Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Community COVID-19 Update & Communication
Copyrighted April 22, 2020 City of Dubuque Work Session - Bottom # 2. ITEM TITLE: Community COVI D-19 Update & Communication Response SUMMARY: • Mary Roses Corrigan, Public Health Specialist • Tom Berger, Dubuque County Emergency Management Coordinator • Kelly Larson, Human Rights Director • Jerelyn O'Connor, Neighborhood Development Specialist • Mark Dalsing, Police Chief (Community Safety & Enforcement) SUGGESTED DISPOSITION: ATTACHMENTS: Description Public Health Specialist Update Human Rights / Neighborhoods - Vulnerable Populations Report Attachment 1A Handout disinfecting -your -home English Attachment 1 B Handout_disinfecting-your-home Marshallese Attachment 1C Handout disinfecting your home Spanish Attachment 3 C OV I D 19-W hat -You -Can -Do -High -Risk Attachment 4 10 Ways to Manage Respiratory Symptoms at Home Attachment 5 Preventing the Spread if You are Sick Attachment 6 Final Self assessment form for shelters and SROs Attachment 7 Final Medical Provider Shelter Referral Form Attachment 8 Final Self assessment form for people who are sick Final Quarantine Shelter Plan Type Staff Memo Staff Memo Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Supporting Documentation Masterpiece on the Mississippi Dubuque kard AII•America City NAI rntl 11111,1 2007*2012.2013 2017*2019 TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Specialist SUBJECT: COVID-19 update DATE: April 15, 2020 CURRENT 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 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. 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. • Current Cases • Joint Information System is lead by PIO Randy Gehl - the JIS coordinated a media conference on March 30, 2020 of Mercy, Finley, MA and GRMC to discuss their preparedness and surge activities as requested by the Mayor and supported by the BOS. In addition, the JIS has coordinated responses to requests from the TH and other news media and provided daily COVID-19 specific media/news releases. I am giving regular updates at every city council meeting, and on other days, Facebook live updates • Changes in Communicable disease follow up for COVID-We are preparing a community testing site. — goals etc • The guidance from our incident management team and from the IDPH and CDC will continue to change, based on new cases, the number of cases and the ongoing epidemiological data and investigations in Iowa and the U.S. Changes/new guidelines • Governor Kim Reynolds guidance and information • RMCC information • Housing issues and homeless isolation and other human service needs covered by Kelley Larson • PPE requests, donations, sourcing products — Tom Berger, EMA, will cover • Guidance for food establishments in Dubuque: Health Services Dept prepared and distributed specific guidance for food establishments (mainly grocery stores) on facilitating social distancing within their stores. • Long Term Care status and planning • Community Test site guidance What you can do now • Continue to stay home as much as possible • We need to re-emphasize handwashing • Limit trips to grocery stores and for other necessities — for example, once a week at the most • Utilize curbside pick-up, carryout and delivery • Practice social distancing • Strictly follow self -isolation practices. If you are not sure whether you've been exposed, start self -isolating anyway. • Follow the 3 C's • Continue to seek and utilize factual information from the city of Dubuque, IDPH and CDC websites and postings. Masterpiece on the Mississippi Dubuque krirkzi AA•A.eriesBia 111, 2007.2012t2013 2017*2019 To: Michael C. Van Milligen, City Manager From: Kelly Larson, Human Rights Director Jerelyn O'Connor, Neighborhood Development Specialist Date: April 16, 2020 Subject: Week 5 COVID-19 Update: Vulnerable Populations The purpose of this memo is to summarize work being done to coordinate meeting the needs of our community's most vulnerable populations during the COVID-19 pandemic. This memo will provide specific information on the activities of the last week and general summarized information on activities since the last City Council work session on COVID-19 on March 25, 2020. Background and Overarching Structure: Dubuque has a "COAD" (Community Organizations Active in Disaster) that has been engaged in planning and preparation well before this incident. The COAD is co-chaired by the Community Foundation of Greater Dubuque and the United Way of Dubuque Area Tri-States. These two organizations are the overarching organizations who are coordinating the COVID-19 identification of needs and resources amongst non-profit institutions. Human Rights Director Kelly Larson and Neighborhood Development Specialist Jerelyn O'Connor are the City liaisons to these institutions and are participating in weekly conference calls hosted by United Way. In addition, the Human Rights Department is coordinating an Equitable Emergency Management Committee that is tasked with keeping lines of communication open with neighborhood leaders and community leaders in various underrepresented communities that may not be directly connected to specific non-profit organizations or that may be fearful of accessing services. The Dubuque County COVID-19 Emergency Response Team directs the response to the pandemic. The Housing and Human Services Support Function supports housing and human services needs that arise during the pandemic. Human Rights Director Kelly Larson, Neighborhood Development Specialist Jerelyn O'Connor, United Way President/CEO Danielle Peterson, and Community Foundation of Greater Dubuque President/CEO are serving as support for the housing and human services functions for the Emergency Operations Center. The Housing and Community Development Department is coordinating needs related to reducing spread among homeless populations and doubled up/multigenerational families living together. Week 5: April 13-17, 2020 Resources and Actions: COVID-19 Disaster Relief Fund Community Foundation of Greater Dubuque The COAD established this fund with the CFGD managing the fund as the fiscal agent. Funding commitments as of April 15 were at $1,007,960 and $402,640 has been granted out. To date, the Disaster Relief Fund has received 32 applications for a total of $730,036 in requests. This week, 5 additional grants of a total $100,440 were recommended for funding and are detailed below. The committee will continue to do some fact-finding and further discuss other applications next week. The current focus is on reducing the economic and health impact on vulnerable populations. Organization Funds Used For Duride $10,000 Provide delivery services for their members and partnering agencies Presentation Lantern Center $10,000 Food pantry for immigrants in partnership with VIATS Resources Unite $20,000 Support for their rural food Pantries River Bend Foodbank $50,440 Meal boxes in both Dubuque and Jackson counties Salvation Army $10,000 Funds for their direct assistance and food pantry Since the Disaster Relief Fund was activated, grants were also made to Dubuque Rescue Mission, Dubuque Area Labor Harvest, Boys and Girls Club, Resources United, Salvation Army, Hillcrest, Legal Aid, Catholic Charities, VNA, YM/YWCA, Food Pantry, ECIA, Cascade Food Pantry and Rural food pantry, Dubuque Dream Center, First Congregational Church, Project Rooted, St. Vincent De Paul, Substance Abuse Services Center, Mount Pleasant Horne, Convivium, Dubuque County Early Childhood, Crescent Community Health Center, MercyOne, Riverview Center, Habitat for Humanity, United Way, and YWCA Clinton. CFGD is being mindful of partnerships as the most efficient and effective way to ensure that limited funds are distributed wisely. CFGD CEO Nancy Van Milligen wrote ": I want to make 2 sure you understand we are not just doling out money - we are taking a systems wide approach to solving problems and granting in the best and most efficient way possible. This will be important as the long term impact of the corona virus is imminent." The United Way and Dubuque Community Foundation have also initiated a regular conference call with all the providers of food resources. The COAD is addressing the immediate need of food access but is also looking at a longer term strategy of food access issues. Again, CFGD Nancy Van Milligen wrote "The focus right now is basic needs: food, shelter, health and safety. As you can see from the list the majority of grants have gone to feeding families. As you might expect, our communities have never had to feed these vast numbers of folks. Also, the uncertainty of how long we will be feeding people and the number of families that will continue to be added is a concern. How can we make sure that we are spending our dollars efficiently and effectively and, using an equity lens, reaching the people with the most need." CFGD is also partnering with Creative Adventure Lab to offer free assistance to non-profit organizations on operational needs. Additional Support for Non -Profits Delivering Disaster Relief Services United Way Weekly conference calls are hosted by United Way with local non-profit agencies and representatives from the CFGD and the City of Dubuque. The goal of the calls is to streamline communication between human service provider agencies, ensure collaborative and effective use of resources, and collect information on service changes so that the 211 system remains up to date. This information is posted weekly on the United Way website and distributed through social media. https://dbqunitedway.orq/resources-covid. In mid March, United Way conducted a survey of local non -profits on the status of their operations and what their clients are reporting. 