HomeMy WebLinkAboutDecember 16, 2021 BOH Minutes for December 16,2021,adopted Jan.20,2022
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Commissioners: Stephen Visco (chair),Malcolm MacNab, MD,PHD (Vice chair),James Cooper,Meredith Lepore,Melissa Murphy
Staff:Roberto Santamaria, Kathy LaFavre,John Hedden, Cathy Flynn,Anne Barrett
--.MINUTES — :.
Thursday, December 16,2021
This meeting was held via remote participation using ZOOM and YouTube.
Called to order at 3:00 p.m. by Mr.Visco
Staff in attendance: R.. Santamaria, Health Director; J. Mele, Director Human Services; K. LaFavre, Health
Inspector;J. Hedden, Inspector; C. Flynn, Health.Inspector;Jake Visco, Health Agent;T.
Norton,Town Minutes Taker
Attending Members: Stephen Visco; Malcolm MacNab, MD, PHD;James Cooper; Meredith.Lepore; Melissa
Murphy, Select Board
I. ANNOUNCEMENTS
II. PUBLIC COMMENTS-ANY MEMBER OF THE PUBLIC MAY ADDRESS COMMISSIONERS AT THIS TIME
1. Robert Bates.-Thanked the BOH and the Health Department for everything they've done through COVID. The
second thing is PFAS concerns about the potential installation of artificial turf Asked that the BOH look at regulations
similar to those put out by the.Oaks Bluff Board of Health.
Santamaria-Those regulations are under review; he took sent a copy to Town Counsel for their review. Today's
agenda is focused on COVID;that subject will be on the January agenda.
III.APPROVAL OF MINUTES
1. November 18,.2021
Action Motion to Approve. (made by: MacNab) (seconded)
Roll-call vote Carried 5-0//Cooper,Lepore,Murphy,MacNab, and Visco-aye
IV. BOH APPLICATIONS REVIEW
1. Loan release:for Ross, 2 Ahab, 65-61
2.. Loan Release for 3 Hatch Circle 66-276.:
Sitting Visco,MacNab, Cooper,Lepore,Murphy
Documentation Supporting documents and plans, staff recommendations.
Representative None
Discussion Santamaria-We need to close out the loans.
Action Motion to Approve the release of the loans for Items 1-2. (made by: MacNab) (seconded)
Roll-call vote Carried 5-0//Cooper,MacNab,Murphy,Lepore, and Visco
3. Loan request for Sims, 32 Ahab Dr, 82-103
Sitting : . Visco,MacNab, Cooper,Lepore,Murphy -
Documentation Supporting documents and plans, staff recommendations.
Discussion Santamaria This is to accept the loan.
Action Motion to Approve the application. (made by: Murphy) (seconded)
Roll-call vote Carried 5-0//Cooper,Murphy,MacNab,Lepore,and Visco
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BOH Minutes for December 16,2021,adopted Jan.20,2022
4. Variance for 6 Boulevarde, 80-75.1,Regulation 61.04B nitrogen loading
Sitting Visco,MacNab, Cooper,Lepore,Murphy
Documentation Supporting documents and plans, staff recommendations.
Representative Dan Mulloy, Site Design Engineering
Discussion Mulloy—In well protection district
Santamaria—We support this.
Action Motion to Approve. (made by: MacNab) (seconded)
Roll-call vote Carried 5-0//McNab,Murphy, Cooper,Lepore, and Visco-aye
5. 47 Millbrook Road—Nitrogen Aggregation plan
Sitting Visco,MacNab, Cooper,Lepore,Murphy
Documentation Supporting documents and plans, staff recommendations.
Brian Maxwell,Bracken Engineering
Discussion Santamaria—The standard subdivision frontage is not available so using 3,000 square feet(sf) from
the one to aggregate to the other, so both can have a 4-bedroom septic.
Maxwell—We will be applying for a variance, which we want to discuss it at this time. One lot is
over 23,000sf and the other over 40,000sf. The property as a whole could support a 6-bedroom-
septic without nitrogen-reducing technology; we are proposing nitrogen-reducing technology for
two 4-bedroom septic systems.We feel that provides a net benefit.
Cooper—Asked if any deed paperwork needs to be done.
Maxwell—The deeds will reflect a loading easement for each lot and place a restriction on the lots
to limit them to 4 bedrooms and a stand-alone nitrogen aggregate plan.
LaFavre — She had asked that both docs would limit the bedrooms; she wants that as part of the
approval process.
