HomeMy WebLinkAbout2020/05/11 - BOH Packet Pursuant to Proclamation by the Governor 20-28, in-person attendance to Board of Health
meetings is temporarily prohibited.
Our Board of Health meetings are live streamed at hitp:Hmasonwebtv.com/ and we will accept
public comment via email — Vldrewc&bco.mason.wa.us; or mail to Commissioners Office, 411
North 5tn Street, Shelton, WA 98584; or call 360-427-9670 ext. 419. If you need to listen to
the Board of Health meeting via your telephone, please provide your telephone number to the
Commissioners' office no later than 4 p.m. the Friday before the meeting.
We intend to limit our meetings to discuss and/or take action on only necessary and routine
matters or matters necessary to respond to the COVID-19 outbreak and current public health
emergency.
MASON COUNTY BOARD OF HEALTH
SPECIAL MEETING AGENDA
411 North Fifth Street, Shelton WA 98584
11:30 a.m. Monday, May 11, 2020
1. Call to Order
2. Roll Call
3. Actions to Consider- Adoption of Resolution approving Application for COVID-
19 Phase I to Phase II
4. Adjourn
[Type here]
Agendas are subject to change,please contact the Commissioners'office for the most recent version.
Last printed 05/06/20 at 10:52 AM
If special accommodations are needed,contact the Commissioners'office at ext.419,Shelton#360-427-9670;Belfair#275-4467,
Elma#482-5269.
Resolution No.
A Resolution Adopting a Request for Variance from COVID-19 Phase 1 Recovery to
Phase 2 Recovery
WHEREAS, Mason County Community Services, Public Health opened Incident Command for
support of COVID-19 response on February 24, 2020; and,
WHEREAS, Mason County initiated Area Command on March 4, 2020 to address COVID-19
response; and,
WHEREAS, The Governor has proposed a means by which counties may move from COVID-
19 Phase 1 response to COVID-19 Phase 2 response through the use of a variance request;
and,
WHEREAS, the Mason County Board of Health recognizes the need to balance safety from
COVID-19 as well as the need to recover the economy and medical system; and
WHEREAS, the Mason County Board of Health met in a special meeting, in compliance with the
Open Public Meetings Act, on May 11, 2020 to consider the Application for Variance COVID-19
Phase 1 to COVID-19 Phase 2; and
NOW,THEREFORE BE IT RESOLVED by the Mason County Board of Health to approve the Mason
County Application for Variance from COVID-19 Phase 1 to Phase 2 (Attachment A) and direct staff
to send the application to the Washington State Department of Health.
Adopted this 11th day of May 2020
MASON COUNTY, WASHINGTON
BOARD OF HEALTH
Scott Hilburn, Hospital District #1
Kathy McDowell, City Commissioner
Kevin Shutty, Commissioner
Randy Neatherlin, Commissioner
Board of Health Resolution No.
Request to COVID-19 Phase 2
Sharon Trask, Commissioner
Peggy Van Buskirk, Hospital District #2
ATTEST
Gary Plews, Fire Commissioner
Melissa Drewry, Clerk of the Board Keri Davidson, Shelton School Board
Page 2 of 2
I\Board of Health\Resolutions\2020 BOH Resolutions-Proclamations\Resolution for COVID Phase 2 request.docx
SOON-
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Mason County Appkationfor
v Variance
oz`NMh
Phase lto Phase z
Abstract
Mason County application to Washington Department of Health to move from Phase 1 recovery
to Phase z
David Windom
dwindorn@co.mason,wa.us
Contents
Statementof Purpose.............................................................................................................................2
Washington's Phased Approach..............................................................................................................2
PublicHealth Criteria ..............................................................................................................................3
CaseData............................................................................................................................................3
Hospitalizations...................................................................................................................................5
Physical Distancing Adherence Trends................................................................................................5
LongTerm Care Facilities....................................................................................................................5
Readiness and Capabilities Needed.........................................................................................................5
Healthcare System Readiness .............................................................................................................5
BedAvailability................................................................................................................................5
Ventilators.......................................................................................................................................6
PPE..................................................................................................................................................6
Testing Capacity and Availability.........................................................................................................6
Case and Contact Investigations..........................................................................................................6
Ability to Protect High-risk Populations ..............................................................................................7
SocialConsiderations..........................................................................................................................7
MasonCounty is Ready.......................................................................................................................8
Conclusion ............................................................................................... Error! Bookmark not defined.
