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COVID-19 Update
City of Dubuque City Council Meeting ITEM TITLE SUMMARY: SUGGESTED DISPOSITION: Copyrighted January 18, 2022 Presentation(s) # 1. COVID-19 Update Public Health Specialist Mary Rose Corrigan will provide an update on the COVI D-19 pandemic and response activities. Dubuque THE CITY OF All-Americe City MI N Nnl. CT-7C: I1-i4-llE. DUB E 2007*2012*2013 Masterpiece on the Mississippi 2017*2019 TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Specialist SUBJECT: COVID-19 City Council update DATE: Jan 18, 2022 BACKGROUND INFORMATION 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 The Dubuque County Public Health Incident Management (IMT) team consisting of City of Dubuque Health Services Department (Mary Rose Corrigan) Dubuque County Health Department, (Interim Director, Samantha Kloft) 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 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 IDPH epidemiologist. Randy Gehl serves as the Public Information (PIO) officer for the IMT. CURRENT INFORMATION Current case counts and other related COVID -19 data can be found at www.coronavirus.iowa.gov. • A map on the Vaccine Page shows the vaccination numbers from CDC as well as Iowa data. Data Via CDC: httDS://covid. cdc.aov/covid-data-tracker/#datatracker-home Vaccination scheduling and access information can be found at https://www.citVofdubugue.org/2965/COVID-19-Vaccinations and Vaccinate.lowa.gov, and at https://vaccinefinder.org County Vaccination data: https:Hcovid.cdc.gov/covid-data-tracker/#county-view Dubuque VNA VNA continues to operate the public call center for Dubuque County 7 days/week for general COVID questions. To date VNA has fielded over47913 calls/contacts from the community and administered 11,016 vaccines. VNA distributes home Testlowa COVID test kits to anyone needing a test, free of charge. VNA has currently given out over 1049 test kits. VNA offers vaccinations through community events as applicable. VNA will continue to direct individuals to Friday walk- in clinicsat the VNA office to be responsible with inventory, however any individuals seeking a vaccine at VNA on any day will not be turned away. VNA offers COVID vaccine to all age eligible children participating in VNA Vaccines For Children (VFC) immunization clinics. COVID-19 Contact Tracing The Dubuque Visiting Nurse Association has been responsible for contact tracing in Dubuque County since August 12, 2021. As of January 10, 2022, the VNA has reached out to 7,841 positive COVID-19 cases to contact tracing activities. Dubuque County schools also assist with contact tracing. At the upcoming January 19, 2022 Board of Health meeting, the IMT is recommending discontinuing contact tracing in Dubuque County and has formulated a new approach in lieu of contact tracing based on the current COVID-19 situation. This plan includes increased public messaging around updated quarantine and isolation guidance as well as the development of a COVID-19 hotline for questions and support. These activities will be implemented in place of traditional VNA contact tracing for positive COVID-19 cases. Messaging will focus on updated isolation and quarantine guidance to ensure community members are well informed prior to receiving a positive COVID-19 test, and will be available at testing sites and retail outlets. Posters will be printed and distributed to local testing providers to offer to patients upon getting tested. Ads will also be printed in local newspapers to reach populations who typically access those sources. Additionally, QR codes will be developed and provided in a similar way to allow community members with internet access to easily link to the most recent and relevant CDC guidance. The COVID-19 hotline will be staffed by VNA staff during operating hours to answer community questions related to isolation and quarantine. This will work similarly to previously conducted contact tracing, but community members will be responsible for reaching out with questions, rather than staff reaching out to positive cases. Many of the calls from VNA were not answered by the public. The IMT will specifically request the Board of Health allow the shifting of budgeted funds from the traditional contact tracing