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WC CWF Health District Board Minutes - 09/10/2021 WICHITA FALLS-WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES "gontryfret. September 10, 2021 Wichita Falls-Wichita County Public Health District 1700 Third Street- Parker Conference Room Wichita Falls, Texas Public Health frll f.aAl.11 �ilri! BOARD MEMBERS PRESENT: Keith Williamson, M.D., Chair Physician-City Appointment Lauren Jansen, Ph.D., R.I ., Vice-Chair Registered Nurse—City Appointment Melissa Plowman Restaurant Association -City Appointment Paris Ward* M.A., B.S. Citizen At-Large-City Appointment David Dariston, Ph.D. Citizen At-Large-County Appointment Tonya Egloff, D.D.S. Dentist-County Appointment BOARD MEMBERS U E CUSED ABSENCE: Julie Gibson. D.V.M., Secretary Veterinarian-City Appointment OTHERS PRESENT: Lou Kreidler, R.N.„ B.S.N. Director of Health Amy K. Fagan, All_P.A. Assistant Director of Health Michael Smith City Council Liaison I. CALL To ORDER Keith Williamson, Chair called the meeting to order at 12'04 pm after a quorum of members was attained. iI. APPROVAL OF MINUTES TES AND ABSENCES Keith Williamson called for the review and approval of the July 9, 2021 minutes. Lauren Jansen introduced a motion to approve the minutes as presented and Melissa Plowman seconded the motion. The motion passed unanimously. The absence of Julie Gibson was noted as unexcused. IiI. COVID-19 UPDATE Amy Fagan advised the majority of the information presented is from analysis through last Friday, September 3, 2021. The C VI D-19 report is updated and published weekly that has total confirmed cases, recoveries, deaths, active cases of those hospitalized or home recovering, and fully vaccinated. Vaccine Breakthrough case(VBT) analysis published every two weeks are those fully vaccinated,the two dose series completed or one dose series completed plus two weeks (14 days) then if afterwards contracts COVID it is a VBT Re-infections published every Friday, means those that contracted CO ID more than once. Initially as seen in Re-infections the same as Vaccine Breakthroughs much milder symptoms or no symptoms with just the Alpha or undetermined Subtype before Delta variant, people were asymptomatic but that has changed. An interesting change over time with Delta as example 94% of VBT cases are symptomatic. The Janssen (J&J)first data published was the vaccine would not be as effective but the idea was to stay out of the hospital to keep from dying.Vaccines are not 100% manufacturers have been clear about that, but had more protection than anticipated when came out. Over 95% of the cases attribute to the Delta variant, in deaths of fully vaccinated one identified as Alpha variant and two Delta variant Cases are lower at 762 of those 93%unvaccinated individuals. The 4-Week Analysis provides a comparison of two 4-week periods from July 10-August 6, 2021 and August 7-September 30, 2021. in the five categories all had significant increases. Average number of residents with C lID-19 Hospitalized 158%increase, Total number of New Cases 225%, Total number of New Tests 147%, Average Positivity Rate (of those tested, percent that is positive)27%and Deaths 118%. This year had a dramatic rise of new cases received each week starting less than 50 cases per week to over 500 per week. The rise in 2020 was from June 11 to October 16, 2020 at 18 weeks and this year from June 4 to August 2 ,2021 at 11 weeks. The 20-29 and 30-39 age categories were the highest percentage of new cases in a 2-week period, ending August 13 and August 20, 2021. In a 2-week period ending August 27 and September 3, 2021 the highest percentage of new cases were in the 11-19 age category. Old school contact tracing is still done, collect information from the individual,ask them if they had been exposed to anyone known of and monitor outbreaks on those type of things. On every Case manager investigation,Amy goes through makes a determination then categorizes the case. Cases by Type August 2021;Community Spread 57%,Contact 20%, Close/Household Contact 22%,Travel 1%. Cases by Type to Date: Community Spread 46%,Contact 33%, Close/Household Contact 20%,Travel 1%. Increase in Community Spread where no index case can be identified is concerning, there are less public health interventions that can be utilized to curtail further spread when the source is not identifiable. One category of spread that can be further analyzed, in an effort to reduce spread is the Contact category where there is an index case identified and considered the most likely source of infection. The 20% determined to be Contact for the month of August 2021 the most listed sub-categories are family,school/student,friends,employee/outbreak,and oc-worker. Current United Regional COVID Admissions by Age on September 2, 2021 show the highest population are in their 60s followed by 70s,50s and 40s,with 88%of D V1 D patients unvaccinated. Several months after C VI D- 19 vaccine became available in the community,the age of individuals who died while an active case shifted from the 80+demographic to lower ages.The first 320 deaths(April 15, 2020 to March 3, 2021)compared to the last 47 deaths (March 4 to September 3,2021), all individuals under the age of 60 was unvaccinated, overall 15%of individuals that passed was vaccinated primarily in their 80's and 701s.Vaccine Breakthrough cases with odds of survival and odds of not contracting COVID go up substantially. COVID patients hospitalized at United Regional Health Care System (URHC)as of September 2, 2021 was 9 ; 12 vaccinated and 84 unvaccinated, of those 26 in critical care with 1 vaccinated and 25 unvaccinated. Since July 1, 2021, URHC had 371 COVID admissions with 323 unvaccinated 8 ° . The forecast based on the latest trends (June 4 to September 3, 2021) are estimated at 1,000 new cases per week starting the week of September 17, 2021, today it is under projection. The highest weekly cases reported in Wichita County since the start of the pandemic was 1,185 for the week ending December 31, 2020 and 1,187 for the week ending January 7,2021. One of the most concerning trends is the increase in the number of COVID positive Wichita County residents hospitalized, if the trend continues the projection for hospitalizations at the end of October 2021 is 120 patients.The number of available Adult ICU beds has gone up by one from three that is for the entire Trauma Service Area(TSA)about twice of Wichita County at 138,000. The TSA system is very intricate, on how transfers happen hospital to hospital and standard of care each hospital can provide it is the same throughout the State of Texas.There are zero pediatric ICU beds in the entire TSA with none at URHC, used to transfers