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COVID-19 Pandemic Update Work SessionCopyrighted May 3, 2021 City of Dubuque Work Session - Top # 2. City Council Meeting ITEM TITLE: 5:30 PM - COVID-19 Pandemic Update SUMMARY: 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 memo Staff Memo THE C Dubuque DUUB_-_*._TE *Awiu Ciq ' iece on the Mississippi Masterpiece PP zoo�•zoi 2-2013 zoi7*2019oi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Agenda for 5.3.21 City Council Work Session: re COVID-19 Response DATE: April 29, 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. /'�� �� I&X� Mic ael C. Van Milligen MCVM:jh Attachment cc: Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager THE CITY OF Dubuque DUB E AlhMeriea Clb n . II Masterpiece on the Mississippi � pp 13 z°°'`° zoi7*20*zot9 TO: Michael C Van Milligen, City Manager FROM: Cori Burbach, Assistant City Manager DATE: April 29, 2021 RE: Agenda for 5.3.21 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 May 3, 2021. The presentation will provide updates from City staff and our partners on the internal and community -facing response to COVID-19. Tentative aresentation order: 5:30 pm Community COVID-19 Update & Communication Response Mary Rose Corrigan, Public Health Specialist 5:45 pm Update on vaccine distribution, call center and outreach to marginalized communities Rick Steines, Fire Chief Cori Burbach, Assistant City Manager Kelly Larson, Human Rights Director 6:00 pm Community Partner Presentations Rick Dickinson, Greater Dubuque Development Corporation Jenna Manders, Community Foundation of Greater Dubuque 6:15 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. May 3, 2021 Community COVID-19 Update Mary Rose Corrigan, Public Health Specialist Vaccine Distribution Updates Rick Steines, Fire Chief Cori Burbach, Assistant City Manager Kelly Larson, Human Rights Director Fire Dept Vaccine Clinics to date & upcoming Grand River Center Apr 8 Apr 15 Apr 22 Apr 29 May 6 May 13 May 20 May 27 Audubon School Apr 28 May 19 May 26 Farmers Market (12th & Iowa) May 8 Outreach & Scheduling SleevesUP! call center activity Neighborhood canvassing Equity Immersion Team Update Food Provider Network Civic Leaders Vaccine Q&A Panels 3 panels (English & Spanish) 1000+ views Marshallese coming soon Community Partner Updates Community Foundation of Greater Dubuque (Jenna Manders, Director of Strategic Relations) Additional Questions? https://cityofdubuque-my.sharepoint.com/personal/mcorriga_cityofdubuque_org/Documents/Coronavirus/COVID presentations/Covid PP city council/20215.3 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: May 3, 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 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 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 https://cityofdubuque-my.sharepoint.com/personal/mcorriga_cityofdubuque_org/Documents/Coronavirus/COVID presentations/Covid PP city council/20215.3 City Council update.docx 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 93 positive cases during April, 2021, which is up from the 44 total during March, 2021. The IMT is asking schools to assist in promoting vaccination among students 16 years and older. Schools are assessing the need to host school-based vaccination clinics for students and families. The Dubuque County higher education institution representatives have met weekly with the IMT to prepare for vaccinations. All colleges in Dubuque County have began vaccinating students along with remaining faculty and staff that have not yet received vaccine. Second doses will be administered prior to the local higher education institutions finishing their spring semesters. 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 41,425 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 5,844 vaccines and today joined in utilizing the software the city purchased for their scheduling. VNA continues to partner with Kelly Larson and the Equity Immersion Committee to schedule vulnerable populations through various ways, including tickets that break down barriers for scheduling and reserving 30 appointments each week for these populations. All VNA clinics now incorporate both scheduled and walk in appointments. Spanish translations are available on Thursdays and Fridays at VNA clinics, as well as Marshallese translation on Fridays. Emergency Management Agency (EMA) Director Tom Berger reports they do not need to travel to the regional node in Cedar Rapids to pick up requested PPE due to demand for supplies decreasing steadily. The EMA is transitioning to packing 30 day supplies of gowns, masks, gloves and face shields to place in storage for future spikes in cases or future events. 