Vermont Business Magazine Closing time used to have a different meaning before we'd ever heard of the novel coronavirus. Now it means just plain closed. Governor Phil Scott Monday afternoon added to his executive order from last Friday and has ordered all bars and restaurants closed across the state starting at 2 pm, March 17, St Patrick's Day, until April 6 except for take out and delivery. The irony was lost on no one.

The governor announced the new guidance in response to COVID-19, commonly known as the novel coronavirus. Today’s guidance updates the executive order he issued on March 13, which declared a state of emergency in Vermont.

First, as announced at a press conference Monday morning, new guidance further restricts the size of mass gatherings to the lesser of 50 people or 50% of the occupancy of a facility. This restriction applies to all social, recreational or entertainment activities, such as an auditorium, stadium, arena, large conference room, meeting hall, theater, gymnasium, fitness center, library or any other confined indoor or confined outdoor space.

The governor is also ordering the closure of all bars and restaurants statewide. Establishments can continue to offer food takeout and delivery service. This measure is effective beginning 2 p.m. Tuesday, March 17 and is in effect until April 6, though this could be extended.

These changes reflect the growing trend of confirmed coronavirus cases in Vermont, new recommendations from the CDC, social distancing and mitigation efforts recommended by the Vermont Department of Health, and ongoing discussions with neighboring states.

Additional reductions or prohibitions may be implemented or amended as needed.

Additionally, state government agencies and departments are working to transition the state employee workforce to remote work, while also implementing measures to limit person to person transactions in state offices, like the DMV. Those measures will be combined with 90-day extensions in license and registration renewals.

Most individuals affected by COVID-19 will experience mild to moderate symptoms but some individuals – especially the elderly and those with chronic medical conditions – are at higher risk of getting very sick from this illness. Through his emergency powers, Governor Scott is implementing additional mitigation strategies to protect those at greatest risk, slow the spread of illness in our communities and minimize the risk to the public.

“I want Vermonters to know we’re continuously evaluating other mitigation steps and we’ll continue to communicate those as they are put into place,” said Governor Scott. “It’s important to remember that in times of crisis we all need to make sacrifices. But Vermonters, and all Americans, have risen to many challenges before, and this time will be no different.”

Details on the specific actions taken are outlined in the Governor’s Executive Order, which is available by clicking here. Addendum 1, reducing gathering size, is available by clicking here and Addendum 2, closing bars and restaurants, is available by clicking here.

Daily Update on Novel Coronavirus (COVID-19)

Vermont Department of Health, March 16, 2020

New information is in red

This update is also available at healthvermont.gov/covid19 under UPDATES

Current Status in Vermont

Gov. Phil Scott has called on Vermonters to help protect our most vulnerable ­– the elderly and the very ill ­– and announced several strategies to help slow the spread of the new coronavirus. Gov. Scott declared a state of emergency to help ensure Vermont has all the necessary resources to respond to this evolving threat. Read the executive order

The strategies include:

• Restricting visitor access at long-term care facilities
• Prohibiting non-essential gatherings of more than 50 people (see press conference story from Monday morning). Read the executive order addendum.
• Ordering the closure of all bars and restaurants statewide, effective 2 p.m. Tuesday, March 17 until April 6. Establishments can continue to offer takeout and delivery service. Read the executive order addendum.
• Making a Continuity of Education Plan for the orderly dismissal of all schools, and cancellation of all school related activities, no later than Wednesday, March 18 and lasting through April 6. It may be extended for a longer period.

Gov. Scott’s directive will task local districts with three key components to support the State response:

· Food and special needs services for children;

· Collaborating with the state to provide childcare options for healthcare workers and others essential to the response; and

· Systems for ensuring maintenance of education during the initial dismissal; and a continuing education plan if schools are dismissed for an extended period.

The Lab continues to ramp up its capacity to meet the growing need. We are doing everything we can to meet the high and growing demand for testing, including consolidating resources from various sources in Vermont and increasing our staffing capacity. We expect testing demands will continue to increase. At the national level, the CDC expects commercial labs will come onboard and be able to offer testing. At this time, we don’t know how that will impact Vermont.

As the Health Department works closely with hospitals around the state, we are focused on making sure everyone is getting the health care they need while also protecting Vermonters. We are encouraging anyone who is sick to stay home and contact their health care provider by phone. They should avoid going to the hospital, except in a life-threatening situation. Anyone who does not have a health care provider can call 2-1-1 to be connected to a clinic in their area.