made to Cooks.About two weeks ago,Cooks said due to limited staffing the facility may or may not be able to accept transfers from other hospitals, having significant limitations on them and their systems. Not only a concern for the community especially in Central Texas but the State of Texas, there is not enough beds, not enough ICU beds, not enough resources. The Governor can step in with supplemental resources in terms of staffing, traveling nurses, but not with the limited capacity for transfer and availability for types of care unavailable, it is not only a concern for the community but the State of Texas. Vaccine rate/percentage in the population as of today: 12+with one dose 50.2%, 12+ fully vaccinated 43.6%, and 65+fully vaccinated 77.52%. Education continues, post on social media, cut off rumors, provide community information,and statistics, to keep people informed. Keith Williamson asked what role natural immunity will have in the fall, in helping not to hit those high numbers. Amy Fagan replied she hoped it would go into a seasonal piece or enough people of the 19,000 that contracted COVID over the last year-in-a half that less people would contract COVID again,to gain that immunity. Now said there may be some indication that people who had the flu vaccine is their bodies naturally are better at fighting off the virus. The virus goes after those communities with low vaccination rates and it bums through the population. IV. GRANT FUNDING Amy Fagan said any good news about COVID would be that people somewhat know what Public Health does and the federal appropriation directed a lot of money focused to Public Health. The Health District has gotten three supplemental Immunization grants, two supplemental Epidemiology grants,a supplemental Preparedness grant,and a Workforce grant that will be the focus today since it is slightly different and beyond COVID.The grant is underthe appropriations act Public Health Crisis Response federal funding for the next 21 months just over $1.9 million dollars.The funds are to help with COVID response but if cases become lower, it does not warrant the situation to do other public health work. Fifteen full time positions were hired, the majority Contact Tracers changed to Health Educators/Contact Tracers since half of what the positions do is provide health education to people, another position to hire is an epidemiologist one is on staff now, the dream is to do population health. All so to get a Health Equity grant, the population is kind of studied with publication of the Public Health Assessment but would do a better job of accessing the community doing outreach, to hire are an Outreach Education Specialist. Other positions are a Health Promotion Program Manager and Health Educator that will come on help with the COV1D case management but at some point the idea is to reduce the disease burden so 2 people can live with CID and recover better.Again will be able to do Diabetes Prevention Education since the loss of previous funds, probably Immunizations just not in reference to COVID vaccines, spending not near the amount with demand down. Arrangements made with one of the local Hispanic leaders is to go out Sunday to a church to administer vaccinations, it is wonderful new to have that church support it lends a lot of credibility to it, it is a great initiative but the demand for vaccines is still low. Keith Williamson replied that is good news,exceptional to be able to go out to the people,to meet on their terms to give them vaccine and the most effective. Councilor Smith said it is not good news just here but nationwide of the unvaccinated. His thought is it should have some effect on the hardcore group that is unvaccinated, are they uniformed, not know what is going on or just does not care. Amy Fagan said everything has been so politicized that people tend to decide inside their political affiliation now, many people on both sides have made choices different from that group,but it seems to be the extreme ideology within those groups and leading misinformation. The Health District has been out in the front,very transparent, try to answer all the questions. The primary concerns heard from when the vaccine came out are, it went to fast, what is in it, will it make you sick. That question is asked all the time of why people make the choice not to vaccinate because genuinely want to know. Her thought on what happened is back when the vaccine was being produced it also coincided with a big change in politics and the president. Everyone had questions,is the vaccine safe, it happened so fast never seen anything like this,will it make you sick, if pregnant or want to get pregnant can you or should you get the vaccine, those basic questions are legitimate. From the basic questions people found answers from extreme sources with extreme answers shared repeatedly, people believe it. It will have to be one person at a time or groups then go back out to those groups to have those discussions.The Epidemiologist went out to the Fire Department, to talk with the first responders out in people's houses that do life saving measures for people with C VID, she went out three days because of the three shifts morning and night They asked those basic questions in different variations of the extreme, she answered, and the feedback from those unvaccinated was still not going to get it. Several did come in to get the vaccine, also seen when an individual known gets very sick with COVID or dies. The Health District does talk and provide information to make an independent decision when ready and provide the vaccine when ready. Lou Kreider said the positive grant gives the ability to have individuals go out to focus on targeted communities that will help Public Health.The work with the Hispanic community at Our Lady Guadalupe this weekend was the start, to get into those communities to provide information with support of the community leaders to believe, to trust in what Public Health does, and to work for their respect to create an authentic relationship. Keith Williamson thinks a lot of discussion will be heard about requiring the vaccine over various groups going forward, it is a very hard discussion. For those who have not had personal experience of the illness and more severe outcomes that they can remain simply argumentative about it and not accept a rational position it is just something to argue over. He thinks some strong leadership from some place is going to be needed. V. NEXT MEETING DATE Friday, November 12, 2g2i VI. ADJOURN Keith Williamson adjourned the meeting at 12:55 pm. fa', ArAitar Sig ature 4t1 liteCt 4 , Print Name-Keith Williamson,MD, Chair,La ten = sen,PhD,RN, Vice-Chair,Julie Gibson,DVM, Secretary 3