The Board of Health met on 08/11/2021. The first item they took up was the Covid-19 update. Given that it was a Covid-19 update, they talked extensively about Covid-19, so I am posting this update only to the website and not directly to the All Things Appleton Facebook page, as I typically do, because I have no idea what Facebook’s algorithms will and will not flag.
Interim Health Officer Sonja Jensen noted that since they last met two months ago, there had definitely been some changes in their case count. Right now, numbers are around where they were in early April. The two-week burden per 100,000 people was 184 which places the city in the “high” category where it has been for a couple of weeks.
The city updated it’s Covid tracker dashboard to show the community level of transmission as defined by the CDC. As of Monday 08/09/2021, the city had a “Substantial” community transmission level and was trending toward High. All of the counties surrounding Appleton were at a high level of community transmission.
Appleton’s vaccinations levels were a little higher than the levels at the state and the surrounding counties. She said that while that was something to be happy about, Appleton still has a long way to go to get anywhere close to what they would call herd immunity which is usually around 80% vaccinated.
They were able to calculate out the vaccination rates of 12–17-year-olds specifically. As of Monday 08/09/2021, 41.1% were fully vaccinated and 48.5% had received at least one dose. Anyone under 12 is not yet eligible to be vaccinated.
She said that the day before she had attended a meeting with area healthcare providers. Hospitalizations are going up in the Fox Valley HERC region, which was part of a statewide trend. As of right now about 97% or more of the people hospitalized are people who are not fully vaccinated. They were also seeing a trend where the average age of people who are hospitalized is younger than it was before. She said she had heard 40-42 was the average age of hospitalized people. [She didn’t mention where she had heard that figure from.]
The Board then opened things up for questions and discussion.
Alderperson Vered Meltzer (District 2) wondered if there was any data about how many of the hospitalized people were in the under 12 population who are not yet eligible to be vaccinated.
Interim Health Officer Jensen did not have that data. All she had was the average age which was definitely trending younger. She said she had heard from some of the hospital partners in the Milwaukee area that they are seeing more admissions at Children’s Hospital, but she didn’t have any statistics. [I understand that it’s not necessarily her fault that she has no statistics, but it would be very helpful to the community if there were clear numbers regarding how many people are hospitalized, what their ages are, what their vaccination status is, and what sort of underlying health conditions, if any, they have.]
Board member Dr. Lee Vogel said that communities and states that are seeing a surge in Delta variant cases are seeing an uptick in children both getting this illness and getting sicker from it. She stated, “It turns out that the adolescents seem to be at most risk for complications and now even death.” [And that is one of the reasons why I am not posting this on Facebook, because I don’t know from where she’s getting that information. I don’t know if she meant adolescents are the most at risk group for people under 19, which would probably be accurate, or if she literally meant they were the most at risk group across the board, which as far as I can tell doesn’t seem to be true.]
She went on to say “Often they have risk factors such as obesity, but not necessarily. The American Academy of Pediatrics put out a warning that 94,000 cases in kids alone have occurred with this recent surge. There’s been over 400 deaths of children from Covid and many of those were early on when the severity seemed to be less but one of the–Delta is really a game changer right now.” [The 400 deaths are nation-wide I’m assuming because in Wisconsin there have only been 3 deaths in children 10-19 and no deaths in children 9 and under as of August 12, 2021.]
She was concerned about the Delta variant. She said that studies showed that the Delta variant was about 200% more contagious than the original form of the virus and that asymptomatic people could pass it on better than the original version.
She also discussed vaccinations and breakthrough cases. As Interim Health Officer Jensen had indicated, 97% of hospitalizations right now during the current Delta variant surge are among people who are unvaccinated as are 99% of the deaths. [Note: Dr. Vogel said they were among “unvaccinated” people but Health Officer Jensen said they were among people not fully vaccinated which is a slight difference.]
The 3% of hospitalizations and the 1% of deaths in vaccinated people tended to be in people who were immune compromised. “So, part of my rationale for getting a vaccine is not only to protect myself and my family and my loved ones, but it’s to protect the people around us. It is a very effective vaccine. There’s never been a vaccine that’s been developed that 100% prevents illness–even when we recommend pneumonia vaccine or the Pneumovax or a shingles vaccine or all of the childhood vaccines–they don’t prevent 100% of illness. They get us to a kind of herd immunity that diminishes the opportunity for viruses to kind of percolate among the unvaccinated, and they also for an individual perspective, a vaccine reduces–it does reduce my chance of getting an illness in and of itself, but it also reduces my chance of being so sick that I need to be hospitalized or could die.” [This again was something that made me hesitant to post this directly to Facebook, because there seems to be a big question right now about how much people who are vaccinated can get Covid, and the CDC is recommending that in areas of substantial or high transmission even vaccinated people wear masks to reduce their risk of spreading the virus .]
She stated that the Covid vaccines “probably are the most effective vaccine ever created.” She thought it was important to get herd immunity because an unvaccinated population not only was at risk for hospitalization, death, and long-Covid, but also increased the risk that the virus could mutate. She concluded, “And so the ability to get our economy open, the ability to someday go without masks is really dependent upon the vaccinations, so that’s what I wanted to offer in terms of experience and science.”
