Governor: Two-week 'pause' planned after Thanksgiving as RI hospitals reach 'tipping point'

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A “two-week pause” that involves new restrictions on social gatherings, dining and commercial activity will begin Nov. 30, Gov. Gina Raimondo announced Thursday – a move she framed as essential to curb the rapid spread of the coronavirus and prevent the state’s health care system from becoming overwhelmed.

“I have done everything that I knew how to do to avoid the severe restrictions that I’ll be laying out today … We are on a very bad path to overwhelm our hospitals, so something more needs to be done,” the governor said.

She later added: “We’re at a critical place with our hospitals right now. It’s a tipping point.”

Raimondo said existing COVID-19 guidelines will remain in place for one more week, through the Thanksgiving holiday, with two changes – an immediate lowering of the social gathering limit to “a single household,” which will continue through the “pause,” and a requirement for big box retailers to develop new protocols ahead of Black Friday and the holiday shopping season.

The “single household” gathering threshold, as the governor explained it, means social circles should be limited to the number of people with whom a person lives.

“You cannot be spending social time indoors with people you don’t live with,” she said.

Then, effective Nov. 30 through Dec. 13, a number of other changes will take effect. In terms of why the new rules will not be implemented for another week, Raimondo said she is seeking to provide time for both residents and businesses – especially restaurants, which have existing inventory on hand – to ready themselves.

“I want everybody to have some time to get prepared,” she said.

Schools will remain open during the “pause,” although districts will be given the option of moving to a “limited” in-person option for all high schools. That involves full distance learning for the majority of students, while key subgroups such as special needs children and language learners would still receive in-person instruction.

“We’re giving superintendents the flexibility to shift the high schools to their limited in-person plan if that’s what they choose, after Thanksgiving,” the governor said.

Raimondo said the shift is focused on high school students because they are typically more mobile than their younger counterparts – working jobs after school, for example, or running errands for family members. She continued to defend keeping school buildings open, saying there is “not a shred of data to suggest schools are major spreaders” and that a return to complete distance learning would do “irreparable farm” to countless children.

“There is a 100 percent certainty that children will be sicker mentally, physically, emotionally if they are out of school,” she said.

Organized sports and indoor sports facilities will be among those ordered closed during the “pause.” Exemptions are provided for college and professional sports, which the governor said have their own rules. She said Department of Environmental Management Director Janet Coit is working with the Rhode Island Interscholastic League to develop plans for the start of the winter school sports season, which will not occur until January. All activity, including practices, will be suspended during the “pause,” she said.

Additionally closed during the “pause” will be in-person instruction at colleges and universities; all bar areas in bars and restaurants; and indoor recreation venues such as movie theaters, bowling alleys and casinos. Businesses are also being asked to have employees work at home whenever possible.

Raimondo said an announcement is planned next week regarding a “significant, tens of millions of dollars of stimulus” for affected businesses. The relief, she pledged, will be “fast” and “simple.”

“None of this is going to be easy, and I really wish I didn’t have to do it … I know the financial pain that’s going on in Rhode Island right now,” she said of the closures. “But I’m in a world of all bad choices, and I’m trying to pick the least bad of the options, and I am trying to get us through to the end of the year without overwhelming the hospital system.”

Some activity that remains open during the “pause” will face new limitations. Indoor dining will be limited to 33 percent of an establishment’s capacity, although that does not include outdoor dining. Full delivery and take-out service will continue to be allowed.

“I know you’re not happy with this. It’s the best we could do,” she said, addressing the state’s hospitality industry.

Retail establishments will be limited to one customer per 100 square feet at a time, while big box stores will be allowed one person per 150 square feet. Houses of worship will be limited to 25 percent capacity, and the governor asked worshippers to “celebrate virtually.”

Other activity will remain open for the two-week period, including manufacturing and construction, personal services such as barber shops and nail salons, and health care providers.

“Don’t put off your visit to the doctor … We need to stay healthy,” Raimondo said.

Detailed regulations for each industry will be posted on reopeningri.com “as soon as possible,” the governor said.

Raimondo said the “pause” restrictions have two primary objectives – to “reduce our mobility and reduce our connectivity” with others who live outside a person’s direct household.

Citing an analysis of the state’s case and contact tracing data conducted by IBM, she continued to point to “clear patterns” showing social settings are a main driver of virus spread – although she acknowledged the limitations of the existing contact tracing process and her own appeals to Rhode Islanders to change their personal behavior.

“I’m not going to pretend that we know with great specificity exactly how everyone in Rhode Island has contracted COVID,” she said, adding: “The reality is, with so much community spread right now, it’s really hard to pinpoint … It’s not always possible to trace the exact source of every infection. At one point, it was. We can’t do that now.”

