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COVI D-19 Pandemic Monthly Update Work Session Copyrig hted November 16, 2020 City of Dubuque Work Session - Top # 1. City Council Meeting ITEM TITLE: 5:00 PM - COVID-19 Pandemic Monthly Update SUM MARY: City staff and network partners will provide updates on the internal and community-facing responses to the COVI D-19 pandemic. Tentative presentation order: 1. Community COVI D-19 Update & Communication Response: Mary Rose Corrigan, Public Health Specialist 2. Community Foundation of Greater Dubuque Update: Nancy Van Milligen, President/CEO 3. United Way of Dubuque Update: Danielle Peterson, President/CEO 4. Greater Dubuque Development Corporation: Rick Dickinson, PresidentJCEO SUGGESTED DISPOSITION: ATTACHMENTS: Description Type COVI D-19 Work Session Agenda-MVM Memo City Manager Memo staff inemo Staff Memo Dubuque THE CITY OF � ui-Aseria cih DuB E , . � . , � II � Maste iece on tj2e Mississi i zoo�•zoiz•zois YP pp zoi�*zoi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Agenda for November 16, 2020 City Council Work Session on COVID-19 Response DATE: November 10, 2020 Assistant City Manager Cori Burbach is transmitting the agenda for the Work Session on COVID-19 Response. The presentation will provide updates from City staff and our partners on the internal and community-facing response to COVID-19. v Mic ael C. Van Milligen MCVM:jh Attachment cc: Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager Dubuque THE CITY OF � All•A�eriea Ciq Du B E ;,�.� y�; � � � �� Maste iece on the 1Vlississi i Z°°'+z°lZ'z°13 � pp zoi�*zoi9 TO: Michael C Van Milligen, City Manager FROM: Cori Burbach, Assistant City Manager DATE: November 10, 2020 RE: Agenda for 11.16.20 City Council Work Session: re: COVID-19 Response The purpose of this memo is to provide an agenda for the City Council Work Session scheduled for November 16, 2020. The presentation will provide updates from City staff and our partners on the internal and community-facing response to COVID-19. Tentative presentation order: 5:00 pm Community COVID-19 Update & Communication Response Mary Rose Corrigan, Public Health Specialist 5:40 pm Community Foundation of Greater Dubuque Update Nancy Van Milligen, President/CEO 5:45 pm United Way of Dubuque Update Danielle Peterson, President/CEO 5:50 pm Greater Dubuque Development Corporation Rick Dickinson, President/CEO 6:00 Adjourn for Inclusive Dubuque work session Additional information is attached to this memorandum, and the most up-to-date information will be shared verbally during the work session. Thank you. TO: Mike Van Milligen, City Manager FROM: Mary Rose Corrigan, Public Health Specialist SUBJECT: COVID-19 City council Work Session update DATE: November 16, 2020 CURRENT INFORMATION The Dubuque County Public Health Incident Management (IMT) team consisting of City of Dubuque Health Services Department (Mary Rose Corrigan) Dubuque County Health Department, (Patrice Lambert) VNA (Stacey Killian) and the Dubuque County Emergency Management Agency (Tom Berger), along with both hospitals continue in full activation. The IMT also consists of county Health Department Assistant Director, Samantha Kloft and City of Dubuque Health Services Department Environmental Sanitarians Tim Link and Sydney Moquin. We are coordinating our response efforts in conjunction with the Iowa Department of Public Health (IDPH), and with guidance from CDC via weekly webinars and direct contact with our regional epidemiologist. Randy Gehl serves as the Public Information (PIO) officer for the IMT. Current case counts and other related COVID -19 data can be found at www.coronavirus.iowa.gov. The important metrics for the city council to understand and monitor include: ➢ The 14 day ave positivity rate trend line ➢ Hospitalizations ➢ Cases by age group ➢ Epi-curve/overall trend line and days to double ➢ Cases by zip code ➢ Equity related data as it becomes available ➢ Long Term Care (LTC) outbreaks ➢ Days to Double 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 Locally, the Fire Department is doing an elevated number of COVID-related responses. This spike is in the past two weeks, increase of about 4-5 calls per day over our average. The COVID isolation apartments are also keeping Fire Department staff busy with check in/out and meal service. Today there are 14 people in the shelter. White House Task Force Report dated Nov 10, 2020 maintains Iowa and Dubuque County and the