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COVID-19 UpdateCity of Dubuque City Council Meeting Presentation(s) # 02. Copyrighted April 17, 2023 ITEM TITLE: COVID-19 Update SUMMARY: Public Health Director Mary Rose Corrigan will provide an after action report on the COVI D-19 pandemic and response activities. First report given on March 16, 2020, last report given on this day, April 17, 2023. SUGGESTED DISPOSITION: ATTACHMENTS: Description Memo Uploaded 4.17.23 Type Staff Memo Dubuque THE CITY OF All -America City NI N N�11 � 71-9�.; I.I �". 1 DUB E 'I 2007*2012.2013 Masterpiece on the Mississippi 2017*2019 TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Director SUBJECT: COVID-19 After Action Report (AAR) summary DATE: April 17, 2023 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) VNA (Stacey Killian) and the Dubuque County Emergency Management Agency (Tom Berger), along with both hospitals continue monitoring the pandemic and providing guidance. However, members of the IMT and community healthcare partners continue to gradually resume "pre -pandemic" activities. The IMT also consists of City of Dubuque Health Services Department Environmental Sanitarians Tim Link and Sydney Moquin who are spending much less time on the pandemic response. The Iowa Department of Public Health (IDPH) provides information via Health Alerts and their website. Randy Gehl continues to serve as the Public Information (PIO) officer for the IMT. The COVID-19 pandemic has proven to be one of the most complex public health threats in history. It required a robust response (from the international to the local level) that continues to this date. As of April 17, 2023, there have been 104 million cases of COVID-19 in the United States resulting in 1,128,404 deaths', including 332 deaths in Dubuque County as of March 31, 2023. Dubuque VNA VNA operated the public call center for Dubuque County 7 days/week for general COVID questions along with quarantine and isolation specifics. To date VNA has fielded over 48,954 calls/contacts from the community and continues to administer vaccines. Along with free vaccinations, VNA distributed home Testlowa COVID test kits to anyone needing a test, free of charge. During the pandemic, VNA provided the clinical and contract tracing support necessary to respond to the pandemic. VNA's team of nurses, social workers, and administrative staff provided staff to implement much of the response. VNA staff assisted with outbreaks in long term care facilities, and at schools and businesses in order for those organizations to manage COVID-19 1 Centers for Disease Control and Prevention, "COVID Data Tracker," CDC.gov, https://covid.cdc.gov/covid-data- tracker/#datatracker-home cases, isolation and quarantine protocols and testing within those facilities. VNA also developed a system to communicate COVID-19 information to City and County EMS and first responders. Emergency Management Agency (EMA) Emergency Management was tasked with logistics for the COVID-19 emergency. This included receiving donated goods and personal protective equipment (PPE) and distributing it to health care and response agencies. The EMA was also tasked with taking requests from health care organizations and requesting supplies from the state emergency operation center. Once the equipment arrived, EMA part time staff helped with the distribution of the PPE. The EMA was also involved with the Kennedy Mall POD and planning for an alternative care site for diversion of patients from hospitals due to capacity issues. The EMA served as the liaison between the public health IMT and the county firefighters association, county EMS association and the small-town cities within Dubuque County hosting virtual meetings that started out weekly and eventually tailed off to monthly. The EMA Coordinator assisted the IMT professionals and was available to take on missions and tasks as assigned to help the IMT. The emergency operations center was active in a virtual role and communicated with the state EOC daily through WEB EOC and other conference calls and meetings. Hospital Capacity Planning The IMT met on a scheduled basis with hospitals to assess local capacity, capability and patient load. Local hospital data and challenges were shared. Although hospitals were extremely stretched, they maintained the capability to care for patients of our community and beyond. The Emergency Management Coordinator (Tom Berger) worked with the Fire Chief (Rick Steines) and his staff to arrange and secure a designated alternative care facility. The facility was ready to receive hospital patients, but ultimately was not needed. The IMT assured weekly communication and coordination between the long term care facilities and hospitals through weekly joint meetings and updates. Public Information The City Public Information Office (PIO), in conjunction with the Incident Management Team (IMT), produced and distributed weekly County COVID updates with important messages to residents as well as new data on new cases, hospitalizations, deaths, and vaccinations. The PIO office coordinated media requests for interviews and information to assist the IMT with general messaging/communication needs. 