I had the opportunity to watch the 11/11/2020 Board of Health meeting.
Health Officer Eggebrecht started out the update by claiming that since Labor Day cases in Appleton have accelerated.
[As I feel compelled to point out whenever that claim is made, cases were accelerating before Labor Day. It’s factually incorrect to claim otherwise.]
Appleton’s burden as of 11/11/2020 is 1124. A burden of 350 per 100,000 people is very high, and we’re obviously well above that. Our trajectory is also in the very high category.
Per the city’s Emergency Manager, the National Guard testing site at North has been very busy. They’re definitely identifying a lot of cases.
The National Guard team is composed of 8 individuals. The city was told that the team would do 300 tests at 40 tests an hour, but they’re actually doing 50 to 80 tests an hour and are going well above 300 tests a day. Thankfully, they’ve been given the supplies to enable them to go above 300. [As an aside, no one expressed any concern that the speed at which they’re performing tests impacts the tests’ accuracy.]
The Appleton North side did 3,851 tests in October and 2,094 tests in November as of 11/10. They’re turning out the highest number of tests for their site size of any testing site in the state of WI.
The tests are sent to Exact Sciences in Madison. Results are taking 3-5 days to get back. At the time of testing, they give out a phone number that people can call if they don’t get their results by day 5. All results are being emailed now. Some people have gotten results within 2 days.
If a person is positive, the Public Health Nurse team follows up with them to educate them about the importance of quarantining.
It’s been difficult to keep up with contact tracing. They’ve hired additional nurses to perform contact tracing and currently have 11 nurses doing that. The additional nurses will be with them at least into December. Whether they’ll be able to stay beyond that depends on the availability of funding from the Federal government.
The city is striving to follow up with cases within 24 hours. They get additional help from 4 of the city assessors as well as staff in the weights and measures department and one of the city’s administrative assistants. The city also has a good partnership with Lawrence University and local public and private schools who are able to notify their students and staff and perform contact tracing. Most of the local businesses also have become adept at identifying close contact in the workplace and making sure the appropriate people are quarantined. The community has really stepped up to partner with public health on this effort.
In addition to the contact tracing, they like to follow up with people after 10 days to make sure they’re actually well enough to be out of isolation. The health department’s two environmentalists are making some of these calls.
The majority of people who test positive are cooperative with quarantine recommendations. It’s rare that they have someone who is non-compliant, but if someone tells them they aren’t going to isolate, they let Health Officer Eggebrecht know. [No mention was made about what if anything he does in these situations.]
It was stated that most of the people in our community want to keep others safe.
There was concern about federal funding running out in December. The funding for the National Guard testing sites ends 12/10/2020 unless President Trump reauthorizes it. Funding for additional nurses to perform contact tracing also ends in December. Congress and the president both would need to authorize more of that funding.
City leadership is working with other leaders in the area and trying to find a way to consolidate the various National Guard testing sites in the region and have a civilian team run them. Without testing and contact tracing the city will likely be blind to cases until those sick people enter the hospital. Mayor Woodfor thinks there is a desire from state and federal governments to provide more funding.
They’re all pleased that there was positive news about a vaccine this week, but Health Officer Eggebrecht stressed that it’s important to balance that enthusiasm with reality that the vaccine won’t be available overnight and we still don’t know how safe it is.
Additionally, there are some challenges with the storage of the vaccine. It requires very cold temperatures (minus 70 degrees Fahrenheit was mentioned). And not every place has the capability to store coronavirus vaccines.
The first batches will likely end being provided to the high risk groups that will be identified at the federal and state levels.
The Appleton Health Department does not intend to gear up for the vaccine, and the state is not recommending that local health departments purchase the equipment to maintain the vaccine at this point.
Per Mayor Woodford, we shouldn’t anticipate that the vaccine is going to be widely available to our community for a long time yet, so we should focus on strategies that we know are effective such as face coverings, physical distancing, avoiding gatherings, and good hygiene. [He then proceeded to remove his mask and take a long, lingering drink from his travel mug.]
I think it was Cathy Spears (it’s so hard to tell with everyone wearing masks) who said that at the time of H1N1 the city had practiced with AASD for mass vaccine implementation. She wanted to know if we kept that training up and, in the event the vaccine becomes available, would we still have the capacity to work with AASD to do a major vaccination event for the community.
Kurt Eggebrecht confirmed that they did do training with AASD and those options would be available, but again he cautioned that we need to temper our enthusiasm and make sure that the vaccine is safe and effective before we do anything.
Per Health Officer Eggebrecht, we have a long ways to go until the vaccine is available. The city was at 4,000 positive cases as of yesterday. Household contact is the greatest risk for secondary infection. The number of infections is underreported. Not everyone in a household gets tested, and 40% of people are asymptomatic and don’t even know they’re ill. He said that .9%–almost 1%–of cases will result in death. [To interject here 29 deaths out of 4069 confirmed cases is .7% and if we assumed there were 40% more cases that were positive that haven’t been tested then the death rate would go down to .4%]
There are a lot of Covid hospitalizations. All hospitals are reaching capacity. Covid is not the only reason people are in the ICU, but that’s the majority of people right now. That’s true with all systems across the region and across the entire state. Eau Claire is getting hit. People have been shifted to the LaCrosse hospital which is now at capacity. Recently people came to Appleton from Eagle River and Reinlander and had to be redirected elsewhere.
He is concerned that deaths will increase significantly. He believes it’s important to educate the community to take Governor Evers’ precautions seriously–to stay home unless it’s essential to venture out. The community really needs to understand the seriousness of this. People should be celebrating Thanksgiving and Christmas differently this year. They should celebrate only with household members and not comingle with people from out of state or out of the community or with people you haven’t been living with or sharing meals with. He can see the tidal wave of deaths coming. We just had our worst week in terms of the number of cases, and the community needs to understand where we’re heading if we don’t change our behavior. [It should be pointed out that this comes on the heels of him praising the community at the Common Council meeting only 7 days ago. Even earlier in this Board of Health meeting, local businesses were praised for their mitigation efforts].
Mayor Woodford expressed frustration that local governments continue to have to compete with messages from state and federal leaders that Covid isn’t real or is not a big deal. He feels these politicians are undermining local municipalities’ ability to communicate clearly with their residents. In his opinion, this isn’t about being sensationalist, it’s about taking simple practical steps to prevent the spread of a communicable disease. And it continues to be politicized and they are fighting it in their messages every day. And it’s that much harder for them to get that message across. They will continue to share that message about the truly simple things that people can do. This does not have to be a competition between public health and the economy, but they are continuing to deal with that dynamic.
You can view the full meeting here: https://cityofappleton.legistar.com/DepartmentDetail.aspx?ID=21305&GUID=BF7AF975-BEFA-4FB2-9486-DA6373C8CDE1
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