City of Dubuque in the Red Zone status. The following three counties had the highest number of new cases over the last 3 weeks: 1. Polk County, 2. Linn County, and 3. Scott County. These counties represent 24.2% of new cases in Iowa. The report states, “The silent community spread that precedes and continues throughout surges can only be identified and interrupted through proactive and increased testing and surveillance, as universities have done with frequent (weekly) required testing.” Recommendations noted in the report that are already implemented include: • required mask/face coverings (including teachers at schools,) • providing assistance to nursing homes for care and capacity planning, • Message to communities’ basic actions they should take now: 1) Do not gather without a mask with individuals living outside of your household, 2) Always wear a mask in public places:3) Stop gatherings beyond immediate household until cases and test positivity are in the yellow zone. 4) Get your flu shot. • The most recent trends, showing steep inclines across all indicators, need immediate action including mask requirements to decrease severity in morbidity and mortality among Iowans." • Ensure all hospitals, including rural hospitals, have access to antivirals, antibodies, PPE, and ventilators. Work though FEMA to secure supplies when stocks of less than a week’s supply is confirmed. appointment slots. However, the free sites have logistical issues including staffing, site a scheduled appointment has increased. Sites are working on expanding test including health care providers, are scheduled at capacity. Therefore, the wait time for than once. Almost 19% of the cases tested since March have been positive. All clinics, County. This does not account for number of tests, since many people are tested more centers where it is required), almost 41,000 people have been tested in Dubuque Although we are not doing targeted testing and screening (except in long term care The White House Report also recommends expanded and targeted, proactive testing. spread. cools, friends and families are moving social gatherings indoors, significantly increasing at LTCs, crowds in public and specifically social gatherings in private. As the weather Zone designation in Dubuque county are cases contracted through community spread county’s five LTC outbreaks and increased hospitalizations. Contributing to the Red previous 7 days, along with test positivity above 10%, while factoring in Dubuque The designation is based on having greater than 100 cases/100,000 population in the congestion and the priority of continuing to serve customers with other services they normally provide. Ie Hy-Vee and Hartig’ s.) Contact tracing: Despite ongoing hiring of additional staff, IDPH is behind in contact tracing for positive COVID-19 cases. And until last week, VNA was providing a courtesy phone call to all positive cases in order to provide timely notification and guidance. Due to the recent surge in cases and IDPH falling behind, along with a change in the contact tracing data collection web-based system, we recently transitioned to a combination approach to COVID-19 contact tracing. Now, the Dubuque VNA is conducting primary contact tracing for the majority of Dubuque County residents who test positive for COVID-19. IDPH is assisting with contact tracing for Dubuque County when the VNA cannot respond in a timely manner or falls behind. All VNA staff are competent in contact tracing and assist with COVID mitigation efforts. In Dubuque, the VNA currently has 33 staff members with 3 open positions. VNA is also assisting with pre-K -12 schools and higher education institutions on case notification. Schools and higher education institutions are also actively participating in the contact tracing. pandemic response. other human needs referrals. VNA will be adding additional staff nurses to focus on the days/week. In addition, they continue to provide thermometers, food assistance and Dubuque VNA Continues to operate the public call center for Dubuque County 7 semester breaks are in place at local colleges and universities. education students as they do with preK-12. Plans and guidance for holiday and with the IMT. VNA provides similar contact tracing and assistance with the higher The Dubuque County higher education institution representatives also meet bi-weekly possible. The current level of transmission in school aged children…… notification of positive