Key takeaways from Wednesday’s COVID-19 briefing:

     • New rules starting Monday on masks, proof of vaccination
     • Booster shots ‘a necessity’ against Omicron variant
     • More vaccination clinics, testing capacity promised
     • Additional school districts adopting ‘test-to-stay’ program
     • FEMA personnel sought to help staff state’s hospitals

PROVIDENCE, R.I. (WPRI) — Gov. Dan McKee on Wednesday announced that most indoor establishments in Rhode Island will need to require masks or proof of vaccination starting next week, in a bid to stem the state’s recent rise in COVID-19 hospitalizations.

During a State House news conference, McKee laid out a series of new policies on masking, vaccinations, testing and hospital staffing that he argued will help alleviate pressure on the health care system without placing too big a burden on small businesses.

“Now’s the time to act,” McKee said. “It’s not a time to just sit and wait. … All our hospitals in Rhode Island are at a breaking point.”

“We’re standing here today saying, come away from this conversation understanding that it is time to mask in public spaces indoors,” Health Department Director Dr. Nicole Alexander-Scott said. “That’s the key takeaway — and to make sure you get vaccinated with the booster.”

Rhode Island has averaged more than 1,000 new COVID-19 cases a day for the last week, far above the level prior to Thanksgiving and approaching last winter’s peaks. There were 280 COVID-19 patients hospitalized in Rhode Island as of Monday, up from 169 on Dec. 1, and hospital leaders have warned that an ongoing staffing shortage is making it harder to handle the surge.

There is also growing concern about the recently identified Omicron variant, which U.K. officials have warned is significantly more infectious than the Delta variant. Rhode Island had identified two Omicron cases as of Wednesday through genetic sequencing.

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McKee’s major announcement was a new set of requirements around masking and vaccinations for most indoor establishments in Rhode Island. All the new rules will take effect on Monday, and he broke them into three categories based on size and category. They apply to anyone ages 2 and up.

For larger indoor venues (with a capacity of 250 or more), masks will be required for all attendees regardless of vaccination status.

For smaller indoor venues (with a capacity of under 250) — including restaurants, retailers and venues of assembly — each individual establishment can require either mandatory masks for all; mandatory proof of vaccination for all; or masks only for individuals who fail to show proof of vaccination.

For offices, manufacturers and other businesses with indoor operations, the rule will be similar to the one for smaller indoor venues. Individual establishments can require proof of vaccination from all patrons and employees; implement a universal mask mandate; or require masks only for individuals who fail to show proof of vaccination.

For the purposes of the new rules, the state is still defining an individual as “fully vaccinated” if they have received either two doses of the Pfizer and Moderna vaccines or one dose of the Johnson & Johnson vaccine.

The state will publish a detailed question-and-answer document about implementation of the new rules by the end of the day on Thursday, including how it will be enforced, McKee said. The new requirements will be “reevaluated” within 30 days after he signs the new executive order, he said.

“The intention is that it’s temporary,” McKee said.

Rhode Islanders who have misplaced their paper vaccination cards can download a vaccine record from The Health Department is also preparing to launch a smartphone app called 401 Health that will provide a verified digital copy of the record.

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Alexander-Scott said vaccinations remain “the critical key” to reducing spread of coronavirus, but are not enough in current circumstances.

“Masking is effective, vaccinated as well as unvaccinated,” she said, “because it works against COVID, the current variant of Delta, the Omicron variant — which is quickly arriving — and other respiratory viruses that we know spread by a similar means.”

Hospital executives applauded McKee’s move.

“These actions are greatly welcomed and needed,” said Lifespan President and CEO Tim Babineau, whose system includes Rhode Island Hospital. “The pandemic has driven burnout among healthcare workers to crisis levels. The situation in our hospitals remains extremely difficult — we have far fewer health care workers to care for patients than we did even a year ago.”

“Many patients are presenting with more acute illnesses and conditions requiring longer inpatient hospital stays and more intensive treatment,” Babineau continued. “In addition, the post-holiday rise in COVID and flu infections are putting additional pressure on our already stressed workforce.”

Business leaders reacted warily.

Dale Venturini, president and CEO of the Rhode Island Hospitality Association, said a recent survey of her members “showed mixed results on mandatory mask and vaccine mandates.”

“The overriding concern is for the staff who will now be on the front lines of enforcement,” she said in a statement.