Action Motion to Approve the nitrogen-aggregate plan with the suggested restriction. (made by:
MacNab) (seconded)
Roll-call vote Carried 5-0//Cooper,Murphy,Lepore,MacNab, and Visco-aye
VI. COVID EMERGENCY ORDER DISCUSSION
Sitting Visco,MacNab, Cooper,Lepore,Murphy
Speakers Michael Langlois
Michael Kopko
Amy Eldridge
Meg Browers
Discussion Santamaria— Over the last few months, there have been rises and falls in COVID cases. We are
using wastewater reports and are noticing a lot of"whiplash",which is tough on the public.As we
discussed, the State of Massachusetts has 73% fully-vaccinated rate; Nantucket is pushing almost
80% fully-vaccinated rate. We are seeing large cases within the school and a spike in sewer report.
We are noticing the reason is because testing is hard to come by and people don't get tested until
they show symptoms.We starting to get complaints from business owners and hearing stories about
how business have had to close for mental health reasons due to aggressive and even violent
reactions to being asked to wear a mask. It is important we take into account the safety of our
inspectors, establishment owners, and how well we're doing on the vaccination. Pfizer is effective
against the Omicron variant. He suggests the removal of the Emergency Order and go to a
permanent Mask Advisory. We need to put the burden on personal responsibility.
MacNab—Asked if the recent spikes have a pattern to contact. He'd like to understand the nature
of the present disease.
Santamaria—Saw a large number of antigen positives at the school.About half is untraceable.
MacNab—Asked how much of the antigen testing is confirmed by the PCR testing.
Santamaria—A lot of it is antigen testing.
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Mele We're holding at 3 hospitali7ations:.He doesn't believe there have been any.flyouts due to
severity.The cases appear to be largely home spread.
Murphy—The State and local vaccination rate, asked if that includes children.:
Santamaria-The 80%vaccination rate includes all eligible people 12 and above..
Murphy—Asked if they are using school population data to track how:many kids 5-11 are getting
vaccinated.
Santamaria—MIIS (Massachusetts Immunization Information System) for that; MIIS is reporting
at about 95%accuracy. .
Mauphy—Asked the about the availability for hospitalization in Boston
Santamaria —We have 3 hospitali7ations with COVID. Mass General-Brigham has a mandate to
slow down their elective procedures to maintain open beds;they haven't seen a large surge.
Murphy—Asked about the availability of COVID treatment at our hospital.
Santamaria—Explained the available treatments.:
Murphy—It would be good to hear from Gary Shaw about treatments they have access to.Asked if
a proof of vaccination policy has been considered.
Santamaria—He'd prefer to leave that in the hand of individuals.
Murphy - Her three areas of concern are accessibility of vaccination, especially for the younger
population,and access to testing in a timely fashion and the access:to booster shots. Considering that
she thinks about the mask mandate and stay at home orders; those were in place to prevent our
hospital from being overwhelmed. She'd like to see this Board make a very strongly recommended
mask advisory that when you can't,maintain social distance, wear a mask and encourage businesses
to continue recommend wearing a mask. .
Cooper=Asked for percentage of population that has had COVID.
Santamaria—He doesn't have that number;we've had over 2100 positive tests logged in.
MacNab—There's two sine waives: spike in viruses and spike.in:septic;we always seem to be behind
that sine wave. He understands there's human responsibility but obviously people aren't doing that.
He has yet to be convinced the mask mandate isn't necessary.
Lepore—Regarding ages 5-11 vaccines,most of the kids she knows have received at least 1 dose of
vaccine. She also supports a mask mandate;agrees with Dr. MacNab. She wonders:how much of the
current spike is related to Stroll. Kids are wearing masks all day in school;if they can do that, so can.
the adults;in her opinion,it's not too much to ask.
Murphy — She hears those concerns. However, she thinks a mandate does more harm than good
and we'll get the same compliance with an advisory as with a mandate. Enforcement falls completely
on businesses; it's unsustainable for them to:be the enforcement agents. She wants to save the
mandate for a:true health crisis; the mandate would be stronger at that point.
Cooper — We can mandate what we want but, if someone doesn't want to wear a mask, there's
nothing we can do. He doubts a mandate will work.
Visco—He'd like to stick with a strong advisory and put the onus on the people to do the right thing.
MacNab—It's a message of the.BOH;we have regulations that aren't being followed.We're a health
organization and health regulatory body;we're supposed to:look out for the health of the Island.The.
mandate says wearing a mask is important;he doesn't want to wait until we have a problem.We need
to get:ahead of.the cure.
Lepore -Agrees with Dr. MacNab. People are going to be bad; but a mandate is more important
:and makes people think. It won't take much to overwhelm our hospital. Our hospital has 9 beds,
plus the Emergency Room;we want to protect our hospital resources. An advisory sends the wrong
message.
Cooper -;If you can't enforce something, you can't make it work. We don't have the people to
enforce the mandate;we can't force people to change their minds about wearing a mask.
