We will start with a quick update. Results out of 470. The total is 389. No deaths yesterday. We continue to work with eight different facilities around the state. That number will unfortunately grow. A few things about longterm care and your living facilities. Those are highpriority challenges. Settings thatp care tohousing and those most at risk from covid19. Staff and caregivers depend on our response and support. Our Health Care Prevention and Response Team is our First Responder unit. Prevention starts with primary intensive, including andction prevention effective messaging. This has been ongoing for weeks, if not months. The response clock starts when we receive information about possible exposure at these facilities. Testing is per ties and turned around quickly. Constantis in communication with each facility. They receive additional personal whenctive equipment needed. The state provides it. That has happened rapidly and successfully over several days. Exposureevaluates the risks and begin contact racing. Facility to determine the best way to prevent spread, testing ,veryone, checking temperatures residents. For our Public Health response happens quickly when lives are at stake. Done inhis is communication with other teams at the Operation Centers to ensure the responses coordinated. Be ins people needing to isolation or quarantine situations. They are coordinated to the essential services rapidResponse Team. Response and intervention insurance those vulnerable members of community, especially in quarantine, have the supplies they need in basic needs are met. Anyone who has been paying attention to the news in the last 24 to 48 hours has heard about the topic of masks. City Health Department have been advising people who do not have symptoms to not wear masks when in public. They say they offer limited protection of the public. In the past 24 hours, that ,dvice has been broadened although the definitive advice has not come from the cdc. Else in theing. Pidemic i am joining other Health Leaders recommending wearing facemasks in public, even if you have no symptoms. Some of the most recent data shows presymptom addicts spread of covid is possible, especially onset,s prior to symptom offs t helping to prevent spreading virus. I expect cdc will make the recommendation today or in the coming days. Importantstress two points. We must reserve medical grade masks for healthcare workers on the front lines with patients. Distancing, the stayathome order of the governor, is the most effective way to slow the spread. The sacrifices being made with social density singhs beginning to slow the spread. Even as we see the curve potentially flattening, it will continue, so in the future we can get together again. Thank you. , want to recap some important information. I want to recap some important information. My Team Presented modeling projections yesterday, which we use to guide our decisions and plan our response. That important to know while trends have given us some hope, we know this can change daytoday. Today we saw a significant increase in positive cases. While i want everyone to stick together and remain optimistic. We have to be realistic as well. We will see ups and downs, outbreaks, and my team will adapt, as we have done with our rapid Response Teams, to address these challenges in our state. We cannot take our foot off the gas. Social distancing and washing your hands continue to be the most effective tools we have to reduce the spread and make sure we dont overwhelm our hospitals. You are also hearing a lot about wearing masks. I want to be clear. This is not a substitute for staying home. It is not an accused to mingle excuse to mingle with others. Please continue to follow the measures in place, even if you are wearing a mask. As i said any times, Public Safety is a top priority of any government. That is what i have had in mind as i made decisions during this pandemic. Steps to slow the spread of covid19, flatten the many friends,p as families, neighbors as healthy as possible. Again, i know this has caused a lot of Economic Uncertainty and put a strain on families and businesses. We basically had to shut down our economy in order to save lives, and i know how hard this has been. I want to take a few minutes to remind you of the Resources Available through the actions of the state and at the federal level. First, as a result of the cares back, most will receive a onetime check of 1200. If you file taxes last year, you dont have to do anything. The money will be deposited into your bank account this month, or a check will be sent in the mail. , we have expanded unemployment edge ability and remove many requirements. Online, and an additional 600 will be added each week. , we are waiting guidance from the fed for the selfemployed. There are programs to help businesses get through this, including the paycheck protection program. Banks ands loans from Credit Unions to cover these its ifand employees are kept on for eight weeks, 100 of the loan is forgiven. This program is open today, so please visit sba. Gov to learn more. Small Business Owners are eligible to apply for disaster loans, and you can receive a grant up to 10,000, which will not need to be repaid. This is available to selfemployed individuals, and the turnaround time is just a few days. These are just a handful of what is available, and you can find all this information online. There is much more to do, and we will continue to focus on Economic Relief as part of our response. It is important to use the resources i described to get through this. Called onis week, i you to support our covid19 response, even before this crisis. Across showed