COVID-19 Pandemic Update Work Session Copyrig hted
April 5, 2021
City of Dubuque Work Session - Top # 1.
City Council Meeting
ITEM TITLE: 5:30 PM - COVID-19 Pandemic Update
SUM MARY: City staff and network partners will provide updates on the internal and
community-facing response to COVI D-19.
SUGGESTED
DISPOSITION:
ATTACHMENTS:
Description Type
COVI D-19 Work Session Agenda-MVM Memo City Manager Memo
staff inemo Staff Memo
Vaccine Outreach Memo_UPDATED 4/5/2021 Supporting Documentation
Dubuque
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TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Agenda for April 5, 2021 City Council Work Session on COVID-19
Response
DATE: March 31, 2021
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.
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Mic ael C. Van Milligen
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Attachment
cc: Crenna Brumwell, City Attorney
Cori Burbach, Assistant City Manager
Dubuque
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TO: Michael C Van Milligen, City Manager
FROM: Cori Burbach, Assistant City Manager
DATE: March 31, 2021
RE: Agenda for 4.5.21 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 April 5, 2021. The presentation will provide updates from City staff and
our partners on the internal and community-facing response to COVID-19.
Tentative presentation order:
5:30 pm Community COVID-19 Update & Communication Response
Mary Rose Corrigan, Public Health Specialist
Alexis Steger, Housing & Community Development Director
5:45 pm Update on vaccine distribution, including GRC POD, call center and
outreach to marginalized communities
Rick Steines, Fire Chief
Cori Burbach, Assistant City Manager
Kelly Larson, Human Rights Director
6:00 pm American Rescue Plan + Financial Update
Jenny Larson, Finance & Budget Director
Teri Goodmann, Director of Strategic Partnerships
6:15 pm Community Partner Presentations
Rick Dickinson, Greater Dubuque Development Corporation
Jenna Manders, Community Foundation of Greater Dubuque
6:25 Q&A
6:30 Adjourn for regular Council meeting
The most up-to-date information will be shared verbally during the work session.
Thank you.
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TO: Mike Van Milligen, City Manager
FROM: Mary Rose Corrigan, Public Health Specialist
SUBJECT: COVID-19 City Council Work Session update
DATE: April 5, 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. Another section of the
IMT is vulnerable populations, lead by Kelly Larson, Human Rights Director. The
vulnerable populations section is assisted by Housing and Community Development
Director Alexis Steger along with other city staff and many community partners.
CURRENT INFORMATION
Current case counts and other related COVID -19 data can be found at
www.coronavirus.iowa.gov.
COVID -19 Vaccine administration data can be found at
https://coronavirus.iowa.gov/pages/vaccineinformation#VaccineInformation
Vaccination scheduling and access information can be found at Vaccinate.Iowa.gov,
and at https://vaccinefinder.org/
Long Term Care facility status: Dubuque County currently has no long term care
facility (LTC) outbreaks and the state of Iowa reports only two current outbreaks.
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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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.
Dubuque County K-12 schools have had 44 positive cases during the month of March,
2021.
The Dubuque County higher education institution representatives also meet bi-weekly
with the IMT. The IDPH has included colleges and universities as priorities for receiving
the Johnson and Johnson vaccine. The IMT has initiated planning with county colleges
and universities for immunizing their populations when Johnson and Johnson vaccine
allocations are adequate and utilizing the other vaccines for those students and staff
that will be present for both doses to be administered in Dubuque County.
Dubuque VNA Continues to operate the public call center for Dubuque County 7
days/week for general COVID questions. To date VNA has fielded over 40,000 contacts
calls/contact from the community. The VNA continues contact tracing for positive cases
along with providing daily public health follow up to two facilities including local school
districts.
VNA staff have administered approximately 2500 vaccines at the POD in the last two
weeks. VNA staffed the initial Dubuque County Sleeves Up phone line and now is
working with the Equity Immersion Team for assisting vulnerable populations with
vaccinations.
In addition, VNA continues to provide thermometers, food assistance and other human
needs referrals. VNA staff are contacting 2 facilities daily to assist with COVID-19
management and support.
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. The EMA
continues to provide logistical and operational support for the POD and ongoing
vaccination planning in conjunction with City Health Services staff.
Hospital Capacity Planning The IMT continues to monitor hospital capacity and
capability and communicate with MercyOne and UnityPoint Finley Hospitals. This
includes closely monitoring new cases, outbreaks and other data points to assure that
hospitals continue to plan for surges 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 remained manageable. 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. The
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Dubuque County Board of Health (BOH) executed a no cost agreement/contract for an
alternate care facility through March.
