COVID-19 Update 11 2 20 Copyrighted
November 2, 2020
City of Dubuque Presentation(s) # 1.
City Council Meeting
ITEM TITLE: COVID-19 Update
SUM MARY: Mary Rose Corrigan, Public Health Specialist for the City of Dubuque,
will provide an update on the COVI D-19 pandemic and response
activities.
SUGGESTED
DISPOSITION:
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TO: Mike Van Milligen, City Manager
FROM: Mary Rose Corrigan, Public Health Specialist
SUBJECT: COVID-19 update
DATE: November 2, 2020
CURRENT INFORMATION
• The Dubuque County Public Health Incident Management (IMT) team consisting
of City of Dubuque Health Services Department (Mary Rose Corrigan) Dubuque
County Health Department, (Patrice Lambert) VNA (Stacey Killian) and the
Dubuque County Emergency Management Agency (Tom Berger), along with
both hospitals continue in full activation. The IMT also consists of county Health
Department Assistant Director, Samantha Kloft and City of Dubuque Health
Services Department Environmental Sanitarians Tim Link and Sydney Moquin.
We are coordinating our response efforts in conjunction with the Iowa
Department of Public Health (IDPH), and with guidance from CDC via weekly
webinars and direct contact with our regional epidemiologist. Randy Gehl serves
as the Public Information (PIO) officer for the IMT.
• Current case counts and other related COVID -19 data can be found at
www.coronavirus.iowa.gov. The important metrics for the city council to
understand and monitor include:
➢ The 14 day ave positivity rate trend line
➢ Hospitalizations
➢ Cases by age group
➢ Epi-curve/overall trend line and days to double
➢ Cases by zip code
➢ Equity related data as it becomes available
➢ Long Term Care (LTC) outbreaks
Health Services Department
City Hall Annex
1300 Main Street
Dubuque, IA 52001
Office (563) 589-4181
Fax (563) 589-4299
TTY (563) 589-4193
health@cityofdubuque.org
www.cityofdubuque.org
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• White House Task Force Report dated Oct 25, 2020 maintains Iowa and
Dubuque County and the City of Dubuque in the Red Zone status. The following
three counties had the highest number of new cases over the last 3 weeks: 1.
Polk County, 2. Dubuque County, and 3. Woodbury County. These counties
represent 21.9% of new cases in Iowa. Citing Iowa as having the tenth highest
new cases/100,000 (254/100,000 last week compared to a national average of
133/100,00) in the country and the 11th (>10%) highest positivity rate for the third
week in October. The designation is based on having greater than 100
cases/100,000 population in the previous 7 days, along with test positivity above
10%, while factoring in Dubuque county’s four LTC outbreaks and increased
hospitalizations. Contributing to the Red Zone designation in Dubuque county
are cases contracted through community spread at LTCs, crowds in public and
specifically social gatherings in private. As the weather cools, friends and
families are moving social gatherings indoors, significantly increasing spread.
The full report is attached along with the recommendations to the Governor on
increasing mitigation efforts.
• Community Testing: Over 37,000 people have been tested in Dubuque County.
This does not account for number of tests, since many people are tested more
than once. Almost 16% of the cases tested since March have been positive. The
TestIowa clinic continues at Epic Health and Wellness on Cedar Cross Road
along with t Grand River Medical Group at their respiratory clinic on University
Ave. Free testing is offered at Hartig Drug locations through the federal program.
The test sites are not scheduled at full capacity, which allows for timely testing of
those who need or want a test. The local health care provider clinics report they
have adequate testing supplies and continue to be very busy testing
symptomatic, at risk and those patients undergoing procedures, surgeries, or
admittance to the hospital.