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 clinics where they are available. Without the city of Dubuque Public Information Office as a resource, the city and county pandemic response would not have been able to keep citizens and policy makers informed adequately. (See separate memo from Randy Gehl, Public Information Officer.) COVID- 19 Vaccination The IMT managed the IDPH vaccine allocations and distribution, primarily through the VNA. This required weekly communication with vaccine providers on vaccine needs and capabilities. VNA tracked the allocation and distribution of vaccine throughout the community, often including delivering to and sharing vaccine among providers. Two stand-alone Point of Distribution (PODs) for vaccinations were established through the efforts of the IMT, city staff, and funding from Dubuque County; the main POD at the Kennedy Mall with vaccine provided by local healthcare and vaccine providers and a short term POD at the Grand River Center with vaccinations provided by the City of Dubuque Fire Department. Both sites required extensive planning, coordination, staffing and volunteers. A vaccination call -in center and phone line was established and staffed by city staff from numerous city departments. Neighborhood and business "boots on the ground" canvassing disseminated vaccine information. Local pharmacies and retailers and healthcare providers, all provided vaccinations and utilized the federal Operation WARP speed, along with coordination with the VNA and IMT. Dubuque County's vaccination rates as of April 5, 2023: 66.8% of Dubuque County population completed a primary vaccination series (Iowa= 60.2%, US= 69.4%) 20.7% of Dubuque County population completed updated (Bivalent) booster (Iowa= 19.7%, US= 16.7) ) Additional vaccination data: https://covid.cdc.gov/covid-data-tracker/#county- view?list select state=all states&list select county=19061 &data- type=Vaccinations&metric-vax=Bivalent Booster 65PIus Pop Pct Testing The AAR does not begin to explain the many challenges around COVID-19 testing. Various testing methods and their nomenclature, testing supply shortages, test worker safety, availability of testing and testing access, interpretation of testing, natural and vaccine produced immunity, community education on appropriate testing and guidance, cost of testing and mass testing and test reporting often created hysteria, confusion, complacency, and disruption. Ultimately, testing has come down to primarily rapid in - home self -tests available free of charge through multiple outlets and methods, and health care provider administered rapid and or PCR tests. After Action Report The IMT contracted with Emergency Preparedness Consulting (EPC) LLC, to produce the COVID-19 pandemic after action report (AAR). Dubuque County executed a contract with the consultant, which will include a separate component evaluating the City of Dubuque COVID -19 response operations including public education regarding COVID-19 and municipal service delivery, safe workplace guidance and employee safety, and Departments Continuity of Operations Plans. The preparedness committee is still working on the City of Dubuque AAR and improvement plan. The following inputs were used to generate the Dubuque County COVID-19 After -Action Report and Improvement Plan, which is still in draft form: Document review, including incident objectives, briefing documents, presentations, planning documents, guidance documents, public information releases, and social media posts. In-depth interviews with representatives from the Dubuque County IMT and the community stakeholders with which they interacted. Interviews were conducted via online video conferencing platforms and lasted approximately 45-60 minutes. Each interviewee was asked questions designed specifically for the stakeholder group that they represented and were also given an opportunity to provide other feedback. o Interview invitations were sent to 44 individuals and 18 (41 %) responded and were interviewed. Due to the large number of potential respondents from Long -Term Care Facilities, information was solicited from this stakeholder group through an e-mail survey rather than individual interviews. Surveys were sent to 28 individuals and 2 (7%) responded. Because the IMT approached the incident from a unified standpoint, the activities performed cannot easily be grouped into FEMA Capabilities and CDC Public Health Emergency Preparedness and Response Capabilities. Often, activities from both sets of capabilities were being carried out concurrently. Rather than linking observations to a specific capability, this report groups similar capabilities into "Focus Areas" 1. Response Coordination and Logistics FEMA Capabilities: • Situational Assessment • Operational Coordination • Planning • Logistics and Supply Chain Management CDC Capabilities: • Emergency Operations Coordination • Medical Materiel Distribution 2. Public and Stakeholder Information Management FEMA Capabilities: • Public Information and Warning CDC Capabilities: • Emergency Public Information and Warning Information Sharing 3. Public Health Countermeasures and Vaccination FEMA Capabilities: • Environmental Response/Health