Public Information The IMT, in conjunction with the City Public Information (PIO)
Office, continues to provide daily COVID-19 updates along with social media posts and
fielding and responding to a variety of news media requests. The daily updates continue
to report new positive cases, active cases, deaths, and test positivity but now
emphasize vaccinations, including the percentage of the total county population fully
vaccinated.
A new "SleevesUp!" Dubuque County campaign was initiated recently to promote
vaccinations and expanded vaccination eligibility. Social media posts and videos
featuring messages on vaccine safety and effectiveness as well as testimonials from
county board of health members and city council members are scheduled over the
coming weeks and a countywide billboard campaign will begin next week featuring
multiple messages on 10 different locations.
PIO staff will continue to provide messaging that explains the safety and effectiveness
of the vaccines and addresses FAQs and misinformation and they will promote public
vaccination clinics as they become available
COVID- 19 Vaccination The IMT continues to manage the IDPH vaccine allocations
along with the allocations local pharmacies are receiving through the Federal Retail
Pharmacy Program. We receive allocation notifications on Wednesday mornings which
requires expeditious planning for local distribution and administration by the IMT and the
local providers. The local distribution request must be returned to IDPH by Thursday at
noon and the vaccines arrive here anytime between Friday and Tuesday. Three local
Federal Retail Pharmacy Providers are receiving allocations: MercyOne, HyVee and
Hartig Drug. These allocations are expected to increase over the next several weeks.
Crescent Community Health Center will be receiving doses through the Federal Health
Center COVID-19 Vaccine Program in mid-April.
A community point of distribution (POD) for vaccine providers to administer vaccines
has been operational since Feb 10, 2021 at the Kennedy Mall former women’s
Younkers store. Unity Point Finley, Grand River Medical Group, VNA, Medical
Associates and Union Family Pharmacy have utilized the POD.
With the removal of the Iowa Vaccine Shortage Order, COVID-19 vaccine are available
to all Iowans.
County residents age 65 and over continue to be contacted by their healthcare provider
when vaccines are available and vaccination appointments can be scheduled. Health
care providers have also started scheduling 16-64 year-olds who are at increased risk
of severe illness from COVID-19 due to specific medical conditions. Healthcare
providers are contacting their patients through a variety of channels including telephone,
text, email, and letter. Detailed information on how to schedule appointments will be
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provided by each healthcare provider. Priority groups tied to worksites and within other
priority tiers will also receive vaccinations at the POD, or at a provider, depending on
the criteria. Individuals without a primary health care provider can receive vaccination
assistance and information on the Dubuque County Sleeves Up phone line at 563 587
4950.
Phase 1b tiers 2 through 5 are now being substantially complete. The IMT continues
working with GDDC in conjunction with the Dubuque Area Chamber of Commerce and
the Dyersville Area Chamber of Commerce to gather information from county employers
in order to vaccinate essential workers.
Looking ahead
• Continue Planning and scheduling for community wide vaccinations including
hosting the Sleeves Up call in center
• Provide ongoing education and access for COVID -19 to vulnerable populations,
with the assistance of the Equity Immersion Committee and many community
partners.
• Plan for additional community vaccine distribution and administration sites and
methods in case they are needed
• Update messaging and community education for vaccine education and
administration as availability continues to change
• Implementing and distributing ever changing guidance from CDC, IDPH and
DOE.
• Monitor and provide community education on SARS CoV2 variants.
• Provide COVID-19 guidance for spring and summer special events and activities
• Think ahead to vaccinating children
DUBUQUE
CITY COUNCIL
COVID-19 UPDATE
City Council update-April 5, 2021
Mary Rose Corrigan, Public Health Specialist
INCIDENT MANAGEMENT TEAM (IMT)
Mary Rose
Corrigan
City of Dubuque
Stacey Killian
VNA
Patrice Lambert
Dubuque County
Health Department
Tom Berger
Dubuque County
EMA
Randy Gehl City of Dubuque Public Information Officer
TRENDLINE OF NEW CASES 3 WEEKS AGO
7
19
12
16
10
5
2
5
18
8
5
13
4 3
14-DAY TRENDLINE
TRENDLINE OF NEW CASES CURRENT
16 21 26 21 17
6 8
23 18
37
27 26
18 13
TRENDLINE OF NEW COVID-19
CASES IN DUBUQUE COUNTY
PERCENT OF POSITIVE CASES
2.0%
4.5%
14-DAY AVERAGE OF
PERCENT OF POSITIVE
CASES
TRENDLINE OF NEW CASES
COMMUNITY PROFILE REPORT
VACCINATION PROGRESS
exported 05 Apr 2021
Vaccinations Completed by Age Group Dubuque County Residents
Dec 14, 2020 -Apr 4, 2021
IDPH PHASE 1B TIER 2 BUSINESSES
Vaccination Week Number of Essential Workers being Vaccinated
Last Week’s Vaccinations (3/29)~ 2,022
This Week’s Vaccinations (4/5)~ 1,410
Remaining Vaccinations ~ substantially complete this week
*All other tiers in Phase 1B are complete, while a small number of groups/individuals
continue to come in from each tier.
