WC CWF Health District Board Minutes - 03/12/2021 WICHITA FALLS-WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES
R,c+w++rrp, March 12, 2021
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Wichita Falls-Wichita County Public Health District
1700 Third Street - Zoom Video Conference
'',, ,, Wichita Falls. Texas
Public Health
BOARD MEMBERS PRESENT:
Keith Williamson, M.D., Chair Physician - City Appointment
Lauren Jansen, Ph.D., R.N., Vice-Chair Registered Nurse—City Appointment
Julie Gibson, D.V.M., Secretary Veterinarian - City Appointment
Tonya Egloff, D.D.S. Dentist- County Appointment
Melissa Plowman Restaurant Association - City Appointment
Paris Ward, M.A., B.S. Citizen At-Large - City Appointment
BOARD MEMBERS EXCUSED ABSENCE:
David Carlston, Ph.D. Citizen At-Large -County Appointment
OTHERS PRESENT:
Lou Kreidler, R.N., B.S.N. Director of Health
Amy K. Fagan, M.P.A. Assistant Director of Health
Robert McBroom, M.D., F.A.C.P. Health Authority
Michael Smith City Council Liaison
Woodrow W. Gossom, Jr. County Judge
I. CALL TO ORDER
Keith Williamson, Chair called the meeting to order at 12:00 pm after a quorum of members was attained.
II. APPROVAL OF MINUTES AND ABSENCES
Keith Williamson called for the review and approval of the January 8, 2021 minutes with one wording correction
on page 3, paragraph 3 from interrupted to interpretation. Lauren Jansen introduced a motion to approve the
minutes with the correction noted and Melissa Plowman seconded the motion. The motion passed unanimously.
It was noted David Carlston as an excused absence.
III. COVID-19 UPDATE
Amy Fagan stated it has been a marvelous few weeks with such a difference in the number of cases and
hospitalizations. The first case was on the 181h of March 2020, in doing a year in review with Channel 3 came the
realization of all the time, hard work and components involved. Only had 4 cases today, 71 cases for the week,
it had gotten to 1,200 cases week after week, this week to have a 7.86% positivity rate is amazing.
COVID CASES BY RACE: The same trend continues in terms of disproportion in the number of Hispanic
individuals being effected by COVID at 23%. In the Asian population at 2% an increase in the last 4-5 months it
is not necessarily disproportionate but a change. The Black population stays at 8% which is a little lower than
what the population percentage is for the community.
COVID CASE STATUS: Is low; Recovered 97%, Hospitalized 0%, Recovering 1%, unfortunately Death 2% but
it has been that throughout the pandemic.
COVID CASES BY AGE GROUP: Has not changed much, do see a lower number of individuals that are over
the age of 65, as it would be seen with vaccine allocation according to age group. Do see that percentage pop
up in other sub-sets of the population, practically more in the 30's and less in the 20's. In the last month not many
kids, have only one school with an outbreak.
ACTIVE COVID HOSPITALIZATIONS: Down so much from where it was. Daily hospitalizations post the age and
status of the individual. In the last two out of five deaths was an individual in their 30's and one in their 40's. A
couple months ago saw a decline in those hospitalized percentage based of those over 65, mainly the 30's and
40's hospitalized. Individuals vaccinated now are age 65 and older, also the 16 and over with chronic conditions,
but typically over 40. That confers a secondary indication that vaccines are working as that percentage of people
in the hospital over age 65 has changed.
IN TERMS OF SPREAD: Under Investigation at 0% now often able to investigate a case the same day. Seen
increase in Community Spread at 44% used to be on point with Contact now at 36%.
Sometimes the State delays providing information with suggestions or how to handle issues. Reinfections was
one the State came out Wednesday with a definition. The Health District early on saw reinfection and worked
with Dr. McBroom to establish the criteria for reinfections and it aligns with the State criteria. If a previous case
meets the case standard definition for the second time after 90 days from symptom onset with symptoms it would
be considered a reinfection. Often times people are less sick and their symptoms resolve faster. To date at 29
reinfections, currently 5 are active cases with 1 individual on Hospice care.