40% closed some or all programs and another 30% in process; reaching out by phone to families have contact info for. Top needs lost wages for nonprofit staff and people serving; food access; childcare; adequate supplies for cleaning and safety; adequate COVID19 info overall. Statewide, the 211 system has quadrupled their staff to deal with the pandemic. They have added 10 mental health professionals and 10 medical professionals to better serve the clients who are calling for assistance. Their statewide call volume has increased from 2,000 calls to approximately 20,000 calls monthly. It is crucial that all human service provider agencies share any updates on their services with United Way/211 so the client can best be served with accurate and up-to-date referrals. United Way has received a shipment of 211 posters in English and Spanish and are awaiting posters in Marshallese. They have distributed them for posting at local non- profits. Stickers have been distributed for placement on containers for distribution 3 through meal sites. This is being done to not only spread the word about 211, but also because thee trusted sources may be more effective in encouraging people to contact 211 when needed for assistance. Information about 211 also was included in three languages on the park playground signs the City placed. United Way also stressed the availability of volunteers through their Get Connected site on the United Way website. Non profit organization can utilize this site to advertise their needs for volunteers. Refugee Alliance of Central Iowa (RACI) and Lutheran Services in Iowa in partnership with 211, Polk County Health Department and IDPH have launched a new hotline that will help expand access to capacity of Iowans who are limited in English. The Iowa COVID-19 ELL Help Line (877-558-2609) has interpreters available in several languages 8:30-5:00 and a 24 hour voicemail. United Way has responded to multiple requests submitted from our outreach to community members through non-profit organizations and our Human Rights Department networks: • Food Sites o Multiple food distribution sites throughout the community. Information available in English, Spanish, and Marshallese at https://www.dbgschools.org/coronavirus-information/food-resources/ and https://dbqunitedway.org/covid-19-community-resources#resources o Food delivery - volunteers at Project Rooted and Resources Unite can deliver currently, but may need more volunteers if need increases. Salvation Army and DuRide partnering for delivery of meals to those in self -quarantine. o Iowa Department of Human Services increased April and May food assistance benefits, suspended work requirements, and automatically recertified for six months all families whose certification was due to expire in March, April, or May. o United Way has been able to obtain access to milk and protein to help address some of the shortages food providers have identified. • Unemployment and Small Business Support o Employees impacted by COVID-19 closures can and should apply for unemployment benefits online here: https://www.iowaworkforcedevelopment.gov/file-claim- unemployment-insurance-benefits o Iowa Workforce Development COVID-19 site — constantly updated: https://www.iowaworkforcedevelopment.gov/updates-and-resources-about- covid-19 o Dubuque County received approximately 2,700 applications for unemployment this past week. 4 o CFGD and Creative Adventure Lab have partnered to provide free financial coaching to non -profits needing assistance with planning for continued operations. o Information to support non -profits and small businesses in accessing employer benefits for their continued operations. Greater Dubuque Development Corporation and Northeast Iowa Community College have launched as service for business owners/non-profit CEOs. Call (563) 588- 3350 between 8:30 a.m. — 4 p.m., Monday through Friday, or email at sbhelpline©nicc.edu. To date they have fielded well over 200 calls. Dubuque Initiatives is providing gap funding while businesses await federal funding and/or for special circumstances not covered by federal funding. o This page has information on FEMA non-profit assistance. https://dbqunitedway.org/resources-covid • Housing (general) o Housing providers who need interpretation assistance to communicate with non-English speaking renters can call housing hotline. Information on how to use the hotline is available here: https://iowainternationalcenter.org/local-resources/housing- interpretation/ • Housing (shelters for safe self -quarantine) o Since mid -March, Housing and Community Development Director Alexis Steger and her staff have been in close contact with our local homeless shelters regarding COVID-19. In mid -March, they conducted disaster surveys of the shelters and assessed current needs. They also provided shelter staff with guidance from the Centers for Disease Control on controlling spread in group quarters. See https://www.cdc.gov/coronavirus/2019-ncov/community/homeless- shelters/plan-prepare-respond.html. On March 23, the City Council approved $200,000 in Community Development Block Grant funds for temporary shelter needs. o We have the option for self -quarantine shelters for people who are positive of presumptively positive for COVID-19 and are homeless, living in shelters, or unable to isolate at home due to cramped living quarters or living with someone who is at high risk. The shelters are for individuals who are not symptomatic enough to require hospitalization. The detailed plan for Self -quarantine shelters is an attachment to this document. o As a backup to the City's shelter, a request was made on the weekly non- profit conference call to consider whether any of the non-profit organizations are interested in operating an isolation shelter. It was also noted that additional volunteers may be needed to help staff a facility. An appeal also went out to the Dubuque Area Congregations United, the Ministerium, and the women religious organizations to determine if any of those faith communities had facilities or volunteers to assist with this effort. These efforts are being pursued as a backup in the event that need exceeds City capacity. 5 • Legal Assistance for COVID-19 Related Issues: o Iowa Legal Aid Hotline: This is a call-back hotline. Callers will receive a call back from experienced Iowa Legal Aid staff to go through a screening. Callers who meet Iowa Legal Aid's guidelines will be connected with an Iowa Legal Aid attorney; those who are outside of Iowa Legal Aid's guidelines will be connected with a volunteer attorney through The Iowa State Bar Association and the Polk County Bar Association's Volunteer Lawyers Project. Language assistance is available, including in Marshallese. o Iowa Legal Aid is posting legal updates related to things like evictions here: https://www.iowalegalaid.org/resource/2020-coronavirus-outbreak- what-you-need-to-know • Academic and Social/Emotional Support for Students o Dubuque Dream Center and St. Mark Youth Enrichment are supporting their families with academic and social/emotional resources. • Brain Health o The mobile crisis unit remains operational 1-855-800-1239 and telehealth options are available. o Catholic Charities counselors doing telehealth and also posting "mental health minute" videos on social media. o Mental Health American is working to identify and address barriers that those who are not tech saavy, lack equipment, or are hard of hearing are facing in accessing telehealth. • Domestic Violence o The Dubuque Community Y domestic violence shelter is full, though they have some individuals ready to move out needing assistance with deposits. Catholic Charities and Salvation Army collaborating to address to open up space. They have also requested that we assist in spreading awareness of the domestic violence hotline. • Community Development Block Grant Funds o The City received $647,000 in Community Development Block Grant funds under the federal emergency funding package, which are the subject of a Community Development Advisory Commission meeting on Tuesday, April 21. • Volunteers o United Way has 4,500 volunteers on their Get Connected site, many of whom are anxious to assist. Non-profit providers simply need to post what is needed and how it can be accomplished consistent with social distancing. Reaching -In to Impacted Families and Communities • Direct contact with families o Several non -profits who have contact information for the clients they regularly serve are contacting them directly to check in. 6 o Presentation Lantern Center is regularly in touch with approximately 25 immigrant and refugee families and will be pursuing a grant to meet needs identified among this population. o The City of Dubuque Housing Department has reached out directly to families served by their rental assistance, Gaining Opportunities, homeownership and rehabilitation programs. • Equity in Awareness & Access o The Human Rights Department (HRD) has been supporting the work of the Public Information Office by ensuring that messages from the Dubuque County COVID-19 Emergency Response Team are translated into Spanish and Marshallese, utilizing two individuals who have a history of performing