and Safety CDC Capabilities: • Medical Countermeasures Administration and Dispensing • Nonpharmaceuticallnterventions • Responder Safety and Health 4. Congregate Populations and Equity FEMA Capabilities: • Mass Care Services • Housing • Public Health, Healthcare, and Emergency Medical Services CDC Capabilities: • Medical Countermeasures Administration and Dispensing • Non pharmaceutical Interventions • Mass Care • Public Health Surveillance and Epidemiological Investigation • Public Health Laboratory Testing Observations from each of these four focus areas was provided. A summary of these observations include: Primary Strengths: • Formation of the IMT prompted stakeholders to create their own incident management teams and formalize their process for sending and receiving information. • Stakeholders advised that the predictable cadence and information provided during meetings with the IMT were essential to their internal decision -making and information dissemination. • Multiple guidance documents were developed by the IMT that were comprehensive, relevant, and easily understood. • The Joint Information System leveraged existing platforms to project information to the public. Extensive efforts were made to ensure that messaging was developed specifically for populations that were traditionally difficult to reach. • Community stakeholders advised that although K-12 schools were receiving information from multiple sources, the IMT was key in synthesizing messages. Primary Challenges: Although the IMT addressed many strategic goals throughout the response, there was not a clear process for operational izing activities to meet the goals. The IMT concept did not appear to be understood by elected officials, which created challenges when attempting to shape public policy. Because the City of Dubuque had existing Public Information infrastructure, the primary information sharing activities originated from the City. Several stakeholders felt that there was a disconnect between the communication needs for the City and those of the County. Although there is a process in place for instituting public health countermeasures, several layers of legal, political, and procedural challenges prevented this from being done in an effective and efficient manner. The processes in place for opening a shelter for COVID-19 positive individuals became complicated when it became clear that the type of sheltering and the length of time that the shelter would be open was beyond the scope of the ESF-6 planning assumptions. The IMT is drafting an improvement plan based on these and the detailed observations. Areas of Improvement will include: • A revised Public Health Emergency Response Plan. Prior to the COVID-19 pandemic, the last time our plan was fully executed was in 2008-09, for the H1 N1 influence pandemic. Since that time, new technologies, capabilities, policies, partnerships, experience, staff, and knowledge have changed immensely. • Devise a method for assuring all stakeholders are aware of the role that the IMT serves during a response. • Develop a stakeholder and community communication system/platform to allow prompt notification and information dissemination. • Create standard operating procedures (SOP's) for isolation and quarantine orders, vaccination and medical countermeasure distribution, shelter operations, etc • Develop templates for Incident Action Plans and complete training for use • Regularly update Joint Information System (JIS) participants and train new members in JIS and public information emergency response • Develop a system for information sharing among stakeholders. • Develop internal IT platforms/methods for tracking local data and trends- facility /stakeholder outbreaks. • Assure equity in SOP's, communication, and planning. • Other improvements related to specific response observations. Looking ahead The IMT will take the next year to address these and other tasks and activities we include in Improvement Plan. Finally A heartfelt thank -you to all the Health Services Department staff, city staff and community partners who went above and beyond their normal duties to meet the needs of Dubuque during the pandemic. Thank you to the Mayor and City Council and city manager Mike Van Milligen for the ongoing support, confidence and direction. It is truly appreciated! THE CITY 4F Dubuque DUB E AI•Aler Ci[y ;,i 111, Masterpiece on the Mississippi' �p 7-2012-2013 �°°17*2019 2017+2019 TO: Mike Van Milligen, City Manager FROM: Randy Gehl, Public Information Officer SUBJECT: COVID-19 Communications Summary for After -Action Presentation DATE: April 14, 2023 INTRODUCTION The purpose of this memorandum is to summarize the COVID-19 public information efforts conducted by the City's Public Information Officer and Public Information staff in support of the Dubuque County Public Health Incident Management Team and the City of Dubuque Health Services Department. BACKGROUND At the onset of the pandemic, the City of Dubuque Public Information Office was enlisted to provide communications support to the Dubuque County Public Health Incident Management Team (IMT). All PIO staff assisted in these efforts throughout the pandemic with Public Information Officer Randy