COVID-19 Update Copyrighted
January 19, 2021
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\2021.1.19 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: Jan 19, 2021
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.
Contact tracing: VNA and IDPH continue contract tracing with no lag due to additional
contact tracing staff at IDPH and the lower number of cases in the past month.
Long Term Care facility status: Dubuque County currently has two long term care
facility (LTC) outbreaks, with these facilities having 4 cases in the last 14 days. All LTC
facilities have agreements with pharmacies for vaccination of residents and staff which
is underway and expected to continue through January, 2021.
Schools
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
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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 and higher education institutions.
PreK-12 schools, are working with the IMT to vaccinate school teachers and staff in
priority group 1b. 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 has had 58 positive cases since January 1, 2021.
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 no
positive cases since January 1, 2021. All school and higher education nurses, and
health staff are scheduled or have received vaccine as part of priority group 1a.
Dubuque VNA Continues to operate the public call center for Dubuque County 7
days/week. To date VNA has fielded 32,920 contacts calls/contact from the community,
including over 100 calls per day in the last week regarding vaccine distribution. 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 reaching a total of 1,337 people on this issue. VNA staff are contacting 14
residential care facilities daily.
Emergency Management Agency (EMA) Director Tom Berger reports they travel to
the regional node in Cedar Rapids to pick up requested PPE. Increased supplies were
delivered last week to local healthcare and other institutions needing PPE.
Hospital Capacity Planning The IMT are communicating 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.
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
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environmental sanitarians have done compliance related inspections on 101 food
establishments- there were 13 total Covid complaints with 7 verified, and 3 warning
letters along with 15 referrals to ABD. For tattoo and swimming pool facilities, they’ve
done a total of 11 inspections.
Public Information The IMT, in conjunction with the City Public Information Office,
continues to provide daily COVID-19 updates along with social media posts and fielding
and responding to a variety of news media requests. A COVID-19 Vaccination mailer
was developed by City PIO staff with input from the incident management team and
joint information system group. The purpose of the mailer is to:
• provide basic information to all county residents on the importance of getting
vaccinated when they are eligible,
• create realistic expectations for the availability of vaccines for the general public,
• address basic questions about the vaccines, and
• provide a website URL and contact information for additional
information/updates, including an option to receive updates via email and/or text.
The mailer is 12.5 inches wide and 9.5 inches high and will be mailed to every postal
address in Dubuque County through the US Postal Services "Every Door Direct Mailing"
program. This entails approximately 47,500 addresses, covering every zip code in
Dubuque County. The cost of the mailing is approximately $12,750 and will be paid
with grant funds secured from the Iowa Department of Public Health by Dubuque
County.
The mailer was sent to the printer today and is expected to be mailed by January
27. Information in the mailer will also be distributed through the City's other
communication channels.
COVID- 19 Vaccination The IMT is receiving ever changing and evolving information
and vaccination planning tools from the IDPH. To date, 58 local providers have
indicated their interest in administering vaccine through including eight pharmacies and
their multiple sites. The IMT determines the allocations to the approved vaccine
providers as we receive weekly vaccine allocations. The IMT further prioritizes within
the priority groups on who the vaccine will be administered based on several factors.
The Dubuque County vaccination plan, consists of the following elements:
ASSUMPTIONS
Dubuque County IMT will follow IDPH Vaccine Strategy
https://idph.iowa.gov/Portals/1/userfiles/61/covid19/vaccine/V%202%20IOWA%20COVI
D-19%20VACCINATION%20STRATEGY%2012_4_20_FINAL.pdf
Dbq Co IMT will adhere to the Iowa Disease Advisory Council (IDAC) directives and
Iowa Vaccine Shortage orders https://idph.iowa.gov/Emerging-Health-Issues/Novel-
Coronavirus/IDAC
Dbq Co IMT will utilize a combination of IDPH Approved Vaccine Providers and the IMT
public health vaccine provider (VNA and community partners)
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IDPH will provide vaccine for Dubuque Long Term Care residents and staff through the
National Pharmacy Chain Partnership
The Federal Government will initiate the Federal Retail Pharmacy Program for vaccine
distribution to the general public in Phase 2.