translations for the City of Dubuque. As of April 13, we are no longer translating this updates and are instead prioritizing translation of documents identified by our Marshallese community leaders as needed, such as information that assists with self -isolation and home cleaning. o HRD staff have been actively contacting bilingual and multilingual people, collecting e-mails and phone numbers for community members who speak the following languages in addition to English: Spanish (8), Marshallese (4), Mandarin Chinese (3), Arabic (1), Japanese (1), American Sign Language (1). Most of these individuals do not have certifications as translators or interpreters, though a few of them have a fair degree of experience. One has experience with medical interpretation in Spanish. Many of these individuals are also serving as a source of information for needs within the various language communities in Dubuque. o Currently, the HRD is utilizing their $7,000 line item for equity activities to pay for these translation services and is tracking the information for potential reimbursement under the federal disaster declaration. o We continue to investigate which resources in our community can or cannot be accessed by undocumented residents. Thus far, we have verified that the majority of the food resources are available without documentation, and this information is included in the basic food and necessities list on the United Way site. These lists have been translated into Spanish and Marshallese and shared through our equity networks. Multiple one -page lists of translated resources available through trusted sources including the Iowa Department of Public Health, the Centers for Disease Control, and the Marshallese Education Initiative in Spanish, Marshallese, Chinese, and Arabic are being distributed through our local community networks. o In addition to phone calls, e-mails, and virtual meetings with community leaders within underrepresented communities, the Equity Immersion Team is employing a social media strategy. Our Community Engagement Coordinator has cultivated a very diverse network of over 1500 people and has leveraged his personal network to increase the Human Rights Department's Facebook page following. He focused on engaging people with influence, connecting effectively with 85-90% of those he intentionally seeks to reach. He is successfully actively engaging an average of 15 7 people per post, with 5-15 influential people sharing his posts within their networks. o We have increased our use of Notify Me, reaching out in particular to people who have offered interpretation and translation services with a request that they subscribe to our list or permit us to add them. The Human Rights Department also released a media statement to ensure that community members are aware they can continue to contact us and that we are continuing to attend to civil rights and bias concerns. o Information from the Centers for Disease Control on how best to quarantine and keep a home clean has been translated and distributed in Marshallese and is available in Spanish. Regular contact continues with members from the Guatemalan population to address similar concerns. The biggest challenge we are facing is that the guidance regarding self - quarantine is particularly difficult to follow for families living in small units with multiple family members on a limited income. Consequently, we continue to work closely with the Housing and Community Development Department on quarantine shelters. o Staff are working on options to distribute education packets from the schools in multiple languages through the food distribution sites. We have heard from Marshallese community members that there is a need for guidance on employment laws — we have verified that Marshallese interpretation services are available through the Legal Aid hotline and have created a method for community members bilingual in Marshallese and English to call on behalf of another person, notify of the need for interpretation so that the attorney who calls back does so with an interpreter on the line. o Staff is working on a map with food locations identified and key resources — such 211, the Legal Aid hotline, the small business help line, and the unemployment number - included that can be posted in public open areas and essential businesses in the downtown area for people who may not have internet access. o Human Rights staff continues weekly virtual meetings with PIHP advisory committee that includes staff from Crescent Community Health Center, community leaders from the Marshall Islands, and additional community volunteers with the PHIP. Community members indicate that general awareness of the importance of self -isolation is there and they are doing their best to follow these recommendations. However, extended families often live together in small apartments that do not allow for self -isolation. In addition, many families have members who are at heightened risk of serious infection due to the high rates of diabetes, obesity, and heart disease in the population. Finally, there is fear of discrimination and blame being directed at individuals who may become ill with COVID-19 and often concern about relocating away from family to a quarantine shelter. o The PIHP advisory committee is in the process of establishing a system in collaboration with local non -profits to support the ability of the Marshallese to self -isolate at home in the event that a presumptively positive individual 8 declines to relocate to a shelter. Details are included in the attached quarantine shelter plan. Attachment: City of Dubuque Quarantine/Isolation Plan for COVID-19 Cc :Teri Goodman Cori Burbach Mary Rose Corrigan Alexis Steger Rick Steines Mark Dalsing Shelley Stickfort Randy Gehl Crenna Brumwell Marie Ware Jacqueline Hunter 9 Everyday Steps and Extra Steps When Someone Is Sick How to clean and disinfect Wear disposable gloves to clean and disinfect. Clean • Clean surfaces using soap and water. Practice routine cleaning of frequently touched surfaces. High touch surfaces include: Tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks, etc. Disinfect • Clean the area or item with soap and water or another detergent if it is dirty. Then, use a household disinfectant. • Recommend use of EPA -registered household disinfectant. Follow the instructions on the label to ensure safe and effective use of the product. Many products recommend: - Keeping surface wet for a period of time (see product label). - Precautions such as wearing gloves and making sure you have good ventilation during use of the product. • Diluted household bleach solutions may also be used if appropriate for the surface. Check to ensure the product is not past its expiration date. Unexpired household bleach will be effective against coronaviruses when properly diluted. Follow manufacturer's instructions for application and proper ventilation. Never mix household bleach with ammonia or any other cleanser. Leave solution on the surface for at least 1 minute To make a bleach solution, mix: - 5 tablespoons (1/3rd cup) bleach per gallon of water OR - 4 teaspoons bleach per quart of water • Alcohol solutions with at least 70% alcohol. Soft surfaces For soft surfaces such as carpeted floor, rugs, and drapes • Clean the surface using soap and water or with cleaners appropriate for use on these surfaces. i cdc.gov/coronavirus C03162706 04/03/2020 • Launder items (if possible) according to the manufacturer's instructions. Use the warmest appropriate water setting and dry items completely. OR • Disinfect with an EPA -registered household disinfectant. These disinfectants meet EPA's criteria for use against COVID-19. Electronics • For electronics, such as tablets, touch screens, keyboards, and remote controls. • Consider putting a wipeable cover on electronics. • Follow manufacturer's instruction for cleaning and dinfecting. - If no guidance, use alcohol -based wipes or sprays containing at least 70% alcohol. Dry surface thoroughly. Laundry For clothing, towels, linens and other items • Launder items according to the manufacturer's instructions. Use the warmest appropriate water setting and dry items completely. • Wear disposable gloves when handling dirty laundry from a person who is sick. • Dirty laundry from a person who is sick can be washed with other people's items. • Do not shake dirty laundry. • Clean and disinfect clothes hampers according to guidance above for surfaces. • Remove gloves, and wash hands right away. Clean hands often • Wash your hands often with soap and water for 20 seconds. - Always wash immediately after removing gloves and after contact with a person who is sick. • Hand sanitizer: If soap and water are not readily available and hands are not visibly dirty, use a hand sanitizer that contains at least 60% alcohol. However, if hands are visibly dirty, always wash hands with soap and water. • Additional key times to clean hands include: After blowing one's nose, coughing, or sneezing After using the restroom Before eating or preparing food After contact with animals or pets Before and after providing routine care for another person who needs assistance (e.g. a child) • Avoid touching your eyes, nose, and mouth with unwashed hands. When Someone is Sick Bedroom and Bathroom Keep separate bedroom and bathroom for a person who is sick (if possible) • The person who is sick should stay separated from other people in the home (as much as possible). • If you have a separate