local leaders and partners throughout the state to do everything in our power to vaccinate as many people as possible on our own.

Here are some updates from our Immunization Team: Through this 1st piece of the vaccine rollout when doses were allocated to very specific populations in NV and nationwide, we were learning the nuances of the vaccine and developing processes...

As more vaccine is delivered to the state each week our communication will continue to increase & we will use all methods available to spread the word on how, when and where you can be vaccinated, but we must continue to be patient and maintain our mitigation measures.

As of Jan 10, 61,644 doses of COVID vaccine have been administered & reported to NV WebIZ. This includes more than 8,700 second doses for Nevadans. We are excited for this first milestone of Nevadans receiving their second dose of vaccine and being fully immunized.

Since we can only order doses a week prior to actually having that vaccine on hand, it does cause a logistical challenge that we continue to discuss with our local partners in order to be able to get vaccine to Nevadans efficiently, without too much vaccine sitting on shelves...

The current limit of supply available to us makes this challenging, but the immunization program is committed to ensuring that all Nevadans – in our rural counties, and in our cities, all have an opportunity to receive vaccine as we move through the distribution plan

Now onto Playbook Updates: It has been a long process to review the federal guidance and recommendations and complete this updated Playbook to provide context on Nevada’s plan and guidance for our vaccinators.

Update #1: We are moving away from a Tiered structure to focus on “lanes” of vaccination that will run concurrently. This changes the structure of our playbook and plan going forward but does not impact the counties already moving into what was previously identified as Tier 2.

Update #2: Our essential, frontline workers & specific high-risk populations will move in two parallel lanes. So upon completion of the Healthcare Workforce and Support category, counties will move to vaccinate these two lanes concurrently in prioritized order.

Under the "General Population" lane, the priority will be:
70+
⬇️
65-69 years
⬇️
Nevadans between the ages of 16-64 with underlying conditions; Individuals w/ Disabilities; Nevadans experience homelessness
⬇️
Healthy adults between 16-64

The other lane which will be operating concurrently is “Frontline/Essential Workforce." They will also be getting vaccinated in priority order.

In the lane of frontline essential workforce, we continue to strive to maintain a science-based approach and equitable distribution while considering close contact with those outside your household and likelihood of transmission.

We are no longer using the tiered approach & have updated the playbook to streamline & simplify prioritization. Frontline/Essential Workforce categories are now prioritized in buckets –from Public Safety & Security, to Frontline Community Support, Supply Chain & Logistics, & more

While most of the prioritization order remains similar to the last version of the playbook, some changes have been made & critical industries are identified with further guidance including education, public health, mortuary services, & food service/hospitality among many others.

Another key group that additional guidance has been added for is NV's end-to-end essential goods supply chain which takes into account all the people involved in moving essential items from where it was created to where it is sold – manufacturing, transport, distribution & sales

Additionally, we have proudly added a new bucket called “Frontline Commerce and Service Industries,” which includes the food service/hospitality workforce. We know NV is the hospitality capital of the world & those workers are essential to our State.

Again, this updated structure offers flexibility for those working in our communities to ensure all doses are being used, while still maintaining an order of operation to the rollout of vaccines across different groups.

The full playbook includes many other updates and additional guidance to help our counties, local health authorities and other vaccine providers, and businesses working to support Nevadans through the vaccine rollout process.

If you heard your workforce or age announced, it does not mean that vaccines are available today. When counties are ready to vaccinate different categories within these 2 lanes, we will work with them to ensure you know.

I know this incredible group of health leads, Emergency Managers, & NV National Guard are up to the task. They are building the largest vaccination operation in our State’s history & I know it will be something we'll be proud of!