PHASE 1B
TIER 2
●Frontline essential workers in food,
agriculture, and manufacturing
sectors who live or work in non-
social distanced settings
●Other essential
workers
VACCINE COMMUNITY EDUCATION
•Targeted Outreach to
Organizations & Populations
•Social Media
•City/County Newspapers &
Publications
•Billboards in City & County
•Public Access Television
(Dubuque, Dyersville,
Epworth, Farley)
VACCINE INFORMATION
New Sleeves Up! Phone line
563-690-6253
(690-MAKE)
For Residents needing
•Vaccination
•Booster
•Appointment navigation
NEW TRAVEL GUIDANCE
HTTPS://WWW.CDC.GOV/CORONAVIRUS/2019-NCOV/TRAVELERS/TRAVEL-DURING-COVID19.HTML
NEW GUIDANCE-
FULLY VACCINATED KEEP DOING:
•Mask wearing in
public & with
unvaccinated
•Avoid medium/large
gatherings
•Travel precautions
•Watch for symptoms
•Stay home if ill
•Gather indoors with other fully
vaccinated
•Travel domestically without testing
or quarantine
•Quarantine not required if exposed
to COVID-19 (unless symptoms)
QUESTIONS?
City Council Meeting –April 5, 2021
Dubuque County Public Health
Incident Management Team
TO: Michael C. Van Milligen, City Manager
FROM: Kelly Larson, Human Rights Director
DATE: April 5, 2021
RE: Race and Equity in Vaccine Distribution
The purpose of this memo is to provide a summary of work that the Equity Immersion
Team has been doing to reach-in to groups likely to experience inequitable outcomes in
vaccination rates under the State distribution structure.
Desired Outcome
The desired outcome of the COVID-19 vaccination effort is to vaccinate as many people
as quickly as possible to gain herd immunity while ensuring that those at greatest risk
for adverse outcomes from contracting the virus, including racial and ethnic minorities
and English language learners, are able to receive the vaccine when they are eligible.
Background Data
The percentages of positive cases in Dubuque County from March 2020 through April 4,
2021, broken down by race and ethnicity, are as follows:
• Racial identity unknown or pending investigation = 50%
• White = 46%
• Black or African American = 2%
• Asian = 1%
• Native Hawaiian or Pacific Islander = 1%
• American Indian or Alaskan Native = 0%
• Ethnic identity unknown or pending investigation = 54%
• Not Hispanic or Latino = 45%
2
• Hispanic or Latino = 1%
A total of 202 people in Dubuque County have died from COVID-19 between March
2020 and April 4, 2021. In order to be sensitive to privacy concerns, disaggregated
numbers are not included in this memo. However, deaths have not been
disproportionate to representation in the general population.
Critical population estimates for Dubuque County from the Iowa Department of Public
Health:
• Residents without insurance = 4195
• Tribal residents = 0
• Homeless adults and children = 387
• Offenders = 69
• College students = 5063
• Chronic conditions = 626
• Hispanic and American Indian/Alaskan Native = 107 (0 over 65)
• Hispanic and API = 53 (4 over 65)
• Hispanic and Black = 159 (1 over 65)
• Hispanic and White = 2241 (123 over 65)
• Non-Hispanic and American Indian/Alaskan Native = 187 (20 over 65)
• Non-Hispanic API = 1888 (92 over 65)
• Non-Hispanic Black = 3969 (102 over 65)
Unknowns:
• The level of racial and ethnic diversity among patients served by the various
healthcare providers and employers who have been receiving the bulk of the
vaccines;
• Whether vaccine providers are collecting and analyzing demographic information
as people register for the vaccine to make adjustments to insure equitable
distribution.
Anticipated Barriers
We anticipated the following barriers would arise under the vaccine distribution plan:
• Limited English ability
• Information overload, misinformation, unaddressed concerns about the vaccine
• Distrust in government
• Lack of transportation to distribution locations
• Lack of a healthcare provider
3
• Inability to get time off work to get a vaccine
Strategies and Actions to Address Barriers
The general strategy employed by the team has been to supplement the marketing
conducted through the Incident Management Team with additional messaging that :
• Is translated into Spanish and Marshallese to address limited English ability;
• Uses social media and short bursts of information to address misinformation ,
concerns, and information overload;
• Is distributed through trusted messengers to address distrust;
• Includes information on transportation options to points of distribution;
• Includes information on Sleeves Up Dubuque for people who do not have a
healthcare provider;
• Encourages people to speak with their employer regarding time off for
vaccination.
