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COVID-19 UpdateCopyrighted May 18, 2020 City of Dubuque Presentation(s) # 1. ITEM TITLE: COVID-19 Update SUMMARY: Mary Rose Corrigan, Public Health Specialist for the City of Dubuque, will provide an update on the COVI D-19 pandemic and response activities. SUGGESTED DISPOSITION: Masterpiece on the Mississippi Dubuque All -America City ��IIN N�II (117;1.1 ACAb 111118, 2007*2012*2013 2017*2019 TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Specialist SUBJECT: COVID-19 update DATE: May 18, 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), the Governor's Office, and with guidance from CDC via weekly webinars and direct contact with our regional epidemiologist. • 134 new cases were added to Dubuque County's total since I last gave a report to the City Council on May 4, 2020. As of May 18, Dubuque County has 286 positive COVID-19 cases. To date, we have a total of 10 deaths in Dubuque County. Currently, Dubuque County has 16 COVID-19 patients who are hospitalized. Also, 3761 people have been tested in Dubuque County with 3475 negative results. The number of tests administered has more than doubled since May 4, 2020. 7.6% of the cases tested have been positive. 130 people or about 45% of Dubuque County positive cases have recovered to date. • The State has 15,084 cases, up from 9703 positive cases on May 4, 2020. Many new cases have been from meat processing and long- term care facilities identified by State strike team testing due to outbreaks. A total of 363 Iowans have died. In all there have been 104,567 tests administered in Iowa. Currently, 382 cases are hospitalized. 7,732 or (51%) of Iowans have recovered. • Friday, May 15, 2020 Gov. Reynolds proclamation restricting many businesses was lifted on the 22 counties where it remained in place (after these restrictions were lifted in the rest of the state on May 8, 2020.) Essentially most things are now open or operating except for mass gatherings and community events, and sporting and recreations activities with more than 10 people. The Governor has said she will lift or reevaluate these restrictions prior to their expiration on May 27, 2020. As the testing numbers ramp up, the State Hygienic Lab has completed testing validation on the new methodology used for Testlowa. This means that test results will be available at a faster, more -timely rate. • Community Testing: While Dubuque County has not been a Testlowa or IDPH strike teams site, over the past several weeks we requested and received viral test kits from the state for targeted testing, focusing on individuals identified through public health contact tracing along with long term care facility staff. During the week of May 4-8, 335 exposed individuals identified through contact tracing were tested at a community site and 1335 long-term care were individuals were tested either at their facility or at the community site. No long-term care outbreaks were identified. Through targeted testing at the community site, 8.8% were positive. This rate of positivity can be attributed to the known risk factors for the individuals tested. Since we have unused tests available from the targeted testing, we are offering testing to congregate living facility staff, law enforcement and one work site this week. The organizations receiving testing must provide their own medical director or physician to order the tests. Crescent Community Health center will also continue to test those with known exposures identified through contact tracing. I want to thank all the local health care workers and others who assisted with the community testing, who are employees of MercyOne, Unity Point -Finley, Grand River Medical Group, Medical Associates and Crescent Community Health Center. The majority of the costs incurred from the testing will be paid by funds from the Dubuque County Board of Health that were allocated for community COVID-19 response by the Dubuque County Board of Supervisors. Also, a thank you to City staff from the Health, Engineering and Police Departments for their work in planning and staffing the testing initiative. As we face the dilemma of how much to test for COVID-19, consideration must include financial costs to our local governments and ultimately our citizens along with the fact that a test demonstrates if you are positive or more importantly negative for just that point in time. We have to weigh that with the likely probability that this pandemic may continue for several more months, even into next year. The SARS CoV-2 virus will not stop spreading until 60-70% of the population has been infected or until there is an effective vaccine or at the very least, an effective antiviral medication that could reduce the infectious period. Currently, of Iowa's 99 counties, Dubuque County has the 7th highest number of people tested (3,761), the 14th highest number of positive cases (286), and the 9th highest number of deaths (10). As Dubuque completes these targeted testing initiatives with tests provided by the IDPH, the Dubuque County Public Health Incident Management Team would like to continue this new model to provide for ongoing targeted testing based on our epidemiological profile locally in Dubuque County. Every community has unique aspects. The Dubuque workforce, demographics and organizations within our community as well as our public health and healthcare workforce capacity, all influence not only the testing capability within our community but also where we should prioritize testing, and use our resources to gain the most information and benefit to the community. Even though we may not currently be a Testlowa site, we continue to encourage more Dubuque County residents to complete the Testlowa assessment. This will not only assist the State in determining a need for broad community testing in Dubuque, but also the assessments provide valuable data to the Governor and the IDPH on the risk level of our residents and the need for future testing. Therefore, we encourage residents to continue to take the on-line Testlowa assessment. Of the state's 432,302 completed, Dubuque County residents have completed 11,730 Testlowa assessments (12%.) • Contact tracing: As testing is increasing around the state due to Testlowa and the various strike teams at worksite facilities and long- term care facilities, IDPH has offered to do the contact tracing for local communities. Due to the increased number of tests being conducted in Dubuque County, VNA has turned contact tracing over to the IDPH since prior to the additional testing initiatives, VNA felt they were already at capacity in terms of their ability to keep up with the contact tracing on the number of positive cases being identified. Contact tracing involves more than one initial contact with the positive case and those who were exposed