bedroom and bathroom: Only clean the area around the person who is sick when needed, such as when the area is soiled. This will help limit your contact with the person who is sick. Page 2 of 3 Caregivers can provide personal cleaning supplies to the person who is sick (if appropriate). Supplies include tissues, paper towels, cleaners, and EPA - registered disinfectants. If they feel up to it, the person who is sick can clean their own space. • If shared bathroom: The person who is sick should clean and disinfect after each use. If this is not possible, the caregiver should wait as long as possible before cleaning and disinfecting. • See precautions for household members and caregivers for more information. https://www. cdc.gov/coronavirus/2019- ncov/hcp/guidance-prevent-spread.html Food • Stay separated: The person who is sick should eat (or be fed) in their room if possible. • Wash dishes and utensils using gloves and hot water: Handle any used dishes, cups/glasses, or silverware with gloves. Wash them with soap and hot water or in a dishwasher. • Clean hands after taking off gloves or handling used items. Trash • Dedicated, lined trash can: If possible, dedicate a lined trash can for the person who is sick. Use gloves when removing garbage bags, and handling and disposing of trash. Wash hands afterwards. Page 3 of 3 Ta Kwoj Komane Aolep Ran im Bar Jet Bunton Elane Ewor Juon Enaninmej Kilen Karreo im manman kij Ekonak kulob ilo iien karreo im manman kij. Karreo • Karreoik ion aolep men kin joob im den. Kaminene karreoik aolep ijoko ekka jibwi. Ijoko ekka jibwi einwot: Tebol ko, kein kobbolok kojem, kein ikkun lait, ion kauntor ko, kein jobjob, tebol, talboon, kein taib, jikin kobojak, jikin kotor den, jikin amun im kolkol konno, ko bar jet. Bu im Manman kij • Karreoik ijo ak mweiuk eo kon joob im den ak joob bouta elane etton. Inem, kojerbal kein bu in karreo em ko. • Emman kojerbal wot Bu in manman kij ko EPA ear komalimi. Loor komlele ko ikulin tonan likkuun kojbarok bwe en ej j elok jorren im likkun wor tokjen kojerbal bu/kein karreo eo. Elon jet mweiuk romman: - Rej komman an to an tutu ijoko kwoj karreoiki (Lale kilin). - Kojbarok einwot ilo am ekkonak kulob im likkuun lale ebwe jikin lewaj mejatoto ilo iien kojerbal uno ak bu eo. • Jemaron bar ilutok den in karreo einwot jerajko (bleach) elane emman nan ijo kwoj karreoiki. Etale elane bu ak buttik eo emaakt kitien. Jerajko ko ejanin maat kitier renaj emman nan mane lok coronavirus elane ejjejet kereiki. Loor wot komlele eo ikulin Ikijen wewen kojerbale im en bwe jikin lewaj mejatoto. Jejjab kere jerajko iben ammonia ak bar kein kerre ko jet. Likut den eo emoj kerreiki na ion ijo kwoj karreoiki iumin dik tata 1 minit Nan make iiok/ bleach, kerre ko: - 5 tebol jibuun a k (1 /3 in juon k a b) in bleach nan juon kollan in den Ak - 4 tebol jibuun in bleach nan juon kwat in den • Kerre arkool kin diktata70%in arkool. Ijoko rebidodo Nan ijoko rebidodo einwot ion karpet ko, rak im bareinwot ion men ko ekka jujuri • Karreoik ion ijokein kin joob im den ak kin kein karreo ko rokkar nan kojerbali nan surface rot in. • Menin kwalkol ko (ne emaron) ekkar nan komlele ko ijo ikulin. Lelok nan jonan menen eo ekkar tata im likkuun komoraiki men eo kwoj kwale. AK • Buki kin kein manman kij ko EPA ej kili nan kojerbali ilo moko nan manman kij. Kein manman kij kein rotobar jonak ko an EPA nan kojerbali nae COVID-19. Men ko rej kojerbal jarom • Nan men ko rej kojerbal jarom, einwot tablet ko, taj screen ko, kiboot ko, im kantirol ko. • Door juon libobo eo enaj bidodo karreoiki ion. ■ • Loor komlele ko ikilin kin kilen karreoiki im kojerbal kein karreo ko jet. - Elane ejjelok komlele, kojerbal wipe ko ewor arkool ie ak buttik ko ewor diktata 70% arkool ie. Likkuun komoraiki ijo. Kwalkol nuknuk Ikijen nuknuk, tol, mottan • Ekkonak kulob ko jej juloki elane kwoj jobjob an armej eo enaninmej nuknuk. • Nuknuk eo an annej eo enaninmej. Romaron bar kwalkol iben cdc.govlcoronavirus En emakujkuj kwalkol pa En emakujkuj kwalkol pa • En emakujkuj am kwal peium kin joob im den dik tata 20 jokon - Mokaj im kwale elkin wot am utki kulob ko elkin am ebake ak unur armej eo enaninmej. • Kojerbal hand sanitizer: If Elane ejab bojak joob im den im ejab kanuj alikar an etton peium, kojerbal hand sanitizer ko ewor diktata 60% arkool ie. Botab, elane elab an baj etton peium aolep iien kwoj aikuj kwalkol pa kin joob im den. • Bar jet iien ko elap aer aorok nan am kwal peium einwot: - Elkin an juon armej iwir, bokbok, ak makje, - Elkin kojerbal em jiddik ko - Mokta j en mona ak komman mona - Elkin jobjob menin mour ak nejnej ko - Elkin im mokta jen am lelok jiban nan juon eo ej aikuj jiban. (e.g. a child) • Kaj j eon jab jibwe mej am, botum, im lonim elane ejab erreo peium. nuknuk ko an armej ro bar jet. • Jab boki nuknuk ko rotton. • Karreoiki im buttuki nien nuknuk ko ekkar nan komlele kein ilon nan ijoko kwoj karreoiki. • Utik kulob ko, inem mokaj im kwal peium. - Ro rej lale armej romaron provide personal cleaning supplies ellelok kein karreo ko nan armej eo enaninmej (elaneekkar). Supplies include tissues, paper towels, cleaners, and kein karreo ko einwot tijju ko, tol pepa, kein karreo ko, im_ kein manman kij ko EPA ej komalimi. Elane rej konaan, armej eo enaninmej emaron make karreoiki pelakin. • Elane juon wot imon kobojak nan aolep: aremj eo enaninmej ej an eddo karreo inem kojerbal kein manman kij ko. Elane ebon tobrak, eo ej lale armej eo ej aikuj kottar jonan wot an maron kottar mokta jen an karreo im manman kij. • Lale ijin precautions for household members and caregivers nan melele ko rollon lok https://www. cdc. gov/coronavirus/2019 - ncov/hcp/guidance-prevent- spread.html • Armej eo enaninmej ej aikuj make lok ian jen armej ro jet ilo mweo(jonan wot an aikuj). • Armej eo enaninmej ej aikuj make lok ian jen armej ro jet ilo mweo(jonan wot an aikuj). • Elane ewor ruum in kiki kab kobojak ko rojonolok: Karreoik wot enbwinin armej eo enaninmej elane ekkar, einwot elane ebokbok ijo. Wewen in enaj jiban kadiklok am anur armej eo enaninmej. Mona Mona • Bed make lok iam: Armej eo enaninmej ej aikuj mona (ak najidiki) ilo ruum eo an elane emaron. • Le kulob im kojerbal den bwil ilo iien kwalkol kein mona ko Den:Jibwe aolep konno ko ilo am le kulob. Kojerbal joob im den ak ilo kein kwalkol konno ko. • Karreoik pa k o elkin utik kulob ko ak jibwi men ko rotton. Kobej • Kojonoloke juon nien kobej: Elane emaron, kojonolok juon nien kobej nan armej eo enaninmej. Ekkonak kulob ilo iien komakut bek in kobej ko, im ilo iien jobjok im ej j olok kobej. In e m b a r k alkol pa elkin Como limpiar y desinfectar '44 Use guantes desechables para limpiar y desinfectar. Limpie • Limpie las superficies con agua y jabon. Practique la limpieza de rutina de las superficies que se tocan con mas frecuencia. Las superficies de contacto frecuente incluyen: Mesas, picaportes, interruptores de luz, mostradores, manijas, escritorios, telefonos, teclados, inodoros, grifos, lavabos, etc. Desinfecte • Limpie el area u objeto con agua y jabon u otro detergente si esta sucio. Luego, use un desinfectante de uso domestico. • Recomiende el uso de desinfectantes de uso domestico registrados por la EPAicono de sitio externo. Siga las instrucciones que figuran en la etiqueta para garantizar un uso seguro y eficaz del producto. Muchos productos recomiendan: o Mantener humeda la superficie por un tiempo (vea la etiqueta del producto) o Precauciones como el uso de guantes y asegurarse de ventilar bien los ambientes durante el uso del producto. • Tambien se pueden usar soluciones de cloro diluido si son apropiadas para la superficie. o Revise la etiqueta para confirmar si el producto blanqueador con cloro es apto para desinfeccion y verifique que no este vencido. Algunos blanqueadores con cloro, como los disenados para usar de manera segura sobre ropa de color o para blanquear, posiblemente no sean utiles para desinfectar. O El blanqueador con cloro que no este vencido sera eficaz contra los coronavirus si se diluye adecuadamente. Siga las instrucciones del fabricante para conocer la forma de aplicacion y ventile el ambiente. Nunca mezcle el blanqueador con cloro con amoniaco ni con otros productos de limpieza. Deje la solucion sobre la superficie por al menos 1 minuto. Para hacer una solucion de cloro, mezcle: O 5 cucharadas (1/3 de taza) de blanqueador con cloro por galon de agua 0 O 4 cucharaditas de blanqueador con cloro por cuarto de galon de agua • Tambien puede utilizar soluciones con al menos un 70 % de alcohol. Mas detalles: Guia completa para la desinfeccion 0 Superficies blandas En superficies blandas como pisos alfombrados, tapetes y cortinas • Limpie la superficie con agua y jabon o utilice limpiadores apropiados para esas superficies. • Lave los objetos (de ser posible) segun las instrucciones del fabricante.Use la maxima temperatura de agua permitida y sequelos completamente. • Desinfectelos con un desinfectante de use domestico registrado por la EPA. Estos desinfectantesicono de sitio externo cumplen los criterion de la EPA para combatir el COVID-19. Articulos electronicos Para articulos electronicos, como tablets, pantallas tactiles, teclados y controles remotos. • Considere colocarles a los articulos electronicos una funda que pueda limpiarse • Siga las instrucciones del fabricante sobre como usar el producto para limpiar y desinfectar o Si no se incluye ninguna instruccion, use toallitas a base de alcohol o rociadores que contengan al menos un 70 % de