The Equity Immersion Team has been meeting on a bi-weekly basis since January 11
to implement this strategy. Team members include:
• City Staff Members: Temwa Phiri, Kelly Larson, Collins Eboh, Gina Bell, Jesse
Coulson, Hollie Ohnesorge, Kecia Dougherty, Kristin Dietz, Cheryl Sheldon, Rick
Fullmer, Jeremy Jensen
• Community Partners: James Sizer, Director Multicultural Student Affairs
University of Dubuque; Katie Bahl, East Central Iowa Intergovernmental
Association; Jason Neises, Community Foundation of Greater Dubuque ; Clara
Lopez-Ortiz, Community Foundation of Greater Dubuque; Alex Baum,
Community Foundation of Greater Dubuque; Gisella Aitken-Shadle, Northeast
Iowa Community College; Gabby Sullivan, Dubuque Dream Center; Josh Jasper,
Resources Unite
• Loras College Civic Leaders: Logan Jones, Jenna Jager, Stefanie Hill, Joshua
Delgado, Max Ellenbecker, Sarah Backus
The team has identified the following trusted messengers who are networked with
various people on the Equity Immersion Team:
• Minority Owned Businesses
• Crescent Community Health Center & Pacific Islander Health project
• Fountain of Youth
• Presentation Lantern Center
• Dubuque Dream Center
• Immigration Needs Assessment Group
4
• United Way monthly call – social service agencies
• Homeless Advisory Council/Shelters
• Switching Places Foundation
• Dub City Radio
• Afro Dubuque Facebook Group – Over 200 members
• Latino Empowerment And Development (L.E.A.D.) Facebook group – over 200
members
• Tri-State Marshallese Community Facebook Group – over 350 Members
• Café Latino Dubuque Facebook Group – Over 135 Members
• I Need Help Dubuque Facebook Group – Over 4.4K Members
To date, the following actions have been taken:
• Information has been distributed through Tri-Phoenix Group social media and e-
mail to their network that includes Black business owners, organizations, and
professionals. They are also in the process of creating a page on their website
for updates as well as adding weekly updates via their radio platform.
• Information is distributed through bi-weekly meetings that are held with members
of the Pacific Islander Health Project, including Marshallese community leaders.
Reports are that people are ready and willing to get vaccinated, though there is
some concern about distrust arising from a vaccination campaign in the Marshall
Islands several decades ago that impacted fertility rates. Upcoming focus groups
with each of the Marshallese churches will also include information.
• Several Marshallese community leaders employed by Crescent Community
Health Center and the Dubuque Community School District videotaped
themselves receiving the vaccine and those videos have been distributed
through social media.
• Loras College LULAC (League of United Latin American Citizens) members have
developed and distributed a video in Spanish that has been shared across social
media: https://www.facebook.com/LorasCollegeLULAC/
• We have engaged translators/interpreters who speak Spanish and Marshallese
to assist us with translation of information. We have received and distributed the
following in English, Marshallese and Spanish: Dubuque County Vaccine Mailer,
Sleeves Up information, Phase IB information. To date, we have not had
success in getting information translated into any of the Guatemalan dialects.
• General vaccine information and Sleeves Up information has been distributed
through the Food Provider network on bi-weekly calls and through an e-mail.
This includes 32 agencies, along with additional partners and funders, serving
low-income populations in Dubuque and rural areas around Cascade and
5
Dyersville. Information has also been posted on the Feed Dubuque County
facebook page.
• General information and free transportation information has been shared through
the Housing Department Facebook page in English, Spanish, and Marshallese,
reaching over 600 followers.
• ECIA has shared available information with their staff to share with clients and
networks, and posted on Facebook.
• We have shared information on free RTA rides to vaccination clinics.
• We participate in monthly meetings through United Way with human services
providers to provide updates, collect information on barriers, and request
distribution of information. The county-wide vaccine mailer in English, Spanish,
and Marshallese was shared and distributed through this group.
• The county-wide vaccine mailer was also distributed through the Presentation
Lantern Center in multiple languages. Reports are that community members
served through Presentation Lantern Center are ready and willing to receive the
vaccine.
• Information has been distributed through immigrant support groups including:
o The Immigration Forum
o The Immigration Needs Assessment Steering Committee
o The immigration group of the Sisters Collaborative
• Some general conversations have been had with members of the Marshallese,
Guatemalan, and African-American communities to try to address vaccine
skepticism.