Dbq Co IMT will require vaccinations by appointment while the vaccine supply is limited
IDPH provides information to Dubuque County IMT to assist in distributing
vaccination, including:
• Priority group recommendations
• Priority group and vulnerable population estimates
• Current approved vaccine providers
• Vaccine standing orders
• Vaccine specific guidance- transportation, storage, handling, preparation,
administration, record keeping etc
• Vaccine transfer instructions
Iowa's Immunization Registry Information System (IRIS) is used to manage:
• Vaccine allocations to counties from IDPH
• Dubuque County’s allocation of vaccine to Dubuque vaccine providers
• Documentation of vaccine’s administered to individuals
• Documentation of transfers of vaccine between vaccine providers
• Information regarding vaccine providers’ vaccine inventory
Dbq Co IMT will collect information from entities designated in the IDAC priority groups
to facilitate planning and scheduling of vaccinations. This includes gathering
information from worksites, schools, and other entities/organizations related to the
priority groups that will provide information necessary to schedule vaccinations and
document in IRIS. This will also include having prioritized groups in the cue to initiate
scheduling for vaccination, once adequate supplies are allocated and available, and in
the event extra or additional vaccines become available.
Dbq Co IMT will sub-prioritize within the designated IDAC priority groups based
on:
• Age
• Estimated population within the priority group/sub-group
• Risk
• Vaccine provider capability
• Vaccine supply
• Practical logistics
• Local business/industry systems and climate, vulnerable populations, access to
healthcare
• COVID -19 disease trends
• Surgeries/Emergency treatment exposure
• Work with elderly and other vulnerable populations
• Specialize with children
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• Actively seeing vulnerable populations, Medicaid and uninsured
Local approved vaccine providers and locations for vaccine administration will be
selected based the following factors:
• Vaccine provider current capacity and capability
• Vaccine supply
• Vaccine provider location and facility, ability to mobilize/relocate to community
based and/or worksite locations
• Ability to partner with other community vaccine providers
• Ability to provide vaccine for open and/or closed Points of Distribution, including
ability to schedule vaccination appointments
As vaccine becomes more available and a predictable supply chain is evident, a
common community based Point of Distribution (POD) will be established/opened for
approved vaccine providers to utilize. This POD or “market place” vaccination site will
provide space for those eligible to receive vaccinations.
The POD(s) will
• Be easily Accessible for Dubuque County residents
• Be accessible via mass transportation (i.e. bus lines)
• Meet all necessary ADA requirements, and public health measures to assure
safety during the vaccination process
• Be planned with input from vaccine providers and utilizing existing Dubuque
County POD plans
POD location and appointment sign up information will be disseminated widely, in
conjunction with the Joint Information Center, which is coordinated by City of Dubuque
Public Information Officer, Randy Gehl
Neither the IMT nor the IDPH has enough information from the Federal government to
predict an exact number of allocated vaccines beyond one week. IDPH is estimating
additional vaccine will be available beginning February first since the long- term care
facilities and phase 1a vaccinations will be nearly complete. Vaccine allocation and
supply is dependent on the following:
• Manufacturing
• Federal allocation
• Distribution logistics
• Priority group designations
• Federal administration and forthcoming changes after the Presidential
Inauguration
The IDPH Infectious Disease Advisory Council (IDAC) released priority group 1b on
January 11, 2021 recommendations since its first health care worker priority group on
December 18, 2020. (see attached IDAC document)
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Final decisions about prioritization of populations and priority groups will not be made
until closer to implementation. Therefore, IDPH is preparing multiple scenarios for
local distribution and administration.
Looking ahead
• Promote influenza vaccinations!
• Plan for community vaccine distribution and administration
• 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 a multi-media plan for
dissemination
• Insist on public health mitigation strategies continuing
• Implementing and distributing ever changing guidance from CDC, IDPH and
DOE.
Iowa’s Infectious Disease Advisory Committee
Recommendations for initial prioritization populations for
Phase 1B administration of COVID-19 vaccine
FINAL RECOMMENDATION
1/11/2021
The Iowa Infectious Disease Advisory Council (IDAC) has reviewed the priority population recommendations of
Phase 1b identified in the Advisory Committee on Immunization Practices (ACIP) guidance issued December 20,
2020. IDAC offers the modifications and recommendations outlined below to assist vaccine providers in prioritizing
Phase 1b populations. Upon activation of Phase 1b IDAC supports the continuation of vaccination efforts for
individuals included in Phase 1A. IDAC will continue to discuss Phase 1C recommendations and expects to have an
update this week.