alcohol. Segue la superficie por completo. ( 1 'Lk k.' ". I r Ropa Para lavar ropa, toallas, ropa de cama y otros articulos • Lave los articulos segun las instrucciones del fabricante. Use la maxima temperatura de agua permitida y segue los articulos completamente. • Use guantes desechables al manipular ropa sucia de una persona enferma. • La ropa sucia de una persona enferma se puede lavar con la de las demas personas. • No sacuda la ropa sucia. • Limpie y desinfecte los cestos de ropa segun la guia para superficies detallada arriba. • Al quitarse los guantes Lavese las manos de inmediato. Limpiese las manos con frecuencia • Lavese las manos frecuentemente con agua y jabon durante 20 segundos. o Lavese siempre las manos de inmediato despues de quitarse guantes y luego de tener contacto con una persona enferma. • Desinfectante de manos: si no dispone de agua y jabon y sus manos no estan visiblemente sucias, use un desinfectante de manos que contenga al menos un 60 % de alcohol. No obstante, si sus manos estan visiblemente sucias, siempre debe lavarselas con agua y jabon. • Otros momentos clave en que debe lavarse las manos incluyen: o Despues de sonarse la nariz, toser o estornudar o Despues de it al bano o Antes de comer o preparar comidas o Despues de estar en contacto con animales o mascotas o Antes y despues de brindar cuidados de rutina a otra persona que necesite asistencia (p. ej., un nino) • Evite tocarse los ojos, la nariz y la boca con las manos sin lavar. Cuando alguien esta enfermo 41) Habitacion y bano Haga que la persona enferma use una habitacion y bano separados (de ser posible) • La persona enferma deber permanecer separada del resto de las personas del hogar (tanto como sea posible). • Si tiene una habitacion y banos separados: solo limpie el area que rodea a la persona enferma, segun sea necesario, cuando el lugar este sucio. De esta manera limitary el contacto con la persona enferma. o Los cuidadores pueden proporcionar suministros de aseo personal a la persona enferma (si corresponde). Los suministros incluyen panuelos desechables, toallas de papel, limpiadores y desinfectantes registrados por la EPAicono de sitio externo. Si se siente en condiciones para hacerlo, la persona enferma puede limpiar su propio espacio. • Si el bano es compartido: la persona enferma debe limpiar y desinfectar luego de cada uso. Si no es posible, la persona encargada de los cuidados debe esperar tanto como sea posible antes de iniciar las tareas de limpieza y desinfeccion. • Vea las precauciones para cuidadores y miembros del hogar para obtener mas informacion. Alimentos • Mantengase separado: de ser posible, la persona enferma debe comer (o ser alimentada) en su habitacion. • Use guantes y agua caliente para lavar los platos y utensilios:use guantes para manipular platos, tazas/vasos o cubiertos. Lavelos con jabon y agua caliente o en el lavavajillas. • Limpiese las manos despues de quitarse los guantes o manipular articulos usados. • Basura • Cesto con bolsa de uso exclusivo: de ser posible, destine un cesto de basura con bolsa para el uso exclusivo de la persona enferma. Use guantes para retirar las bolsas de basura, y para manipular y desechar los residuos. Lavese las manos al terminar. Mas detalles: Guia completa para la desinfeccion Mas informacion • Sintomas • Que hacer si esta enfermo • Preguntas frecuentes • El COVID-19 y los animales • Prepare su casa • Escuelas, lugares de trabajo y espacios comunitarios • Profesionales de atencion medica Arriba Descargo de responsabilidad: Este sitio web se actualiza con frecuencia. Parte de su contenido puede estar disponible en ingles hasta que se haya traducido todo el contenido. Are You at Higher Risk for Severe Illness? Based on what we know now, those at high -risk for severe illness from COVID-19 are: • People aged 65 years and older • People who live in a nursing home or long-term care facility People of all ages with underlying medical conditions, particularly if not well controlled, including: • People with chronic lung disease or moderate to severe asthma • People who have serious heart conditions • People who are immunocompromised - Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications. • People with severe obesity (body mass index [BMI] of 40 or higher) • People with diabetes • People with chronic kidney disease undergoing dialysis • People with liver disease Here's What You Can do to Help Protect Yourself Stay home if possible. Wash your hands often. Avoid close contact (6 feet, which is about two arm lengths) with people who are sick. Clean and disinfect frequently touched surfaces. Avoid all cruise travel and non -essential air travel. Call your healthcare professional if you are sick. For more information on steps you can take to protect yourself, see CDC's How to Protect Yourself. cdc.gov/coronavirus If you have fever, cough, or shortness of breath, call your healthcare provider. They may tell you to manage your care from home. Follow these tips: 1. Stay home from work, school, and away from other public places. If you must go out, avoid using any kind of public transportation, ridesharing, or taxis. 2. Monitor your symptoms carefully. If your symptoms get worse, call your healthcare provider immediately. 3. Get rest and stay hydrated. 4. If you have a medical appointment, call the healthcare provider ahead of time and tell them that you have or may have COVID-19. 5. For medical emergencies, call 911 and notify the dispatch personnel that you have or may have COVI D-19. 6. Cover your cough and sneezes. 7. Wash your hands often with soap and water for at least 20 seconds or clean your hands with an alcohol -based hand sanitizer that contains at least 60% alcohol. 8. As much as possible, stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available. If you need to be around other people in or outside of the home, wear a facemask. 9. Avoid sharing personal items with other people in your household, like dishes, towels, and bedding. 10. Clean all surfaces that are touched often, like counters, tabletops, and doorknobs. Use household cleaning sprays or wipes according to the label instructions. For more information: www.cdc.gov/COVID19 CS 315822-A 03/12/2020 Steps to help prevent the spread of COVID-19 if you are sick FOLLOW THE STEPS BELOW: If you are sick with COVID-19 or think you might have COVID-19, follow the steps below to help protect other people in your home and community. Stay home except to get medical care • Stay home: Most people with COVID-19 have mild illness and are able to recover at home without medical care. Do not leave your home, except to get medical care. Do not visit public areas. • Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you have trouble breathing, or have any other emergency warning signs, or if you think it is an emergency. • Avoid public transportation: Avoid using public transportation, ride -sharing, or taxis. Separate yourself from other people in your home, this is known as home isolation • Stay away from others: As much as possible, stay away from others. You should stay in a specific "sick room" if possible, and away from other people in your home. Use a separate bathroom, if available. - See COVID-19 and Animals is you have questions about pets. https://www.cdc.gov/coronavirus/2019-ncov/faq. html#COVID19animals Call ahead before visiting your doctor • Call ahead: Many medical visits for routine care are being postponed or done by phone or telemedicine. • If you have a medical appointment that cannot be postponed, call your doctor's office, and tell them you have or may have COVID-19. This will help the office protect themselves and other patients. If you are sick wear a facemask in the following situations, if available. • If you are sick: You should wear a facemask, if available, when you are around other people (including before you enter a healthcare provider's office). • If you are caring for others: If the person who is sick is not able to wear a facemask (for example, because it causes trouble breathing), then as their caregiver, you should wear a facemask when in the same room with them. Visitors, other than caregivers, are not recommended. Note: During a public health emergency, facemasks may be reserved for healthcare workers. You may need to improvise a facemask using a scarf or bandana. Cover your coughs and sneezes • Cover: Cover your mouth and nose with a tissue when you cough or sneeze. • Dispose: Throw used tissues in a lined trash can. • Wash hands: Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol -based hand sanitizer that contains at least 60% alcohol. Clean your hands often • Wash hands: Wash your hands often with soap and water for at least 20 seconds. This is especially important after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. • Hand sanitizer: If soap and water are not available, use an alcohol -based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. • Soap and water: Soap and water are the best option, especially if hands are visibly dirty. • Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands. Avoid sharing personal household items • Do not share: Do not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people in your home. • Wash thoroughly after use: After using these items, wash them thoroughly with soap and water or put in the dishwasher. cdc.gov/COVID19 CS 316120-0 04/01/2020 Clean all "high-touch"surfaces everyday Clean high -touch surfaces in your isolation area ("sick room" and