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. The alternative care site contract has ended and those needing isolation, quarantine housing will utilize local hotels. The Dubuque County case manager who managed the https://cityofdubuque-my.sharepoint.com/personal/mcorriga_cityofdubuque_org/Documents/Coronavirus/COVID presentations/Covid PP city council/20215.3 City Council update.docx isolation and quarantine shelter assists oversees the process for those needing this resource. Public Information The PIO team continues to promote vaccination clinics through all channels available. Over 100 posters promoting clinics May 1-14, 2021 were produced and distributed by Health Services staff. COVID updates are now being issued on Mondays, Wednesdays, and Friday. The "SleevesUp!" Dubuque County campaign continues to promote vaccinations, and where vaccines can be accessed, which is frequently being updated. 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 running and a countywide billboard campaign is underway featuring multiple messages on 10 different locations. Sixty-second commercials ran for two weeks on five different radio stations in the county. Posters and flyers are also being distributed with the latest clinic information. Additional targeted vaccine information is being produced for various audiences and events. 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. Nine local Federal Retail Pharmacy Providers are now receiving allocations: MercyOne, HyVee, Walmart, Walgreens, CVS (Target), INFOCUS, Union, Prescription Shoppe, and Hartig Drug, along with Crescent Community Health Center receiving doses through the Federal Health Center COVID-19 Vaccine Program. These allocations have increased significantly over the next several weeks. 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 continue to utilize the POD. The Grand River Center (GRC) POD, developed by staffed by the Dubuque Fire Department and city staff under the guidance of the IMT, and continues to host drive through clinics, hosting a clinic at Farmers Market on May 8, 2021 and assisting with the Saturday May 1st clinic at Crescent Community Health Center. All of these clinics offer walk in and appointments. The decline in vaccine demand over the last four weeks continues and the IMT has responded with “no appointment required” clinics as much as possible. The decline in https://cityofdubuque-my.sharepoint.com/personal/mcorriga_cityofdubuque_org/Documents/Coronavirus/COVID presentations/Covid PP city council/20215.3 City Council update.docx demand is a state and national trend. The IMT is facilitating and planning smaller community-based, outreach vaccination clinics over the next several weeks as the Kennedy Mall POD continues to see significant traffic. Operation Warp Speed no longer requires the state or counties to achieve the 80% vaccine administration rate (burn rate) and has also relaxed the “no waste” policy To facilitate access to vaccination appointments, the Dubuque County Sleeves Up phone line at 563 587 4950 is staffed by city staff who have shifted their job responsibilities. Call takers facilitate vaccine clinic locations, appointment making and internet navigation though inbound and outbound calls to connect people to vaccines. A software system manages this effort. The IMT has completed the vaccination offering to county employers with GDDC in conjunction with the Dubuque Area Chamber of Commerce and the Dyersville Area Chamber of Commerce. The IMT and local employers greatly appreciate the assistance provided and system developed for accomplishing this substantial task. The IMT thanks and commends GDDC and it’s partners for all their work on this vaccination effort. Looking ahead • As private clinics and hospitals incorporate vaccination into their daily work and patient visits, the IMT will continue planning for meeting community wide vaccination needs. As local pharmacies and the Crescent Community Health Center continue to receive federal vaccine allocations, we will be less reliant on the local health care provider clinics and PODs to administer vaccines. While vaccine allocation and supply is no longer an issue, the roll out will be slow but steady from here on out. • Plan for Kennedy Mall POD and Grand River Center POD phase out • 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 non-traditional and targeted community vaccine distribution and administration sites and methods in case they are needed • Provide ongoing community vaccine education and administration as availability continues to change, utilizing multi-media • 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 • Booster doses are on the fall/winter horizon DUBUQUE CITY COUNCIL COVID-19 WORK SESSION City Council update-May 3, 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 PERCENT OF POSITIVE CASES 4.9% 2.1% 14-DAY AVERAGE OF PERCENT OF POSITIVE CASES COMMUNITY PROFILE REPORT COMMUNITY PROFILE REPORT VACCINATION PROGRESS exported 03 May 2021 Vaccine Dose Administration by Day in Iowa (Includes prime and boost doses) Dec 14, 2020 -May 1, 2021, by Day exported 03 May 2021 Doses Administered by Manufacturer Dubuque County Dec 14, 2020 -May 2, 2021 exported 03 May 2021 Vaccine Series by Resident Dubuque County Dec 14, 2020 -May 2, 2021 CDC Data tracker Dubuque County fully vaccinated DUBUQUE COUNTY VACCINATION PROGRESS 11 HERD IMMUNITY: WHAT IS IT? •Concept •Different for different diseases •No universally accepted number or % •R factor <1 •Relies on geographic and demographic distribution of immunity 