• I continue to meet with representatives from major health care providers weekly
to assess their needs and testing capacity. Local testing capacity includes
TestIowa and HHS testing, the physician and health care provider clinics who are
for the most testing according to State Hygienic Lab guideline s and both
hospitals. The Public Health Incident Management Team is providing additional
testing of individuals identified through contact tracing
• Contact tracing: In addition to IDPH contact tracing, VNA continues enhanced
contact tracing for all new positive cases to provide a local connection and
assess isolation and shelter needs along with testing information and notification
of exposed cases. VNA is also assisting with pre-K -12 schools and higher
education institutions on contact tracing. Schools and higher education
institutions are also actively participating in the contact tracing. All of VNA staff is
performing contact tracing and they have scaled back non -essential services in
order to provide this function. Sadly, many of their calls to cases are met with
anger, and/or a refusal to name close contacts.
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• Long Term Care facility status: Dubuque County currently has four long-term
care facility outbreaks. Nursing homes continue to test staff and residents on a
frequency based on the previous week’s positivity rate and other CMS directives,
utilizing federally deployed testing equipment and supplies. LTC will have the
option of partnering with a national pharmacy retailer for all COVID-19
vaccination steps.
Schools
• The Public Health Incident Management team continues to provide guidance and
planning assistance with the county colleges and universities and the K-12
districts. The K-12 schools must use the IDPH 14- day positivity rate posted on
the coronavirus.iowa.gov site as one of the indicators that determines
maintaining in- person school attendance. Although the positivity rate is above
15%, the rate at which schools can request a waiver to in person learning, the
county schools are opting to keep their hybrid models in lieu of the case and
contact tracing data that reveals spread happening primarily outside of the
classrooms. The IMT meets bi-weekly with preK-12 school. The VNA works
closely with the preK-12 schools on notification of positive cases and starting the
contact tracing process as soon as possible, which has proven to be ahead of
the state contact tracing efforts.
The Dubuque County higher education institution representatives also meet bi-
weekly with the IMT. VNA provides similar contact tracing and assistance with
the higher education students as they do with preK-12. Plans and guidance are
being made at the local institutions for Thanksgiving break and December
breaks.
• Dubuque VNA Continues to operate the public call center for Dubuque County 7
days/week. In addition, they continue to provide thermometers, food assistance
and other human needs referrals. VNA will be adding additional staff nurses to
focus on the pandemic response.
• Vaccines The IMT is receiving ongoing information and vaccination planning
tools from the IDPH. We continue to work with local healthcare providers to
assess their interest in being a vaccination site and provide information on
vaccine planning. To date, 15 local providers have indicated their interest in
administering vaccine through 25 sites. No vaccine has been approved and no
firm date for beginning administration has been established.
• Hospital Capacity Planning The IMT and some city staff are working with
MercyOne and Unity Point Finley Hospital on hospital capacity planning.
Hospitals are challenged by three main factors: 1) the number of COVID-19
patients; 2) staffing challenges to illness, isolation and quarantine issues; 3)
equipment and supply chain limits for some items. The entire state and country
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are experiencing these same issues. In fact, prior to this pandemic, there was a
health care worker shortage across the country. The governor’s office and the
IDPH have indicated we must do our own hospital capacity planning, along with
the regional state system and surge partnerships within communities and
corporate systems. The state cannot supply staffing or equipment for any kind of
a “field or temporary hospital.” This is not to say that absolutely no state or
federal level resources will be available, but with the increase in cases in the US,
there will be high demand for any federal resources. Rest assured our hospitals
are not beyond their capacity and welcome our assistance to plan for maximizing
the clinical space available in Dubuque County.
• Public Health Mitigation measure enforcement in restaurants and bars- The
Iowa Alcoholic Beverages Division (ABD) requires licensees to complete a
COVID-19 Compliance Checklist to assist in the implementation of the
Governor’s proclamation requirements. Health Services Department
environmental sanitarians have responded to 13 citizen complaints at food and
alcohol establishments not following the Governor’s proclamation, issued 2
warning letters to food establishments (without a liquor license) and referred 9
establishments with liquor licenses to the ABD for enforcement. The Police and
Fire Departments are also doing enhanced reinforcement.
Looking ahead / What else can we do?