done to date, to this new approach. Emergency Management Agency (EMA) The EMA has seen an uptick in requests for N95 masks, procedure masks, masks for the public and rapid tests. They will be starting to make regular trips to the node in Cedar Rapids for supplies as long as the supplies last. The state is also having trouble filling requests for rapid tests. The training center point of distribution (POD) is ready for use. The VNA operated the POD for five days in October while the need was present for boosters. All equipment, signage and supplies are ready to go on short notice should any of the providers need to utilize the POD for their patients. Hospital Capacity Planning The IMT continues to monitor hospital capacity and capability and communicate with MercyOne and UnityPoint Finley Hospitals weekly. Hospital COVID inpatient numbers increased throughout November and now again in January, 2022. However, both hospitals have capacity to care for COVID and other ill patients. As of Jan 12, 2022, 75% of Dubuque County hospitalized COVID-19 patients are not vaccinated. In Iowa, the unvaccinated accounted for 68% of hospitalized COVID-19 patients and 77% in the ICU hospitalized on January 16, 2020. Hospitals are experiencing staffing challenges due to COVID related absences. The IMT has access to daily hospital census reports through the IDPH Regional Medical Coordination Center (RMCC) reporting system. The data reported to the IDPH and its designees under this Mandatory Reporting Order is confidential under Iowa law and may not be redisclosed except as expressly authorized by law. Specifically, the patient tracking data as reported by each hospital are confidential pursuant to Iowa Code sections 139A.3(2) and 22.7(2) and (16). The hospital capacity and resources data are confidential pursuant to Iowa Code section 22.7(50), as this data constitutes information concerning physical infrastructure, critical infrastructure, and emergency preparedness developed, maintained, or held by the Department for the protection of life or property. Local public health receives this confidential data as the Department has determined that it is necessary in order to perform response and mitigation duties related to the COVID 19 outbreak. 641 IAC 1.17(3)(a) - (d), (f), 175.10(2)(a), (e). Confidential data provided pursuant to these legal authorities shall continue to maintain its confidential status and shall not be re-released by the agency or organization. Public Information The City Public Information Office (PIO), in conjunction with the Incident Management Team (IMT), continues to provide weekly COVID-19 updates and frequent social media posts, responds to frequent news media requests for interviews and information, and assist with general messaging/communication needs. The PIO continues to track multiple metrics for the IMT and update the COVID-19 webpage on the City website. Videos featuring Public Health Specialist Mary Rose Corrigan are produced when needed and distributed through all available channels. In addition to continued marketing of vaccinations, PIO staff are promoting booster doses and the public clinics planned for the POD and other locations. COVID- 19 Vaccination The IMT continues to manage the IDPH vaccine allocations and distribution. The CDC now recommends children aged 5-11 years old be vaccinated. CDC now recommends booster shots at 5 months after the completion of the primary series of Pfizer-BioNTech COVID-19 vaccine for those aged 12 and older. To date 31,427 booster doses have been administered in Dubuque County and 59% of fully vaccinated eligible individuals have received their booster dose. To facilitate access to vaccination appointments, the Dubuque County Sleeves Up phone line at (563)587-4950 continues, staffed by the City Manager's Office. Call takers facilitate vaccine clinic locations, appointment making and internet navigation though inbound and outbound calls to connect people to vaccines. Testing The Iowa Department of Public Health (IDPH) and State Hygienic Lab (SHL) continue to provide at-home test kits free of charge to Iowa residents through a mail order system or via pick-up locations at healthcare and public health sites in communities. Information about where to obtain these free in- home