bathroom) every day; let a caregiver clean and disinfect high -touch surfaces in other areas of the home. • Clean and disinfect: Routinely clean high -touch surfaces in your "sick room" and bathroom. Let someone else clean and disinfect surfaces in common areas, but not your bedroom and bathroom. - If a caregiver or other person needs to clean and disinfect a sick person's bedroom or bathroom, they should do so on an as -needed basis. The caregiver/other person should wear a mask and wait as long as possible after the sick person has used the bathroom. • High -touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, and bedside tables. • Clean and disinfect areas that may have blood, stool, or body fluids on them. • Household cleaners and disinfectants: Clean the area or item with soap and water or another detergent if it is dirty. Then, use a household disinfectant. - Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed. Many also recommend precautions such as wearing gloves and making sure you have good ventilation during use of the product. - Most EPA -registered household disinfectants should be effective. A full list of disinfectants can be found hereexternal icon. Monitor your symptoms • Common symptoms of COVID-19 include fever and cough. Trouble breathing is a more serious symptom that means you should get medical attention. • If you are having trouble breathing, seek medical attention, but call first. - Call your doctor or emergency room before going in and tell them your symptoms. They will tell you what to do. • Wear a facemask: If available, put on a facemask before you enter the building. If you can't put on a facemask, cover your coughs and sneezes. Try to stay at least 6 feet away from other people. This will help protect the people in the office or waiting room. • Follow care instructions from your healthcare provider and local health department: Your local health authorities will give instructions on checking your symptoms and reporting information. If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*: • Trouble breathing • Persistent pain or pressure in the chest • New confusion or inability to arouse • Bluish lips or face *This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning. Call 911 if you have a medical emergency: If you have a medical emergency and need to call 911, notify the operator that you have or think you might have, COVID-19. If possible, put on a facemask before medical help arrives. How to discontinue home isolation People with COVID-19 who have stayed home (home isolated) can stop home isolation under the following conditions: - If you will not have a test to determine if you are still contagious, you can leave home after these three things have happened: • You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers) AND • other symptoms have improved (for example, when your cough or shortness of breath have improved) AND • at least 7 days have passed since your symptoms first appeared - If you will be tested to determine if you are still contagious, you can leave home after these three things have happened: • You no longer have a fever (without the use medicine that reduces fevers) AND • other symptoms have improved (for example, when your cough or shortness of breath have improved) AND • you received two negative tests in a row, 24 hours apart. Your doctor will follow CDC guidelines. In all cases, follow the guidance of your healthcare provider and local health department. The decision to stop home isolation should be made in consultation with your healthcare provider and state and local health departments. Local decisions depend on local circumstances. More information is available https://www.cdc.gov/ coronavirus/2019-ncov/hcp/disposition-in-home-patients.html. Additional information for healthcare providers: Interim Healthcare Infection Prevention and Control Recommendations for Persons Under Investigation for 2019 Novel Coronavirus. Dubuque Countywide Response to Coronavirus (COVID-19) f.lc77l.'IEMERGENCY IAGEMENT Self -Assessment Form for Shelters and SROs Assess Symptoms • Does the resident have a fever (at least 100.4 F or 37.8 C)? Yes No unknown • Does the resident have a persistent, dry cough? Yes No unknown • Is the resident having difficulty breathing? Yes No unknown NOTICE — If someone develops any of these emergency warning signs get medical attention immediately: • Trouble breathing or not being able to speak without gasping for air • Persistent pain or pressure in the chest • New confusion or inability to fully wake up • Bluish lips or face • Severe persistent dizziness or lightheadedness • Any other symptoms that are severe or concerning Assess Ability to Self -Isolate Do you have a room with a door where a resident can stay and be separated from the rest of the residents in the facility? Yes No Do you have a separate bathroom the resident can use? Yes No If not, does the facility have access to household cleaning supplies — soap, water, and a disinfectant - that can be used to clean a shared bathroom each time it is used? Yes No Do you have someone who can deliver food to the resident in their room? Yes No Do you have a face masks that residents can wear — even if it is just a scarf or bandana? Yes No Do you have cleaning supplies (soap, water, and a disinfectant) that will allow you to clean "high touch" surfaces in the facility every day? (High touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, bedside tables). Yes No Does the resident have any underlying medical conditions such as diabetes, heart disease, or lung disease? Yes No unknown Do any of the other residents in the facility have any of these underlying medical conditions? Yes No unknown Consult with VNA or Other Medical Provider After you have responded to the questions above, contact either the Visiting Nurse Association or Crescent Community Health Center and provide them this information. They will determine whether a referral for further medical care, testing, and/or referral to a quarantine facility is needed. Visiting Nurses Association: 563-556-6200 Crescent Community Health Center: 563-690-2850 •l Dubuque Countywide Response to Coronavirus (COVID-19) ' EMERGENCY AGEMENT Medical Provider Assessment and Referral to Quarantine Shelter Note to medical provider: please complete the form on behalf of the patient by reading these questions aloud for the patient to answer. Do you have a room with a door that separates it from the rest of the home where you can stay by yourself, away from the rest of your family? Yes No Do you have a separate bathroom you can use? Yes No If not, do you have access to household cleaning supplies — soap, water, and a disinfectant - that can be used to clean a shared bathroom each time it is used? Yes No Do you have someone who can deliver food to you in your room? Yes No Do you have a face masks that you and your family can wear — even if it is just a scarf or bandana? Yes No Do you have concerns about your employment or financial situation that we might help address? Yes No Do you have cleaning supplies (soap, water, and a disinfectant) that will allow you to clean "high touch" surfaces in your room every day? (High touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, bedside tables). Yes No Do you have any underlying medical conditions such as diabetes, heart disease, or lung disease? Yes No Does anyone you live with have any of these underlying medical conditions? Yes No NOTICE - If you develop any of these emergency warning signs get medical attention immediately: • Trouble breathing or not being able to speak without gasping for air • Persistent pain or pressure in the chest • New confusion or inability to fully wake up • Bluish lips or face • Severe persistent dizziness or lightheadedness • Any other symptoms that are severe or concerning Does medical provider recommend referral to shelter and does patient agree? Yes No If "yes" to the above question, contact Alexis Steger, Housing & Community Development Director, 563-580- 2947 to begin shelter process. Provide a copy of this form to the patient. Dubuque Countywide Response to Coronavirus (COVID-19) EMERGENCY AGEMENT Assessment Form for People Who are Sick Step 1: Assess Symptoms • Does the person who is sick have a fever (at least 100.4 F or 37.8 C)? Yes No unknown • Does the person who is sick have a persistent, dry cough? Yes No unknown • Is the person who is sick having difficulty breathing? Yes No unknown NOTICE — If someone develops any of these emergency warning signs get medical attention immediately: • Trouble breathing or not being able to speak without gasping for air • Persistent pain or pressure in the chest • New confusion or inability to fully wake up • Bluish lips or face • Severe persistent dizziness or lightheadedness • Any other symptoms that are severe or concerning Step 2: Assess Ability to Self -Isolate Does the house where the person lives have a room with a door where the person who is sick can stay and be separated from the rest of the family? Yes No Does the house have a separate bathroom that the person who is sick can use? Yes No If there is only a shared bathroom, do the person who is sick have access to household cleaning supplies — soap, water, and a disinfectant - that can be used to clean a shared bathroom each time it is used? Yes No Does the person who is sick have someone who can deliver food to them in their room? Yes No Does the person who is sick have face masks that they and their family can