COVID-19 Update Copyrig hted
December 7, 2020
City of Dubuque Presentation(s) # 2.
City Council Meeting
ITEM TITLE: COVID-19 Update
SUM MARY: 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:
F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.7 City Council Update.docx
TO: Mike Van Milligen, City Manager
FROM: Mary Rose Corrigan, Public Health Specialist
SUBJECT: COVID-19 City council Work Session update
DATE: December 7, 2020
BACKGROUND 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 INFORMATION
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
F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.7 City Council Update.docx
White House Task Force Report dated Nov 29, 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 27.5% of new cases in Iowa.
Iowa as a state is also a red zone for cases, with 650 new cases per 100,000
population, compared to a national average of 349 per 100,000, with the 6th highest
rate in the country. Iowa is in the red zone for test positivity, indicating a rate at or above
10.1%, with the 7th highest rate in the country.
Although Iowa has seen a decrease in new cases and a decrease in test positivity, the
report states,
The COVID risk to all Americans is at a historic high. The national daily COVID
incidence after Memorial Day, but before the summer surge, was fewer than 25,000
new cases/day and is now more than 180,000 new cases/day; COVID inpatients then
were fewer than 30,000 but are now more than 90,000; fatalities have more than
doubled. We are in a very dangerous place due to the current, extremely high COVID
baseline and limited hospital capacity; a further post-Thanksgiving surge will
compromise COVID patient care, as well as medical care overall. required mask/face
coverings (including teachers at schools.) Testing and case trends should be cautiously
interpreted this week given the Thanksgiving holiday weekend.
The Task Force Report recommends:
• if you are over 65 or have significant health conditions, you should not enter any
indoor public spaces where anyone is unmasked due to the immediate risk to
your health
• If you are under 40, you need to assume you became infected during the
Thanksgiving period if you gathered beyond your immediate household. Most
likely, you will not have symptoms; however, you are dangerous to others and
you must isolate away from anyone at increased risk for severe disease and get
tested immediately.
• If you are over 65 or have significant medical conditions and you gathered
outside of your immediate household, you are at a significant risk for serious
COVID infection; if you develop any symptoms, you must be tested immediately.
• 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.
Contact tracing: VNA and IDPH have improved timely contract tracing in the past few
weeks due to additional contact tracing staff at IDPH and the lower number of cases in
the past week. 95% of the cases have a complete investigation. Most of the 880 staff
hours billed to the County in November were for contact tracing, which was 300 less
hours than October.
F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.7 City Council Update.docx
Long Term Care facility status: Dubuque County currently has four long term care
facility (LTC) outbreaks, with these facilities having 7 cases in the last 14 days and a
total of 116 cases. Because nursing homes continue to test staff twice weekly, the
screening will pick up asymptomatic cases and potentially move the facilities into
outbreak status. All LTC facilities have agreements with pharmacies for vaccination of
residents and staff. LTC are considered in the top priority group for receiving vaccine.
Schools
The Public Health Incident Management team continues to provide guidance and
planning assistance with the county colleges and universities and the K-12 districts.
Despite the 14 day average positivity rate being above the 15% (currently 14%) action
level when schools can petition for all virtual, the county schools are opting to keep their
hybrid models in lieu of the case and contact tracing data that reveals spread happening
primarily outside of the classrooms and the low rates among students and staff. The
IMT meets bi-weekly with preK-12 school. The VNA works closely with the preK-12
schools on notification of positive cases and starting the contact tracing process as
soon as possible. To date Dubuque County K12 schools have had 154 positive cases.
The Dubuque County higher education institution representatives also meet bi-weekly
with the IMT. VNA provides similar contact tracing and assistance with the higher
education students as they do with preK-12. Dubuque County colleges have had 75
positive cases.
Dubuque VNA Continues to operate the public call center for Dubuque County 7
days/week. To date VNA has fielded 30,808 (553 contacts in the last week)
calls/contact from the community In addition, they continue to provide thermometers,
food assistance and other human needs referrals. VNA will be adding additional staff
nurses to focus on the pandemic response. VNA staff will also be reaching out to all
cases 28 days after testing positive to promote plasma donation for the convalescent
plasma treatments being used by hospitals.
Emergency Management Agency (EMA) Director Tom Berger reports they are now
traveling to the regional node in Cedar Rapids to pick up requested PPE and supplying
the Test Iowa Sites rather than them receiving direct shipments from the DOT. PPE
supplies for healthcare facilities are adequate.
Vaccines The IMT is receiving ongoing information and vaccination planning tools from
the IDPH. To date, 9 local providers have indicated their interest in administering
vaccine through 18 sites, along with eight pharmacies and their multiple sites. Pfizer
vaccine is on the FDA agenda for approval on December 12, 2020 and Moderna’s
vaccine is scheduled for December 14, 2020 FDA review and approval (see attached
December 3, 2020 Iowa COVID-19 Vaccine Planning document.) No firm date for
beginning administration has been established, but we can expect vaccines arriving
around December 14, 2020. The initial doses will be allocated to hospital health care
workers and LTC residents. The IMT will determine the specific allocations to the
hospitals and other vaccine providers as we receive ongoing vaccine allocations. The
F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.7 City Council Update.docx
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
IDPH is convening a team of external and internal subject matter experts, known
collectively as the Infectious Disease Advisory Council (IDAC), to provide additional
clinical guidance.