support all sectors, especially health care. Workers on the front lines are putting in long hours, and some will become ill. To build aid need reserve, so were asking those with medical experience to volunteer. If you have this experience, please visit vermont. Gov volunteer. Others are looking to help as well come and confine additional opportunities on this website. Peopleasking a lot of and asking you to take care of yourself, it is so important to stayathome to save lives, but this does not mean you cant get outdoors and enjoy some fresh air. In fact, being outdoors has probably never been more air,tant, exercise, fresh and nature can help us manage the stress and uncertainty we are experiencing. However, we have to be smart about where and how we get outdoors. We will talk a little bit more about what you can do safely. Thank you. It has never been more important to get outside, but also stay close to home. Nature can and help maintain our wellbeing. Exercise and the beauty of vermont as we transition into spring as well. We have to be thoughtful. I would be the first person to discover all our state has to offer in terms of outdoor opportunities, but it is important to be smart about how far you travel and time spent outside. Anyone planning to spend Time Outdoors this weekend, should do the following. First, stay close to home. We live in a place with outstanding Outdoor Recreation in nature. Much of it is within walking distance. Explore,t the time to but focus on backyard adventures. Stay in places you can walk or bike to and limit your trips to less than 10 miles. Continue to observe social distancing outdoors. If you arrive at a crowded trailhead or parking situation, turnaround and choose an alternative that is not crowded. Also, it is important to leash your dogs. You need to keep your social distance. When choosing a recreation opportunity, skip the risk and engage in low risk activities. Be smart and cautious to avoid incidents that could require medical attention. If you have an accident youre putting Emergency Responders in danger. Their sole focus should be the covid19 crisis. We cant have them respond to other emergencies, especially those that could have been prevented. Respect the signs and land. Stay off trails that are closed. They are closed for a reason. For areas open, practice no trace principles. You,u brought it with bring it out with you. We have information on our website on the status of trails, and are pulling in information on other areas and trails. If you are interested in supporting us, do so online. We know they are the lifeblood of vermont Outdoor Recreation. Continue to support your Favorite Outdoor retailer, campground, or shop come about online. , we will beer warms outside, and being outside button thant some ever. Is more important than ever. We can keep our Community Safe by recreating close to home. Thank you. I will open it up to questions. Thank you. We will do what we did and wednesday. On wednesday. We will allow followups for clarity. You dont need to wait for me to but we have a long queue and need to get through this. The firstart with person. The Medical Center capacity, another one threatened that, some of the senior care facilities . You worried about residents taking up hospital beds . Yes. It is not a concern. I am not aware that a High Percentage of residents requiring hospital care. That can change on a daytoday basis. Residents were in the rehabilitation portion of themacility, which makes in a healthier facility population. So i am not as concerned. We are hearing from medical workers concerned about bringing virus home to their families, some raising questions about staying in dorms. Have you had any discussions on that . Has that been on the table . , have not had any have not had i any conversations. I know they will help any way they can, but im not aware of those conversations. I am good for now. Was a discussion forerday about the request ventilators. Specifyous if you could the percentage of the request from the government that hasnt been filled, and how that is prioritized and distributed among hospitals, Nursing Homes, and ems. Argue on the line commissioner . Line, you on the commissioner . Maybe we can come back to that. He would have the answer to that. I dont want to give you anything incorrect. Sure. Anyone else . Now. Ll go to the phone the vermont standard. Neil, vermont standard, unmute. Were going to move to mike donahue from the islander. Unmute. Thank you, governor. Told vermont cases are one month from maxing out. What are theng next directives you have in your game plan to defeat the virus and get everybody to come into compliance . Is what again, our hope we are trying to do today to socially distance ourselves and put measures in place to prevent people from congregating in different places. The directive yesterday or the day before about big box stores, we are trying to encourage them to do something online, curbside service, and just get the essentials in their stores to prevent people from going on family outings, shopping trips. Monitor,l continue to ,aking sure we are enforcing encouraging the actions in i wouldut at this time, rather continue to do what we have been doing. As we noted yesterday in the commissioner had shown that we are moving in the right direction. The mitigation efforts are soing a beneficial response, we want to continue down that path. Gettingpeople are not your message for ignoring it. Readyndering if you are to go into Governor Charlie Baker mode to make sure people on the front lines have what tests, andlike in whenure people stay they should not be driving or going out to get cigarettes. We are