The Rhode Island Small Business Coalition, which was founded last year to deal with the pandemic, said in a statement its members are “pleased to see businesses under 250 will not be forced with a full mask mandate,” but said they are still concerned about the potential effects of the new regulations.

Christopher Carlozzi, senior state director for the National Federation of Independent Business in Rhode Island, said: “As small businesses continue to grapple with record inflation, labor shortages, and supply chain disruptions, today’s announcement that employers and employees will, once again, be put in the position of enforcing and regulating public health mandates is troubling.”

Churches will also be affected by the new restrictions heading into Christmas Week. In a statement, Roman Catholic Bishop of Providence Thomas Tobin urged Catholics “to follow state guidelines and to wear a mask whenever they are attending Holy Mass.”

But Tobin added, “At the same time, no individual should be turned away from Mass or singled out if they choose not to wear a mask. Such individuals may have good and substantive reasons for not doing so.” He also said liturgical ministers such as priests, altar servers and cantors won’t need to mask during services.

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State Rep. Brian Newberry, R-North Smithfield, questioned the continued use of the governor’s executive powers to set far-reaching health rules, and called on lawmakers to return to the State House for an up-or-down vote on the new requirements.

“Seems kind of hard to claim with a straight face that we are living in an ’emergency’ when your ’emergency’ mask mandate order doesn’t go into effect for 5 days but conveniently right after the last pre-Christmas shopping and party weekend,” Newberry tweeted. “Funny that.”

In a separate statement, House Republicans blamed the new restrictions on what they called the “ill-advised” decision by McKee and the Department of Health to require vaccinations for all health care workers, arguing it exacerbated the current hospital staffing crisis. They called on the governor to repeal the mandate.

“This latest Executive Order resolves the question which the Governor has continuously refused to answer for months: Under what circumstances will this state of emergency end? The answer apparently is – it won’t end,” the GOP lawmakers said.

Apart from the new vax-or-mask rules, McKee used the news conference to stress the importance of all Rhode Islanders receiving vaccine booster shots. About 260,000 residents have gotten one so far, officials said.

“The booster is going to be critical,” McKee said, predicting the CDC will soon shift the official definition of “fully vaccinated” to include booster shots.

Alexander-Scott pointed to early research on Omicron showing it is more transmissible than the Delta variant — which is currently responsible for most virus spread in Rhode Island — and that vaccinations are only 35% effective against Omicron without a booster, versus about 75% with a booster. She said her department is working to expand the number of vaccination sites to meet demand for boosters.

“Boosters are no longer just only if you need it or a voluntary effort,” she said. “They are a necessity to get Rhode Island ready for where we need to be with Omicron. … It’s true today, and it will be that much truer in several weeks when we have more Omicron circulating in Rhode Island, and likely predominant in Rhode Island shortly.”

Alexander-Scott also urged parents to get their children vaccinated. McKee said he hosted a conference call with municipal leaders Wednesday morning asking them to hold more vaccination clinics.

McKee acknowledged frustration about the slow turnaround time for coronavirus tests in recent weeks, saying there has been “more testing than was anticipated.” He said the state will distribute 100,000 at-home rapid tests over the next two weeks, and he has requested an additional 1 million at-home rapid tests from FEMA for distribution to the cities and towns.

“We have completely maxed out the lab capacity in Rhode Island,” said Tom McCarthy, the state’s head of COVID-19 response. Efforts are being made to find additional capacity, and rapid test availability is going to be expanded, he said.

Six additional school districts and charter schools will be adopting the “test-to-stay” program that allows children to stay in school after a COVID exposure: Smithfield, North Smithfield, Barrington, Tiverton, Blackstone Valley Community Prep, and the Learning Community.

To address the hospital staffing crisis, McKee said he has requested FEMA medical personnel for Rhode Island to help supplement the existing workforce at the state’s hospitals. He is also creating a working group of Rhode Island officials to examine the issue. However, he said there are currently no plans to open a field hospital or other alternative hospital site.

Alexander-Scott was also asked to address continuing reports of disagreement between the Health Department and the governor’s office over what steps should be taken to deal with the current surge, particularly on masks.

“For our purpose we are always going to — from a public health perspective — require, advocate for, put in place the highest impact public health interventions that cause the lowest negative impact as soon as possible. That’s our responsibility,” she said. “Then the governor needs to take that information, weigh it with the stakeholders and be able to provide the information going forward.”