• Information has been shared with members of the immigration work group
through the Community Foundation of Greater Dubuque with the request it be
shared further through networks and information on barriers be shared back
through the group.
• We have continually reinforced the importance of interrupting the spread of
rumors and relying on trusted sources of information.
• We continue to share general information clarifying the phases and distribution
options in Dubuque County on a regular basis, through social media and the
networks above.
Ongoing Concerns and Adjustments
Ongoing concerns include the following:
• Crescent Community Health Center, whom we know serves many of our critical
populations, was recently notified that they will be receiving vaccines through the
Federal Health Center allocation beginning in mid-April. They have received
some County allocations for their patients to test out their administration process.
6
Although the allocation amount is unknown, we are in conversations with
Crescent about their ability to reach beyond their patient population under federal
rules and with additional staffing support.
• We have no information on the demographics of patients served by the providers
who have been receiving the bulk of vaccines up to this point. Similarly, we lack
any information on how pharmacies receiving vaccines are registering people
and whether they are taking demographics into account.
• We have received anecdotal information that some people outside of priority
categories may be able to receive vaccines when volunteering at a vaccination
clinic. Upon discovering this, we have done our best to broaden who is receiving
information on volunteer opportunities.
• We also are concerned about the tendency to judge people who decline a
vaccine, as there are valid reasons someone may not be vaccinated. We think it
is important to recognize that each individual must balance their own and their
family’s needs with the needs of the larger community.
• Finally, it’s important to note that distrust in government and/or in the healthcare
community did not begin with the COVID-19 vaccine and will not end there. This
is simply the current issue facing us. There are cultural competency concerns
shared within our communities of color and with our Human Rights staff that
often are not discussed outside of those groups because of an overarching
feeling of being unwelcome in Dubuque in the first place and/or a fear of
backlash. Work within each institution throughout our community to increase
cultural competency and to examine operations through an equity lens continues
to be needed long term.
Adjustments being made or under consideration include the following:
• We recently released a supplemental flyer highlighting crucial information and
listing the Human Rights Department as a point of contact for members to relay
any barriers being encountered.
• We are investigating options to support distribution through Crescent Community
Health Center or another provider for populations who do not have a healthcare
home.
• We are developing contingency plans for a mass vaccination site in the event
that the number of vaccines received increases dramatically.
• L.E.A.D., with the support of the Presentation Lantern Center, the Community
Foundation of Greater Dubuque, and Medical Associates, will be hosting an on-
line panel discussion consisting of Latino physicians and residents who have
received vaccines and are willing to answer questions and share their
experiences. This event will be conducted in Spanish and live -streamed on
Facebook. We are working to put together a similar panel designed to address
7
questions and concerns that have been shared with us by a variety of Black and
brown community members.
• The Visiting Nurse Association has worked with us to implement adjustments to
their process - based on feedback from community leaders within Spanish-
speaking immigrant communities – that are improving this group’s access to
vaccines. Over the past two weeks, these changes have permitted us to
schedule approximately 40 members of our Latinx population for vaccines.
Performance Measures and Accountability
As of April 4, 2021, the number of completed vaccinations in Dubuque County breaks
down as follows:
• Total of all races = 24,051
• Black = 107 (0.4% of vaccines given)
• Pacific Islander = 108 (0.4% of vaccines given)
• Other race = 37 (0.2% of vaccines given)
• Asian = 81 (0.3% of vaccines given)
• American Indian = 11 (0.05% of vaccines given)
• Unknown = 2,864 (12% of vaccines given)
• White = 20,843 (87% of vaccines given)
• Hispanic or Latino = 135 (0.6% of vaccines given)
• Unknown = 3,033 (12.5% of vaccines given)
• Not Hispanic or Latino = 20,883 (87% of vaccines given)
As of April 4, 2021, number of initiated vaccinations in Dubuque County breaks down as
follows:
• Total of all races = 12,172
• Black = 100 (0.8% of vaccines given)
• Pacific Islander = 107 (0.9% of vaccines given)
• Other race = 61 (0.5% of vaccines given)
• Asian = 96 (0.8% of vaccines given)
• American Indian = 18 (0.1% of vaccines given)
• Unknown = 1,920 (16% of vaccines given)
• White = 9,870 (81% of vaccines given)
• Hispanic or Latino = 143 (1.2% of vaccines given)
• Unknown = 2,219 (18% of vaccines given)
8
• Not Hispanic or Latino = 9,810 (81% of vaccines given)
Later this year, we will forward our suggestions and observations regarding what did
and did not work to the incident management team as part of an after-action debrief.
cc: Mary Rose Corrigan, Public Health Specialist
Temwa Phiri, Community Engagement Coordinator
Collins Eboh, Organizational Equity Coordinator
THE CITY OF DUbi1[�UE
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TO: Michael C. Van Milligen, City Manager
FROM: Kelly Larson, Human Rights Director
DATE: April 5, 2021
RE: Race and Equity in Vaccine Distribution
The purpose of this memo is to provide a summary of work that the Equity Immersion
Team has been doing to reach-in to groups likely to experience inequitable outcomes in
vaccination rates under the State distribution structure.