wear — even if it is just a scarf or bandana? Yes No Does the person who is sick have concerns about their employment or financial situation that they may need help addressing? Yes No Does the person who is sick have cleaning supplies (soap, water, and a disinfectant) that will allow them to clean "high touch" surfaces in their room every day? (High touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, bedside tables). Yes No Does the person who is sick have any underlying medical conditions such as diabetes, heart disease, or lung disease? Yes No Does the person who is sick live with anyone having any of these underlying medical conditions? Yes No Step 3: Talk to a Medical Provider After you have responded to the questions above, contact your regular medical provider. If you do not have a regular medical provider, or if you do not have insurance or are worried about cost, you can contact Crescent Community Health Center at 563-690-2850. Give the medical provider the information above. The medical provider will: 1) ask you some additional questions; 2) decide whether you need to be tested for COVID-19; 3) tell you whether it would be safer for you to leave your home and go to a quarantine facility to keep the members of your family safe; 4) give you some numbers to call if you need help getting cleaning supplies or masks, or if you need help with unemployment or housing problems; 5) let you choose whether or not to go to the quarantine facility or whether you can follow the directions to keep your family safe at home. Step 4: Decide What is Best for You and Your Family There is a lot we do not know about COVID-19 and how it works. In addition, it can be hard to protect yourself and your family when you or someone else in your family needs to keep going to work so that the family has an income. This can create a lot of stress and make it hard to decide what is best. If you are unsure what to do, you might want to talk about it with your family or your pastor, or you may want to call 211 and ask to talk to a counselor. Updated April 16, 2020 City of Dubuque Quarantine/Isolation Shelter Plan for COVID-19 Primary Emergency Support Staff for Housing & Human Services The following people are coordinating the emergency support function for Housing and Human Services (HHS) during COVID-19 under the general direction of the Dubuque County Public Health Incident Management Team. • Housing and Community Development Director Alexis Steger • Human Rights Director Kelly Larson • Neighborhood Development Specialist Jerelyn O'Connor • Disaster Program Manager Jolene Carpenter with American Red Cross Northeast Iowa Region • Vicky Gassman, Visiting Nurses Association • Nancy Van Milligen, President and CEO, Community Foundation of Greater Dubuque, • Danielle Peterson, President and CEO, United Way of Dubuque Area Tri-States Quarantine/Isolation Shelter Purpose and General Parameters The primary purpose of quarantine/isolation shelter sites is to support individuals who: • are positive or presumptively positive for COVID-19, and • have mild symptoms and are not in need of hospitalization, and • are homeless and unable to self -isolate in a shelter or live in cramped quarters in a home or apartment with people who are at heightened risk for a serious infection. Positive or Presumptively Positive Determination A positive determination is based on a COVID-19 test result. A "presumptively positive" determination will be made when an individual exhibits the following symptoms: • A fever of at least 100.4 F or 37.8 C • A persistent, dry cough • Difficulty breathing Self -quarantine will be recommended for anyone who is presumptively positive, whether or not they are tested. If they are tested and confirmed positive, the Visiting Nurses Association (VNA) will conduct a contact analysis and additional steps may be recommended. Finally, individuals without symptoms who are placed in quarantine based on possible exposure may be referred to a shelter at the discretion of the VNA based on individual circumstances. Ability to Safely Self -Isolate Determination for Individuals in Homeless Shelters Relocation to a quarantine shelter for an individual who is positive or presumptively positive and living in a homeless shelter will be at the direction of the non-profit organization operating the shelter in collaboration with the Director of Housing and Community Development. In the 1 Updated April 16, 2020 event that the individual tests positive for COVID-19 the VNA will pursue contact tracing that may result in placing all current residents within the homeless shelter under fourteen -day isolation at the shelter. In the event that there are additional positive cases in the shelter, the VNA may determine to treat the shelter as having an "outbreak" and implement plans similar to those utilized at congregate living facilities. Ability to Safely Self -Isolate Determination for Individuals in Houses or Apartments Positive or presumptively positive individuals in their own homes, apartments, or single room occupancy units will be provided information on how to safely self -isolate and offered the opportunity to relocate to the quarantine shelter if: 1) they have limited ability to self -isolate at home, and 2) are living with someone who is at increased risk of severe complications and are not able to self -isolate at home. In the event that the individual tests positive for COVID-19 the VNA will pursue contact tracing that may result in placing all residents within the home or apartment under fourteen -day isolation at home. Generally, relocation to a quarantine shelter for an individual living in their own home, apartment, or single room occupancy unit will be at the choice of that individual. Forced relocation through quarantine orders will be issued in limited circumstances and on a case by case basis by the County Attorney as recommended by the County Board of Health or the Iowa Department of Public Health. Estimated Need for Quarantine/Isolation Shelters The number of people who may need quarantine/isolation in a facility is unknown. The primary concern is for people who are living in shared spaces such as homeless shelters, single room occupancy quarters with shared common areas, and families who are doubled up. • Homeless Shelters: There are approximately 68 people living in the following shelters in Dubuque: the Dubuque Rescue Mission, Teresa Shelter, Maria House, Mary's Inn, YMCA, Hope House. Additional risk factors, such as underlying health conditions, are unknown but presumed likely in a population experiencing homelessness. • Single Room Occupancy: Currently there are a total of 14 people residing at Salvia House; 4 at Manasseh House; 64 at Davis Place; and 34 at ZTM Sober Living. Salvia and Manasseh Houses have residents primarily in their fifties and sixties, with several smokers and people with underlying medical conditions such as pregnancy, Multiple Sclerosis, and diabetes. Salvia and Manasseh house have some capacity to quarantine/isolate onsite. ZTM Sober Living has one open apartment they are keeping open to use for quarantine. • Doubled up families and heightened risk: The Pacific Islander Health Project reports that Crescent's Pacific Islander medical population has grown from 165 in 2017 to 226 in 2018 to 263 in 2019. These are unique patients, not visits. The number of Pacific Islander patients with diabetes and with hypertension has grown significantly each year as well. The percentage of the Pacific Island patients with each of these chronic diseases has remained fairly constant, at approximately 35% for diabetes and 27% for 2 Updated April 16, 2020 hypertension. Many families live intergenerationally, whether for financial or cultural reasons or a combination. The same is true for many of our Guatemalan families. The Dubuque Community School District is aware of 206 families who are homeless or doubled up. This number is likely much lower than the actual number of doubled up families in Dubuque. Preventative Actions that Have Been Taken To Date Homeless Shelters The Housing and Community Development Department assessed homeless shelters within the City of Dubuque in mid -March and provided Centers for Disease Control guidance to assist them in identifying potential COVID infections in their environments as quickly as possible. Shelters were instructed to contact Housing and Community Development Director Alexis Steger at any point that they identify someone in need of a quarantine shelter. Families at Heightened Risk of Serious Complications The Human Rights Director has been meeting weekly with the Pacific Islander Health Project (PIHP) Advisory Council and Crescent Community Health Center and has provided guidance on determining a patient's ability to self -isolate. Crescent Community Health Center staff were instructed to contact Housing and Community Development Director Alexis Steger or Human Rights Director Kelly Larson at any point that they identify someone in need of a quarantine shelter. Instructions on how to safely self -isolate at home is available in English and Spanish from the CDC and has been translated into Marshallese and distributed broadly in the community. Attachments 1A, 1B, 1C. The PIHP Advisory Council is working with local non-profit organizations to put together home isolation packets for distribution to families most in need and at highest risk of exposure and complications. The packets will include: 1) English, Spanish, and Marshallese