Gehl serving as PIO for the IMT. DISCUSSION Throughout the course of the pandemic, the PIO worked closely, often daily, with the IMT, especially with Public Health Director Mary Rose Corrigan and the executive director of the Dubuque County Health Department, to discuss messaging/outreach plans, get approval on announcements, strategize on responses to media inquiries, and more. Because the IMT approached the incident from a unified standpoint, the variety of Public and Stakeholder Information Management activities performed cannot easily be grouped into FEMA Capabilities and CDC Public Health Emergency Preparedness and Response Capabilities. Often, activities from both sets of capabilities were being carried out concurrently. Rather than linking observations to a specific capability, the After -Action Report grouped these activities into Focus Area 2: Public and Stakeholder Information Management. FEMA Capabilities: • Public Information and Warning CDC Capabilities: 1 • Emergency Public Information and Warning • Information Sharing The following is a very general summary of the public information/outreach efforts conducted by the City's PIO staff throughout the pandemic: Dubuque County COVID-19 Updates 586 COVID Updates issued between March 18, 2020, and Jan. 25, 2023. • Content of the updates was adjusted over the course of the pandemic but included: county -level data such new county cases, deaths, active cases, long- term care facility outbreaks, testing and positivity rates, variants, hospitalizations, and vaccination rates; testing information; vaccination access and guidance; statewide data; community levels and transmission rates; state and local proclamations; CDC alerts and guidance; and more. • Updates were sent by email and text to nearly 1,100 recipients at the peak of the pandemic. Recipients included all county and regional media and county elected officials and city clerks. The public was able/encouraged to subscribe. Over 800 subscribers when updates ended. • All updates were also shared on the City's Facebook, Twitter, and Nextdoor social media platforms. All videos were shared on those channels as well, in addition to CityChannel Dubuque and the City's YouTube channel. • Updates were issued daily from March 18, 2020, to April 23, 2021. • Updates were issued on Mondays, Wednesdays, and Fridays from April 23, 2021, to Aug. 9, 2021 • Weekly updates were issued from Aug. 11, 2021, to Jan. 25, 2023. Videos Between March 16, 2020, and Nov. 16, 2022, the PIO's Media Services staff produced 145 Dubuque County Public Health Incident Management Team video updates on the pandemic. All videos featured Public Health Director Mary Rose Corrigan who prepared her own remarks. Videos were produced almost daily for the first 3-4 months of the pandemic and the frequency was gradually reduced to an as -needed basis late in the pandemic. These video updates were aired on CityChannel Dubuque, streamed or posted on the City's YouTube channel and other social media channels, and included in the COVID updates. The videos were used to share timely, localized information presented in easy -to -understand language from a trusted, local public health official. The format of the video usually included informational graphics to support the message and occasionally featured humor or a holiday theme.\ COVID-19 Website Created and managed website to serve as the central repository for all COVID-19 information. Content included all county updates and videos, local testing options, local 2 vaccination options, FAQs, translations of key messages, community support and resources, and links to trusted information sources. This content was mirrored on the Dubuque County COVID-19 webpage. Campaigns & Materials Multiple outreach campaigns were conducted throughout the campaign to promote special messaging, such as masking and the "SleevesUp, Dubuque County!" vaccination campaign. In order to reach as many county residents as possible, multiple channels were used, including direct mail, countywide CodeRED phone calls, advertising in county print publications and on county radio stations, billboards throughout the county, posters and flyers distributed throughout the county, and social media. One mailer announcing the initial vaccine access details was mailed to all Dubuque County residents in January 2021 and another was mailed, after vaccine eligibility expanded, in May 2021. Flyers, posters, and signage were also produced by PIO staff and used to promote general guidance, testing guidance and availability, mask mandates, vaccination eligibility and clinics, and more. Joint Information System A Joint Information System (JIS) is a PIO function under the National Incident Management System (NIMS). The JIS "integrates incident information and public affairs into a unified organization that provides consistent, coordinated, accurate, accessible, timely and complete information to the public and stakeholders during incident operations." The City PIO established a JIS for the countywide response to the pandemic and facilitated the group. It included communications/marketing representatives from: MercyOne Dubuque Medical Center, UnityPoint Health — Finley Hospital, Medical