trying to educate as much as possible and direct them to do the right thing, but the ppe and so forth, we are constantly trying to make sure we are fulfilling our inventory and getting those two people on the front lines, so we will continue to do that. Are having ise encouraging. Many people are working on this. We are finding opportunities every day and continue to work on those to make sure we have the equipment available when and if this increases the which we but ourwill increase, goal is to not exceed the capacity of our health care system. That continues to be our goal, and that is why we have taken a lot of the actions we have taken thus far. Thank you. [indiscernible] [indiscernible] can you hear me . Yes. There seems to be confusion about wearing masks. Appropriate it is for the state to issue guidance about masks . Sorry. I will let the doctor answer that. Fare should not get too butd of the game on this, it is clear from what has been , the termay that it facial covering rather than using a mask. The president went as far as wearing scarves, which may be reasonable, but not the most effective. Used cloth material can be rather than medical grade masks. How we we will find out can interpret what is thought to be the most effective. I know the governor has been interested in Companies Across the state who have asked about what they can do. Once we get more specific todance, it will be easier go into their own closets or for foro get guidance organizations and businesses interested in preparing us. That is where we are at now. Doesnt sound like you will guidelines for what people should be wearing outside at all times or anything like that . Are waiting for federal cdc guidance, but as you heard in the previous question, some of the inventory, the personal protective equipment necessary for the front lines to protect them, so we dont want to take away from their masksile, to use in95 that would take away from those Health Care Providers that need them today. We thought a lot about this over the last week or so. To be givent anyone the false impression this will protect them from contracting could in anbut it a way toc way provide prevent you from spreading it to someone else, so while encouraging that, we do not want to take away from the stockpile right now, especially the n95 masks. Thanks. [indiscernible] thank you. Could you tell us the definition of recovery and how many have recovered in vermont . Definition is evolving. If you haveguidance recovered enough to get back to work if you are in an essential job or health care worker, the guidance from the cdc is seven days from the onset of your symptoms, then three days without fever or associated symptoms that you had. It is a hard number to get a handle on. We know, perhaps, from the hospital level, if you have been hospitalized and became well enough to be discharged, if you fit into recovered definition, i think about all the people who have not needed hospitalization. It is hard to get a handle on exactly what percentage of the population you are not aware of had a mild illness and then able to leavewere their isolation status, if you will. Yous too early to give precise statistics, unfortunate. Way the state is asking people who have been identified as being affected and selfisolating, are they reporting and they have been three days without symptoms . Not to my knowledge at this point in time. Thank you. Vermont business magazine. Thank you. Hazarded i guess regarding the peak of the virus. Workers,thought about construction, golf courses, like you put out when people get back to work in some order, have you thought about that, mightoutdoor jobs which naturally be more socially distant . We have been giving some of that some thought in preparation for what is coming in the next month or so. As you might have noticed, when wemanaged our way into this, took different steps to protect the citizens of vermont. We continue to do that on a unwindasis, so we will in the same fashion and Pay Attention to the data and experts coming forward to guide us. We have done that throughout this pandemic, and we will do that throughout the other side of this, so we will continue to wait until we peak, then make certain we have done so, then we will mitigate our way out of this as well. Thank you. And galloway. Ne galloway. Nne, unmute. Hi. Can you hear me . Weekend. We can. I wonder how many n95 the state has stockpiled, how many healthcare workers have been state isnd how the dealing with Nursing Homes . With the first question. Commissioner, are you on the line now . If you are on, you might have to unmute. Question. O the second lets try this. Can you hear me now . Yes. Go ahead, mike. Give me a moment, governor. I will get the ppe information in front of me. Ok, we will come back to you. Question, the number of healthcare workers who have tested positive, that is a number i have memorized and have that on the top of my head, but i will have to get back to you. Party andnue to be a the results come back as quickly as possible but i cannot give you a precise number at the second. The other part of the question, it was about nursing home facilities. Could you repeat that . It the preference of the department of health that nursing home patients stay in place rather than transfer to the hospital . , will interpret the way you phrase that question as, actually, maybe prohibit or prevent them from going to a. To a hospital. Nope, just make sure they stay in place. The decision to be hospitalized is a medical decision, and every nursing home patient is under the care of a physician or nurse tactician or practitioner. If it is their decision hospitalization is