Fully vaccinated (Pfizer, Moderna) means both shots and two weeks from the second dose. There are three
women fully vaccinated that have contracted COVID, one in February now two in March. Nothing is 100%
effective, expectation was 5% of vaccinated individuals may contract COVID which is not unusual. AU three had
a mild case with two of whom resolved within two days, hopefully there will not be many more.The Discontinuation
of Isolation and Quarantine protocol was modified about two to three weeks ago based on the new evidence
regarding vaccinations. In discussion with Dr. McBroom it was decided best to include vaccinated individuals
which means the 1 dose plus two weeks or 2 doses plus two weeks, with an exposure that would not require
quarantine, but still able to contract COVID need to limit interactions and wear face coverings at all times.
Lou Kreidler stated vaccines began at the end of December with 7,351 vaccinations given of those 3,144 are
second doses. This week received 200 doses of Johnson & Johnson (J&J) and had the first clinic on Tuesday.
Actually received only 100 doses from the State then'had 100 doses transferred to the Health District from a
provider in town unable to use the doses. People do call and only want J&J, Moderna or Pfizer, doing the best to
comply although people are encouraged to get vaccinated with whatever vaccine is available at the time. The
community continues to struggle with the number of vaccines received overall from the State, but hopeful with
the J&J will continue to see an increase of vaccines come in. As a community it does not matter whether they
come into the Health District or other providers, what is important is the community is getting vaccine and
vaccinated.
Judge Gossom asked if there was a total community number of shots delivered the first and the second. At the
City-County Hospital Board meeting it appeared 20,000 vaccinations had been given.
Lou Kreidler said DSHS does put information out, that Lindsay Barker, Public Information Director of
Communications and Marketing monitors and updates the City web page. Information is available from the State
for the total number of vaccines received and total number of second doses. Last week when the State sent out
what the allocations are for this week pharmacy allocations had been added as well. Beginning to see more
vaccines in the community and availability from the pharmacies.
Amy Fagan stated as of yesterday it is 20,584 first doses and 14,016 second doses. Those numbers do not
include when the Feds did direct shipments to Community Healthcare Center and the pharmacies, the numbers
should be even higher.
Lou Kreidler stated as a rriedical community everyone has worked well together, it has been about getting in
vaccines and getting vaccines into individuals. Several weeks the Health District was the only entity in town that
received vaccines and those were transferred to other entities so they would have vaccine, it gets vaccines into
individuals faster and still use what was allotted by the State.This week United Regional had vaccines transferred
from outside of town, so great not only in town transfer of vaccine into the community.
Judge Gossom wondered what was it with getting vaccine. Deputy Commissioner Garcia lumped Wichita County
in the region with the metroplex and said people can drive to the Texas Motor Speedway to get their shot.
Lou Kreidler replied she had conversations with Deputy Commissioner Garcia and another person that works in
her office it is the same way across the State, last week Decatur received less vaccines than the Health District.
The larger number of vaccines are funneled to hub locations in all eight service regions. Wichita County is part
of Region 2 which includes Dallas/Fort Worth, so Tarrant County, Dallas County and Collin County all have large
hubs set up. The Judge was referring to Denton's set up on a provider location at Texas Motor Speedway doing
10,000 vaccines a day. Wichita Falls is not alone not the only community in Texas that has the same frustrations
with the State on how vaccines have been received. Everyone continues as local Health Departments to face the
same issues and have the same conversations with the State. She does not know if it is going to make a
difference until the State starts to receive a larger amount of vaccine.
Dr. Williamson asked why the precipitous declining cases, any idea. He had gotten theories from it is seasonal
to done great with masks all of a sudden.
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Lou Kreidler thinks it is a combination of things; may be seasonal more people are getting outside, no big
gatherings as seen at Thanksgiving and Christmas, vaccinations make a difference continuance of more
individuals vaccinated.
Councilor Smith said it can be seen in the graphs the spikes following certain holidays and social gatherings.
Governor Abbott opening up all businesses 100%what is anticipated in the next two to three weeks as far as an
increase.
Amy Fagan stated in June cases were low and July was the beginning of the first spike it was summer but not a
lot of large gatherings, the primary spread was in Nursing homes and businesses. Nursing homes have done a
lot of work to ensure all their residents are vaccinated but speaking with some facilities Executive Directors half
of their staff did not take the vaccine, so all those facilities still require face coverings. Her concern is going back
to where businesses make the choice to mask or not mask. Businesses that had outbreaks prior to the mask
requirements are going to have those same outbreaks again. Outside of healthcare the businesses that had
outbreaks constituted a lot, so vaccines absolutely helped with the substantial decline.The healthcare community
needed to be vaccinated because they not only were getting sick but spreading disease. In industries most of the
individuals are age based in the 30's and 40's and some of these businesses had a lot of the outbreaks. In a
broad generalization not backed by hard evidence most people who work in the restaurants are age based in the
20's and 30's and not vaccinated because it has not been made available to that age group unless they have a
chronic condition. It is concerning because of what was seen back in July, if businesses make choices to remove
face covering requirements those are the populations that are going to get sick. Another concern is for bars and .
things of that nature where people are in a setting for a prolonged period of time,which did contribute to the July
outbreaks and people who work there tend not to be in the vaccinated group.Another is Spring Break people are
going to be traveling and returning to school, just thankful the schools will continue to require face coverings.