Board Chairperson Cathy Spears asked Dr. Vogel to explain the difference between the Covid vaccines which are mRNA vaccines and the traditional vaccines that have been available in the past.
Dr. Vogel said there was a lot of misinformation out there and “hopefully we can provide accurate information continuously as we go along. And it’s understandable that we’re bombarded in new ways with media and technology, where misinformation can kind of be promulgated.” She recommended that people with the technology to do so go to the CDC website which has some good videos that explain things for people who aren’t scientists and aren’t in medicine.
She said that people worry that the development of the mRNA vaccines was rushed; however, “There are phases of research that are required of any medication or any vaccine that’s approved by the FDA. These vaccines went through every single phase. One of the reasons that they could go through a little bit quicker is that some of the technology around mRNA vaccines actually has been studied for decades. This year, in fact, there were manufacturers who were looking at mRNA technology–had been studying it for the influenza vaccine. At some point many of our vaccines may move into a category of mRNA.”
She stressed, “It does not alter our DNA. What it does is, as it’s taken up, it’s used up at the site of the injection so it’s not percolating within your system. And messenger–‘mRNA’ stands for ‘messenger RNA’. If you think about–if we have a quick lesson about tissues and cells in our body, the basic unit is a cell and in that the DNA of our cell is contained in a little bundle. mRNA does not get into attack the DNA. Instead, what it does is it gives messages inside the general body of the cell to make certain proteins and these proteins are called antibodies. It also helps stimulate our t-cells which are kind of white blood cells that fight infection. And so, it gives our body the ability to make things in the future, while the mRNA is actually used up. So, it is–they’re not live viruses, and that’s the mechanism, hopefully understanding that will help a little bit.”
Chairperson Spears asked if Interim Health Officer Jensen had anything to add.
She responded that she did want to let the Board know that they had a partnership with the Appleton Area School District to set up four vaccination clinics. They’ve also invited any families of students to come as well as students from private schools in Appleton. Those clinics will be happening the week of August 15, concurrent with the registration at the middle school They will be providing the Pfizer vaccine to anybody 12 and up.
Chairperson Spears asked how testing in the area was going and if the city was going to be looking at providing any kind of drive-through or mass testing sites like they did last winter.
Interim Health Officer Jensen said that was something that was always on their mind. Last winter there hadn’t been as much access for tests in the community, but now there are pharmacies and ThedaCare still has a mobile testing unit at the Timber Rattler stadium. They will continue to listen and assess whether that’s a service they feel is needed.
Alderperson Meltzer said that at the Common Council meeting last week, Alderperson Joe Martin (District 4) had reported that, although he was able to get a testing appointment through a local provider, when he called local pharmacies, he found they weren’t doing any testing. Interim Health Officer Jensen had said that she would looking into that and bring back more information. Did she have any information about whether or not testing was available at pharmacies in Appleton?
Interim Health Officer Jensen said that from everything they looked testing was still available at pharmacies in Appleton. [That’s true. You can still go online and schedule tests at CVS.] That didn’t mean testing was available at every location, and they were sometimes also by appointment, so a same day appointment might not be available. The best resource to go to would be the link through the Wisconsin DHS website.
She said they were trying to keep a finger on how community testing was going and would work on providing drive up testing if they felt that was needed, but there were still pharmacies offering testing as well as vaccination.
Dr Vogel said that we were caught at this window which was too be expected. We’re a year into the pandemic and we thought we were on the downside but now we’re on the upswing again. She thought we could use lessons learned from last year which was to ramp up faster with certain mitigation measures. But they were also cautious about when to push for greater testing and how to go about increasing vaccination rates. She said they were in that window of hoping that they didn’t have to push the gas pedal like last year, but Appleton did need to do some mitigation measures. The question was how fast and how much?
Chairperson Spears encouraged anyone who had questions to go to their primary care provider or one of the local health systems. Urgent Care facilities have walk-in capabilities, and if someone was showing symptoms then that would be the place to go.
Alderperson Sheri Hartzheim (District 13) said that, in answer to Alderperson Metzler’s question earlier regarding hospitalization among under 12 year-olds, she had pulled up the Wisconsin DHS website and it showed that, as of 08/10/2021, there had been 391 instances of 0-9 year-olds hospitalized since the Covid cases first started being tracked. That was 1% of total cases. [She didn’t mention this, but the website also indicates that since Wisconsin started tracking Covid data, only eighteen 0–9-year-olds with coronavirus have ever received intensive care. The website also doesn’t differentiate between children who were hospitalized for other things and happened to concurrently have a positive Covid test vs children who were hospitalized specifically due to issues stemming from being sick with Covid.]
Per Alderperson Hartzheim, the Wisconsin DHS website also showed that 76.9% of the Fox Valley hospitals still had capacity and immediate beds available.
Chairperson Spears said that was a good thing for people who have non-Covid concerns and health issues because they could get treatment and not be pushed away.
There were no more questions.
View full meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=869341&GUID=54AE7EA9-23B2-4603-8800-FA61DC63F965&Options=info|&Search=
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