This council will assist the State in developing COVID-19 vaccine prioritization of
populations for early stages in the vaccination response when supply is limited along
will bring together ethical and clinical expertise from across the state to represent
multiple perspectives including:
Rural/urban populations
Hospital administration
Infectious disease specialists
Vulnerable populations in congregate settings
Advocates for aging populations
Individuals with intellectual and developmental disabilities
Refugees
The reason for this is to minimize health inequities based on geography, poverty and
other social determinants. This group will also provide input as additional vaccines
become available, as well as therapeutics.
Further Distribution:
The Department is preparing for broader distribution as vaccine supply increases.
There are currently 1,187 providers signed up to administer the vaccine in Iowa with
new applications being received daily.
There is a process for reallocation should a specific location not be able to administer
their allotment.
Locally, a Vaccine equity and accessibility committee has been established, let by Kelly
Larson, Human Rights Department Director. The goal of the committee is to provide
outreach to vulnerable populations for information and education dissemination
regarding the vaccine, along with how various populations and groups can receive the
vaccine.
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Hospital Capacity Planning The IMT and city Human Resources Department staff are
working with MercyOne and Unity Point Finley Hospital on hospital capacity and
capability planning. The purpose of the planning effort is to maximize capacity and
capability of MercyOne and UnityPoint Finley Hospitals in order to care for COVID-19
patients while maintaining services for other non-COVID-19 patients.
IDPH and the Governor’s Office have communicated that their focus will be health care
staffing, in order to maximize hospital capacity through increased capability. The state
does not have Alternate Care Site (ACS) resources to distribute. However, they are
exploring additional staffing resources. Locally, planning on an ACS facility for lower
acuity patients with will continue in the event one is needed.
Although the hospital COVID-19 census decreased last week, we expect the number of
cases to return to pre-Thanksgiving levels. The hospitals must continue to plan for
increased number of patients not only for COVID-19 but also as we await the start of the
influenza season.
The city has engaged employees to the hospital staffing needs for information sharing
throughout the community and to encourage employees to apply if their ability and
schedules allow.
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 continue to
respond to citizen complaints at food and alcohol establishments not following the
Governor’s proclamation or the city face covering ordinance. The Police and Fire
Departments are also doing enhanced reinforcement with ABD staff joining their efforts.
Last week ABD filed three hearing complaints on Dubuque businesses for violations of
Governor Reynolds’ emergency public health disaster proclamation, including Mason
Dixon, 1st & Main, and Main Street social. These are in addition to the complaints filed
by city Police and Fire Departments.
Looking ahead / What else can we do?
• Preparing for the upcoming Influenza season- get vaccinated!
• 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 for vaccine education and
administration.
• Insist on public health mitigation strategies for issuance of Special Events
Permits.
• Implementing and distributing ever changing guidance from CDC, IDPH and
DOE.
Health Services Department and Incident Management Team
City Council update Dec 7, 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
Active Cases
2,343
3,411
2,532
ACTIVE COVID-19 CASES
DUBUQUE COUNTY: NOV. 7 -DEC.7
141
106
134
23
63 65
32 34
73
87
64
78
57
29
14-DAY TRENDLINE OF NEW COVID-19
CASES
IN DUBUQUE COUNTY
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
3/15/2020 4/15/2020 5/15/2020 6/15/2020 7/15/2020 8/15/2020 9/15/2020 10/15/2020 11/15/2020
DUBUQUE COUNTY COVID -19
CASES TO DATE
July 14
Aug.30
Sept.24
Oct.10
Oct.24
Nov.4
Nov.10
Nov.18
Nov.26
19.3%
14.0%
14-DAY AVERAGE OF
PERCENT OF POSITIVE CASES
(TEST POSITIVITY RATE)
43
60
29
COVID -19 HOSPITALIZATIONS OF DUBUQUE COUNTY RESIDENTS
•White House Task Foce Report
11/29/2020
•Iowa:
650 cases/100,000
•US:
349/100,000
Task Force Recommendations
•Over 65 or have significant health conditions, avoid indoor public spaces where anyone is unmasked
•Under 40, assume infected during the Thanksgiving period if you gathered beyond your immediate household.
•Over 65 or have significant medical conditions and gathered outside of your immediate household, you are at a significant risk for serious COVID infection
•Do not gather without a mask and limit gatherings beyond immediate household
•Wear a mask in public places
•Get your flu shot
Revised
Quarantine
Guidance
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
Donating Convalescent Plasma in Dubuque
Mississippi Valley Regional Blood Center
Complete the online donation from Donations are kept locally to supply Dubuque County hospitals.
www.bloodcenter.org
BioLife Plasma Services –Dubuque
Call to talk to a nurse after receiving positive COVID-19 test result.
Donations do not stay local, but are sent throughout the country as well as internationally.
(563) 583-3637
BioLife Plasma Services
American Red Cross –Eastern Iowa Chapter, Dubuque
Complete the online donation form
Plasma Donations from Recovered COVID-19 Patients (redcrossblood.org)
Vaccination Planning
•Provider agreements completed: 11 for 19 sites
•Priority for Health Care Workers: 4857 in Dubuque County
•Phase 1A Priority -Hospitals and LTC
•Vaccine allotment for counties based on population etc
•Receive vaccine ~ Dec 14, 2020
Other Response Efforts
•Contact Tracing-VNA
•Long Term Care Facilities
•Schools
•EMA/PPE
•Enforcement of Public Health Mitigation
Strategies
Questions