In addition, IDAC strongly supports that no individual shall be restricted from obtaining vaccine based on residency
or citizenship as noted in the memo from the Iowa Department of Public Health Re: Administration of COVID-19
Vaccine – County/State of Residence, dated December 11, 2020.
https://idph.iowa.gov/Portals/1/userfiles/61/covid19/vaccine/Vaccine%20Memo-
Regardless%20of%20Residence.pdf
The following factors shall be considered when sub-prioritizing Phase 1b populations recommended by IDAC
(noted below), while a vaccine shortage exists:
As local public health agencies and vaccine providers plan for limited use of vaccine among Phase 1B populations,
the following factors shall be considered:
1. Historical COVID-19 disease trends affecting the eligible populations.
2. The risk of exposure, the risk of transmission, the risk of complications, the frequency of exposure, and the
duration of exposure from COVID-19 for the eligible populations. Considerations should include congregate
settings, workplace environmental controls, population density, and other factors that may impact risk of
exposure and transmission of COVID-19.
3. Apply health equity considerations when prioritizing eligible populations. Considerations should include, but
are not limited to access to health care, disparate health outcomes, socioeconomic status, insurance
coverage, etc.
Phase 1b priority populations
Due to the current and short-term projections for vaccine allocation for Iowa, IDAC recommends the following, more
narrowly defined, eligible populations for Phase 1b:
Persons aged > 75years, OR the following populations vulnerable to high risk of exposure or severity of illness:
● Individuals with disabilities living in home settings whom are dependent on attendant care staff, and their
attendant care staff, if not otherwise vaccinated under Phase 1a.
● Correctional facility staff and individuals incarcerated, including state and city or county operated facilities.
● Staff of and individuals living in congregate settings, not covered by the first two bullets, including shelters,
sober living homes, behavioral health treatment centers, and detention centers. College dormitories shall
not be included as part of Phase 1B.
● Where public health data indicates outbreaks or clusters of disease among food, agriculture, distribution
and manufacturing workers whom work in or live in congregate settings that do not allow for social
distancing. For example, working in a meatpacking or manufacturing production line or migrant workers
whom live in bunkroom style housing.
● PK-12 school staff, early childhood education, and childcare workers. Sub-prioritization should consider
persons who work with younger and at-risk children in care, to better ensure child-wellbeing and mitigate
impact to parent workforce.
● First responders (e.g., firefighters, police officers, and dependent adult abuse and child welfare social
workers).
● Inspectors responsible for health, life and safety, including those in hospital and long-term care settings,
child, and food production safety.
● Government officials, including staff, to ensure continuity of government, engaged in state business at the
Iowa Capitol during the legislative session.
Vaccine allocation strategy for Phase 1b, while a vaccine shortage exists:
● 50% of the vaccine allocation shall be dedicated to priority age populations and individuals of all ages with
co-morbidities.
● 50% of the vaccine allocation shall be dedicated to the populations vulnerable to high risk of exposure or
severity of illness.
● Allocations shall be monitored and adjusted to ensure efficient and timely use of available vaccine doses.
Allocation of vaccine shall be based on available US Census population data, proportionate to the county. Exceptions
and allocation adjustments will be made for priority groups IF the distribution of specific populations are
inconsistent with US Census data. In addition, modifications in allocations may be taken to adjust for
disproportionate workforce in less populated counties.
Mary Rose Corrigan, Public Health Specialist
Health Services Department
Public Health Incident Management Team
City Council COVID-19 Work Session
January 19, 2021
Dubuque County Public Health
Incident Management Team (IMT)
Mary Rose Corrigan Stacey Kilian
City of Dubuque VNA
Randy Gehl, City of Dubuque
Public Information Officer
Patrice Lambert Tom Berger
Dubuque County Dubuque County
Health Department EMA
87
34
84 74
45
10
33 44 41
27
46
18 25 25
14-DAY TRENDLINE OF NEW COVID-
19 CASES IN DUBUQUE COUNTY
27 22 1722
12
9
13
12/17/2012/18/2012/19/2012/20/2012/21/2012/22/2012/23/2012/24/2012/25/2012/26/2012/27/2012/28/2012/29/2012/30/2012/31/201/1/211/2/211/3/211/4/211/5/211/6/211/7/211/8/211/9/211/10/211/11/211/12/211/13/211/14/211/15/211/16/211/17/21COVID-19 HOSPITALIZATIONS
OF DUBUQUE COUNTY
RESIDENTS: DEC. 17 -JAN. 17
11.8%9.9%
14-DAY AVERAGE OF
PERCENT OF POSITIVE CASES
4.7%
4.1%
6.0%
12.2%
7.1%
7.7%
8.6%
9.2%
6.1%
6.1%
7.1%
6.4%
4.7%
3.4%
2.7%
1.3%
2.7%
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 by Age
Group:
Jan. 1 -19, 2021
9
2
Tattoo Establishments Pools
Social Distancing Compliance
Inspections
101
13 15 7 3
0
20
40
60
80
100
120
Food
Establishments
Total COVID19
Complaints
Referred to ABD COVID19
Complaints
Verified
Warning Letters
Issued from city
City of Dubuque COVID19 Compliance
Inspections
September 24, 2020-January 19, 2021
COVID -19 Vaccination Update Phase 1a
Expected
Allocation Date Pfizer Moderna Total
12/14/2020 1,950 0 1,950
12/21/2020 0 400 400
12/28/2020 0 400 400
1/4/2021**1,950 0 1,950
1/11/2021 0 1,000 1,000
Total in 5 weeks 3,900 1,800 5,700
Previous Allocations This Week’s Allocations
Expected
Allocation Date Pfizer Moderna Total
1/18/2021**0 400 400
1/18/2021 0 800 800
**Note: Allocation is booster only.
Total COVID-19
vaccinations
provided to date:
4,550
**Note: Allocation is booster only.
Dubuque County Vaccination Planning
●IMT will follow IDPH Vaccine Strategy and IDAC priorities
●Vaccine administered by IDPH Approved Vaccine Providers and the IMT public
health vaccine provider (VNA)
●IMT will require vaccinations by appointment while the vaccine supply is limited
●Utilize Iowa’s Immunization Registry Information System (IRIS)
●Priority group information gathering
Who will get vaccinated next? Iowa Vaccine Priority 1b-
Persons aged > 75years, OR populations vulnerable to high risk of exposure or severity of illness
●Individuals with disabilities living in home settings whom are dependent on attendant care
staff, and their attendant care staff, if not otherwise vaccinated under Phase 1a. ●Correctional facility staff and individuals incarcerated, including state and city or county
operated facilities. ●Staff of and individuals living in congregate settings, not covered by the first two bullets,
including shelters, sober living homes, behavioral health treatment centers, and detention
centers. College dormitories shall not be included as part of Phase 1B. ●Where public health data indicates outbreaks or clusters of disease among food,
agriculture, distribution and manufacturing workers whom work in or live in
congregate settings that do not allow for social distancing. For example, working in a
meatpacking or manufacturing production line or migrant workers whom live in bunkroom
style housing. ●PK-12 school staff, early childhood education, and childcare workers. Sub-prioritization
should consider persons who work with younger and at-risk children in care, to better ensure
child-wellbeing and mitigate impact to parent workforce. ●First responders (e.g., firefighters, police officers, and dependent adult abuse and child
welfare social workers).
Modified Phase 1B priority populations
●Inspectors responsible for health, life and safety, including those in hospital
and long-term care settings, child, and food production safety
●Government officials, including staff, to ensure continuity of government,
engaged in state business at the Iowa Capitol during the legislative session
Vaccine allocation strategy for Phase 1b, while a vaccine
shortage exists
●50% for priority age populations and individuals of all ages
with co -morbidities.
●50% to the populations vulnerable to high risk of exposure
or severity of illness.
●Allocations shall be monitored and adjusted to ensure
efficient and timely use of available vaccine doses.
Local Vaccine Allocation & Distribution Considerations
●Age
●Estimated population within the priority group/sub-group
●Risk
●Vaccine provider capability
●Vaccine supply
●Practical logistics
●Local business/industry systems and climate, vulnerable populations, access
to healthcare
●COVID -19 disease trends
●Surgeries/Emergency treatment
●Work with elderly
●Specialize with children
●Actively seeing vulnerable populations, Medicaid and uninsured
Where will I get Vaccinated?
•Clinics/medical providers offices
•Hospitals
•Pharmacies
•Public Health Clinics
•Work Sites
•Community Point of Distribution (POD)
Vaccine Planning Considerations for Vaccine
Providers
●Priority Groups and vulnerable populations
●Billing
●Remote site administration, ie worksites, schools, colleges,
congregate living facilities, institutions
●Onsite administrations ie logistics, parking, flow, capacity, space
●Costs/fees? (in addition to allowable administration fees)
●Scheduling systems and processes for appointments
●Capacity/capability-how many vaccinations can you administer?
Vaccine Plan: adaptable and flexible
Execution based on Vaccine allocation and supply
•Manufacturing
•Federal allocation
•Distribution logistics
•Priority group designations
•Federal administration and forthcoming changes after the Presidential
Inauguration
IDAC decisions and priority groups
Additional COVID -19 Activities
●Schools, preK -12 and higher ed
●Long Term Care
●Dubuque VNA call center and other functions
●Emergency Management Agency (EMA)
●Vaccine public information/education
Questions