The Covid Update took up the bulk of the 04/14/2021 Board of Health meeting.
Health Officer Kurt Eggebrecht reviewed the case numbers. As of that meeting, over the two weeks prior they had had 93 total weeks cases followed by 116 weekly cases, which resulted in a total 2 week burden of 278. The city continues to stay in the “High” category and its trajectory was increasing over the last two weeks.
He went on to speak about the Covid variants that are circulating in Appleton and across the state. They created a chart that illustrated the case counts by age group across 3 periods of time–the first from Jan 1-April 5, the second from Feb 1-Apr 5, and the third from Mar 22-Apr 5. Their concern was with the 25-39 year old age group. He said they have a concern with the 25-39 year old age group; the rates in that age group are consistent throughout the region. More importantly, when they look at March 22 to April 5 they are seeing, not just in Appleton but across the state, a rise in cases among the school age population. He said that the reason that was important is because they don’t have a vaccine for that age group.
He said that in Michigan and some other states where Covid variants are increasing, as they are across Wisconsin as well, that they’re seeing a younger age group being impacted and hospitalized. He said in Michigan they were seeing an acceleration of hospitalizations in the 35-45 year old age group.
He then showed a chart that does not seem to be in the agenda packet and which I don’t see attached to the minutes of the meeting either. It apparently illustrated the increase in the different Covid variants. Wisconsin has seen a significant growth in the UK B-117 variant, which is now accounting for about 50% of all reported cases. The variants are more contagious and rapidly expanding across Wisconsin. He said that Appleton is reflecting the same trends that they’re seeing across the state.
He said in a bit he would talk about vaccinations and why Appleton is seeing a dropoff in cases in 65+ year olds, but first he wanted to talk about testing. Testing demand is down, but he said it’s still a very important component of what they do. He only showed numbers for the National Guard site which has moved from Reid Golf course to the building that used to house the Family Video on Calumet and John Street. Daily tests in April are down, but he said that the positivity rate remains high.
People can go to the Covid dashboard on the city website, scroll down, and see what the percent positive for testing is and what the vaccination rates are. As of 04/14/2021 Outagamie County had 35.9% of residents vaccinated with at least one dose. Winnebago was at 34.9%, and Calumet County was at 32.8%. Just the week before, Outagamie county was at 32%, so it really improved within just one week. He said a week ago, 40% of Appleton’s vaccine eligible residents had received at least one vaccine dose and 24% were fully immunized, and those numbers increased since then. Over 80% of Appleton’s 65+ year old population has been vaccinated, and he was very happy with those rates.
He also wanted to speak about the pause in Johnson and Johnson vaccine use. He thought the general message was that, through an abundance of caution, the state halted the use of that vaccine. 6 women ranging in age from 18-48 experienced blood clotting, but that was out of 6.8 million doses administered which would make it about a 1 in a million chance of happening. He thought the pause demonstrated robust concern about any vaccine and he took it as a very positive sign. He hoped that it would be perceived as just a pause and not the end of the use of the Johnson and Johnson vaccine which he said was a very effective vaccine and had some advantage by being a one dose vaccine. He asked Dr. Vogel if she had any insight.
Dr. Vogel was concerned about vaccine hesitancy and she tried to put the danger of getting vaccinated into perspective. The ability to even identify some of these events has a lot to do with the sophistication of our registries and tracking systems. She talked positively about VAERS and encouraged people to use it because it’s an opportunity for vaccinated people to essentially participate in a massive study that identifies adverse events. That’s how they know that 20-30% of people after the second dose of Pfizer or Moderna don’t feel well for a couple days. It’s also how they know about the 6 women that had the blood clotting issues. One of whom had a stroke in a part of the brain they don’t usually see blood clots. She said her daughter had received the Johnson and Johnson vaccine and would still get vaccinated with it even after this. She said there is disagreement among scientists as to whether the vaccine should have been paused at all. She stated that there have been about 4,000 deaths following a vaccination in the US since vaccinations started, and none of them except for these 6 have been proven to have any correlation to have been caused by any vaccine whatsoever. She wasn’t trying to be cavalier, just trying to put it in perspective. Whenever a doctor prescribes a medication one should have a discussion about the risks and benefits. She pointed out that we don’t remove motor vehicles because of car accidents. We also still sell tobacco and alcohol. We are in the middle of a pandemic, and she wanted to encourage people not to be fearful. The vaccine was paused out of an abundance of caution and she thought even if it the cases were proven to be related to the vaccine that the Johnson and Johnson vaccine would still end up being allowed to be used again. She said that anybody in our community who has diabetes, and his hospitalized with Covid, will have a 1 in 5 chance of dying from Covid; however out of 190 million vaccinations in the US there have only been 6 related deaths. She said she was putting it into perspective and they would still be encouraging, at some point, to continue using the vaccine. She said we are in a race against the Covid variants, and they need to vaccinate people before we have variants that are more contagious and more deadly. She said that the people that are being hospitalized are indeed sicker with the new variants.
Doug Nelson wanted to know if the pause on the Johnson and Johnson vaccine had effected vaccinations in Appleton.