• Conduct food and liquor inspections and assist special events with the
recommended COVID-19 public health measurers and compliance with
Governor’s Proclamation
• Preparing for the upcoming Influenza season- get vaccinated!
• Implementing ever changing guidance from CDC, IDPH and DOE.
• Plan for community vaccine point of distribution (POD.) and community wide
vaccine administration
• City Public Information Office staff, in conjunction with the IMT, will be providing
new messaging and community education in conjunction with local health care
providers to combat pandemic fatigue, and address the communities lack of
adhering to recommended COVID-19 safe guidance.
• Police and Fire Departments will formulate strategies on assisting ABD/DIA with
enforcement on the Governors’ Proclamation violations, along with enforcing the
city’s face covering ordinance.
• City Attorney is researching other mitigation strategies and best practices from
local communities, including additional provisions in local proclamations,
ordinances, local enforcement of proclamation options etc
• Dubuque County Health Department continues to supplying county municipalities
with local data and meeting with mayors.
• Continue to focus on to plan for opening and ongoing operation along with other
organizations with providing guidance for when they have a positive case.
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Health Services Department
City Council update Nov 2, 2020
Mary Rose Corrigan, Public Health Specialist
Dubuque County Public Health
Incident Management Team (IMT)
Mary Rose Corrigan Stacey Kilian
City of Dubuque Visiting Nurses Association
Randy Gehl, City of Dubuque
Public Information Officer
Patrice Lambert Tom Berger
Dubuque County Emergency Management
Numbers to Watch
•The 14 day ave positivity rate trend line
•Hospitalizations
•Cases by age group
•Epi-curve and Days to Double
•Cases by zip code
•Equity related data as it becomes available
•Long Term Care outbreaks
14.0%
19.3%
0%
5%
10%
15%
20%
25%
DUBUQUE COUNTY PAST 14-DAY AVERAGE COVID -19 TEST
POSITIVITY RATE
(IDPH CALCULATION)
Iowa Hospitalizations Nov 2, 2020
0
1,000
2,000
3,000
4,000
5,000
6,000
3/15/2020 4/15/2020 5/15/2020 6/15/2020 7/15/2020 8/15/2020 9/15/2020 10/15/2020
TOTAL NUMBER OF COVID-19 CASES CONFIRMED
IN DUBUQUE COUNTY TO DATE
July 14
Aug.30
Sep. 24
Oct. 10
Oct. 24
exported 02 Nov 2020
Days to Double
42 Current Days to Double
exported 02 Nov 2020
Week of Oct 25, 2020
Filters applied: Age Group Description -Version 2 contains 11-14 (Child), 15-18 (Young Adult), 19-24 (Adult), 25-29 (Adult), 30-34 (Adult), 35-39 (Adult), 40-44 (Middle Age), 45-49 (Middle Age), 50-54 (Middle
Age), 55-59 (Middle Age), 60-64 (Older Adult), 65-69 (Older Adult), 85+ (Elderly); CalendarWeek contains 2020-10-25
8.3%
7.2%
6.5%6.4%
5.9%5.6%5.5%5.4%5.3%5.2%5.0%4.9%
4.4%4.4%4.2%
1.4%
COVID CASES TO DATE AS % OF ZIP CODE POPULATION AS
OF NOV. 2
White House Task Force Report Oct 25, 2020
•Dubuque, Polk, Woodbury
Counties = 22% of cases
Looking ahead/ What else can we do?
•Expanded public health enhanced contact tracing-VNA
•Marketing & community education
•Governor’s Proclamation, city face covering enforcement: Police,
Fire, Health planning to assist ABD and DIA
•Hospital capacity planning and readiness
•City attorney researching other communities, ordinances etc
•Vacinne Planning
•Influenza season
51
13
9 7
2
0
10
20
30
40
50
60
Food Establishments Total COVID19
Complaints
Referred to ABD COVID19 Complaints
Verified
Warning Letters Issued
City of Dubuque COVID19 Compliance Inspections
September 24, 2020-November 2, 2020
Questions