warranted and meets the goal for that resident to go to a hospital setting, we would want that to happen. There is no problem with that happening. Hospitals are prepared to receive covid positive patients. Just because theyre coming from a nursing home doesnt matter. , then why are so many nursing home patients dying in place . There is a large number of orders on their chart based on their advanced directive that were instructions not to transfer to the hospital, to live out their last days in place, if you will. A successso story that has been advertised. And have survived despite of numerous chronic illnesses. When one doesy not go to the hospital, it is a death sentence, if you will. There are patients who have survived the illness and i hope to hear more stories like that, to be honest. [inaudible] measure it in terms of patient days. Based on an estimated consumption rate daily, and the youl quantity, i will give a couple of examples. For every five face protection, we have 11,795 patients a day available. Gloves, 52,908. And so forth. I dont understand when you say patient days. Patients across the state, how long will that last . I dont understand. We haveive you face protection, 50 9000 units. 59,000 units. Often do these things need to be changed out . That is a medical question i do not have the answer to. Purchasing based on estimates of need . We are not using estimates to purchase. Allre purchasing any and ppe at the most rapid rate possible. You are saying we have enough to get to the crisis . That is not what im saying. There are a lot of different trajectories this can take based on folks complying with the key measures that have put in place. If everything holds and are trajectory remains where it is today, we will have plenty. If folks begin congregating and not paying attention to the guides and the executive orders, our rates will go up in the number of cases will go up. Is there a better way to translate the data in terms of patient days . Is there a better way to say it . Silly person can understand it. So a person can understand it. Can we get back to you on this . I think we can simplify this and we will do that. I understand the dilemma. Back. Will circle ok. Pat bradley. Good morning. My question is for dr. Levine. About howou talked the rapid Response Team works with facilities where we have seen the outbreaks. In particular, when we talk yesterday,know during one of the updates, he had gone back and forth with you informationg more and more readily available information about the outbreak. The rapidake a look Response Team, a lot of people out there who have their loved ones there who do not know what is going on. To interactplans with the public better in real a delayher than having in getting information . Families where it happened yesterday or the day before . How are you communicating with them . That is a great question. Part of our Rapid Response is we are working with the facilities. The facility has the responsibility to communicate what their staff, what the residents, and the family of those residents. We are doing our best to not only educate and implement as needed but we communicate with those facilities so they can provide the appropriate messaging. We are not the caregivers for every individual who lives there. Important we get those messages to be quite clear so everyone understands the implications of what we are. Dvising none of that was what the mayor was referring to. He was referring to his own knowledge and his office is knowledge offices knowledge. That could not that should not be construed in conveying any misconceptions. We can do nothing without the cooperation of the facility. Does that answer your question . [indiscernible] getting this information publicized not only for family members but whatever Community Media . And to the paa rules have to do with patient by patient. We can use much more aggregate data about the facility talking about the number of residents who have an infection, the number of potential Health Care Workers who have an infection without naming one. Without naming anyone. It is easy to communicate that way without worrying about being inappropriate or interfering with confidentiality. To speed uporking the process between discovering wherebreak at a facility the family members know and the general public know that it occurs . Yes. Short answer, yes. Long answer, we are aware of one instant. That does not mean that has been the practice all along. Thank you. [indiscernible] question aboutup advanced directives. [indiscernible] are you able to calculate because they are under a directive . Is there more an emphasis in , more of ans emphasis on those advanced directives . Various words came through well and various did not. Let me interpret this question. Basically, can we figure out the monitors who might be in a nursing room nursing home or under in advance directive and factor that in as individualsow many who might not have that advance and try to broaden our ventilator needs after that . [indiscernible] we are one of the top three states for age. If there are 400 plus facilities, it does not mean a lot of them are more independent Senior Living facilities. The person is less medically frail and can survive on their own. Have to be careful when we think about that because many people would want to get the wonderful care the hospital can provide but draw the line at having a ventilator. Not what i perceived as the life i want to have. Challenging for us to precalculate. Wef what we are doing are monitoring on the continuum toward worstcase. I would rather do that than assume there are an abundance of those who do not want to