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Board of Health - August 14, 2020 Minutes

Regular Meeting: August 16, 2020

Opening: Noon, Virtual Meeting, Chelsey Matter chairperson
Present: Amy LaValla, Tracie Newman, Chelsey Matter (phone), Lyn Telford (phone), Kayla Nelson, Bernie Dardis, Arlette Preston, Dr. Lako-Adamson, Pearl Ferguson-Mell
Others Present: Desi Fleming, Kim Vance, Grant Larson, Larry Anenson, Suzanne Schaefer, Doug Murphy, Zach Bruns, Lori Sall
Absent:

Approval of Minutes: Amy Lavalla absent but arrived late on May 28 change. Amy made a motion, seconded by Lyn Telford. Unanimous approved with change in attendance.

Announcements: Introductions of all our new board members. Tracie Newman replacing Robin Nelson, Kayla Nelson, Amy LaValla, Bernie Dardis replacing Mike Thorstad, Arlette Preston new Commission liaison, Pearl Ferguson replacing Chip Ammerman.

COVID-19 Update: Desi let managers talk about their department assistance. Holly is our Communication’s Specialist so inquiries initially go through her, also monitoring what is put out to counteract misinformation. We were planning on putting out a masking campaign but then the state did call MaskUpND. So we are going to build off that. We have done translation of materials for different cultural groups. Melissa Perala on vacation but she manages the budget. We were allocated funding for the COVID task force and local public health funding. It has been a daily learning process for her figuring out what supplies/costs come out of which fund.

Larry Anenson, Planning Section Chief, oversees the contact tracing team: We built a contact tracing team. It helps slow the spread of disease. We have about 15 members right now, at one point we had 36-37 individuals. It is very fluid and we have been onboarding new staff as permanent staff moves back to their normal jobs. We need to follow guidelines put forth by the North Dakota Department of Health. They like to check in with contacts daily and build a rapport with them but they also have online surveys. They help educate them on how long they should self-isolate. The tracers work every day 7 days a week and from 9:00 am to 7:30 pm in a call center here on-site, not from home. So they provide high-quality services because they have available training and support for them to access.

Doug Murphy, Operations Section Chief: We deal with facilities requesting to be tested. Long term care in Cass and Clay each week staff and residents need to be tested. We go to the facility for the residents. For the most part, a nursing home nurse runs the tests on residents and we test the staff. We have Rheault Farms for a static testing. It is not a public testing site, it is for our testing matrix or a makeup site for an employee. We also get trailer loads of PPE from our state medical cache. Teresa Steiner (FCPH Office Associate II) does a lot of buying for supplies for the test sites and not just for here but for the region. We have had a lot of complaints with people being rude or aggressive with nurses at the testing site. We are pulling these individuals from the ability to have tests on site. NDSU will be tested next week. Students, staff and employees and anyone in the university system (ex: UND, Mayville). Six-day event, all call out for nurses and guard. Largest event times (six days) that has been held in North Dakota. On top of that, we are still doing 2000 at our regular site.

Desi: The higher education testing was not our idea, it’s a point in time test, and a lot of work but it was a governor directive. Initially, it wasn’t supposed to involve us but we are going to be involved now. It’s been very stressful, we started in the middle of March and we had the highest numbers and then the state has been changing our systems that have been working, it can be frustrating. We picked our priority groups, we don’t have unlimited testing supplies and we are trying to be good stewards of the supplies. It doesn’t help that across the state they continue to do mass testing, we will do the best we can trying to get it done. Getting support from the state. Lynn Telford wants to know if there is anything the board can do to support Fargo Cass Public Health. Desi: We have a meeting this afternoon with state. We were doing the logistics part for Cass county and then agreed to doing it for the region. But we didn’t think we were taking on everything for the region. We can’t take the largest county and then add even more. We are meeting today with State health officer, Andrew Stahl, and Tammy Miller, and others. We can only be stretched so far and money isn’t the issue. We need them to understand our limitations so they recognize when we can’t handle anymore. We can’t expand to regional, and when push comes to shove we may ask for backing. Mayor Mahoney has been helping us push back.