In terms of her own appeals to Rhode Islanders, Raimondo said: “There’s a lot of really funny memes going around about me showing up in people’s living rooms. I kind of wish I could do that … But I have been utterly ineffective in getting people to follow the rules in their own homes. So since we can’t do that, then this is the way we’ve got to go.”

In terms of Thanksgiving, Raimondo made a new plea for Rhode Islanders to celebrate the holiday “at home with the people you live with.” Those who insist on traveling, she said, are “breaking the rules and putting people’s lives at risk” – although she said if “you already have your plans made to go out to a restaurant, we’re not going to get in the way of that.”

Raimondo said people who travel for the holiday are asked to be tested both before their departure and following their return. She said some rapid COVID-19 testing will be available at T.F. Green Airport on the Saturday, Sunday and Monday following Thanksgiving, while members of the Rhode Island National Guard will be present to distribute information regarding testing and self-quarantine protocols.

The latest COVID-19 data updates point to the grim picture facing Rhode Island.

Thursday’s update showed 921 new cases among 15,819 tests, a positive rate of 5.8 percent. But the state has surpassed 1,000 new cases on multiple days in the past week, including a single-day high of 1,280 in Wednesday’s initial report. Four more COVID-related deaths were also announced Thursday, bringing the state’s overall toll to 1,288.

Week-to-week metrics also underscore the increasing cause for alarm. Data released Tuesday show the state’s positive rate for last week was 5.9 percent, up from 3.9 percent the week prior. The number of new hospital admissions rose from 243 to 247 over the same period of time, while the number of new cases per 100,000 residents rose from 363 to 535.

All three metrics have now well exceeded their safe thresholds, earning red warning arrows in a chart on the state’s data portal.

It is the ongoing rise in hospitalizations, though, that is clearly the most urgent worry.

A record 298 Rhode Islanders were hospitalized as a result of the coronavirus on Thursday, up from 284 on Wednesday. Raimondo said that means the existing COVID beds in the state’s hospitals are at 97 percent capacity.

The field hospital at the former Citizens Bank building in Cranston will be ready for patients next week, while the field hospital at the Rhode Island Convention Center – which had been planned for decommissioning – will now be operational by Dec. 1. Raimondo said Care New England and Lifespan will make decisions in terms of when patients start being directed to each facility.

Staffing the field hospitals is an ongoing concern, Raimondo said. The greatest fear, though, is reaching a point at which the state’s health care facilities are forced to activate “crisis standards of care” – putting non-critical services on hold and rationing treatment.

“If the system gets overwhelmed … then our backup option is to make beds available by clearing out other beds in the hospital, which means shutting off other critical procedures,” she said.

She added: “Trust me, if I could have figured out a way to do this without these draconian measures, I would have … I’ll own these decisions, which aren’t easy. But I feel it’s the only option we have right now to save as many lives as we can.”

Raimondo also said Dec. 13 will not bring a “flip of the switch” back to the current COVID-19 guidelines. While she said there is a “real shot” to stem the spread of the virus through the “pause,” the possibility of a more complete lockdown, remains in play based on the state’s standing in the days to come.

“I have to play this a day at a time, a week at a time, and see how it goes,” she said, pointing to the test positivity rate and mobility data as among the “leading indicators” that will govern her decision-making.

Elsewhere during Thursdays briefing:

* Raimondo touted “good news” on the COVID-19 vaccine front, including initial results from Pfizer and Moderna showing their respective vaccines being roughly 95 percent effective in preventing infection. She also noted that Pfizer has selected Rhode Island as one of four states in which to pilot the vaccine’s rollout, which will not bring the vaccine to residents sooner will ensure the state is “ready to go the minute we have it.”

“There is good news, and there is very definitely light at the end of the tunnel,” she said, although she added later: “I think we’re now in the seventh inning … It is my estimation that the six weeks before us will be the hardest yet of this crisis.”

Raimondo also said she is “hopeful that there will be some amount of vaccine available in Rhode Island by the end of the year.”

* Raimondo acknowledged the state is “struggling to keep up with demand” for COVID-19 testing. She said additional testing sites and capacity will be added this week and in the weeks to come with a goal of doubling daily tests in Rhode Island by Nov. 30.

“We’re on it. We’re going to get better,” she said.

The state’s contact tracing system is also “behind,” Raimondo said, and she urged people who receive a test to check for results frequently online at portal.ri.gov/results. Those who have tested positive, she said, should not wait for a contact tracing call from the Department of Health to begin their quarantine and reach out to potential contacts.

* The governor said officials are working to develop a caregiver exemption that would allow for a family member to attend to a loved one in a nursing home or assisted living facility. Guidelines for that exemption are forthcoming and at the “top of our list,” she said.

* Going forward, Raimondo’s weekly briefings will move to 1 p.m. on Thursdays. Due to the Thanksgiving holiday, however, this coming week’s briefing will be held on Wednesday.

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