Board of Health - December 17, 2021 Minutes
Regular Meeting: December 17, 2021
Present: Chelsey Matter, Amy LaValla, DNP, PMHNP-BC, APRN, PHN, Charlene Nelson, Kayla Nelson DNP, APRN, FNP-C, Lyn Telford MSN, RN, CEN, Arlette Preston, Robin Nelson, Duane Breitling
Absent: Bernie Dardis
Others Present: Dr. Terry Hogan, Larry Anenson, Kim Vance, Desi Fleming, Justin Bohrer, Suzanne Schaefer, Tracie Newman MD, MPH, FAAP, Jan Eliassen
Approve minutes of October 14, 2021. Motion by Robin Nelson, seconded by Lyn Telford. Unanimously approved.
Reappointed Chelsey Matter and Lyn Telford. Fridays will continue to be the Board of Health meeting date.
Introduction of Dr. Terry Hogan:
Dr. Terry Hogan is a retired professor of Sociology and Governmental Studies for the past 26 years in Chicago. He now works for the City of Fargo dealing with issues about diversity, equity and inclusion (DEI). Diversity means variation and differences. Equity means equal or fairness and being impartial. Inclusion means regardless of one’s background that everyone has a seat at the table. In broad terms one day you will serve as a facilitator the next an arbitrator working on strategies, initiatives and best practices. The goal is to run a community/city-wide assessment for DEI. Other goals being worked on are educating new Americans regarding how their new government works, who their officials are, and how to build relationships and partnerships that will work for all stakeholders. DEI work is slow and methodical. They need to educate the public so they don’t feel they are being challenged and stress that we are working to bring business and people together. They are also going to work within the City of Fargo departments and do a SWOT (strengths, weaknesses, opportunities and threats) analysis. Every institution is unique. He would like to bring more of his staff on board to assist. Arlette Preston pointed out that COVID has hit populations of color harder and we need to strive to make the connection between diverse groups and health stronger.
Desi: Number of active cases 843 in Cass County, 2,500 in the state. The positivity rate is high and the testing rate is low. Cass county makes about 27-33% of the testing, so not a lot of testing happening elsewhere in the state. 146 hospitalized and the numbers are not decreasing. Hospital capacity is very tight for staffed beds. 281 deaths in Cass County, as of last week, 33 deaths in the state and this week we are standing with 29 deaths. In the United States, we reached 800,000 deaths nationwide, a study released estimated that 163,000 of those deaths since June likely could have been prevented with vaccination. Pfizer has been approved for boosters for 16-17 year olds. Vaccination clinic here is slowing and mostly booster shots are being given. We are working with Essentia, Sanford and Family HealthCare about taking over more of the vaccinations so we can resume more of our normal work. We will stop mass vaccination clinics starting at the end of December for COVID-19. We will incorporate the COVID vaccinations into our immunization schedule and return our staff to their normal positions serving the community. The testing site is still quite busy and we are leasing the building on a month by month basis. We will continue to evaluate our role as being the main testing point in the Cass County area. We are running into issues with the public being desensitized to COVID information. We will still keep up our messaging as misinformation is still our nemesis. We will continue educating the public about mitigation strategies, vaccine, masking indoors and social distancing.
Dr. Newman and the new variant Omicron:
Omicron variant is now in many countries and 30 U.S. states, but we can assume that is in all 50 states because this variant is highly transmissible. More than 90% of all South African cases are Omicron. US cases of Omicron continue to rapidly increase and should surge about January. Preliminary data is that Omicron is more transmissible but perhaps less severe and at this point, we can’t tell if it has an enhanced capacity to escape immunity and vaccine. Hospitalizations and death continue to be lagging indicators. The modeling is showing that Omicron is 500% more transmissible than Delta. Just to clarify what transmissibility is: R(0) average number from one case (with nothing stopping/no vaccine/infection based immunity/screening/quarantining or other mitigation). R(t) is with transmissibility with human behaviors, masking, immunity, etc. these two spreads are not apples to apples in comparison.
Omicron does seem easier to track which is helpful, they are showing up on PCR tests as 2 channels vs 3, swabs previously had to be sent for sequencing so this allows for quicker tracking. Now they are working to see if the rapid antigen tests are effective.
Data coming from the UK and South Africa with Omicron shows that people have a higher hospitalization rate without vaccine. Our booster shots are the best tool to combat Omicron. We can expect breakthroughs in those who have only had two shots.
Current Vaccine Rates:
1 Dose 2 Doses
U.S. Total 72% 61%
U.S. 5-11-year olds 17% 4%
N.D. Total 54% 50%
N.D. 5-11-year olds 12.6% 6%
Cass County Total 63% 59%
Cass 5-11-year olds 22% 11%
27% of Americans have received COVID-19 boosters and 33% of North Dakotans have received a 3rd Dose.
Monoclonal Antibodies are available to combat COVID-19 infections but it is not a substitute for vaccination. Pfizer has preliminary data for Paxlovid an oral antiviral that has effectiveness against Omicron, which seems more promising than Merck’s Molnupiravir oral antiviral. There are still questions out there regarding Omicron because we only have preliminary data. The CDC is working to slow the spread of Omicron variant in the US by detecting variants, slowing spread from international travel, slowing domestic spread with contact tracing and supporting individual actions (masking, vaccination, boosters, testing and isolation).
Robin Nelson questioned the use of the mobile vaccine clinics. Desi responded that they are run by Family HealthCare and they are providing childhood disease vaccines necessary for school attendance as well as COVID 19 vaccine. It is voluntary and a parent must sign the form for the vaccination, it is to assist families who do not have the luxury of taking time off work to take their child in for their vaccinations. Suzanne Schaefer said the current booster number in Cass County right now is 37%. We will be handing out resources at the front information desk about all the locations/days/times to get a COVID vaccination. Charlene Nelson also questioned the mobile clinics and how they are set up. Desi stated that they are paid for by an immunization grant and that we subcontracted to Family HealthCare to do the actual clinics. Its goal is to increase the immunization rates for populations that are under-served or may have difficulty in getting to the clinic to have immunizations done. Arlette Preston and Lyn Telford feel that the state should be more involved in getting people to get boosters.
The schedule for 2022 was reviewed and approved.
Public Comment: There was no public comment.
Next Meeting: February 18, 2022