Kayla Nelson wants to know what is going on with testing for schools and back to school. Desi: The Governor’s office and ND university system plan is just for higher education, for faculty students and staff. They are doing some of the student-athletes, more because of an NCAA requirement. It’s just higher education at this time. The only test available right now is the nasal swab. Doug is projecting because of the nasal swab, it may not be well attended. Doing this across North Dakota. MN had no plan for higher education testing. So now Moorhead students can come to ND testing sites. Doug: NDSU, next week starting on the 18th for 6 days, Tuesday through Sunday 10 a.m. to 4:30 p.m. We close the gate at 4:30 at FARGODOME parking lot. We need to do 2000 each day, not publicized. We still won’t turn people away. We are hoping to have staff from the state to help. 80 people and 20 nurses to just do that. We are not doing less testing, this is additional on top. It isn’t mandatory for them to return to school and they can be tested at their providers or at the testing site at the Fargo Dome. Tracie Newman: doing corporate-wide 3,000 tests at Sanford. Doug relays that if someone is asymptomatic that they are getting turned away from hospital systems. Bernie Dardis: is there any testing through K-12 staff for school restart? Doug Murphy: our understanding is that we aren’t doing K-12 staff, but if they make a change we will do this. Desi: this is what Tammy Miller is saying at the same time.

Desi: it is a point in time of test, it is a false sense of security, we should assume that everyone is infectious and keep with the preventative measures. There aren’t tests available for everyone so they have to be careful with the supplies. Heidi Lako-Adamson: this is where masks come in. If both parties are wearing masks there is almost a zero percent transmissible rate. That is where masks and PPE come into it with masks and face shields. Doug: Please remember it is a point in time test. Desi: The recommendation right now from disease control is self-monitoring of the symptoms.

Grant Larson: Chris Ohman is the point man for helping educate businesses and events of the guidelines. We help develop their plans but we can’t approve them or deny them. As a collective team we educate and steer them to Disease Control if they are questions. We reach out to businesses that have two or more cases with their facility. We offer workplace assessments and we run through the guidelines and how it would work in their building. We can help facilitate testing for them as well.

Desi: we would do contact tracing for the higher education group. Family Healthcare is for people who don’t have an established provider and would fit their criteria for becoming a patient. It isn’t for anybody, they also screen people. Sanford will not do travel-related testing and we didn’t really want to do that unless it was for essential travel. We do now need to take those people on at our static site if it is for essential travel.

Suzanne Schaefer: The testing process started with triplicate forms. Most sites are now done through registering with an app, there are still some paper sites. We get misinformation sometimes that slows things down. We called out all negatives and positives, about a week and a half ago we transferred to an electronic system. The positives get called by Suzanne and then negatives get feed into Dynamics and if the individual selected it can them email or text out the results. Maeve Williams has been helping Suzanne Schaefer. People who don’t opt into the electronic system we call them. Then we wait 24 hours and if they didn’t get their results we call those out. There are some barriers still, sometimes technology causes issues. We still rely on the state lab to take those results and push them through which sometimes delays the process.

Desi: They are trying to space the tests out so the lab can handle them. We can’t have all the samples to come in at once. There are vaccines in phase two trials. They have extreme cold requirements and we are hoping they can be stable sitting out before we administer them. We are thinking that it will be most likely early 2021 to get them out. 40-60% are not willing to take because they feel that it was fast-tracked and the safety portion was skipped. We will start having that discussion.
We did clarify at the last commission meeting that we did a directive (a strong encouragement) not a mandate. In public spaces please wear a mask, wash hands, physical distancing, and stay home when you are sick. We don’t deny services if not wearing a mask, we just implement other measures. Commission approved that anonymously. Commissioner Strand said if numbers rise we should do something else with more teeth.

Next Meeting: October 16, 2020

Meeting Adjourned