Travel guidance has been updated to include the United Kingdom and Ireland:

Travelers returning from Europe, the United Kingdom, Ireland, China, Iran and South Korea should stay home and monitor their health for 14 days. Call the Health Department at 802-863-7240 for monitoring information. If you have symptoms of fever, cough or difficulty breathing call your health care provider.

State and health officials are also working to bolster messages about social distancing ­to various audiences. Social distancing means remaining out of congregate settings, avoiding mass gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible.

Case Information

Over the weekend, Vermont’s Public Health Laboratory reported additional positive cases, bringing the total to 12. Four of these were non-Vermont residents.

• A female in her 60s, from Bennington County, is hospitalized at Southwestern Vermont Medical Center.
• A male in his 60s, of Orange County, is self-isolating at home.
• A female in her 30s, of Chittenden County, is self-isolating at home.
• A male in his 30s, of Chittenden County, is self-isolating at home.

As of 1:00 p.m. on March 16, 2020:

Vermont cases of COVID-19	8
Non-residents cases testing positive in Vermont	4
Vermonters tested negative for COVID-19	421
Vermonters being monitored	274
Vermonters who have completed monitoring	143

Public health epidemiologists are working to investigate possible travel or exposure history and to identify anyone who had close contact with the patients. Those individuals will be assessed for their exposure risk and provided with guidance for their health. Where appropriate, they will receive recommendations for self-isolation or other restrictions.

We are in close contact with any hospitals involved with the patients’ care to ensure patients and staff are properly cared for and protected.

We expect, and are prepared for, more cases in Vermont, and are taking every action to limit the spread of illness.

In addition to protecting a patient’s personal health information, state health and public safety officials are committed to ensuring that Vermonters are aware of any risk to themselves and their community. This is the essential work of public health. We will contact anyone identified as at-risk as part of any case investigation, and recommend they stay home for 14 days or follow other restrictions as needed.

Anyone who feels ill or has concerns about their health should call their health care provider.

For the most up-to-date information and guidance about COVID-19, including from the CDC, visit healthvermont.gov/covid19.

Cost Sharing for Testing

• Governor Phil Scott announced on March 6 that the State will ensure that anyone who meets the medical requirements for testing for COVID-19 can do so at no cost. These actions will help ensure that the cost of testing for COVID-19 will not be a concern, if the test is determined to be medically necessary.
• To make sure tests that are determined to be medically necessary are free, the Department of Financial Regulation will issue an emergency bulletin requiring Vermont health insurers to waive any out-of-pocket costs for COVID-19 testing including testing during emergency room, urgent care, and office visits.
• Similarly, no cost-sharing will be applied to COVID-19 testing for Medicaid members. And the cost of testing for anyone who is uninsured will also be absorbed by state government. Only about 3% of Vermonters do not have health care coverage.
• Earlier this week, the Centers for Medicare and Medicaid Services (CMS) also announced that those receiving health insurance through Medicare are eligible for medically necessary COVID-19 testing at no cost.

Containment and Prevention Measures

• We expect there will be more cases of COVID-19 in the state. Vermont Health Officials urge Vermonters to stay informed and take all necessary precautions.
• Following new guidance from the Centers for Disease Control and Prevention, returning travelers from Europe, United Kingdom, Ireland, China, South Korea or Iran should stay home and monitor their health for 14 days after returning to the United States. They should call the Health Department at 802-863-7240 to discuss monitoring for symptoms of shortness of breath, cough or fever. If you develop these symptoms, contact your health care provider right away.
• Since the virus first emerged, the Vermont Health Department has been in constant contact with CDC and other states to closely monitor developments, and work to minimize the spread of illness. Staff across the Department of Health are working in the Health Operations Center and the State Emergency Operations Center activated March 11 to provide statewide support.
• Epidemiologists and public health nurses have been following CDC protocols for monitoring people who have recently returned from travel to affected areas. Monitoring means checking their temperature daily, watching for symptoms, and for some people, staying home.
• The Vermont Department of Health has compiled helpful guidance on how to help keep respiratory illnesses like COVID-19 from spreading, travel information and situation updates from the Centers for Disease Control and Prevention. This can all be found at healthvermont.gov/COVID-19.
• The Health Department Laboratory has been testing for COVID-19 since early March and continues to increase capacity daily.
• The Health Department is working to strengthen protections for older Vermonters, including developing screening questions for visitors to long-term care facilities to identify anyone at risk. These have been made available for hospitals or other health care facilities.
• Health Commissioner Mark Levine is holding weekly calls with health care leadership around the state to provide updates and answer questions about the current situation.