test kits can be found at: https://www.testiowa.com/en Federal test mail is now live: https://www.covidtests.gov/ Dubuque County in home testlowa pick-up sites include: https://www.cityofdubugue.org/2940/Local-COVID-19-Testinq-Options Testing options are updated regularly and posted at https://www.cityofdubugue.org/2940/Local-COVID-19-Testinq-Options As the need for COVID testing remains high and COVID testing supplies, particularly rapid testing supplies, are limited, quarantine is still a necessary step while awaiting test results in order to prevent the further spread of COVID-19. Rapid test kit supplies are limited for healthcare providers, and they continue to be on "allocation" from suppliers. Over the counter rapid test kit are available at numerous retail stores, but supplies fluctuate daily and are limited. Newly established free testing sites are challenged to stay open due to regulatory and technology issues. The IMT does not regulate testing sites. I meet weekly with the community testing providers who provided updates on supplies and demand. The Variants SARs COV2 variant Omicron emerged November 23, 2021 and now is the dominant strain in Iowa and Dubuque County. The State Hygienic Laboratory (SHL) continues to sequence approximately 300 positive samples per week for variants. With high community spread continuing, and vaccinated individuals experiencing break through infections due to waning immunity, ongoing public health mitigation strategies are important and necessary. Continued spread will allow time for further mutation of the virus and additional variants developing. Omicron accounts for 100% of the positive COVID tests in Dubuque County that are sequenced for variants by the SHL. Looking ahead • Implement new community information strategies in lieu of traditional contact tracing • Provide ongoing education and access for COVID -19 testing and vaccination to all populations, including omicron information, with the assistance of the Equity Immersion Committee and many community partners. • Continue community vaccine education and administration as eligibility and availability changes, utilizing multi -media and community outreach, with a focus on school age, immunocompromised and achieving "up to date" status for the general population • Implementing and distributing ever changing guidance from CDC, IDPH, OSHA and the Governor's Office. • Monitor and provide community education on SARS CoV2 variants. • Provide COVID-19 guidance for special events and activities • Continue assurance of COVID 19 testing access and in -home kit distribution as supplies and testing providers are available • Monitor county transmission rates to provide up to date information on masking and other mitigation strategies. • Currently approximately 85%+ of my time is devoted to COVID-19 0 DUBUQUE CITY COUNCIL COVI Dm 19 UPDATE Mary Rose Corrigan, Public Health S ecialist Jan 18, 2022 A • • 4D lcw Positive Cases - Rolling 7 Day Volume Dubuque County Mar 1, 2020 - Jan 17, 2022 1.5K — 1K 500 n Max 1,133 Avg 230.23 Min 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 2020 2021 2022 POWERED '" HIGH COMMUNITY TRANSMISSION IDPH DATA NEW COVID-19 POSITIVE DUBUQUE COUNTY RESIDENTS ITS 12M2021 I2f IM I 1211512021 1 M V2021 12129;2021 1 f512022 111212Q22 Increasing cases last 7 days 21.5 % 7 day + ave Community Transmission in the U w ow Territories M®M_ PVw -_ Positive Tests Last 7 days by Age Group Dubuque County Jan 11, 2022 - Jan 17, 2022 As of Date: January 17, 2022 25% 20% 15% 0 c U L CL 10% 5% 0% 22% ��> si ri E:1 y�:���> �3:> • 13% 40-49 50-59 60-69 70-79 80+ All Variants by Month Dubuque County Omicron 100% in Jan Jan 1, 2021 - Jan 3, 2022, by Month Dataset last updated: January 12, 2022 100% 80% 60% 40% 20% 0% 2021-Mar 2021-Apr 2021-May 2021Jun 2021Ju1 2021-Aug 2021-Sep 2021-Oct 2021-Nov 2021-Dec 2022Jan WHO Labels ■ Alpha ■ Other ■ Epsilon ■ Gamma ■ Delta ■ Omicron POWERED BY - - � All variants by month- IOWA 77% Omicron 100% BO% WHO Labels ■ Other ■ Alpha 60% ■ Epsilon Delta ■ Iota ■ Gamma ■ 2era 40% ■ Seta Emu Lambda ■ Omicron 20M 096 2021Jan 2021-Feb 2021-Mar 2021-Apr 2021-May 2021Jun 2021Jul 2021-Aug 2021-Sep 2021-0rt 2021-Nov 2021-Der 2022Jan HOSPITAL CAPACITY, CAPABILITY & DATA Hospital data reported weekly to IMT and