Desired Outcome
The desired outcome of the COVID-19 vaccination effort is to vaccinate as many people
as quickly as possible to gain herd immunity while ensuring that those at greatest risk
for adverse outcomes from contracting the virus, including racial and ethnic minorities
and English language learners, are able to receive the vaccine when they are eligible.
Background Data
The percentages of positive cases in Dubuque County from March 2020 through April 4,
2021, broken down by race and ethnicity, are as follows:
• Racial identity unknown or pending investigation = 50%
• White = 46%
• Black or African American = 2%
• Asian = 1%
• Native Hawaiian or Pacific Islander = 1%
• American Indian or Alaskan Native = 0%
• Ethnic identity unknown or pending investigation = 54%
• Not Hispanic or Latino = 45%
• Hispanic or Latino = 1%
A total of 202 people in Dubuque County have died from COVID-19 between March
2020 and April 4, 2021. In order to be sensitive to privacy concerns, disaggregated
numbers are not included in this memo. However, deaths have been disproportionate
to representation in the general population.
Critical population estimates for Dubuque County from the lowa Department of Public
Health:
• Residents without insurance = 4195
• Tribal residents = 0
• Homeless adults and children = 387
• Offenders = 69
• College students = 5063
• Chronic conditions = 626
• Hispanic and American Indian/Alaskan Native = 107 (0 over 65)
• Hispanic and API = 53 (4 over 65)
• Hispanic and Black = 159 (1 over 65)
• Hispanic and White = 2241 (123 over 65)
• Non-Hispanic and American Indian/Alaskan Native = 187 (20 over 65)
• Non-Hispanic API = 1888 (92 over 65)
• Non-Hispanic Black = 3969 (102 over 65)
Unknowns:
• The level of racial and ethnic diversity among patients served by the various
healthcare providers and employers who have been receiving the bulk of the
vaccines;
• Whether vaccine providers are collecting and analyzing demographic information
as people register for the vaccine to make adjustments to insure equitable
distribution.
Anticipated Barriers
We anticipated the following barriers would arise under the vaccine distribution plan:
• Limited English ability
• Information overload, misinformation, unaddressed concerns about the vaccine
• Distrust in government
• Lack of transportation to distribution locations
• Lack of a healthcare provider
2
• Inability to get time off work to get a vaccine
Strategies and Actions to Address Barriers
The general strategy employed by the team has been to supplement the marketing
conducted through the Incident Management Team with additional messaging that:
• Is translated into Spanish and Marshallese to address limited English ability;
• Uses social media and short bursts of information to address misinformation,
concerns, and information overload;
• Is distributed through trusted messengers to address distrust;
• Includes information on transportation options to points of distribution;
• Includes information on Sleeves Up Dubuque for people who do not have a
healthcare provider;
• Encourages people to speak with their employer regarding time off for
vaccination.
The Equity Immersion Team has been meeting on a bi-weekly basis since January 11
to implement this strategy. Team members include:
• City Staff Members: Temwa Phiri, Kelly Larson, Collins Eboh, Gina Bell, Jesse
Coulson, Hollie Ohnesorge, Kecia Dougherty, Kristin Dietz, Cheryl Sheldon, Rick
Fullmer, Jeremy Jensen
• Community Partners: James Sizer, Director Multicultural Student Affairs
University of Dubuque; Katie Bahl, East Central lowa Intergovernmental
Association; Jason Neises, Community Foundation of Greater Dubuque; Clara
Lopez-Ortiz, Community Foundation of Greater Dubuque; Alex Baum,
Community Foundation of Greater Dubuque; Gisella Aitken-Shadle, Northeast
lowa Community College; Gabby Sullivan, Dubuque Dream Center; Josh Jasper,
Resources Unite
• Loras College Civic Leaders: Logan Jones, Jenna Jager, Stefanie Hill, Joshua
Delgado, Max Ellenbecker, Sarah Backus
The team has identified the following trusted messengers who are networked with
various people on the Equity Immersion Team:
• Minority Owned Businesses
• Crescent Community Health Center & Pacific Islander Health project
• Fountain of Youth
• Presentation Lantern Center
• Dubuque Dream Center
• Immigration Needs Assessment Group
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• United Way monthly call — social service agencies
• Homeless Advisory Council/Shelters
• Switching Places Foundation
• Dub City Radio
• Afro Dubuque Facebook Group — Over 200 members
• Latino Empowerment And Development (L.E.A.D.) Facebook group — over 200
members
• Tri-State Marshallese Community Facebook Group — over 350 Members
• Cafe Latino Dubuque Facebook Group — Over 135 Members
• I Need Help Dubuque Facebook Group — Over 4.4K Members
To date, the following actions have been taken:
• Information has been distributed through Tri-Phoenix Group social media and e-
mail to their network that includes Black business owners, organizations, and
professionals. They are also in the process of creating a page on their website
for updates as well as adding weekly updates via their radio platform.
