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HomeMy WebLinkAbout2020-12-11 emergency meeting BOH Minutes for December 11,2020,adopted Dec,1 , i U j ,, ,: _ BOARD OF HEALTH - . ,s ,, , o014Tucj-F. . . . 3 �� Emergency Meeting �. ' ht.. ► ', Town of Nantucket 2020 DEC 18 AM 10: 42 \yip ___Ac,s 3 East Chestnut Street \9pORA ,__ Nantucket,Massachusetts 02554 www.nantucket-ma.gov Commissioners: Stephen Visco (chair),Malcolm MacNab, MD,PHD (Vice chair),James Cooper, Meredith Lepore, Melissa Murphy Select Board Staff:Roberto Santamaria,Artell Crowley,Kathy LaFavre,Anne Barrett,Madison Humphrey — MINUTES — Friday, December 11,2020 This meeting was held via remote participation using ZOOM and YouTube, Pursuant to Governor Baker's March 12 2020 Order Regarding Open Meeting Law Called to order at 1:03 p.m. by Mr. Visco Announcements Staff: Libby Gibson, Town Manager; Roberto Santamaria, Health Director; Terry Norton, Minutes Taker Attending Members: Stephen Visco, Chair; Malcolm MacNab, Vice chair;James Cooper; Meredith Lepore; Melissa Murphy Speakers: Gary Shaw,President Nantucket Cottage Hospital (NCH);Jerico Mele,Health Services Documentation: COVID Operations Task Force guidelines;COVID case 14-day graph;Emergency Order–Task Force Agenda adopted by unanimous consent I. EMERGENCY DISCUSSION a. Nantucket recent COVID-19 spike mitigation efforts Discussion Santamaria–Over the last few weeks we've seen a rise in COVID cases.Trying to ascertain what can be done without a full shutdown; a shutdown isn't necessarily logical – few restaurants and stores are open,they aren't contributing to the spread,and the Governor's order reduces occupancy. We're looking at the COVID Operations Task Force (COIN). Mele – The Task Force started operations this week. Reviewed the operation guidelines: investigation of possible violations, ascertain if ticketing is required, records keeping, and sharing results. Also, we will try to establish best practices for the COTF. When we get a call or tip to investigate, there will be protocols to follow. He's setting up a COVID webpage with outreach education; there will also be a means to submit tips for violations. As of today, we've had 2 enforcement actions pending. This is all provisional. We will do increased outreach and get that outreach to the people and businesses. Murphy – This kind of reorganization of the enforcement task force is necessary and proactive. Quick communication is beneficial. MacNab–Asked if we have any cases traced to the restaurants. Mele–That is outside the information he has. Santamaria–We don't have any cases tracked to restaurants or retail. MacNab–Asked if we have specific metrics for going back to a Phase 2 situation. Shaw – Reviewed the graph regarding COVID cases over the last 14 days. Tomorrow will be reporting 22 cases. Explained the pie graph on the severity and spread of the disease;we are seeing the majority of spread in the 20-30-year-olds with mild symptoms.The 11%represents cases among 1-10-year-olds. There are very few cases in the over 65s. The biggest impact has been the number of cars coming in for testing. Page 1 of 4 BOH Minutes for December 11, 2020,adopted Dec. 17 Santamaria—He is working on a new metric;he was working off the one set in March and ApriL He will present the new projected metrics at the December 17,2020,BOH meeting. Lepore—We've sent 11 people off Island and there have been 3 deaths;she feels like we're waiting for things to get worse. Today, we had over 10% positives. Questions when the Island will reach the situation that it is bad. Santamaria—We aren't down-playing the surge and the need to take drastic measures.The schools not being in session is a preventative measure. Businesses moving to 40% occupancy is an action; the library and museums have closed voluntarily. If we were to do anything more drastic,asked what those actions would be. Lepore—She doesn't have an action. We are seeing spread in trades and households. We close the schools but everyone else can go to work;that doesn't sit welL Perhaps we should make changes to where people are contracting the disease. Shaw—The Governor said, "lets follow where the glitter is." That's what we're doing with the pie chart,seeing where the risk is—dense households-there is little you can do to prevent spread within households. He doesn't feel it necessary to pound a nail into the trades. No one is discounting the deaths or shipping people off Island. The Town is doing good public health. He put the pie chart out to show the risk and what might happen if the spread starts going"sideways."This is not a time to panic or to pound the spikes in;it is a good time to watch and be proactive. Mele —The primary source for a lot of cases is within homes; that falls outside anything he would plan to do for enforcement. If we can reduce the need for people to go out to work,we will see a reduction in infection rate. A huge percentage of problems is from the secondary economic conditions, not the disease. Visco—A couple of people have commented about resources for people under quarantine;there is help out there for them. Mele — That is his project for next week — meet with people doing that work and getting their information out there. Murphy—Meagan Washington asked her if Pods are safe or not. She might be talking about Pods and winter sports. Santamaria—That depends on how you define your Pod. One thing we are seeing is that your Pod includes those people you work with. A Pod can be safe as long as everyone within it is taking precautions. Michael Reiterman—We're talking about escalations and actions; he'd like to see a slide of what actions are implemented and enforced,criteria for escalation,and what actions would be taken when we meet that criteria. The public would then understand what will happen when. He'd like to see a statistic about what the enforcement was in September, October, November, and December; is it commensurate and proportional. Santamaria— Since September, when we released the second orders and started enforcement,we have issued 30 to 31 tickets totally $16000 to $17000. The first ticket we issued was for$1000 on July 4th for a gathering on Atlantic Avenue. As far as orders go, we are one of the most aggressive zones yet. The most severe intervention at this time would be to start closing industries. Reiterman — That is great information. It would be helpful if that were on a slide, so