care and cleaning instructions for isolation at home; 2) washable cloth masks; 3) thermometers with translated use and cleaning instructions; 4) soap, hand sanitizer, and bleach or a disinfectant. The goal is to distribute the along with food and translated K-12 education supplies for children. Quarantine/Isolation Shelters: Availability, Budget and Monitoring The City has agreements in place with two quarantine/isolation shelters: • A local hotel has agreed to house people at a cost of $80 per room per day. 69 units are available and entire floors can be used as needed. • A local privately -owned rental property has agreed to house people at a cost of $14 per room, per day. We currently have 8 units, with the potential for 24 additional units in two separate wings. Budget projects for this facility are attached. Attachment 2. Use of 3 Updated April 16, 2020 the hotel will result in higher costs of $66 per day, per person based on the higher room rate. In addition, the City is developing back-up plans with local faith communities and will continue to evaluate community needs and availability of resources, modifying quarantine/isolation shelters as necessary. Shelters will not have staff on -site but will be monitored daily by City staff and Visiting Nurses Association staff. The following steps have been taken to provide shelter placement and monitoring. • Five staff members from Housing and Community Development (three of whom are paramedics), one staff member from Human Rights, and one staff member from Public Works (who has CPR and AED certifications) have volunteered to serve as site monitors. They all completed virtual training through the Red Cross on operating a shelter on April 7. • Arrangements have been made with Emergency Management to provide staff members safety equipment to the best of availability, including a plastic face shield, an N95 respirator, a disposable surgical gown, and disposable examination gloves. o Staff from the Fire Department will provide a safety briefing on proper use of the equipment and general COVID-19 disinfecting protocol. o Staff who are older than sixty or who have underlying health conditions will not be placed to serve at the shelter. o Staff members who exhibit symptoms will remain at home. • Staff Assignments: o City staff members will be on call for twenty-four hour shifts on a rotating basis, with a back-up on -call person each day that someone is located in a shelter. o On -call City staff will be responsible for helping to arrange resident transportation to the site, assigning residents to rooms, reviewing quarantine requirements with residents, obtaining and delivering meals, responding to resident needs, and monitoring compliance with requirements to remain quarantined. Staff will provide individuals arriving at the shelter a facemask and complete an intake process with them. Staff will not be expected to remain on - site once the resident is settled. o Monitoring will be through the use of a camera placed in public hallways (as approved by City Attorney Crenna Brumwell) that will notify on -call staff when there is motion within the hallway and will record information for viewing to determine violation of protocol. Staff will visit the site to reinforce protocol as needed. The camera also allows for direct voice communication between residents and the on -call staff member. o Staff will be provided a separate onsite staging room for equipment, supplies, and monitoring if it becomes necessary for the on -call staff to remain on site for an extended period of time. 4 Updated April 16, 2020 o Health monitoring will be provided by a nurse from the VNA, who will perform a health check by visiting each resident at the shelter on a daily basis for the duration of their stay. o Assignments may be modified based on needs that arise and/or number of residents placed in the shelter. Facility Supplies and Operations Postings: • COVID-19 posters about hand and respiratory hygiene and cough etiquette will be posted at the entrance and inside the shelter. CDC fact sheets will be available at the shelter (see attachments 3-5). Furniture: • The hotel is equipped with necessary furniture. • The 8 initial apartments at the private rental property will be set up with a cot, blankets, and personal hygiene items from the Red Cross and minimal additional furniture from the Dubuque Rescue Mission. We are working with the library to identify reading and recreational materials that may be able to be provided. Food: • The Mission has indicated a willingness to provide carry out meals for people in an isolation shelter as their resources allow. There is concern this support could be limited. • Project Rooted and Resources Unite are additional options we can call upon so long as they are able to maintain their supply of food and volunteers. • The Red Cross is available to provide food if other options are depleted. • Given the nature of the virus, it will be important to keep plenty of fluids available to residents to keep them hydrated. • Residents may order food or grocery delivery so long as those delivering the items are practicing social distancing and leaving items outside of the door. Transportation: • The Regional Transit Authority is available to transport residents to the shelter as needed. Costs will be covered by United Way vouchers so long as those remain available. • A backup alternative for transportation is Paramount Ambulance. They have equipped an ambulance specifically for COVID-19 related transport and it is available on -demand at a cost of $50 per person transported. Referral Process for Quarantine/Isolation Shelter The process for referrals involves working closely with homeless shelters, single -room occupancy shelters, non-profit human services providers, and community leaders connected 5 Updated April 16, 2020 with vulnerable populations to identify people who are positive or presumptively positive for COVID-19, are unable to isolate safely at home, and are recommended for a quarantine/isolation shelter. For Homeless Shelters and Single Room Occupancy Quarters: • The HHS team has developed the attached checklist for shelters to: o Assess residents for symptoms consistent with COVID o Consult with a health care provider and receive a referral for testing when necessary o Contact and arrange for transportation of residents to an isolation facility (see attachment 6) • This checklist will be provided by the Housing and Community Development Director to the following shelters: Dubuque Rescue Mission, Maria House, Teresa Shelter, Catholic Worker House, Salvia House, Manasseh House, Davis Place. For Medical Staff: • The HHS team has developed the attached checklist for medical providers who identify residents who are presumptively positive or positive for COVID-19 and do not require hospitalization to: o Assess the resident's housing situation to determine whether or not they will be able to self -isolate at home o Contact and arrange for transportation of residents who cannot self -isolate at home to an isolation facility (see attachment 7) • This checklist will be provided by the Public Health Specialist to medical providers in town, including Crescent Community Health Center, MercyOne, Unity Point, Medical Associates, Grand River Medical Group, and other primary healthcare providers. For Residents who are Sick: • The HHS team has developed the attached checklist for residents to: o Assess themselves for symptoms consistent with COVID-19 o Assess their housing situation to determine whether or not they will be able to self -isolate at home o Contact a healthcare provider for a referral for testing and/or a quarantine shelter. (See attachment 8) • This checklist will be distributed as follows: o Through United Way and the Community Foundation of Greater Dubuque to Human Services Non -profits for use with their clients. o Through the Human Rights Director to members of the Pacific Islander Health Project, the My Brother's Keeper Network, and the Immigration Forum. o Through the Equity team members to community leaders in neighborhood groups and underrepresented communities through social media, Notify Me, e- mail, and phone calls. 6 Updated April 16, 2020 o Through the Housing and Community Development Director to Housing Choice Voucher recipients. Release of Residents and Decontamination Standards for release from quarantine: • Residents who have not been tested will be advised they can return to their home or shelter upon: o They have had no fever for at least 72 hours (that is three full days with no fever without the use of medicine that reduces fevers) AND o Other symptoms have improved (for example, when their cough or shortness of breath have improved) AND o At least 7 days have passed since their symptoms first appeared. • Residents who have tested positive will be advised on returning to their home by the Visiting Nurses Association. Facility decontamination: • The City of Dubuque will contract with Serve Pro for decontamination of each room occupied upon release of the resident occupying that room. Serve Pro will be provided disinfecting guidance available from the Centers for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning- disinfection.html Best efforts will be made to leave rooms vacant for 24 hours before cleaning and to allow them to air out for 24-48 hours post -cleaning before placing another resident. This document may be updated as public health guidance and circumstances change. 7