Where we need them to be, they are lower than the week prior when nearly 28,000 new cases and a Positivity Rate of more than 24 was recorded. 1829tly, younger adults account for most of the positive cases. 20 overall. The cases remain fairly evenly spread against most age groups. We have also seen a decrease in the overall number of iowans hospitalized due to covid19 with the exception of yesterday which was a slight increase. When week ago, on november 17, we reached our peak of inpitalizations at 1527 and the five days that followed, we of asytoday decreases many as 76 patients in one day. Again, while these are positive signs, it is too early to know if they are indicators of a trend. Several National Models are now forecasting the number of new cases and hospitalizations predicted in the United States and i state over the next four weeks. But do predict an increase, of varying degrees. The models make serious assumptions about the levels of mitigation and other mitigation that may not reflect recent changes in behavior. I want to reassure iowans that honor what is reported, in iowa, we are monitoring the situation every day in real time. We are studying the data, talking with the leaders of our Health Systems and hospitals, we are reaching out to longterm care facilities and we are discussing additional steps may need to be taken to keep our most vulnerable safe. I am asking you to have that same focus. Concentrate on what you can do now and over the next four weeks to stop the spread and we know that each of us can make a difference in slowing the spread of covid19. The increase in positive cases over the last several weeks has also resulted in increased usage of ppe among hospitals, longterm care facilities, and other Health Care Providers. Thanks toths of months of procurement and monitoring and management, iowas ppe stockpile is strong. Here to provide an update is jake nicholson, and administer at administrator at Homeland Security management. Thank you, governor. Brief you on measures the state his taken to continue access to ppe to protect those working on the front lines. This fall, our Resource Management team analyzed trends in our statewide usage rates and monitor shortages. As a result of our efforts to build the stockpile, we believe we are wellpositioned to meet the need for months to come. Weeks, weast three have seen a significant increase in usage of ppe. We have over 16 months supply of gloves and 18 months supply of disposable gloves gowns in our stockpile. Resupply shipments are scheduled every month for the next seven months. Building and maintain a large stockpile cannot mean the need meet the needs of iowans. We have worked tirelessly to distribute ppe and supplies. We could not have done this without the dedication and commitment of partners. Our research Management Team has worked every day since march processing requests, pulling those items, and coordinating their delivery. State has week, the completed 2557 deliveries of ppe totaling 15. 7 million individual items. These of included items large and small. From medical equipment to tissues. We worked in partnership with county Emergency Management sevennators to establish ppe hubs across the state. These hubs will supply with ppe needed to address shortages at hospitals, longterm care facilities, nursing homes, and other Health Care Providers responding to the pandemic. These will be resupplied by the state stockpile to ensure responders have what they need now and in the months to come. We believe our latest distribution model will enable facilities to have request failed more rapidly than ever before. All state andk local organizations in the success. We stand ready to serve the citizens of iowa. Gov. Reynolds thank you. I want to recognize homeland emergencycounty manager coordinators and everyone at the state and local level who have worked together to ensure our stockpile remains strong and the critical supplies get to where they are needed quickly and efficiently. Of a vaccineity will be a significant step forward for our nation and state. Covides will reduce related illnesses, hospitalizations and deaths and further advance our overall recovery to the pandemic. Ant week, pfizer applied for emergency use authorization for its vaccine. Moderna bang is expected to do so in the coming days. For emergency use, vaccines will be fast tracked for distribution nationwide. That could mean vaccinations begin just weeks from now. We heard from the Trump Administration about plans to get vaccines as soon as they are approved. They anticipate 22. 5 million doses of the Pfizer Vaccine and a million foes doses of the Moderna Vaccine be distributed immediately and allocated by state population. Whenever the decisions about approval are made and distribution begins, iowa is ready. The Iowa Department of Public Health has developed a with publicstrategy ,nd private sector partners policymakers, and Community Vaccination providers. Our vaccination strategy addresses allocation, distribution, transportation, dispensing, and administration of covid19 vaccines. Thestrategy is based on availability of the vaccines and the distribution occurring through existing infrastructure. At first, there will be limited supply of vaccine so our immediate Vaccination Efforts will focus on those critical to the response including those who provide erect care and maintain Critical Infrastructure and those of highest risk for developing serious illness from the virus. Prioritization of populations while the supply is limited is being considered by the advisory immunization practices and the National Academy of medicine. The Iowa Department of Public Health will also consider cdc guidelines and work with various stakeholders to implement a targeted approach for covid19 vaccination. Details of the plan will