Case Managers are reminded the importance to continue to ask about the work environment on whether or not
face coverings are required. Quarantines are anticipated to rise but hopefully cases will remain low.
Dr. McBroom stated everything that Lou and Amy just talked about in regards to concerns about possibly a third
or fourth wave, those are all reasonable concerns. He thinks the relaxation of some of the mandates from the
Governor are a little bit of cause of concern but the only thing that can be predicted is the baseline prevalence.
We still do not know the number of people who had COVID that never had significant symptoms never got tested
therefore at least had some degree of partial immunity that contributes to the overall trends that herd immunity.
Bottom line is those numbers are not known so the true prevalence is not known. He thinks the businesses and
the people who are concerned about it probably will continue to keep the mask and people will continue to get
vaccinations. Hopefully there will not be a lot of increase in incidences in people who are neither vaccinated nor
taking personal protection safe guards seriously. Until there is herd immunity there may be some upticks as a
result.
Keith Williamson asked Dr. McBroom if he thought this was going to become an endemic phenomenon where a
booster is needed every year.
Dr. McBroom replied yes he believed it will be a recurrent phenomenon, that this is following the same kind of
behavior that the 1918 Flu Pandemic followed. Flu has become a seasonal phenomenon since then usually the
H1N1 variety. However, when predicting the pandemics of the novel H1N1 back in 2005 and again in 2014,
neither of those really materialized cause of serious concern. The reason for that is the benefit from the vaccine
and exposures because there is so many strains of influenza out there. There is some cause for protection with
awareness of the different South Africa, Brazil, English strains that are already out there.This is going to continue
to happen surprised it had not happened earlier in 2002 it turned out to be a fizzle and not sure why. if the Chinese
numbers can be trusted, then that suggests this type of coronavirus has been endemic in China for a long time.
The first SARS epidemic when it was traced to the exotic animal industry the people who handled those animals
already had antibodies never knew they were sick. There probably be reverses annually for a while until
development of the same type of herd immunity to the ever changing antigenic shifts influenza had, a problem
with the coronavirus genre as well, will get through it too just like getting through influenza. Nature needs a
vacuum once one problem is controlled something else comes up to take its place. It is just the nature of infectious
diseases seen it with every new developing vaccine throughout his 40-year career. He thinks this will probably
continue to decline in significance over the years.
IV. EBOLA UPDATE
The other day Lou Kreidler got notification of a health alert from DSHS of a new Ebola outbreak in Guinea. Earlier
today a meeting was held with all Community Partners, EMS, Fire, Police, SAFB, United Regional and a DSHS
representative on the call. The DSHS representative stated there are individuals in Texas being monitored that
have traveled from the infected areas. The outbreak is still in single digit numbers in 2014 the numbers were in
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the thousands in some areas.The Health District in 2014 monitored individuals in the community which required
monitoring for 21 days after leaving the country of concern. Lou, Amy and three staff that are still here were
involved In the Ebola Response, teams are organized, the kits back out and a health alert was released to the
community.Also plan to work with the dispatch call centers to ensure travel questions are asked again since that
is the biggest risk. There is a vaccine but not sure what the efficacy is, there are a lot of issues, a lot of anti-
government trust issues in those areas. Ebola is on the Health District radar and will be prepared if notified by
CDC or DSHS of a traveler in the area.
Keith Williamson said after the meeting this morning he sent an email to both Chief of Police on MS1.1 campus
and the International Students Director of the situation.
V. NEXT MEETING DATE
Friday May 7, 2021 was noted as the next meeting date.
VI. ADJOURN
Keith Williamson adjourned the meeting at 12:45 pm. •
Signature
Keith Williamson, MD
Print Name-Keith Williamson, MD, Chair,Lauren Jansen,PhD, RN, Vice-Chair, Julie Gibson, DVM, Secretary
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