by that person. It also involves ongoing monitoring of positive cases and providing releases when symptoms have subsided, and appropriate isolation duration has been met. With IDPH conducting the contact tracing, VNA staff will be able to provide strategic public health services specifically for Dubuque County, including trending the data to find pockets of outbreaks, and provide support and guidance in those areas that we currently don't have time for, and also to provide more support to the businesses and facilities with positive cases, for both prevention and mitigation. Having all the data, but not the aggressive contract tracing deadlines set by IDPH, puts VNA in a unique position to help guide the community. This week that will include conducting target testing. • Long Term Care status: Long term care facilities continue meeting weekly with each other (with MR Corrigan attending) and provide input to the Public Health Incident Management Team on needs, planning and capacity. One long term care facility in Dubuque County is experiencing an outbreak and we are monitoring their needs on a daily basis. Long term care facilities also receive guidance from the local hospitals and clinics. • Housing needs, and special isolation needs, along with other human service needs are addressed by the Human Resources section of our Incident Management Team, and are managed by Human Rights Director, Kelly Larson, and Housing and Community Development Director, Alexis Steger. Temporary isolation housing is available for individuals not able to secure appropriate isolation in their own residences. As more residents are taking advantage of this necessary service, the City is seeking assistance for the management of the four established shelters. Other needs, such as food, continues to be provided to a variety of individuals via delivery, and through distribution by several community - based organizations. • Personal protective equipment (PPE) requests, donations, sourcing products —a process for local organizations to obtain personal protective equipment and other needs are available through the Dubuque County Emergency Management Agency (EMA). Director Tom Berger uses locally sourced and State Strategic National Stockpile (SNS) assets to supply those requests. In addition to PPE, staffing, testing and other needs must be requested through the county EMA. The EMA is meeting all requests, with the exception to disinfecting wipes. • Brain Health/ well- being: May is Mental Health (Brain Health) awareness month. The Brain Health Task Force, facilitated by the Community Foundation of Greater Dubuque, reports that clients are coming into offices for pandemic related issues looking for support with brain health issues. Brain Health Task Force members are providing resources and contact information. The Children's Brain Health Working Group continues to meet. The services offered though the Mental Health/Disability Services of the East Central Region (MHDS-ECR), which includes Dubuque County, are aligning temporary policies with other entitlements and not recommending additional documentation. Federal stimulus checks will not impact eligibility for regional funding and are not considered income. In addition to the mobile crisis units and other response services provided by the region, a "Warm Line" - a telephone line staffed by individuals with lived experience who provide nonjudgmental, nondirective support to an individual who is experiencing a personal crisis is available daily from 2:00-7:00 p.m. at 844-775-9276. Brain Health issues will last longer than the quarantine period as well as anxiety about returning to work, office spaces, retail stores begins to ramp up etc. The schools are making plans now for how to support students when they return in the fall, keeping in mind brain health issues. • Joint Information System is led by PIO Randy Gehl. The JIS has coordinated responses to requests from the TH and other news media and provided daily COVID-19 specific media/news releases 6 days per week. I am giving regular updates at every city council meeting, and on other days, Facebook live updates. Since May 1, 2020, 10 COVID-19 Update Videos have been streamed live on Facebook and CityChannel Dubuque, posted to the City's YouTube channel, and links shared in daily updates: Facebook: Total views = 27,225 (average of 2,722 views per video) YouTube: Total views = 1,033 (average of 103 views per video) Looking ahead • As the Governor's proclamations continue to be modified and restrictions are lifted across Iowa, social distancing and mitigation strategies must continue. Epidemiological data, particularly the "epi-curve" will continue to be monitored, along with hospital and health care capacity, worksite outbreaks, recovery rate etc- all on a local, state level and national level. Our Public Health Incident Management Team is in regular contact with Dubuque's health care providers and provides for ongoing monitoring of community's readiness and ability to test. Last week, the CDC alerted public health and health care providers of a new emerging syndrome in Children associated with COVID-19. It started with reports from the UK and has continued with reports from New York City and New York state. The IDPH has designated this as a reportable condition in order to provide monitoring of this new syndrome in our state. As the virus continues to infect different sectors of the population, new issues will emerge, and different risks may be identified. What you can do now • Continue to stay home as much as possible. Dubuque County has not yet peaked in the number of COVID-19 cases. • Encourage citizens to take the Testlowa assessment • Limit trips to grocery stores and for other necessities — for example, once a week at the most • Utilize curbside pick-up, carry -out and delivery for food and other purchases • Consider your own personal risk factors before venturing to retail stores and places of business or for personal or recreational services. Risks to consider include age, underlying and/or chronic health conditions — especially respiratory and cardiac conditions, diabetes and if you smoke, are obese or live with someone who has any of these risk factors. • Continue to practice social distancing • Strictly follow self -isolation practices. If you are not sure whether you have been exposed, start self -isolating anyway. • Follow the 3 C's - (clean, cover, contain) and emphasize handwashing- which is ideal. When handwashing is not available, use hand sanitizer. • Encourage citizens to continue to seek and utilize factual information from the city of Dubuque, IDPH and CDC websites and postings, being mindful that this is an ever changing and emerging pandemic. • Do research before traveling- so you are totally prepared for other communities' risk, and potential illness.