be contingent upon Additional Information that wont be available until the fda approves emergency authorization for vaccines. Those details include things like the number of doses and thed to the state immunization requirements of the vaccine. Once those details are known, the apartment of health will finalize a strategy and begin to distribute the vaccine. As we move toward thanksgiving, the intended vaccine rings with that the hope that life will return to normal. It will take some time for the vaccine to become widely available. Continuee patient and to do everything we can to prevent getting and spreading the virus. That is especially important this week. We cannot risk cases at this time and together we can keep the numbers trending in the right direction. Consider the amount of planning that typically goes into the holidays from repairing the meals to purchasing gifts. Expect that you put i ask that you put your same time and effort into keeping your family safe which may mean having to adjust traditions. Guidelines have been issued by the cdc and Iowa Department of Public Health including considerations for safe travel, meal preparation, and hosting guests. Consider your mode of transportation and the aware of the risk at your destination. Keep hand sanitizer, wipes, and masks with you. Wear our mask and social distance and public and in close proximity to others not from your household and wash her hands frequently. It goes without saying, dont travel if you are sick. Or if you have recently tested positive for the virus, are awaiting for test results, or if you have had close contact in the last 14 days with someone who has tested positive or has symptoms of covid19. Many families are welcoming home sons and daughters who have been away at college. Make sure they follow the travel guidance. If you or anyly, member of your household is sick, we are asking that you please stay home. Also if you or a member of your household was exposed and you are awaiting test results, the entire household should stay away from others until the results are known. If the results are positive, the individual should isolate from others and members of the household should quarantine at home while monitoring for symptoms for 14 days. The impact of covid19 has been especiallyiowans those unable to feed their families. Beenthan 6 billion has provide food banks and infrastructure. The outpouring of support for this cause has been uplifting. Todayleased to be joined by the president and ceo of food bank of iowa who is here to share the remarkable things happening across the state to combat hunger and how iowans can help this holiday season. Thank, governor. Regardless of your political affiliation, we can all agree that 2020 has been a challenging year. Many of us have suffered. Those suffering the most have lost precious work hours or their employment altogether. As a result, Food Insecurity has doubled since march 2020. Tripled for households with children. There is good news. Help is all around us. There are six food banks who source Government Free and reduced cost food. Deliverit safe, and we it to over 1000 pantries in all 99 counties. Our pantry volunteers are working hard and smart to make sure that no person in their community be hungry. Force ledg iowa task by the Lieutenant Governor has been instrumental in making more and theilable to iowans state of iowa has invested significant funds to help us procure food to feed islands. Haveion of churches stepped up and offered us their facilities, their volunteers, and their Organizational Skills to help us distribute more food in vetro des moines and across the entire state. One last item to note. In response to School Closures in des moines, food bank of iowa has established 15 offsite d mps School Pantries located across the metro. Throughmilies can drive as often as they want without an appointment, no id required, to get food for their families. Please go to our website at food bank iowa. Org to find the d mps School Pantries near you. If you need help anywhere in iowa, please call 211 and ask for the food pantry nearest you or call to find a food pantry here in central iowa. No one should be hungry at the holidays. If you have the wherewithal, please help us feed your neighbors in need. Iowans help iowans in times of crisis. Thatthanksgiving, i know , i willatefulness mention that i am especially grateful to our fellow iowans for helping and im so proud to be in ioan. Thank you. Thank you,ds michelle. I greatly appreciate all you have done to the food bank of iowa and all that has been done by food banks and pantries across the state to ensure Food Security for iowans throughout this year and to the many people and organizations that michelle highlighted. Thank you for stepping up and helping. Like so many others, thanksgiving is a time for reflection on the Many Blessings the year has brought. This year, it can be challenging to look beyond the struggles we have all endured. No one has been untouched by the pandemic. For some, the burden has been far heavier to carry. Especially those who are grieving the loss of a loved one this holiday season. My heart goes out to you and your family. It was president lincoln in 1863 who proclaimed the last thursday of november is thanksgiving day. Hardshipsed upon the of the ongoing civil war and he asked all americans to fervently implore the interposition of the almighty hand it to heal the wounds of the nation and to restore it as soon as may be consistent with divine purposes to the full enjoyment of peace, harmony, tranquility, and union. These words are just as meaningful today and i believe peace will stew be soon be resort if we continue our work together. Iowans have proven that no challenge is bigger than our ability to overcome it. We dont act down from difficulty. We