• Information is distributed through bi-weekly meetings that are held with members
of the Pacific Islander Health Project, including Marshallese community leaders.
Reports are that people are ready and willing to get vaccinated, though there is
some concern about distrust arising from a vaccination campaign in the Marshall
Islands several decades ago that impacted fertility rates. Upcoming focus groups
with each of the Marshallese churches will also include information.
• Several Marshallese community leaders employed by Crescent Community
Health Center and the Dubuque Community School District videotaped
themselves receiving the vaccine and those videos have been distributed
through social media.
• Loras College LULAC (League of United Latin American Citizens) members have
developed and distributed a video in Spanish that has been shared across social
media: https://www.facebook.com/LorasCollegeLULAC/
• We have engaged translators/interpreters who speak Spanish and Marshallese
to assist us with translation of information. We have received and distributed the
following in English, Marshallese and Spanish: Dubuque County Vaccine Mailer,
Sleeves Up information, Phase IB information. To date, we have not had
success in getting information translated into any of the Guatemalan dialects.
• General vaccine information and Sleeves Up information has been distributed
through the Food Provider network on bi-weekly calls and through an e-mail.
This includes 32 agencies, along with additional partners and funders, serving
low-income populations in Dubuque and rural areas around Cascade and
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Dyersville. Information has also been posted on the Feed Dubuque County
facebook page.
• General information and free transportation information has been shared through
the Housing Department Facebook page in English, Spanish, and Marshallese,
reaching over 600 followers.
• ECIA has shared available information with their staff to share with clients and
networks, and posted on Facebook.
• We have shared information on free RTA rides to vaccination clinics.
• We participate in monthly meetings through United Way with human services
providers to provide updates, collect information on barriers, and request
distribution of information. The county-wide vaccine mailer in English, Spanish,
and Marshallese was shared and distributed through this group.
• The county-wide vaccine mailer was also distributed through the Presentation
Lantern Center in multiple languages. Reports are that community members
served through Presentation Lantern Center are ready and willing to receive the
vaccine.
• Information has been distributed through immigrant support groups including:
o The Immigration Forum
o The Immigration Needs Assessment Steering Committee
o The immigration group of the Sisters Collaborative
• Some general conversations have been had with members of the Marshallese,
Guatemalan, and African-American communities to try to address vaccine
skepticism.
• Information has been shared with members of the immigration work group
through the Community Foundation of Greater Dubuque with the request it be
shared further through networks and information on barriers be shared back
through the group.
• We have continually reinforced the importance of interrupting the spread of
rumors and relying on trusted sources of information.
• We continue to share general information clarifying the phases and distribution
options in Dubuque County on a regular basis, through social media and the
networks above.
Ongoing Concerns and Adjustments
Ongoing concerns include the following:
• Crescent Community Health Center, whom we know serves many of our critical
populations, was recently notified that they will be receiving vaccines through the
Federal Health Center allocation beginning in mid-April. They have received
some County allocations for their patients to test out their administration process.
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Although the allocation amount is unknown, we are in conversations with
Crescent about their ability to reach beyond their patient population under federal
rules and with additional staffing support.
• We have no information on the demographics of patients served by the providers
who have been receiving the bulk of vaccines up to this point. Similarly, we lack
any information on how pharmacies receiving vaccines are registering people
and whether they are taking demographics into account.
• We have received anecdotal information that some people outside of priority
categories may be able to receive vaccines when volunteering at a vaccination
clinic. Upon discovering this, we have done our best to broaden who is receiving
information on volunteer opportunities.
• We also are concerned about the tendency to judge people who decline a
vaccine, as there are valid reasons someone may not be vaccinated. We think it
is important to recognize that each individual must balance their own and their
family's needs with the needs of the larger community.
• Finally, it's important to note that distrust in government and/or in the healthcare
community did not begin with the COVID-19 vaccine and will not end there. This
is simply the current issue facing us. There are cultural competency concerns
shared within our communities of color and with our Human Rights staff that
often are not discussed outside of those groups because of an overarching
feeling of being unwelcome in Dubuque in the first place and/or a fear of
backlash. Work within each institution throughout our community to increase
cultural competency and to examine operations through an equity lens continues
to be needed long term.