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) •Code RED call Apr 30 VACCINE INFORMATION New Sleeves Up! Phone line 563-690-6253 (690-MAKE) For Residents needing •Vaccination •Booster •Appointment navigation What would it take to get to 50% fully vaccinated? POPULATION VACCINATION ●96,982 ACS Dubuque Co pop est (2019) ●48491 is 50% ●39824 currently vaccinated ●= 8667 more vaccinations for 50% of total pop Since ~Apr 19, 8295 Vaccinations completed Pace has slowed, therefore fully vaccinated increase will slow Working with Vaccine Providers PLANNING FOR THIS WEEK AND BEYOND Vaccine need projections Are this week’s appointments/slots being filled? Vaccinate during routine clinic/office visits? J & J vaccine allocation-who wants some? IDPH removes “burn” or 80% administration rate rule Vaccine wastage is acceptable • 45 31 29 27 13 16 5 7 3 0 5 10 15 20 25 30 35 40 45 50 August September October November December January February March April Police Calls for Service -Ordinance or Proclamation Violations QUESTIONS? City Council Work Session May 3, 2021 Mary Rose Corrigan Dubuque County Incident Management Team Service People Integrity Responsibility Innovation Teamwork City of Dubuque FACE COVERING ORDINANCE CONSIDERATIONS Many cities and communities, businesses and organizations have adopted policies requiring the wearing of masks and/or face coverings under certain circumstances. While there are many examples of these policies and ordinances, very few include provisions for lifting such policies. As we continue monitoring the pandemic locally and in Iowa, we have monitored a variety of metrics and have created some of our own utilizing primarily IDPH and census data, including: • Epi curve • 14- day new case trend line • Hospitalizations • Hospitalization admits in past 24 hours. • Deaths • Positivity rate: daily & 14- day average • Positivity rate/100,000 pop • Testing, including number of tests administered, testing per capita, local capability and access. • Long Term Care facility outbreaks, cases, and deaths • Recovery rate • Positive cases by age group • Pre-K through 12 school positive cases • Higher Education institution positive cases • Isolation shelter/facility census • White House / CDC COVID -19 community profile reports • Adequate PPE supplies • COVID-19 virus variants and their impact on transmission and vaccine effectiveness • Vaccination coverage/rates Other qualitative information that guides our PH IMT planning, response and community information include: • Business and Worksite outbreaks • Contact tracing trends and resource needs. • Health care provider and hospital needs (capacity, staffing, supplies etc.) • Public health workforce capacity and status • Feedback from news and social media • Planning guidance and forecast information from IDPH and CDC • Information from Iowa Governor’s office, CDC, Dubuque City Council proclamations All of this information and metrics are useful in PH IMT response and emergency declarations. However, assigning quantitative benchmarks for the face covering Service People Integrity Responsibility Innovation Teamwork ordinance removal is challenging for the mere fact that they all are related and influence each other and the response to the pandemic. The most indicative of the pandemic status as it relates to face covering requirements which would be most helpful are: Monitoring new infections: • Epi curve decreasing • 14 day and monthly trend line decreasing • Positivity rate: daily & 14- day average, including longer trend lines decreasing. • Decline in number of deaths trendline. Health Care Capacity: • testing supplies available, • adequate hospital bed, ICU bed and staffing Number of outbreaks: • School • Worksite • Long Term Care • Special populations Vaccination Coverage: • By age group • By vulnerable population • Vaccine breakthrough data • % of population vaccinated Qualitative information to consider: • State and local Emergency Declaration proclamations • Health care provider information on trends • Community information gathered through contact tracing, healthcare providers’ capacity, testing supplies, schools etc. Herd Immunity: • Herd immunity is a concept used to describe the level of immunity for a particular communicable disease within a community. • Desired or obtainable herd immunity varies from infectious disease to disease. Herd immunity is influenced by the R factor, meaning fewer people are infected than one for every person infected. Herd immunity also relies on strategic geographic and demographic distribution of immune individuals, and also among various groups (vulnerable etc.) and even among social networks. Herd immunity can be influenced by disease mutations or variants, and also by waning immunity. Service People Integrity Responsibility Innovation Teamwork Assigning specific quantitative numbers to any of these metrics is difficult due to the frequent addition of new metrics as the virus changes and the pandemic research unfolds. We will continue to evaluate and monitor trends over time periods. Prepared by: Mary Rose Corrigan RN Public Health Specialist May 3, 2021