see in a hospital and air on the side we can make and err on the side that we can provide for the population. The national and worldwide experience continues to expand. People who will be in the hospital are older because they are most vulnerable , it turns out the larger number 20 of those may be in a demographic you may not be purchased anticipating. If your state is large enough in terms of numbers, 20 can be a large number, absolutely. Planningo do our surge considering that as well. Did i answer enough . Yes. That was the first part of the question. Is there a plan to place more of an emphasis on patients entering hospitals or Nursing Homes to make sure their advance directives are in order . That has been practiced for quite some time. It is a performance Quality Indicator for patients who enter hospitals quite often and when Outpatient Care is assessed. Metrics thatthose we have to report and adhere to. Was underway. Thank you. My question is about hospital beds. The predictions that you put out yesterday, do you have enough hospital beds . Let the commissioner answer that question. Governor. Ou, department of financial regulations. After we talked about yesterday, or modeling indicates that vermont is on a better trajectory from a week ago. Under that likely trajectory, we did have enough hospital bed resources to care for those who need a hospital bed. Those numbers can change and they can change for the worse or the better. That is why it is so critical for people to continue to social distance, double down on it because the worst is still ahead of us even though we have a glimmer of hope that we talked about yesterday. Thank you. Just a question about masks. Are you recommending that essential workers such as Grocery Store clerks wear masks that work . Extent ordersto extent orders of staying at home and closing bars and restaurants . You can expect there will be an extension of the initial order and that will be coming in the next two or three days. We will extend for a period of time and update as necessary andd on the data we receive the advice of the experts and watching the modeling that we did. Is important to make sure we are staying underneath that line and we will manage our way out of this. Masks, i part, the will let dr. Levine discussed that. Out,en the guidance comes the federal government or ourselves, it is going to be much more of a blanket recommended to all people. Do not have to single out a particular workgroup like the Grocery Store worker. The socialmphasize distancing. Youernor said that may think that Grocery Store worker is being protected by wearing a mask but it is you being protected from them and the reason for wearing the mask is to protect others around you. In case you are in that presymptomatic infectious stage. Recommendu personally they wear them anyway would you personally recommend that they wear them anyway . Not just Grocery Store clerks but others . I will start and then i will let dr. Levine finish. If it makes you feel more at ease, more comfortable, and you want to do something to protect others, please do so. Mask. Use the n95 do not take away from the frontline Health Care Workers at this time. Be aware that this is not the ander in terms of going out integrating with others and becoming social again. We do not want people to move around. We want people to stay at home. Saltsnot want to give any any false sense of security in this way. Thank you. Whether the is, list of medical resources for vermont has included [indiscernible] i wonder about [indiscernible] the followup question would be whether you can say that the pattern of hospitalization focusy, has it tended to are we getting hospitalization in Community Access hospitals . I think i am going to i will take the first part of that question if you dont mind. Included into those numbers. It is a resource we can turn to if we have to. New hampshire is probably doing the same exercise that we are doing right now and looking at ilable beds and we want to given the fact that New Hampshire is doing the same exercise that we are. Time, we are coordinating with dartmouth in all of these exercises to make sure they are aware of what we and, if possible, a resource for vermonters. Can you do the second part of that question . Commissioner the answer some part of that. If we have to, we will go to dr. Levine. On the first part of your question, as secretary smith alluded to, 40 of those who get treatment at dartmouth are vermonters. We are aware of those numbers. Not included in our modeling numbers, so those would be in addition to. I think i missed the first thing that you said. It is an interesting political [indiscernible] if we are coming to that capacity line. Said, we recognize the capacity that is there. We want to be very positive not to count that we are doing our estimate on available beds. We understand what you are saying and we understand the capacity that is there but we want to be darn sure that we are counting the beds we know are available. Thank you. Did that answer all of your questions . I think it would help the public to be able to follow this one way to do that would be to list the number of patients that are hospitalized with covid. You can find the remainder of this breaking online at cspan. Org coronavirus. You will take you live to the white house for an update from President Trump in the Coronavirus Task force on the federal governments response to the outbreak. Pres. Trump i just had a meeting with kevin mccarthy, future speaker of the house, i hope. He has done a fantastic job for the people of california and the people of california have done a fantastic job when you look at theum