Associates, Grand River Medical Group, Crescent Community Health Center, Epic Health & Wellness, Dubuque Community School District, Greater Dubuque Development Corporation, and Dubuque Area Chamber of Commerce. Information and resources were shared and discussed to increase message consistency and unity among entities and to address misinformation, joint statements/announcements were prepared, and joint marketing campaigns were developed and co -sponsored. Media Relations The City PIO facilitated all media inquiries and interview requests related to COVID from local, regional, and even national media. Requests were relayed to the IMT and the appropriate IMT member was then assisted in preparing for the interview, upon request. When possible, background information or answers to specific questions were provided to reporters by the PIO. 3 REQUESTED ACTION Please share this information with City Council as part of the Public Health Director's City Council presentation or as you see fit. CC: Mary Rose Corrigan, Public Health Specialist 11 � DUBUQUE CITY COUNCIL COVID49 � AFTER ACTION REVIEW Mary Rose Corrigan, Public Health Director April 17, 2023 0 • • r 1 u COVID-19 PANDEMIC 2020-2023 Levels of Community Transmission Over Time Updated March 13, 2023 Level of Community Transmission of COVID-19, by County, United States, 2020-Feb-01 Source, HHS Protect (CTE_county_timeseries, ACDC, CELR) Fel c J I " Centers for Disease Control and Prevention ArsDR Agency for Toxic Substances and Disease Registry 6.. 0 Q Level of Community Transmission W mmmmmow�� Low Moderate Substantial High Geospatial Research, � h, Ana Services Program Level of Community Transmission of COVID-19, by County, United States, 2020-Mar-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Mz On ♦0 Level of Community Transmission Low Moderate Substantial High Centers for Disease Control and Prevention aoop© Apt Agency for Toxic Substances and Disease Registry Geospatial Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2020-Apr-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) .: L.- 0 Q Level of Community Transmission Low Moderate Substantial High Centers for Disease Control and Prevention ®oop© A� AgencyforToxicSubstances x f , f� and Disease Registry Geospatial Research, Analysis and zC Services Program Level of Community Transmission of COVID-19, by County, United States, 2020-May-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) M� L.- 40 Q Level of Community Transmission Low Moderate Substantial High Centers for Disease Control and Prevention ®oop© f// Apt Agency for Toxic Substances x and Disease Registry Geospatial Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2020-Jun-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Jul t. oQ Level of Community Transmission Low Moderate Substantial High 41 Centers for Disease Control and Prevention ®oop© A� Agency for Toxic Substances x , f� and Disease Registry Geospatial Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2020-Jul-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Jul t- o Q a► +T "4�w#�fdil Level of Community Transmission Low Moderate Substantial High r r Centers for Disease Control and Prevention ®© CD © i , A � Agency for ToxicSu6stances x and Disease Registry Geospatial Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2020-Aug-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Au 6. 0Q 1 r. 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No data or Q o Level of Community Transmission Low Moderate Substantial High Centers for Disease Control and Prevention Mae =t '� CDC] ATSDR Agency for Toxic Substances and Disease Registry Geospatial Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2022-Apr-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Level of Community Transmission ow Moderate Substantial High MaeCenters for Disease Control and Prevention CDO ATSDR Ag Diseasncy fore Reg stry Substances and Disease Registry Genspatial Research, Analysis and z Services Program Level of Community Transmission of COV[D-19, by County, United States, 2022-May-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) M� Centers for Disease Control and Prevention CDCj ATSDR Agencyfor Toxic and Disease Registry m oQ Level of Community Transmission .Mmmmmi�� Low Moderate Substantial High No data ®L .film Geospatiai Research, Analysis and Services Program Level of Community Transmission of COV[D-19, by County, United States, 2022-Jun-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Jul CCenters for Disease Control and Prevention DCATSDR Agencyfor Toxic _ j and Disease Registry M 0 Q Level of Community Transmission .Mmmmmi�� Low Moderate Substantial High No data ®Leja® Geospatiai Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2022-Jul-01 Source: NHS Protect (CTE_county_timeseries, ACDC, CELR) Jul Cnters for Disease Control and Prevention e CDC to ATSDR AgencyrToxicSubstances ? J!:5�.._'r _I and Disease Registry Level of Community Transmission i Low Moderate Substantial High No data Mae pm Geospatial Research, Analysisand Services Program Level of Community Transmission of COV[D-19, by County, United States, 2022-Aug-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Au Centers for Disease