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.
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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.
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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!