Health Officer Eggebrecht said they didn’t use the Johnson and Johnson vaccine that week. All of their appointments had been taken. They provided over 1,000 vaccines on Tuesday, were planning to provide over 1,000 on Wednesday, and were planning over 1,000 on Thursday. He thought they might see an impact if the pause went on for longer and said he would keep the Board updated. He again said he thought the pause should be perceived as a positive demonstrating that the system works in terms of identifying any concern. He also pointed out that the pause wasn’t a mandate but instead just a recommendation that Wiscon chose to accept as did most states. He thought it was prudent and reiterated what Dr. Vogel said about keeping the risk in perspective. Per Health Officer Eggebrecht, 1 in 600 people that contract Covid die of it but 1 in 1 million vaccinated people have experienced this side effect.
Alderperson Denise Fenton (District 6) was glad the vaccine appointments were filling up. She was concerned about vaccine reluctance. She said that she knew from personal experience the vaccine clinic requires an ID to match a person with their appointment, but there has been some news going around that an ID is not required. She wanted everybody to be vaccinated and worried about someone having problems because they were undocumented or didn’t have an ID.
Health Officer Eggebrecht said they do use the form of ID just out of convenience for the person that’s coming to their appointment, but it’s not a requirement. They do however ask people to complete the consent form.
Regarding vaccine hesitancy, he said they have representatives from the city that serve on a multi-cultural team that’s trying to address some concerns. There are groups within our community that they have purposefully reached out to. They hold back a percent of all appointments for people of color and also for people who don’t have access to the internet and need to register by phone. Over time, phone registrations have decreased because the 65+ year old people who relied on that have been mostly vaccinated. They have also partnered with Ascension’s Milwaukee office to more purposefully reach out to communities of color. He mentioned pop-up clinics that may be in a more friendly neighborhood location and said they would be doing that in the coming weeks. They’ve been meeting with key leadership within the communities in hopes of identifying and reducing any hesitancy. He thought their best advocates were the people who have gotten vaccinated who can describe their experience to friends and family and disabuse them of any false rumors they might have heard about vaccinations.
He said that we are in a race to herd immunity and that getting vaccinated is a civic duty as well as providing individual protection. They hope people take it seriously.
Alderperson Fenton said she liked the Saturday clinics because middle of the day is difficult for some people. She assumed they would keep doing those.
Health Officer Eggebrecht said that his intention was to run 21 more clinics from April through May on Tuesdays, Wednesdays, and Thursdays. They were also hoping to run another Saturday clinic on April 24. He thought they were reaching the point where the community clinic would need to be targeted more into those popup clinics to find those pockets of people that haven’t yet been vaccinated. They are hearing from other locations across the state that their clinics are slowing in terms of registration. He mentioned that Milwaukee just transitioned to being a walk-in clinic rather than requiring appointments. Winnebago County has also had trouble filling their clinics. He thought they reached the point where the people who were eager to get vaccinated have been and now they need to purposefully encourage people to make appointments.
Denise Fenton wondered if there has been any discussion on getting the 16-18 year old population vaccinated and maybe doing something in conjunction with the schools.
Health Officer Eggebrecht said they’ve been meeting with the regional school superintendents every Wednesday morning since last summer and continue to do so. At last week’s meeting they floated the idea of having a 16-18 specific clinic as early as the 24th, but due to logistical issues they decided against that. There was concern about being able to get enough of the Pfizer vaccine and also processing the number of students in that age group. They were able to do school faculty in one day, but AASD alone has 3,000 16-18 year old students. That’s also a very active age in terms of socialization and they weren’t sure the students would carve out time on a Saturday morning to get vaccinated. Instead, they’ve made a list of all vaccinators in the Valley available to school superintendents to share with parents. Pharmacists that are available on evenings and weekends may be more accessible to them. If they hear a groundswell of support for a specialized clinic they could reevaluate that decision. It’s still difficult to order a specific vaccine and amount at a specific time, so given those logistics it’s probably best for the district to simply promote all of the vaccinators.
Dr. Vogel spoke about vaccine hesitancy again. One of the things people have observed with the Johnson and Johnson vaccine is that it can feel like it’s burning a bit when it’s administered. She thought that burning could set off what health professionals call a vasovagal reaction which is a simple faint preceded by light headedness and the feeling of being kind of dizzy. She said some people get this all the time if they see a needle. There’s also just a sensitivity in our skin cells for certain things which results in a flesh response that results in getting light-headed. She said that can also set off potential anxieties in people who otherwise wouldn’t experience adverse effects, so vaccine administrators are usually warning people it might burn a little bit and it’s not a reason to not get a vaccine.
She also wanted everyone who’s been vaccinated to know they’re not going to experience immunity for two weeks after the second dose of Moderna or Pfizer or 2-4 weeks after the Johnson and Johnson vaccine. She said we all need to still be cautious about masking and extending our safety bubbles. She also wanted to tell people who were vaccinated that they are now ambassadors for the vaccines, and she encouraged them to tell their friends and family about it. She also appealed to healthcare workers because there’s vaccine hesitancy among healthcare workers also. She said she didn’t usually like to use war metaphors, but this is healthcare as war. “A firefighter can’t sign up and say ‘Not in my job description. I didn’t sign up for helping save that person’s life in a burning fire.’ And for us as healthcare workers we need to say, ‘Yeah, maybe there’s a little bit more risk, potentially, but we need to lead the way and we need to do that.’”