Control and Prevention CDC' ATSDR Agency for Toxic Substances and Disease Registry M oQ Level of Community Transmission .Mmmmmi�� Low Moderate Substantial High No data ®Leja® Geospatiai Research, Analysis and Services Program Level of Community Transmission of COV[D-19, by County, United States, 2022-Sep-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Sel Centers for Disease Control and Prevention CDC1 ATSDR Agency for Toxic Substances and Disease Registry L. oQ Level of Community Transmission .Mmmmmi�� Low Moderate Substantial High No data ®Leja® Geospatiai Research, Analysis and Services Program Level of Community Transmission of COVID-19, by County, United States, 2022-Oct-01 Source; HHS Protect (CTE_county_timeseries, ACDC, CELR) LOC On Op *.f Level of Community Transmission Low Moderate Substantial High No data .. ®©®�M Centersfor Disease Control and Prevention $ D ATSDR Agency far Toxic Substances Geospatial Research, Analysis and e ri-:. and Disease Registry Services Program Level of Community Transmission of CQVID-19, by County, United States, 2022-Nov-03 Source: HHS Protect (CTE_county_tirneseries, ACDC, CELR) Nov Centers for Disease Control and Prevention ATSM Agenryfor Toxic Substances t 44 and Disease Registry 6. I Q Level of Community Transmission Low Moderate Substantial High No data ® Am Geospatial Research, Analysis, and Services Program Level of Community Transmission of CQVID-19, by County, United States, 2022-Nov-30 Source: HHS Protect (CTE_county_tirneseries, ACDC, CELR) Nov Centers for Disease Control and Prevention ATSM Agenryfor Toxic Substances t 44 and Disease Registry 6. • R«�"�ir,�N'ri it t► Level of Community Transmission Low Moderate Substantial High No data Mae Am Geospatial Research, Analysis, and Services Program Level of Community Transmission of CQVID-19, by County, United States, 2023-Jan-04 Source: HHS Protect (CTE_county_timeseries, ACDC, CLLR) Jant- V� Centers for Disease control and Prevention CDCAT$DR Agency for Toxic Substances and Disease Registry C1 �► �t 'f4�t';* Level of Community Transmission Low Moderate Substantial High . No data Geospatial Research, Analysis, and Services Program Level of Community Transmission of COVID-19, by County, United States, 2023-Feb-01 Source: HHS Protect (CTE_county_timeseries, ACDC, CELR) Febi Centers for Disease Controi and Prevention Cdt] ATSDR agency for Toxic Substances and Disease Registry O0 Level of Community Transmission Low Moderate Substantial High =11 No data ® pm Geospatial Research, Analysis, and Services Program Level of Community Transmission of COVID-19, by County, United States, 2023-Mar-01 Source: HHS Protect (CTE_county_tfineseries, ACDC, CELR) Centers for Disease Control and Prevention ATSM Agency for Toxic Substances 0� and Disease Registry 6— I Q • t4��j�T �s1���*� ... ti' Level of Community Transmission Low Moderate Substantial High No data ®�pam Geospatial Research, Analysis, and Services Program Level of Community Transmission of COVID-19, by County, United States, 2023-Mar-01 Source: HHS Protect (CTE_county_tfineseries, ACDC, CELR) Centers for Disease Control and Prevention ATSM Agency for Toxic Substances 0� and Disease Registry 6— I Q • t4��j�T �s1���*� ... ti' Level of Community Transmission Low Moderate Substantial High No data ®�pam Geospatial Research, Analysis, and Services Program APRIL 5, 2023 e LEGEND X Law Moderate Substantial High Mi�xica Cwdad . oir e.Bahamas Cti b,i Republica raC14 IIIYIf.i1: � w COVID- 19 UPDATES -LOOKING BACK States Reporting Cases of COVID-19 to CDC" March 20, 2020 March 2, 2020 People Being Monitored by Ptihlic Health Asymptomatic (no symptoms) 5 Symptomatic (with symptoms) & being tested 0 Completed public health monitoring 139 COVID-19 Testing in Iowa Positive ------------ a Negative 3 Rending � 7 Total 15 Monitoring began F-ebruary 3, 2020, In mmordknee wkh morn rnendations from the Pre%edanf% Task Force orr Cororraklru#. in e> 47�p- I I I KNA 1 I 0 NP GAVEL NOTICI 2019 11 n l.-4fM - CURONAVIRUS H EA LT H A L E RT: Travelers from China There is an outbreak of respiratory illness in China. up to 14 days after leaving Ch in a. "A,4. -i RAY 1r� �~�Fr-. 7 Travelers should stay home and monitortheir health within Y this 14-day period. ,A, "`mot':; A health official will contact you to gna'ive additionai instructions.f`` 04 i .. Take your temperature with a thermometer 2 times a day and watch your heal. If you develop a fever (1 00.4" Fl38"C or higher), cough, or have difficulty breathing: # - Call your health department for advice before seeking care. - If you can't reach your health department, call ahead before going to a doctor's office or emergency room. • Tel them your symptoms and that you were in China. ; o ' M For more information: J� +ti. www.cdc.gov/nCoV 61010.4 =*] :a ■ =• Response Coordination and Logistics Public and Stakeholder Information Management Public Health Countermeasures and Vaccination Congregate Populations and Equity RESPONSE COORDINATION &LOGISTICS INCIDENT MANAGEMENT TEAM (IMF ity of Dubuque Health Department ity of Dubuque Public Information Officer Dubuque DUBUQUE COUNTY PUBLIC HEALTH IMT 4 Dubuque VNA i Mary Rose Corrigan City Health Services o * ngr Tom Berger Emergency Mgmt. Samantha Kloft County Health Dept. V i Dubuque Countywide Response to Coronavirus (COVID-19)10 " Allie White County Health Dept. RESPONSE COORDINATION &LOGISTICS STRENGTHS I MT formation Stakeholder briefings Operational izing strategic goals COVID-19 Roadmap for response, COOP, and logistics and supplies CHALLENGES I MT misunderstood • EOC action planning • Policy maker involvement • City / County governmental synchronization �r SiQP HERE FIRST aApalf¢nlsmdm Le sCe(eld AlfEes AIM � DUBUQUE COUNTY COVID-19 CASES TO DATE 10,000 9,000 Nov. 8,000 N f. 7,000 NIS. 6,000 M8v. 5,000 4,000 Oct. r 3,000 1 virus -related Reflections in the z,000 4 deathsi area L ' Park setting up 1,0000 i Vf " otio otio otio o�.