are committed. This is who we are and its why i know we will get through this together. Thats what i am grateful for this angst giving and what i will be counting among my blessings this year and always. I wish you and your family a healthy and happy thanksgiving. With that, we will open it up to questions. Since your last news conference, there have been more than 50 outbreaks at longterm care facilities added to the state website and others confirmed by local media that have not been added to the tally. What additional mitigation are you planning for longterm care facilities . We continue to look at the number of tests to make sure we all have the capacity to test. We continue to work with the department of infections appeals, Public Health, cdc and other partners to make sure we are practicing all infectious controls that they are in place. They are looking at guidance for visitation especially in the holidays. We continue to implement that throughout the state. Testing, we are finding more positive cases and while it is hard and we have more facilities moving into outbreak status, it allows us to identify a potential outbreaks sooner rather than later and we can start isolating and making sure that we are protecting the others that have not tested positive. While the numbers are increasing , it gives us a heads up on how to get in front of it and hopefully avoid some of the horrible outcomes we know happen with this vulnerable population. We are talking about it every day and looking at additional things we can do to help mitigate the outbreaks. As we see Community Spread across the state, this is happening with the staff and residents. We will continue to monitor that. We want to make sure we have adequate ppe. We want to make sure we are using ppe appropriately. Thats what the training is around. Staffing is one of the biggest issues. You allocated money to deal with staffing issues. The state doesnt publicly report staff deaths and some advocates have said that that might give a good sense or a better sense of what there are deficits in the workforce. Why doesnt the state report staff deaths . Gov. Reynolds we are focusing on what we can do to mitigate the efforts. Workforce is an issue in our hospitals, clinics, and longterm care facilities. We allocated 25 million to help with that. I announced we allocated 14 million to help with longterm care facilities and workforce needs. We are exploring additional options as many of the states are also doing to see if we can bring resources into the states to alleviate the pressures on our Health Care Facilities and longterm care facilities. I believe we list that data in the aggregate. We are giving the information, we are not distinguishing between the two. The positives are residents and staff. I wonder why the state isnt publicly announcing staff deaths. There is a difference between whether its for the Public Health or the public good or interest. We list the outbreak status on the website. We list the number of deaths in the aggregate and thats what we will continue to do. With howeaders say high the Community Spread is, it will be hard to keep it out of these facilities. I wonder if you think you did enough to keep the Community Spread down to protect the most vulnerable and did you do enough to send the message to people causingir actions are the spread to get to these people and they are killing people . From theolds beginning, the message has not changed. We need to say we need to do everything we can to protect the health of the most vulnerable population and that includes everybody in a longterm care facility and our health care workforce. Also the number one priority has been to do everything we can to flatten the curve, make sure we dont overwhelm Health Care Resources so we have Health Care Systems that not only can take care of individuals with covid, but also can take care of other individuals that need to utilize the hospitals. Changed. Age has never it has consistently been the same. We were very aggressive at the beginning with our longterm care facilities. The nation with strike teams and testing making it available for longterm care facilities. Before the by next now and we have been aggressive in trying to provide training, information, ppe, testing, and helping educate those not only the staff but making sure we are doing the right things to keep them separated. We have been very aggressive in how we have handled it. Its easy to look at and see if maybe you should have done more or less or handle things differently. I have tried to be very targeted in the mitigation efforts we have put in place. I talk about it often. Not only do we have a responsibility to protect the e and livelihoods but also to find that balance while trying to remind people of the simple things they could do to help us slow the spread, flatten the curve, and protect those i just talked about. And what we can do to help mitigate the areas where we know theres a higher possibility of transmission. Those are the targeted mitigation efforts we have put into place. We will dial up and dial down depending on what we see. Have seen a little bit of we have seen stabilization for short. To say thiso early is a trend. We will continue to monitor and see if theres other things we need to do. Thehat did you see in metrics you watch carefully in october that would have led you not to dial up sooner . Didnt see anything until early november and i wonder if you saw something that didnt indicate we had a disaster coming. Gov. Reynolds its easy to secondguess so i appreciate that. Join me in helping remind iowans that the simple things they can do to help slow the spread. Adding volume to what we are trying to say it, were simple things that individuals could do to make a difference. Is if wegot concerned were monitoring closel