Please find the recording of the meeting HERE.
Karen Koenemann – Public Health Director:
We use data and science to move forward in community. We will see more cases until we have pharmaceutical intervention.
It’s imperative to find balance between preventing people getting sick in large numbers and having a life and a community. How do we maintain this balance?
- Minimum of 65% social distancing.
- Reduce Mobility. Pitkin County was one of the most successful counties in the county reducing mobility
- Takes all of us to be successful, including participation in contact tracing.
How do we have a community in which kids can be educated in the fall?
- Our actions impact schools
- Pandemic Tools
- Containment
- Mitigation/Suppression
- Individual, family, sector, and community buy-in and diligence to these practices
- 3 Cs
Call to action to the community: all hands on deck. We can’t reach our goals or have the ability to contain if we don’t have everyone’s help. Everybody needs to see role and responsibility in this.
Approaches to tightening up – will adapt to where there most transmission is happening
Josh Vance, Epidemiologist and Charley Spikert, Epidemiologist:
- 1842 Sir Edwin Chadwick
- General Board of Health in 1848, The Public Health Act
- Goldman sachs
- Mask usage
- Wearing masks can improve economic situation
- Important messages: 5 commitments and contact tracing
- US Cases are rising in majority of states
- Hospitalizations and deaths increasing in all surrounding states
- We haven’t seen July 4 impact yet
- Some states going back to stronger strategies
- Stay the course so we don’t go backwards
- Colorado
- Cases increasing
- Faring better than surrounding states
- Cases, hospitalizations, and deaths in upward trend
- Hospital Data
- Community Testing requests – trend increasing
- Community testing demand has succeeded comfortable at AVH
- Respiratory Evaluation Center – trend increasing, comfortable level at 10 a day, exceeded for the first time in the last week of June.
- We’re seeing more COVID cases
- Transfer of visits to the emergency department – those with more severe symptoms – trend increasing
- Hospitalizations remain low – lag the increase of cases
- One person at AVH in ICU
- AVH employees with COVID-like illness out – just moving up to level to be cautious
- Antibody test for AVH employees – 14 positive, 450 negative
- AVH Capacity Matrix – increasing number of individuals with COVID like illness
- Impacting staffing, PPE
- Capacity remains comfortable
Josh Vance, Epidemiologist:
- Epi Curve of New Cases
- Epidemic Curve – shows cases that have been reported by Pitkin residents since the beginning of pandemic
- Starting to see increase again
- July 8th – 7 cases reported by Pitkin County residents
- July 9th – 5 confirmed cases
- Recent Sites of Exposure
- Highest % Community Spread – don’t know where/how they got sick. Concerning that there are high levels of unknown exposure
- 24% travel
- 24% Workplace
- 20% Household/friend
- Small % healthcare/party
- Underlying Conditions
- Heart-related conditions – double what is expected to see
- Thyroid disease – 4x higher than was is expected nationally – immune compromised
- While we have a lot of underlying conditions – heart-related , thyroid, and high cholesterol
- Predominating Strain
- D14 Strain – dominated in China and eastern Asia
- New strain G614 takes over in March/April
- Really the only strain we’re seeing throughout the world
- Complacency – seeing this become more of an issue
- Infectivity of G614
- New strain has a spike that can inject itself into cells easier
- With spike – can be up to 10 times more infectious
- Has been dominating since late march/early april – seeing effects because of loosening of distancing strategies
- Fatality rate are the same as other strain
- Is it Airborne?
- Consensus is yes, it’s airborne
- Particles can linger in air from minutes to hours – can infect an individual walking by
- Recent study – asymptomatic individuals – may produce more virus containing aerosols. More research is being done.
- Wearing face masks – most effective means to prevent inter-human transmission
- Health advice needs to match research
- Virus traveling through air conditioning and infecting others
- Protect Our Neighbor
- We would not qualify
- We are seeing high rates in community
- We’re at the highest since the beginning of pandemic
- Rate is very high – becomes difficult for contact tracing and indicates that we have significant spread of disease especially in a small county
- Dramatic increase recently – expect this to go up after 4th of July data
- Do we have data on visitors/tourists?