�U ly otio 300 otio otio otio 3�tih\� o�tih\� 4f h\� 14��ti h\� extih\� yo\yh�ti yy\yy�ti TELEG ERALD HIRM #S' Low M' Coow YMs M Iw of ,Y'St.rr W � � kW4i1716hF 1Li4M . DIJdI�M Health professionals sound alarm Tm�°wa '' 0 CIA ID-19110spit l zatims.. hake (I(nll)ivtl ill a 111olill) w1w0PP"wqIftwwMM" �11�I171LIiLiM11�lY� Ajinrdlrir�.f.�J •Rr..w.«.«�.r.�rFp. �*F*d,i71.r.M� f_ �� I«._wMk�xn■ �...�-+.+l...w.r�+r..+h w�i�1l.�rr,l+.i�?a� '— 1hMI rAwW W444 CInlh 11' "34 Ihr lh.air -Thm LuliL* atI a6m J # lY.i. �frrMll r�•Fw.l r..w leyl.rw� rtlYrI.- Wm?t. h 4,.�:dnrt wl iwrd 4 , .... w PM -.n j +. .w ��,rr T*04" ft U-M Pr 19 illw�M r■ Ya 1.Ye Ors Yrr e.vSli#i y'#.�L � . V . , µarLr•eM y.,!� rw i 11ra1+6 E 4W*W %U&i..ft.4 �.r#d ihir.p/f = M. •�� . .�iI..IFf, II�.r �SII.LH .f{_hwr „r� '11MM� }�. W4�iF �+'Ar nrr.FJrW`#r�l�lf#*IMR� 4A!}r! �MM.4 OIL TI n ri w•a w W ar i.wJr F.Sd M,�}.Ir, Y�FiR Ciir•.r�Y iY�ir�Yr�13 �. LrYiR10 1Pu! r� w....... ,_ � r.r.ww�w i++ ` war k n4�.Ywr.�lir' ir.lwruw+i Y►rrw. F W#W N •r wW1 Y �M.MR� "0P 6w*Iw ird .Y.+a wbh �r rl rYilr�a#Fr. t. m raa—rr*�41f Tr+ +f of*.R#*+4 r.w�a�wJ uMrr +w}tl Frryr F Ir wr* rYa � rr.6WRO W.M aw M DNM&w G won Y. +.wM��4 �#+��� Ir iRUir �i# .,."OWMIL PAU it DUBUQUE COUNTY RESIDENT COVID=19 HOSPITALIZATIONS SEPT. 1 - NOV. 165 2020 57 9/1 /20 9/8/20 9/15/20 9/22/20 9/29/20 10/6/20 10/13/20 10/20/20 10/27/20 11 /3/20 11 /10/20 PUBLIC & STAKEHOLDER INFORMATION MANAGEMENT • Regular, consistent information presented to key stakeholders Challenge of whom/how to inform first • Complex information presented in an understandable format Challenge of conflicting data • Joint Information System education needed Friday, July 10, 2020 DUBUQUE CITY COUNCIL COVID49 COMMUNICATIONS & (4 OUTREACH SUMMARY Randy Gehl, Public Information Officer 410 0 • • r 1 u COVID= 19 PUBLIC INFORMATION & OUTREACH Dubuque County COVID=19 Updates 586 COVID Updates issued between March 18, 2020, and Jan. 25, 2023. Daily updates for first 13 months, then 3 times per week, then weekly. Sent to nearly 1,100 recipient by email and text • All updates posted to social media COVID= 19 PUBLIC INFORMATION & OUTREACH IMT Video Updates 145 videos produced between March 16, 2020, and Nov. 16, 2022. Produced daily and broadcast live, Monday -Friday, for the first 3-4 months Aired on CityChannel Dubuque, streamed or posted on the City's YouTube channel and other social media channels, and included in the COVID updates. ��(. Wed., Septlk,2d22 `�� ,\ SLEEVAP!S � —.. y► 'i u I ..- Sk iue Countq�e�ide Response to L Aronavirus (COVID-19) huque Countywide Response to r Coronavirus (COVID-19) ; For more information on COVID-19 vaccines and boosters, visit www.cdc.gov/coronavirus/vaccines COVID= 19 PUBLIC INFORMATION & OUTREACH Campaigns & Materials • Direct mail, countywide CodeRED phone calls, advertising in county print publications and on county radio stations, billboards throughout the county, posters and flyers distributed throughout the county, and social media. Or _ 2, Varerea hied uo1<vllmio.rlew q�rxllq ds[<Ihl,M1r Impel If illness« IiMe •m pa p91...... Il hod mavv Vaccines are key to fighting COVID-19 illnesses, hospitalizations, and deaths. «yIlTh.w MIIMAwwMw MAN- �Wys. s� »YACCINESARENDI 177 AVAILABLE FUR IRE CERBAI PVII IC<c NEED A COVID-19 TEST? =ateXL FREE AHOME COVID-19 TEST PROVIDERS: e«Iw �ww. Phll-WhrnPwrR w.i.lr.rtmr FREE IN -PERSON COVID-19 TEST IN9 OPTIONS: 21IO 19 RAPIII TEST OPTIONS COVID= 19 PUBLIC INFORMATION & OUTREACH Joint Information ^vstem "...integrates incident information and public affairs into a unified organization that provides consistent, coordinated, accurate, accessible, timely and complete information to the public and stakeholders during incident operations." • MercyOne Dubuque Medical Center, UnityPoint Health - Finley Hospital, Medical Associates, Grand River Medical Group, Crescent Community Health Center, Epic Health & Wellness, Dubuque Community School District, Greater Dubuque Development Corporation, and Dubuque Area Chamber of Commerce. COVID= 19 PUBLIC INFORMATION & OUTREACH Media Relations Facilitated all media inquiries and interview requests related to COVID from local, regional, and even national media. Requests were relayed to the IMT and the appropriate IMT member was then assisted in preparing for the interview, upon request. When possible, background information or answers to specific questions were provided to reporters by the P10. MIXED MESSAGES GALORE immunity reinfection food-sprea d `ema