Murphy—COVID currently is ia complication for three patients.We have time to make a mandate
if the situation changes.We don't have a surge in the disease;she doesn't see evidence for a mandate.
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People who say no to masking during an advisory won't mask during a mandate. Until she sees
trending data that hospitals are running out of room and the virus is having a severe impact on our
health resources, she can't support a mandate.
MacNab—If we wait,it could get beyond our control. Regarding enforcement,we hardly have staff
enough to enforce the regulations we do have. He wants a mandate and he want it now. If there's a
spike,we've protected our hospital and our people.
Lepore — She gets messages from the hospital all the time about the Emergency Room being at
capacity.
Santamaria— Even if we put a mandate in place, it will be an advisory because we don't have the
ability to enforce it.We are training 2 new inspectors, but that won't be enough with everything else
they have to do.
Cooper—Asked if we are expecting a spike.
Santamaria—We will see a spike,probably akin to what we saw last year.
Langlois—he's on the faculty at Harvard Medical School; he's more likely to wear a mask if there's
a mandate over an advisory; the argument that people who wear masks under a mandate will wear
one with an advisory doesn't fly. His understanding is the BOH is elected to be a regulatory board
not an advisory board. The idea Nantucket isolated from"America"is problematic;we don't have a
walk-in clinic and to him that is an embarrassment,given the level of income of our community.We
know that OMICRON is more infectious than the Flue and Moderna is 50%less effective.Also,it's
concerning to him that he's following the news and research more than some BOH members. It feels
like this is turning into a political thing where you're waiting for the Governor to step in.
Kopko—On the subject of compliance,with a mandate, the signs go up and,in his experience, that
generates more compliance even if there is a percent who won't comply.
Eldridge—The advisory giving people a choice meets the burden of personal choice. She feels like
the finish line keeps getting moved,and people following the rules are being penalized for those who
don't.
Browers — There's a lot of absenteeism in the school because of positive testing. Her kids have
missed almost 3 weeks of school as a result. There is a component of our population that isn't
vaccinated; their impact could be reduced by a mask mandate.
Santamaria — The school mandate will continue; we have no jurisdiction of the school, boats, or
airport; those fall under the State and Federal.
Lepore — Wants everyone to think long and hard; teachers, students, and hospital employees are
wearing masks all day;in her opinion, asking someone to wear a mask when going to the store isn't
that big of an ask.
Action Motion to Reinstate the mask mandate to be implemented as soon as possible and to be signed by
the chair. (made by: MacNab) (seconded)
Roll-call vote Not Carried //Murphy, Cooper, and Visco-nay;MacNab and Lepore-aye
Murphy —Asked if we should revisit the wastewater policy and what Emergency Order would be
rescinded.
Santamaria — Revisiting the wastewater policy is up to the board. Emergency Order 16 is under
discussion. If we do a no vote, it remains in place; it requires masks for 2 weeks when the 50%
threshold is reached.
Action Motion to Rescind Emergency Order 16. (made by: Murphy) (seconded)
Roll-call vote Carried 3-2//Murphy, Cooper, and Visco-aye;MacNab and Lepore-nay
Murphy —As the virus evolves, the metrics will need to be revisited. Would like information on
how we need to consider the impact of the virus on the community at this time and going forward.
Also, there needs to be consideration on the impact on hospitals "in America" and on Nantucket.
Santamaria—We need an absolute metric. The issue with COVID is no one wins;we are looking
for the least terrible option. Mr. Mele, Heather Francis, and I will work on plans as we move along.
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Murphy— She thinks the difference between an advisory and strong advisory is communication.
Any education we can do about the benefits of a mask is important.
Lepore—She saw on the news that about 700 fully vaccinated people died from COVID.
Mele —That's too,many people dying from the disease; he believes there are other health factors
involved
Santamaria—The actual number is 699 fatalities among the vaccinated out 100,399 people or 0.7%..
he doesn't know the R number.
VI. BOH BUSINESS
1. In-Person Meeting Schedule:
Santamaria —The current open meeting law (OML) exemption ends on April 1. We need to make a decision on
when we go back to in-person meetings.
Visco—He likes the option of ZOOM meetings for as long as possible..
Santamaria —The State is looking at the OML regarding adding the hybrid option going forward for:regulatory
boards.
Cooper He agrees with Ms.-Lepore's desire to meet on ZOOM as long as possible.
Murphy—She is also in support of remaining remote:
Visco—He also agrees.
VII. ADDITIONAL DOCUMENTS USED
1. Draft BOH Minutes November 18,2021
VIII. ADJOURN
Action Motion to Adjourn at 4:14 pm. (made by: MacNab) (seconded)
Roll-call vote Carried 5-0//Lepore, Cooper,MacNab,Murphy,and Visco-aye
Submitted by:
Terry L. Norton
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