- Don’t count out of county cases
- They are investigated but not counted for fear of double counting here
- Does each mutation mean a new vaccine?
- No, because changes are small.
- Frequent mutation means vaccine won’t be long lasting – needs more research
- Similar to a flu vaccine with receiving it more often
- Made from various components of virus
Tracy Trulove, Pitkin County COVID Public Information Officer:
- Selfie Campaign of community members wearing masks.
- Airport – Table with tremendous amounts of literature and information, sandwich boards, video of 5 Commitments playing
- Drive market
- VMS signs
- Outreach with tourism partners – best way to reach visitors
- CDOT signs – specific rules, will work with us if something’s new
- Pitkin Alert challenge – need to opt in. Pitkin Alert information around town. Information to concierges and hotels for visitors.
Karen Koenemann – Public Health Director:
- Adjustments to PHO:
- State opened libraries, we are aligning with state
- Added clarifying messaging for 6 foot distancing for restaurants
- 25 feet distance from patrons for performance arts events
- Reluctance around participation for contact tracing, tightening up language on isolation and quarantine
- Extend current PHO for 30 days, allows us to see what state does after 30 day extension from July 1st
- Don’t anticipate any other changes, no increase in group or event sizes based on data
- Trigger document – will call an emergency meeting to see if there’s anything needing to be tightened up
- Letter with Eagle county to State- asking the state to create a statewide testing strategy
- To help us locally for the state to implement that strategy across the state.
- Testing supplies in short order across the nation, federal level failure, longer turn-around times. The longer the turn-around time, the longer they won’t know, and hinders the box-it-in strategy.
Torre: 6’ between patrons in restaurants, very difficult. County’s help to get compliance. This clarification is difficult for businesses to match.
- Jordana – guidance is aligning with state. Going forward, the city is doing great work to work with restaurants to make this work for them. Mutual understanding and a system that works for everyone.
- County to align with city with curfew
Questions from the BOH:
Case investigations and contact tracing:
- Test results – electronic data system
- Epi team also created an online form – to initiate tracing faster
- Case triggered for assignment
- Case interview – understand test results, isolation, referral to medical provider if have severe symptoms
- Tracers routinely contact individuals
- Ask about contacts – similar process from there on
- Confirm the individual’s county of residence
Contact Tracing Capacity
- Average of 5-6 cases per day
- Initiations started within 6 hours
- Limitations
- Staff capacity – improving, will increase to 10-12 cases per day
Guests arriving by car
- Signs on highway and strong partnerships
- Testing available to everyone
Cases per week
- Variance – 18 cases, number isn’t relevant anymore because state was in a tighter scenario with safer at home
- As our variance came into place, the state loosened.
- Using data is more robust that tells us truly where we are – will help us determine our next steps
Airport regulations/General aviation/ airlines
- FAA has not provided guidance or requirements to screen passengers at this time
- Airport has completed over 150 action items
Round Robin:
How to address lack of mask wearing on trails? What can we do next regarding encouraging people? Should we pass an ordinance to be more assertive?
- Need to have a conversation with law enforcement
- Have had an ordinance since early May in PHO
- Already have the ability to enforce the mask ordinance and covers all of Pitkin
- State-wide mask ordinance to see this across the state, not a law yet
- Would make messaging easier if it’s consistent across the state
- Advocate to law enforcement and to governor
- Make masks attractive for law enforcement to hand out
Next steps for making masks a state law?
- Letter where different BOH sign
- Recommending enforcement be increased
Torre – strengthen language in PHO, need to have more conversations to come up with a strategy. Current mask mandate does have a lot of allowance.
Contact Tracing technology
- 45 min session led by state, walk through new system
- End of next week will have recommendation
- Database/system that every local health department can use
- Confirmed covid cases imputed and exposed contacts
- Communication database, placeholder for all of our information
- Unite everyone onto the same system to easier conduct investigations and hold data
Suggestions for incentives for contact tracing?
- Mask fashion show
- Mask selfies
- Fashionable masks