Adjustments being made or under consideration include the following:
• We recently released a supplemental flyer highlighting crucial information and
listing the Human Rights Department as a point of contact for members to relay
any barriers being encountered.
• We are investigating options to support distribution through Crescent Community
Health Center or another provider for populations who do not have a healthcare
home.
• We are developing contingency plans for a mass vaccination site in the event
that the number of vaccines received increases dramatically.
• L.E.A.D., with the support of the Presentation Lantern Center, the Community
Foundation of Greater Dubuque, and Medical Associates, will be hosting an on-
line panel discussion consisting of Latino physicians and residents who have
received vaccines and are willing to answer questions and share their
experiences. This event will be conducted in Spanish and live-streamed on
Facebook. We are working to put together a similar panel designed to address
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questions and concerns that have been shared with us by a variety of Black and
brown community members.
• The Visiting Nurse Association has worked with us to implement adjustments to
their process - based on feedback from community leaders within Spanish-
speaking immigrant communities — that are improving this group's access to
vaccines. Over the past two weeks, these changes have permitted us to
schedule approximately 40 members of our Latinx population for vaccines.
Performance Measures and Accountability
As of April 4, 2021, the number of completed vaccinations in Dubuque County breaks
down as follows:
• Total of all races = 24,051
• Black = 107 (0.4% of vaccines given)
• Pacific Islander = 108 (0.4% of vaccines given)
• Other race = 37 (0.2% of vaccines given)
• Asian = 81 (0.3% of vaccines given)
• American Indian = 11 (0.05% of vaccines given)
• Unknown = 2,864 (12% of vaccines given)
• White = 20,843 (87% of vaccines given)
• Hispanic or Latino = 135 (0.6% of vaccines given)
• Unknown = 3,033 (12.5% of vaccines given)
• Not Hispanic or Latino = 20,883 (87% of vaccines given)
As of April 4, 2021, number of initiated vaccinations in Dubuque County breaks down as
follows:
• Total of all races = 12,172
• Black = 100 (0.8% of vaccines given)
• Pacific Islander = 107 (0.9% of vaccines given)
• Other race = 61 (0.5% of vaccines given)
• Asian = 96 (0.8% of vaccines given)
• American Indian = 18 (0.1% of vaccines given)
• Unknown = 1,920 (16% of vaccines given)
• White = 9,870 (81% of vaccines given)
• Hispanic or Latino = 143 (1.2% of vaccines given)
• Unknown = 2,219 (18% of vaccines given)
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• Not Hispanic or Latino = 9,810 (81% of vaccines given)
Later this year, we will forward our suggestions and observations regarding what did
and did not work to the incident management team as part of an after-action debrief.
cc: Mary Rose Corrigan, Public Health Specialist
Temwa Phiri, Community Engagement Coordinator
Collins Eboh, Organizational Equity Coordinator
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April 5, 2021
Community COVID-19 Update
Mary Rose Corrigan, Public Health
Specialist
Alexis Steger, Housing & Community
Development Director
Vaccine Distribution Updates
Rick Steines, Fire Chief
Cori Burbach, Assistant City Manager
Kelly Larson, Human Rights Director
Grand River Center POD
Potential use of Parking Garage & Exhibit Hall A:
4/1/21 –7/31/21
Ability to serve public transit-dependent and other
traditionally hard to reach populations, when supported by
a robust and targeted outreach strategy and in
coordination with other “meet people where they are”
strategies
May be staffed by Dubuque Fire Department and/or other
providers as needed and available
Dubuque County financial assistance:
Not to exceed $47,300
Grand River Center POD
First clinic: April 8, 2021 12 –7 pm
Vulnerable populations focus
SleevesUp! Call Center
Inbound & outbound calls
Day 1:
70% of timeslots filled
Majority = vulnerable
populations
Waitlist is operational
Will be updated to utilize
scheduling software soon
Equity Immersion Team Update
Anticipated Barriers
Strategies to Address Barriers
Performance Measures & Accountability
DESIRED OUTCOME: to vaccinate as many people as quickly as
possible to gain herd immunity while ensuring that those at greatest
risk for adverse outcomes from contracting the virus, including racial
and ethnic minorities and English language learners, are able to
receive the vaccine when they are eligible.
American Rescue Plan Update
Teri Goodmann, Assistant City Manager
Community Partner Updates
Community Foundation of Greater Dubuque
(Jenna Manders, Director of Strategic
Relations)
Greater Dubuque Development Corporation
(Rick Dickinson, President/CEO)
available for questions
Additional Questions?