The Board of Health met 03/09/2022 and received a Covid-19 Update from Health Officer Sepers which included not only the normal case rate and vaccination rate information but also some more details about the new methodology they are using to track Covid levels in the community.
He started out by telling the Board that the Health Department had changed the timeframe for what their reporting weeks were. Previously, they had been Monday through Sunday but had now been changed align with the CDC’s weeks which were Sunday through Saturday.
Over the previous week, which, due to the change, was only 6 days instead of 7, the city of Appleton had 55 cases. If they included Sunday’s numbers, it would have been 60. With 80 cases the week before the two-week disease burden per 100,000 would be either 135 or 141. That was, however, under the old methodology.
Also under that old methodology, the city had been in the “High” burden category (down from “Very High” and “Critically High”) for two weeks in a row. “You can see that we’re getting pretty close to the sort of baseline summer 2021 case-rate, and we would expect that to begin to kind of plateau out or kind of level out here as we kind of hit that bottom of what those cases are.”
He then showed a slide highlighting the new CDC methodology based on community risk. The new methodology takes a stratified approach based on and incident rate over a 7-day-period adjusted per 100,000 residents and then factoring in the higher of two metrics: (1) new weekly Covid-19 hospital admissions per 100,000 population and (2) weekly percentage of staffed inpatient beds occupied by Covid-19 patients.
Per Health Officer Sepers, “The explanation for this is, as the CDC begins to pivot into the endemic stage, right? We are looking at and focusing on those medically significant cases, right.
“So, we could have a variant—and we will have more variants—that is, that will transmit very, very easily, but if we’re not seeing a whole lot of disease burden in terms of healthcare capacity usage, then that’s not something that we would pay close attention to.
“And so, this framework, this methodology, is future proofed a bit in—as it’s laid out, because it will protect against that sort of hospitalization burden. […] As that increases and—you know, we could get a new variant that doesn’t transmit well, but will have a much higher hospitalization rate, and that will sort of capture against that. So, we don’t say this very often, but it looks like the CDC had gotten this right in terms of how this new methodology had come out.”
The next slide showed the community risk level for each county in Wisconsin. Outagamie, Winnebago, and Calumet counties on which Appleton sits were all in the green “Low” category.
He went on to say, “One of the complications of this is Appleton does reside in those three counties, but—not making this any more complicated than what it needs to be—we’re looking at the highest, sort of, CDC risk level for any one of the three counties will set what the Appleton health jurisdiction is in terms of what that risk is. So, if Outagamie and Winnebago are low and if Calumet County were medium then we would say that was a medium risk for all of Appleton.” He added that Appleton couldn’t drill down much further because of how the health service areas were calculated. “There’s a reason why the CDC has done it this way and so we’re going to adopt it rather than swim up-stream on that one.”
He added that there wasn’t a whole lot of variation between the previous methodology from DHS and the new CDC methodology that DHS had also signed on to. For the second week in a row Appleton was in the “Low” category.
He then reviewed the vaccination rates. He pointed out particularly Appleton’s percentage of fully vaccinated residents which was 71.8% and noted that that was a 3-point increase over their last report. [Which was dated 02/14/2022] He also pointed out that 28.5% of 5–11-year-olds were fully vaccinated [up from 25.9% on 02/14/2022]. “The biggest market share in those new vaccinations are in the 5-11 so that’s exactly what we want.”
He then said that as the CDC was preparing for public health pivot, and as everyone looked at what an endemic management of Covid-19 might look like, the CDC released new recommendations regarding new case investigation and contact tracing methodology. They would be moving away from doing full contact tracing and investigations on every positive case. The new recommendation was to focus on those in the most vulnerable populations—those in congregate living facilities and members of homeless populations. He said that DHS had signed onto these new guidelines and provided instructions to health departments in line with these new recommendations.
He finished up with an update on the community testing site, telling the board that it was still up and running, and had moved into the old Office Max space next to the Best Buy location it had been occupying on Kensington Drive
He said that they had not been getting good real time data regarding testing numbers, but they were working with those managing the site to get that information. They were paying close attention to what the daily test numbers were. When they looked at the numbers two weeks ago, they had still been performing between 100 and 300 tests per day which they felt was too high to warrant closing the facility. “We’re kind of looking at a threshold of about 15 or 20 cases per day and having those be non-symptomatic cases. So, if we’re looking at folks just wanting to get tests for travel or something like that, this may not be the best resource.”
The lease is month-to-month, so they have to evaluate on the 9th of the month to see what those testing numbers looking like and whether it makes sense to renew the lease for the next month.
Chairperson Cathy Spears then opened things up for comments and questions.
One board member wanted to clarify whether the vaccination rates were for the entire population or just for the vaccine eligible population. Health Officer Sepers confirmed it was for the entire population.
Chairperson Spears said she found it interesting to look at the state of Wisconsin and see who was in the green “low” category. She thought it would be very interesting to compare the vaccination rates of red, yellow, and green areas. She congratulated Appleton and the Health Department’s efforts to get those vaccination rates up. “It’s really excellent to see that we have such a high vaccination rate.”
[The great thing is information regarding the vaccination rates for all of Wisconsin’s counties is readily available on the WI DHS website, and it’s very easy to match up those rates with the counties by CDC community risk levels. As off 03/09/2022…
The “High” counties had vaccination rates that ranged from 34.5% to 76.3% with an average of 55.0% and a median of 55.1%
The “Medium” counties had vaccination rates that ranged from 45.8% to 74.2% with an average of 56.8% and a median of 55.0%
The “Low” counties had vaccination rates that ranged from 43.8% to 78.3% with an average of 57.2% and a median of 56.3%
Essentially, the vaccination rates are very similar across all groups.
It is one thing for a random member of the public to idly speculate as to whether or not vaccination rates are contributing to community Covid-19 levels, but I do think that during a Board of Health meeting, which is a time to present data and information to the public and to city decision-makers, the chairperson of the Board of Health should not be idly brainstorming, inferring, or speculating about things. A better course of action would perhaps have been to ask a staff member to collect the data and then update the Board at the next meeting as to whether vaccination rates seemed to be a contributing factor in community Covid-19 levels. When I watch an official meeting of the City of Appleton’s government, I would appreciate a higher level of rigor and analysis than what I can find in a random comment thread on the internet.]
View full meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=921503&GUID=2F15E02E-305C-4F8C-9EF6-93B18F94C37C
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