cases and starting the contact tracing process as soon as bi-weekly with preK-12 school. The VNA works closely with the preK-12 schools on data that reveals spread happening primarily outside of the classrooms. The IMT meets schools are opting to keep their hybrid models in lieu of the case and contact tracing 15%, the rate at which schools can request a waiver to in person learning, the county person school attendance. Although the County positivity rate is 24.5%, well above coronavirus.iowa.gov site as one of the indicators that determines maintaining in- K-12 schools must use the IDPH 14- day positivity rate posted on the planning assistance with the county colleges and universities and the K-12 districts. The The Public Health Incident Management team continues to provide guidance and Schools Pharmacy Chain agreements for vaccine administration. skilled (assisted living type) facilities in Dubuque County are signed up in the National vaccination steps. Currently, 12 skilled nursing facilities or nursing homes and 21 non- will have the option of partnering with a national pharmacy retailer for all COVID-19 other CMS directives, utilizing federally deployed testing equipment and supplies. LTC test staff and residents on a frequency based on the previous week’s positivity rate and facility outbreaks, and this number will increase this week. Nursing homes continue to Long Term Care facility status: Dubuque County currently has five long-term care Vaccines The IMT is receiving ongoing information and vaccination planning tools from the IDPH. We continue to work with local healthcare providers to assess their interest in being a vaccination site and provide information on vaccine planning. To date, 19 local providers have indicated their interest in administering vaccine through 75 sites. No vaccine has been approved and no firm date for beginning administration has been established. The county vaccination plan, based on the IDPH strategy, will consist of the following elements: • Organizational structure and partner involvement • Phased approach to COVID-19 vaccination • Critical populations • Provider recruitment and Enrollment • Vaccine administration capacity • Vaccine allocation, ordering, distribution, and inventory management • Vaccine Storage and Handling • Vaccine administration documentation and reporting • Vaccination second-dose reminders • Vaccination program communication and community education, including education to vulnerable populations • Regulatory, safety and program monitoring were then given the opportunity to ask questions of the group. The event was covered UnityPoint Health - Finley Hospital, and MercyOne Dubuque Medical Center. Media Health Center, the Dubuque County Public Health Incident Management Team, from Medical Associates Clinics, Grand River Medical Group, Crescent Community conference on Tuesday, Nov. 10. The event began with remarks from representatives worked with members of the Joint Information System to facilitate a virtual media To communicate the local hospital situation, Public Information Officer Randy Gehl 4. Seek low or no cost solutions, outside funding sources and or resources communication 3. Hospitals and IMT work cooperatively, with transparency and open partnerships 2. Provide ongoing communication to staff, community, and community assure a safe work environment for patients and staff 1. Provide adequate equipment, supplies and medications to care for patients and The Goals of the planning include: other non-COVID-19 patients. Finley Hospitals in order to care for COVID-19 patients while maintaining services for planning effort is to maximize capacity and capability of MercyOne and UnityPoint and Unity Point Finley Hospital on hospital capacity planning. The purpose of the Hospital Capacity Planning The IMT and some city staff are working with MercyOne by the Telegraph Herald, Radio Dubuque, KCRG, KWWL, and KGAN. A vide of the media conference was shared with participating organizations, shared through the City's social media channels, and continues to be replayed on CityChannel Dubuque. The Joint Information System consists of communications staff from Medical Associates Clinics, Grand River Medical Group, Crescent Community Health Center, the Dubuque County Public Health Incident Management Team, UnityPoint Health - Finley Hospital, MercyOne Dubuque Medical Center, Dubuque Community Schools, Greater Dubuque Development Corporation, and the