Loading...
COVID-19 Update Copyrighted December 21, 2020 City of Dubuque Presentation(s) # 1. 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\2020.12.21 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 21, 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\2020.12.21 City Council Update.docx White House Task Force Report dated Dec 13, 2020 maintains Iowa and Dubuque County and the City of Dubuque in the Red Zone status. However, there are fewer metro areas and counties in the Red Zone status. The following three counties continue to have the highest number of new cases over the last 3 weeks: 1. Polk County, 2. Linn County, and 3. Scott County. These counties represent 25.6% of new cases in Iowa. Iowa as a state is also a red zone for cases, with 383 new cases per 100,000 population, (decreased from 650 2 weeks prior) compared to a national average of 451 per 100,000, with the 18th highest rate in the country. As the much of the rest of the country is experiencing increased cases, the upper mid-west states are declining in positivity rates and other COVID markers. Although Iowa has seen a decrease in new cases and a decrease in test positivity, the report continues to recommend mitigation strategies in place and also stresses: • Early diagnosis and treatment including monoclonal antibody treatment for non or prior to hospitalized patients. In-hospital treatments such as FDA approved Remdesivir and anticoagulation and other treatments for late-stage inpatient treatments. • Utilize all antigen tests and other community testing options to find community asymptomatic spread, especially weekly testing of high risk groups. • 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.5) Continue to require masks be worn by students and teachers • Maintain active testing and among groups where cases are increasing and in some cases in schools. 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. Long Term Care facility status: Dubuque County currently has five long term care facility (LTC) outbreaks, with these facilities having 18 cases in the last 14 days and a total of 101 cases. All LTC facilities have agreements with pharmacies for vaccination of residents and staff. Vaccine for LTC is expected to arrive the week of Dec 28, 2020. 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. The IMT continues to meet bi-weekly with preK-12 schools. The VNA works closely with the preK-12 schools on notification of positive cases and starting the contact tracing process as soon as possible. Dubuque County K12 schools currently have 311 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 F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.21 City Council Update.docx education students as they do with preK-12. Dubuque County colleges have had 92 positive cases. Dubuque VNA Continues to operate the public call center for Dubuque County 7 days/week. To date VNA has fielded 31187 (512 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 continues to reach out to all cases 28 days after testing positive to promote plasma donation for the convalescent plasma treatments being used by hospitals. VNA staff are contacting 14 residential care facilities daily. From the start of the pandemic VNA staff have logged 5,106 hours for COVID-19 response. 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, but available through the state. This week they will be picking up and delivering a special push of PPE for the long term care facilities. This is a special allocation with the Governors CARE Act money. It will include over 16,200 gowns, 20,000 masks and 48,000 gloves. Vaccines The IMT is receiving ongoing information and vaccination planning tools from the IDPH. To date, 13 local providers have indicated their interest in administering vaccine through 19 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 was FDA approved on December 18, 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 county vaccination plan, based on the IDPH strategy is now focusing on • Vaccine administration capacity • Vaccine allocation, ordering, distribution, and inventory management • Vaccination program communication and community education, including education to vulnerable populations • Vaccine equity and accessibility The IDPH Infectious Disease Advisory Council (IDAC) has released it’s first recommendation (attached) indicating local public health should consider a tiered approach for vaccinating healthcare personnel defined in 1A, which we are utilizing in the weekly vaccine allocations for Dubuque County. As the IDAC continues it’s work on the Iowa COVID-19 vaccination strategy, they are providing an opportunity for stakeholders, such as local public health, to “engage in dialogue and share specific considerations for those we represent.” The IMT will provide feedback to IDAC by the December 23, 2020 deadline. F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.21 City Council Update.docx Final decisions about prioritization of populations and priority groups will not be made until closer to implementation; therefore we are preparing multiple scenarios for local distribution and administration. 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. As we continue to meet with hospital management and human resources staff, and plan for an alternate care facility site, the hospitals’ census has decreased and leveled off. The Incident Management Team will continue planning and meeting on the issue, but the hospitals are not experiencing the level of urgency they were in November. 