data masks microchips six -feet hesitancy r jab fauci r • AsobL atIUH mrna vari ant sauna e�myocarditis inconsistencies �� fertility cleaning cdc r conspiracy ivermectin gloves mandate S PUBLIC HEALTH COUNTERMEASURES & VACCINATION STRENGTHS Coordination with local health care/comprehensive info Testing, vaccination and treatment information services accessible Guidance & policy information disseminated widely CHALLENGES • Rapidly changing information allowed little time for prep Legal issues, conflicting policies, enforcement of policies and guidance Rollout of vaccine/vaccine supply POD SITE COVID-1 9 VACCINATION CENTER ENTRANCE ENTRADA AL JIKIN - CENTRO DE DRELAN NAN VACl1NACI0N a� WA IN COVID-19 ��avo�E� COVID-19 APPOINTMENT REQUIRED. NO WALK-INS. ONICAMENTE CON CITA PREVIA. RI -APPOINTMENT MT. No appointment? Your healthcare provider or employer will contact you when you are eligible to be vaccinated. E FEDERAL GOVERNMENT FEEiERALLY QLIALIFkED LONG TERM WALGREENS HEALTH CENTERS QPERATI4N: y CARE FACILITIES Limited surplusdoses fur cFQH�I WARP SPEE❑ walpernsl�vsllan.&Ped.l 65+,Dubuque locations4 Contingent fln Supplies STATE L!F IOWA FE€1ERAL RETAIL mw<ao�.ofPumicllra�th PHARMACY PROGRAM . Crescent Community - - Health center CpUNTIES Dept. Local P�hllc Heahh IIMTj As supplies increase CVS, Hartig, Walgreens, HyM-0 puhuque County CPSEN Walmart, etc. SLEEVES Vaccine Providers UP! www.dubuquecounty.org/covidl-,., A TESTING Symptomatic Asymptomatic and Antigen (+) Antigen {-)1 Close Contact with COVID-191 j Antigen (+)° Antigen ()5 Confirm by NAAT' NAAT (+) NAAT(-} Confirm by NAAT' NAAT(+) NAAT() Known Contact?' Yes No Infected with SARS-CoV-2' No current evidence of infection10 JLi Asymptomatic and No Known Exposure' Antigen (+) Antigen (-)d Confirm by NAAT' NAAT i+) NAAT (-) Not Infected with SARS-CoV-2 - �.. �- 4M PUBLIC POLICY ■ City of Dubuque Emergency Declaration March 16, 2020 ■ Updated 6 times Iowa Governor Declaration March 9, 2020 ■ Updated 40 times FACE COVERING REQUIRED City ordinance No. 31-20 Title 6 requires everyone three years old and older within the Dubuque city limits to wear a face covering i when n public, with some exceptions. THE L'!"I'Y LIF _ DuB � E Maslerpiece on the Mississippi ❑� ' ❑� www.City0f0ubuque.org/COVIB19 ML. pia12-080720 610 lei N arc A 0=1101151 WA 0 lei 0 WIT: 0 E Isolate and take precautions if you have or suspect you have COVID-19 Stay home and away from others Isolate to day 6 u ° Wear a hgh.quahty mask d you must be or later, if you around other never had symptonts0r iI '� symptoms arc Improving, and ea Start counting days are fever -free for 24 hours without the Day On the day your symptoms started O 1 2 3 4 use of fcveweducing medication 5 6 1 8 9 10 N If you never had symptams, day 0 is the day you took a COVID-19 test It e s so 0 so Continue to isc iale if your fever persists or '1111 0 ` other symptoms have nat improved ESeek Watch for emergencywaming signs, like trouble breathing Isolate through day 10, ifyouexperwriced moderate illness, like shortness at breath m help if they develop difficulty breathing Isolate through day t0andtalltwich a Until at least day 11, avoid being around healthcare provider people who are more likely to get very sick beforeyou and Wear high -quality maskvhten around 7 Isdauon, dyW �. others indoors were hospitalized or • haveaweakened immune system Removing your mask After ending isolation, wear your mask through day 10 ' OR N take anttests re negative, hours apart , If both tests are negatire, you may remove your mask wane, than day 10 cdc.gov/coronavirus SHELTER OPERATIONS FEB — JUNE 92021 CHALLENGES Staffing Transportation Food Security Compliance Mai ntenance/cleaning Oversight Information to healthcare providers SUCCESSES Referral system Shelter operations manager Food deliveries- Fire Dept VNA daily checks, cleaning, laundry Transportation Security cameras/intercom Higher Education PARTNERSHIPS PAY OFF COMMUNITY FOUNDATION of Greaser Dubuque l # f ]Epic Health 04 Greater DubuqueCID IR1, nusuc�`� CHAMBER, Wellness MEDICAL ASSOCIATES UnityPoint Health Finley Hospital 1000 Grand River MEDICAL GROUP T Crescent Community HEALTH CENTER THE CITY OF L E D U Masterpiece on the Mississippi lVirrc.RCYONE Community Transmission of All Counties in US APRIL 12, 2023 e Community Transmission in US by County Total Percent % Change ' High 888 27.S6% - 3.29% ' Substantial 581 18.03% - 3.54% Moderate 1268 39.35% 2.92% ' Low 485 15.05% 3.91 % How is community transmission calculated? • High Substantial Moderate 0 Low 0 No Data Wed Apr 12 2023 13:53:06 GMT-0500 COVID- 19 mandatory reporting ends March 31, 2023 Testlowa continues Wastewater testing available DOMO dashboard and COVID-19 data discontinued Medicaid Continuous Coverage ends https://hhs.iowa.gov/ime/unwind LOOKING AHEAD Sentinel respiratory disease monitoring Updating plans Exercises & Drills Improving capabilities Iowa H HS weekly epi report Respiratory Virus Surveillance Influenza COVID-19 Others Incidence/trends Hospitalizations Deaths '.1 l Dubuque Countywide Response to Coronavirus (COVID-19) i THE CITY OFR T 8u Mnsferpiece on Ike Mississippi r •"'�U�U^�`EC/GCOi11iN�r■TYr 0 THANK YOU! IMW � • elah, 0 • • r 1 u