Dubuque Area Chamber of Commerce. Public Health Mitigation measure enforcement in restaurants and bars- The Iowa Alcoholic Beverages Division (ABD) requires licensees to complete a COVID-19 Compliance Checklist to assist in the implementation of the Governor’s proclamation requirements. Health Services Department environmental sanitarians have responded to 17 citizen complaints at food and alcohol establishments not followin g the Governor’s proclamation or the city face covering ordinance, issued 2 warning letters to food establishments (without a liquor license) and referred 10 establishments with liquor licenses to the ABD for enforcement. The Police and Fire Departments are also doing enhanced reinforcement. The fire department completed 60 COVID-19 inspections of food establishments for distancing rules. No violations were , noted Fire staff did assist a few with table arrangement to improve layout and avoid blocking exits. Looking ahead / What else can we do? • Preparing for the upcoming Influenza season- get vaccinated! • Implementing and distributing ever changing guidance from CDC, IDPH and DOE. • Plan for community vaccine point of distribution (POD.) and community wide vaccine administration • City Public Information Office staff, in conjunction with the IMT, will be providing new messaging and community education in conjunction with local health care providers to combat pandemic fatigue, and address the communities lack of adhering to recommended COVID-19 safe guidance. • City Attorney continues to dialog with other mitigation strategies and best practices from local communities, including additional provisions in local proclamations, ordinances, local enforcement of proclamation options etc • Continue to focus on providing guidance as we continued and increased community spread • Insist on public health mitigation strategies for issuance of Special Events Permits. Health Services Department City Council update Nov 16, 2020 Mary Rose Corrigan, Public Health Specialist Dubuque County Public Health Incident Management Team (IMT) Mary Rose Corrigan Stacey Kilian City of Dubuque Visiting Nurses Association Randy Gehl, City of Dubuque Public Information Officer Patrice Lambert Tom Berger Dubuque County Emergency Management Numbers to Watch •The 14 day ave positivity rate trend line •Hospitalizations •Cases by age group •Epi-curve and Days to Double •Cases by zip code •Equity related data as it becomes available •Long Term Care outbreaks Active Cases 0 500 1,000 1,500 2,000 2,500 Active COVID-19 Cases in Dubuque County 1,303 2,923 ACTIVE COVID-19 CASES IN DUBUQUE COUNTY: OCT. 1 - NOV. 14, 2020 124% INCREASE 10.7% 8.8%8.6% 7.8%7.5%7.4%7.3%7.3%7.1%7.1%7.0%6.8%6.6%6.4% 5.0% 2.0% COVID -19 CASES AS % OF ZIP CODE POPULATION AS OF NOV. 16 13.9% 24.6% 0% 5% 10% 15% 20% 25% DUBUQUE COUNTY PAST 14-DAY AVERAGE COVID -19 TEST POSITIVITY RATE OCT. 16 -NOV. 16 (IDPH CALCULATION) White House Task Force Report Nov 8, 2020 •Linn, Polk, Scott Counties = 24% of cases Testing in Dubuque County 9,040 8,112 6,908 5,714 5,634 5,455 5,157 5,110 5,010 COVID-19 Cases to Date per Capita (100K Population) as of Nov. 16, 2020 (Iowa Counties with Cities of 50K+ Population) 40,79641,23836,40936,53238,61535,54034,48932,78932,145 COVID-19 Testing per Capita (100K Population) as of Nov. 16, 2020 (Iowa Counties with Cities of 50K+ Population) Iowa Hospitalizations Nov 16, 2020 7 57 9/1/20 9/8/20 9/15/20 9/22/20 9/29/20 10/6/20 10/13/20 10/20/20 10/27/20 11/3/20 11/10/20 DUBUQUE COUNTY RESIDENT COVID -19 HOSPITALIZATIONS SEPT. 1 -NOV. 16, 2020 Hospital Capacity & Capability 1.Provide adequate equipment, supplies and medications to care for patients and assure a safe work environment for patients and staff 2.Provide ongoing communication to staff, community, and community partnerships 3.Hospitals and IMT work cooperatively, with transparency and open communication 4.Seek low or no cost solutions, outside funding sources and or resources Vaccination Planning •Organizational structure and partner involvement •Phased approach to COVID-19 vaccination •Critical populations •Provider recruitment and Enrollment •Administration capacity •Allocation, ordering, distribution, and inventory management •Storage and Handling •Administration documentation and reporting •Second-dose reminders •Vaccination program communication and community education, including education to vulnerable populations •Regulatory, safety and program monitoring Questions