it isn't anecdotal. He's looking at what his home state in Germany did— a complete shutdown; there are actions that are more dramatic and other countries are taking those actions. He still wants to know what the scenarios are if things get work and wants to see the metrics. Mele — Part of the Task Force is to share enforcement information; the method hasn't been determined. He believes the understanding of bio-transmission has altered over time to the established metrics aren't necessary the optimal actions to take now. Shaw — That's why you're seeing quarantine requirements change. Likes the suggestion of a map showing the changes in metrics that require faster reactions. Page 2 of 4 BOH Minutes for December 11,2020,adopted Dec. 17 Murphy—Appreciates that suggestion. It is important for the BOH to understand how rapidly the disease spreads and mitigation recommendations. We did have a 10% metric earlier; that has now shifted based on new information on the disease. Asked where the assessment on rapid testing is and whether or not it could be used for students to stay in school. Shaw—One complexity of testing is it requires a doctor's order.The problem on Nantucket is when you create multiple work streams,it requires providers to write orders and follow up. We have the ability to help the schools if they want more access to testing. When products emerge,we want to know they will meet the test of time and don't require a provider's order. Lepore —We looked at the antigen test but it's not a great test. Explained why it is not viable for the schools. Shaw—We have the most aggressive testing in the state.We received great Stop-the-Spread support from the State. However, he knows of people who have gone through the test line 12 times; that takes tests away from people who need it. Suggested people call the hospital to ask if they should be tested first, especially if they've been tested before. Enoch Sower—Asked how many cases have been traced to Stop&Shop employees and customers. Santamaria — Only a few cases; every one of them had been employees. To our knowledge, no customers have been infected from someone at Stop&Shop. Sower—Asked if they are aware of the Harvard Test from November. Santamaria—We are aware of that study. Sower—Pointed out that Kroger implemented free testing of its employees;asked if Stop &Shop has been encouraged to do so. Santamaria—Yes;we can circle back on that. Lepore—Asked if Mr. Santamaria knows the R number. Santamaria—The R number was 1.42 as of yesterday morning; that was a 7-day calculation. The 14-day R number is 1.7. The R number accounts lfor how the disease is spreading.We want the R number to be below 1,which would show a reduction in spread. MacNab—It would be nice at the next meeting to have a metric of R number or number of cases; it seems to the community that we roar along and make decisions as we go. Santamaria—He will work on that with Mr. Mele. Mele—He will be working on outreach to get that information out. Shaw—We have the ability to stop this spread on this Island if we all care about our fellow man without depending on the Health Department to stop it using a hammer. Asked the community to take precautions. Back in April,we had almost no spread due to the mindset that everyone had the disease; the public needs to go back to the attitude. Murphy —Asked about the number of cases related to travel and if there are any improvements that can be made to protect the community from travelers. Santamaria — It's difficult to discuss how to protect ourselves from travelers because we can lift the drawbridge;we need a lifeline to the Island. We've looked into the logistics of screening at the Airport, boat basin, and boats. We've put a sign at the entrance of Broad Street that tells people coming off the steamship to mask up. Anyone now who doesn't comply is being willfully disobedient. One thing you BOH is to approve the Emergency Order creating the Task Force. Action Motion to Approve Emergency Order 15 establishing the COVID 19 Operations Task Force. (made by: Murphy) (seconded) Roll-call Vote Carried unanimously//Lepore,Murphy, Cooper,MacNab,and Visco-aye Santamaria—He will get a date on Emergency Order 15 and post it ASAP. Lepore—Asked if there is an update on local contact tracing. Santamaria—We can do some locally. The Hospital is moving people forward to help locally;we can look into training. The State Public Health Office of Integrated Surveillance and Informatics Services (ISIS) has put out a training module;he will forward that to members. Page 3 of 4 BOH Minutes for December 11,2020,adopted Dec. 17 Robert Liddle—On behalf of the Nantucket Builders Association,thank you for keeping the sledge hammer stashed rather than on the job site. Mele—He will send the Nantucket Builders Association an information packet. Sower—On the mainland he can order all groceries on line and have it delivered or pick it up. Stop & Shop has all of that same technology; asked if they can be asked to implement that. Santamaria—We've asked them to do that; the problem is that our local Stop &Shop has a space issue. On the main land, they set up a separate "store" in the basement;we don't have that here. Murphy — She asked Ms. Gibson that last week and it was forwarded to Ed Miller, the manager, she got that same response from him.There are people in the community doing shopping for people who are in isolation or are at risk;Mr. Mele can confirm that. Bruce Mandel — About the grocery stores providing a service, in the mid-west and mid-south, Krogers has a service, where you shop from on-line and people go through the store with carts to do your shopping and notify you that your order is ready to be picked up. The system works and doesn't require additional space;wonders why that can't be explored here. Mele — He explored that option; management did a feasibility study and they cannot do it while maintaining their regular services. Mandel — Asked the Health Department to have Stop & Shop to revisit it. Apparently, it is not disruptive. He wonders if it is an excuse. Mele — He asked them last Wednesday to look into it and they did a review. In the next week or two,we should see people stepping in to provide services to people in need. Motion to adjourn the BOH meeting 2:16 p.m. (made by: Murphy) (second) Carried unanimously// Murphy,Lepore, Cooper,MacNab, and Visco-aye Submitted by: Terry L. Norton Page 4 of 4