media Hospitals and IMT work cooperatively, with transparency and open communication IDPH/RMCC collects daily hospital data daily Unvaccinated COVID patients in Dubuque Co hospitals= 75% DUBUQUE COUNTY HOSPITALIZATIONS WITH COVID-19: DEC. 15 - JAN. 12 46 � 34 31 30 3% ---I 1021 12/29/2021 1/512022 1 /12120 MONTHLY HOSPITALIZATION RATES: mcmn)mL DA-m 13X Higher in Unvaccinated Adults Ages 18 Years and olde 1Ox Higher in Unvaccinated Adolescents Ages12-17 Years 1 7X Higher in Unvaccinated Adults Ages 18-49 years Rates of COVID-19-Associated Hospitalizations by Vaccination Status in Adolescents Ages 12-17 Years, June -November 2021 - Rate in Fully Vaccinated Persons - Rate in Unvaccinated Persons 4 �o oho Mayo (��yo ^�o ��o ,r�0 0 0 ,r�0 �o \ A D� 'o' S\ p�^�" '� �O\•� AD O`" "IN ^'�\�'` WPPle D 16X Higher in Unvaccinated Adults Ages 50-64 years 1 2X Higher in Unvaccinated Adults Ages 65 Years and Older Age -Adjusted Rates of COVID-19-Associated Hospitalizations by Vaccination Status in Adults Ages >_18 Years, January -November 2021 - Rate in Fully Vaccinated Persons - Rate in Unvaccinated Persons Week VACCINATION CDC data (Jan 15, 2022) https://covid.cdc.gov/covid-data-tracker/#county- view?list select state=Iowa&data- type=Risk&list select county=19061 People Vaccinated Total of Total Population Population > 5 Years of Age % of Population >_ 5 Years of Age Population > 12 Years of Age of Population > 12 Years of Age Population > 18 Years of Age % of Population �: 18 Years of Age Population > 65 Years of Age of Population > 65 Years of Age At Least One Dose 65,321 67.1 % 65,317 71.6% 62,924 76.1 % 58,941 78.4% 18,268 95% FullyVaccinated 60,847 62.5% 60,847 66.7% 58,73 71.2% 55,203 73.4% 17,296 95% Dubuque County COVID-19 Booster Data by Age January 18, 2022 Age Group 12-15 Number of Individuals Receiving Vaccine series complete a Booster Dose as of 1 / 18, 2022 144 2,328 Percent of fully vaccinated Up to Date 6% 16-17 273 1,320 20.68% 18-19 403 1,352 30% 20-29 1,972 6,794 29% 30-39 2,918 7,366 40% 40-49 3,399 6,934 49% 50-59 5,050 9,270 54% 60-64 3,753 5,476 69% 65+ 13,514 16,588 81 % Note: Not everyone who has completed their vaccination series is eligible for a COVID-19 booster at this time. CDC recommends additional doses based on established time frames. aSE = UP TO DATE Fully vaccinated vs up to date Fully vaccinated A 2-dose series of an mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna), or A single -dose COVID-19 vaccine (Johnson &Johnson's Janssen vaccine) Up -to -Date Additional dose of Pfiezer, Moderna, or J&J VACCINE CLINICS Vaccinations available at clinics/doctors' offices, retail pharmacies https://www.cityofdubugue.org/2965/COVID-1 9-Vaccinations Ongoing walk-in VNA clinics at 660 Iowa St Mondays 3-6 pm -WALK INS: Fridays 8-430pm-WALK INS: 1/2412/7, 2/21 1/21, 1/28, 2/4, 2/11, 2/18, 2/25 •SleevesUp Phone line 563 690 6253 https://www.citvofdubuaue.or.e/2940/Local-COVID- 19-Testing-Oations Testing Access and Availability Health care providers on "limited allocation" for supplies 1 of 2 Free test sites temporarily closed Retail store availability fluctuates and also back ordered Testlowa take home test available https://www.testiowa.com/en Federal website is live: https://www.covidtests.gov/ Durango New Vienna Sageville Rutledc 0 ♦ C• Q '/e•Ile � East aubuqu Centralia © y Ep—h P—t. © Key West QD W. t .n 0 CONTACT TRACING: NEW APPROACH New Quarantine and Isolation public messaging Hotline phone number for questions and support- VNA Social media, print materials for providers and test sites, newspaper ads, posters and website updates, QR code for information Board of Health presentation at Jan 19, 2022 Wear a mask with the best fit, protection, and comfort for you. � . 6k, When worn correctly, respirators offer the highest level of protection and filter 95%of particles. Filtration varies depending on standard. When worn correctly, KN95s provide more protection than disposable masks. Disposable masks offer more protection than cloth masks. 3, ¢cmrc� Masks and respirators should not be worn by children younger than 2 years old. Layered finely woven cloth masks offer more protection. Loosely woven cloth masks provide the least protection. 9 1! 0 0 QUESTIONS? 0 Thank -you Next update: Feb 7, 2022 r r_1 LL • • 4D