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. Last week Governor Reynolds announced the Iowa Transfer Line, which MercyOne corporate is operating to facilitate patient transfer needs throughout the state. This goes beyond the current Regional Medical Coordination Center (RMCC) capabilities and is designed to provide a single point of contact for the patient transfer process. The plan is to transfer non-COVID-19 patients to allow hospitals to have room for active COVID cases requiring hospitalization. Iowa Homeland Security has also signed a contract with Favorite Staffing to supply hospitals with registered nurses based on reporting through the daily RMCC system. This contract will supply up to 150 staff nurses throughout the state at a price of $195/hour paid to the Favorite Staffing by the state for each nurse supplied. The state contract with Favorite Staffing expires December 31, 2020. As of today, 3 nurses are at Unity Point Finley and MercyOne is expecting 4 nurses. The focus of IDPH is to continue to work on addressing the hospital staffing needs. 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. Health Services environmental sanitarians have done compliance related inspections on 89 food establishments- there were 13 total covid complaints with 7 verified, and 2 warning letters along with 14 referrals to ABD . For tattoo and swimming pool facilities, they’ve done a total of 11 inspections. Public Information The IMT wished to express our gratitude to all our media partners, especially the Telegraph Herald and the TV stations that cover our area (KCRG, and KWWL) for their continued reporting on public health information, messaging and data. F:\Users\Health Department\Administration\COVID19\city council COVID\2020.12.21 City Council Update.docx We also want to thank the marketing and public information staff at the hospitals and healthcare provider clinics that make up the Joint Information Center(JIC.) Looking ahead • Promote influenza vaccinations! • Plan for community vaccine point of distribution (POD.) and community wide vaccine administration, if necessary. • City Public Information Office staff, in conjunction with the IMT and the joint Information Center (JIC), will be providing messaging and community education for vaccine education and administration along with an multi-media plan for dissemination • Insist on public health mitigation strategies continuing • Implementing and distributing ever changing guidance from CDC, IDPH and DOE. Health Services Department and Incident Management Team City Council update Dec 21, 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 COVID-19 Cases 35 63 66 52 60 44 24 29 51 60 38 37 12 16 14-DAY TRENDLINE OF NEW COVID -19 CASES IN DUBUQUE COUNTY 68 75 189 145 120 143 131 82 62 158 166 127 126 134 46 14-DAY TRENDLINE OF COVID -19 TESTING IN DUBUQUE COUNTY 89 13 14 7 2 0 10 20 30 40 50 60 70 80 90 100 Food Establishments Total COVID19 Complaints Referred to ABD COVID19 Complaints Verified Warning Letters Issued City of Dubuque COVID19 Compliance Inspections September 24, 2020-December 21, 2020 9 2 Tattoo Establishments Pools Social Distancing Compliance Inspections State Proclamation/Face Covering Enforcement 6% 5% 9% 10% 8% 6% 6% 6% 7% 6% 6% 6% 4% 4% 3% 3% 4% 0%2%4%6%8%10%12% 0-10 11-14 15-18 19-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ New Dubuque County COVID-19 Cases: December 30 34 30 22 27 22 12/8/20 12/9/20 12/10/20 12/11/20 12/12/20 12/13/20 12/14/20 12/15/20 12/16/20 12/17/20 12/18/20 12/19/20 12/20/20 12/21/20 COVID -19 HOSPITALIZATIONS OF DUBUQUE COUNTY RESIDENTS exported 21 Dec 2020 Iowa Total Deaths Dubuque County Deaths by Age Group March 24-Dec 7, 2020 •White House Task Foce Report 12/13/2020 •Iowa: 383 cases/100,000 •US: 451/100,000 White House Task Force Recommendations •Do not gather without a mask and limit gatherings beyond immediate household •Wear a mask in public places •Get your flu shot •Early diagnosis and treatment •Promote community testing and antigen testing of high risk groups Vaccination Planning •Dubuque County Provider agreements completed: 15 for 23 sites •Pharmacy agreements: 9 for 25 sites •Priority for Health Care Workers: 4857 in Dubuque County •Phase 1A Priority -Hospitals and LTC, front line health care workers •First vaccine received ~ Dec 17, 2020 •Weekly allocations expected •Iowa Infectious Disease Advisory Council (IDAC) seeking input on priority groups: https://idph.iowa.gov/Portals/1/userfiles/61/IDAC/IDAC_Letter.pdf Vaccine Priority 1A- health care & long term care •Iowa COVID-19 Vaccine Shortage Order •Dubuque County received 1950 doses –allocated to MercyOne and Unity Point-Finley •Moderna vaccine 400 doses expected this week-allocated to Medical Associates Grand River Medical Group Crescent Community Health Center COVID -19 Vaccination Update Expected Allocation Date Pfizer Moderna Total 12/13/20 26,000 0 26,000 12/20/20 31,000 54,000 85,000 12/27/20 38,000 24,000 66,000 In first 3 weeks 95,000 77,000 172,000 Expected Allocation Date Pfizer Moderna Total 12/13/20 26,000 0 26,000 12/20/20 19,500 53,800 73,300 12/27/20 19,500 19,500 39,000 In first 3 weeks 65,000 73,300 138,300 Originally Expected New Estimates Vaccine Priority 1B- •Residential care facilities, assisted living programs, elder group homes, and independent living facility residents 65+ •Emergency and law enforcement personnel •Food packaging and distribution workers •Teachers/school staff, child care providers •Adults with high-risk medical conditions Additional COVID -19 Activities •Schools, preK-12 and higher ed •LTC •Dubuque VNA call center and other functions •Emergency Management Agency (EMA) Thank you to local media providers!