One of the committee members asked if they have been able to track whether Lawrence students are starting to sign up at the expo center.
Health Officer Eggebrecht said they have been working closely with Lawrence. However, as at the high schools, the students don’t all share the same calendar and schedule. They’ve been encouraging students at each opportunity when clinic appointments open up on Sunday, and Lawrence has been pushing out communications on the importance of vaccinations to their students and faculty. They’re doing a great job in testing as well as encouraging vaccination.
A committee member asked if the hospitals were nearing any kind of capacity issues. Were they getting to the point of having burnout, not being able to take care of people, and shipping patients to other areas?
Per Health Officer Eggebrecht, things have been steady and consistent for the last three weeks. They are concerned about what’s happening in Michigan because there are hospitals in Michigan that are again experiencing pressure on staff from hospitalization rates. But, currently local hospitals are not reporting that they do not have capacity and/or cannot accept additional patients.
Cathy Spears asked in regards to the decrease in testing demand if the health department had reached out to the Chamber of Commerce to do some kind of education to encourage people. The CARES act funding that was allowing businesses to pay employees if they had to isolate and stay home has gone away so she understood the reluctance of an essential worker who isn’t making much money to voluntarily get tested. She wanted to know what the Chamber of Commerce has been doing, whether the city had any partner in that, and if there was any CARES Act money that the city could leverage in that way to assist local businesses.
Health Officer Eggebrecht said they have been in communication with the Chamber and he had another meeting with them scheduled for April 30. He said the Chamber has been quite supportive of the health department’s efforts and that they know that the sooner we get this disease knocked down, the better it is for business. He said there’s a direct understanding of the connection between community herd immunity and the successful operation of all of our local industries.
He said he couldn’t identify how prevalent it is for people to not get tested and stated that testing is more available now than ever. The reasons why people don’t see testing is confusing. Whether or not an individual is paid to go on company time to get tested is an individual decision by a business. They’d encourage that and think it would be wise to do. But it’s a business decision that they can’t influence.
Cathy said when the mask mandate ended statewide, all of a sudden the businesses that were doing masking because they had to stopped encouraging it. She asked if the city had reached out to the Chamber of Commerce to try to get them to talk to business owners who are no longer requiring masks. She said that right now they need people to wear a mask, social distance, and keep those mitigation strategies in place.
Health Officer Eggebrecht thought her observations were correct. He said they have worked with the Chamber and Appleton Downtown, Inc to help with that messaging. He says her point was well taken. He thought it was critically important that the community continue to wear masks and social distance and that the city continue to message that out.
In terms of opportunities for businesses to assist he thought that, right now, the opportunity to vaccinate their employees was critical. He thought they should encourage businesses to do that and also maybe find some creative ways to allow employees to get testing when needed.
Cathy also wanted to know if they were monitoring Covid long-haulers.
Health Officer Eggebrecht said the state monitors that. He mentioned that they’re seeing in different parts of the state recently, a higher incidence of people who have had Covid in the past now testing positive a second time. So immunity from early exposure of the virus is clearly waning and the new variants are breaking through into the population. He stressed the need for vaccination. People need to understand the value of a vaccination because they cannot rest on the fact that they’ve had Covid to provide them immunity.
Cathy asked if faith based organizations were assisting in responding to vaccine hesitancy. Was there the potential to do popup clinics at churches?
Health Officer Eggebrecht said there had been conversations–particularly about using St. Therese and targeting Mothers Day but there’s probably greater acceptance by those people to get vaccinated at their grocery store. He didn’t want to say anything publicly before planning was finalized but there he indicated there are initiatives in the works to encourage specific churches and restaurants to take informal leadership to help with that.
Cathy thanked him and said she was so glad he didn’t retire last year.
Health Officer Eggebrecht reviewed the vaccine clinic numbers. As of 04/13/2021 they exceeded almost 23,000 doses. As vaccine supply has increased, they’ve been able to vaccinate more people. The vaccine clinic numbers represent about 1 of every 4 vaccines provided in Outagamie county. They’ll be running the clinics through May for sure. He wanted to recognize Mosaic Clinic as one of their key partners in providing staffing.
Alderperson Vered Meltzer (District 2) asked if there was a need for volunteers.
Health Officer Eggebrecht answered that they have a partnership with the Volunteer Center which is able to onboarding volunteers electronically which has saved countless hours. They’ve had to slow down the recruitment of non medical volunteers because there were more people volunteering than were needed. He said the Expo Center site is very special compared to other sites around the state. The people who work there really want to be there to serve their community and it has a very welcoming environment.
View full meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=837618&GUID=B00BBAA2-CCA5-49F5-9566-339382FECE1A&Options=info|&Search=
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