Guidance for Vermonters

When to call?

• If you have questions about COVID-19: Dial 2-1-1
• If you are returning from Europe, United Kingdom, Ireland, China, Iran or South Korea: Call Health Department Epidemiology at 802-863-7240
• If you are sick or concerned about your health: Call your health care provider by phone. Please avoid going to the hospital, except in a life-threatening situation.

Guidance for Specific Groups

• Schools: Vermont schools are closed effective Wednesday, March 18 per Governor Scott’s order, including PreK associated with school districts.
• Child care programs including privately owned PreK: The Department of Health, Department for Children and Families and Agency of Education are working on updated guidance.
• Long-term care facilities: A visitor screening tool was provided to long-term care facilities, and similar one for hospitals to help protect patients and/or residents and staff these facilities. These documents have also been posted on healthvermont.gov/covid19, under “Long-Term Care Facilities” and “Health Care Professionals.”

Guidance for Travelers Returning to Vermont from an Affected Area

As of March 16, 2020, travelers returning from Europe, United Kingdom, Ireland, China, Iran and South Korea should stay home, monitor their health and practice social distancing for 14 days. Call Health Department epidemiology and infectious disease staff at 802-863-7240 for monitoring information. If you have symptoms of fever, cough or difficulty breathing call your health care provider. Before you go to an appointment, let your health care provider know that you are being monitored for novel coronavirus.

Household members who did not travel do not need to be monitored and do not need to stay home, unless that person develops symptoms.

Guidance for People in Close Contact with a Person who Tested Positive for COVID-19

People who have been identified by the Health Department as a close contact to someone who tested positive for COVID-19 should stay home, practice social distancing and monitor their health for 14 days. Social distancing means remaining out of congregate settings, avoiding mass gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible. The Health Department will be in contact with you regularly during the monitoring period.

If you develop symptoms: Call your health care provider right away. Before you go to an appointment, let your health care provider know that you are being monitored for novel coronavirus. Call Health Department epidemiology and infectious disease staff at 802-863-7240. Avoid contact with others.

What does close contact mean?

“Close contact” means being within six feet of someone who has tested positive for COVID-19 for a long time.

This can happen when caring for, being intimate partners with, or living with someone who has tested positive for COVID-19. Or if you shared a health care waiting area.

If you have been in close contact with someone who has tested positive for COVID-19: stay home, limit contact with others, and call Health Department Epidemiology at 802-863-7240 Staff will discuss whether you need to see a provider, and how you will monitor yourself for symptoms. When someone tests positive for COVID-19, the Health Department conducts outreach to close contacts of the individual.

Close contact does not mean being more than six feet away in the same indoor environment for a long period of time with someone who has tested positive for COVID-19; It also does not mean walking by, or briefly being in the same room with someone who tested positive. In these situations, you should observe yourself for symptoms. You do not need to call the Health Department.

Anyone who develops symptoms should stay home and call their health care provider.

People At Risk for Serious Illness from COVID-19

Some people are at higher risk of getting very sick from this illness, including older adults and people with chronic medical conditions like heart disease, diabetes or lung disease. According to the CDC, these people should take extra precautions including:

• Stocking up on supplies
• Avoiding crowds
• Avoiding cruise travel and non-essential air travel
• Staying away from others who are sick

Read the CDC’s full guidance on People At Risk for Serious Illness from COVID-19.

Everyday Preventive Measures

Person-to-person spread of the virus is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes. Much is still unknown about how the virus spreads. Take these everyday preventive actions to help stop the spread of germs:

• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces.

Additional Resources

The Vermont Department of Health website contains guidance and answers to frequently asked questions, including:

• What does “monitoring” mean?
• Information for people under monitoring
• What does close contact mean?
• How can I protect myself?
• Should I wear a face mask when I go out in public?
• Guidance for travelers returning to Vermont from an affected area
• Where is it safe to travel internationally?
• I am returning from an affected area. What should I do?
• Who can get tested for COVID-19?
• What should people planning large gatherings in Vermont do?
• What is the turnaround time for testing?
• Where can I find translated materials?
• Can the Health Department provide documentation that I can go to work?
• Guidance for specific groups:
  • Businesses
  • Communities
  • First Responders
  • Health care professionals
  • Long-term care facilities
  • Schools, child care programs and colleges

View these resources at healthvermont.gov/covid19

Vermonters can also dial 2-1-1 for information.

The CDC is regularly updating its guidance at cdc.gov/coronavirus/2019-nCoV/summary.html.

Source: Vermont Department of Health 3.16.2020