DAVID WINDOM
Statement of Purpose
Mason County seeks a collaborative and responsible approach to moving our community from Phase i
Recovery into Phase 2. Mason County with a comprehensive partnership with the community,tribes,
health care,first responders,city,and county leadership,continue to achieve meeting or exceeding the
criteria need to reopen our local economy and support medical systems. Mason County's population
estimate is 66,768(census.gov, 5/5/2020),which is below the next phase standard established by the
governor's office.As a responsible governing body, Mason County is seeking this variance to prevent
collapse or further unnecessary and preventable second and third order of effects.
Washington's Phased Approach
Governor Inslee, in collaboration with local elected officials,the Department of Health, and local health
jurisdictions, has established a data-driven approach to reopening businesses and modifying physical
distancing measures while minimizing the health impacts of COVID-ig.This approach reduces the risk
of COVID-ig to Washington's most vulnerable populations and preserves capacity in our healthcare
system,while opening businesses safely.The plan involves assessing COVID-ig activity in the state
along with healthcare system readiness and our state's ability to perform extensive testing, isolate and
manage cases,quarantine their contacts,and protect high risk populations.The state will implement a
phased approach to reopening businesses and modifying physical distancing measures when disease
activity is adequately suppressed,and readiness is achieved in four key areas.
WASHINGTOWS PHASED APPROACH
Modifying Physical Distancing Measures as we Reopen the State
INDIVIDUALS AND BUSINESSES SHOULD FOLLOW ALL REQUIREMENTS LISTED ABOVE DURING ALL PHASES
0 El El M
Phase 1 Phase 2 Phase 3 Phase 4
High-Risk Resume pubkc lnteractm%
Populations Cnnanuz to Stay Nomeq Stay Healthy continue to Stay Nome,Stay Healthy Conti—to Stay Home,Stay Masi" with Phys(distancing
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Gatherings Dr�iv.4n rpkival terv"with Lather with no mom than S people AN"gatherings with ee more than
(social,spiritual} onshoisaheld parwhide outstdtymrr household par week 50peepht Alkw 9aMemgs with>W people
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-Landscaping emoungedl -Libraries •Con:ertverwes
-AutoMY/boat/01tYseMs Hairandnallalom/barbem -Museums -Large sporting—.b
Business/ -R n atadtturt-ud.pick-upard.rs only) Potgmeming -All other business, yet -Rona amestdcted tufing of v o�itm
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DAVID WINDOM 2
Mason County seeks to use a locally based version of this approach to move from Phase a.as outlined,
by the Governor's office,to a Phase z as acknowledge in the following variance request. Mason County
continues to experience very low occurrence of new cases since the observed peak in late March. It is
conceivable that low numbers of cases may continue to come in over an extended period with potential
increased testing capacity statewide.As new cases trickle in,they fall well within the capability of the
current resources available in Mason County to maintain further test,track, and trace. It is observed
that all positive tests received in April and May have traced back to being symptomatic in March and
continue to fall since the peak that was observed at the end of March.
Mason County continues to move past the most highly infectious stage of COVID-ig. Businesses,
organizations,and the public have been incredibly responsible in complying with all recommendations.
This has brought the case levels down but is also having increasingly harsh effects on economies and
lives.With a comprehensive partnership with the community,tribes, health officials,emergency
responders,city and county leadership, Mason County is strongly prepared and ready to move forward
into Phase 2.
Public Health Criteria
Case Data
Data as of May 01,2020 11:59PM PT
Confirmed cases by county
Hover over a county for details
Total Confirmed 25 i
Cases
Total Deaths
�eun.;rae:am-.d s:w 4.0%
s
Total Tests
Percent Positive 2,2% " k A
Q Mason County Age 0-19 0 0
Age 20-39 2 0
Age 40-59 9 d
Age 60-79 10 1
Age 80f 1 0
Positive UnkAge, 0 0 1
1;
DAVID WINDOM 3
Click here:
COVID-19 in Washington State
Illnesses that began in '...�
Data as of May 01,2020 11.59PM PT the last 4 to 7 days may onfrt—d Cases'
not yet be reported.
•Confirmed cases
s; n Jefferson Counr}
_ 3 ❑10n9 City
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Wwon County
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U
Feb 2020 Mar`_0.:L Apr;20 N4zy 2020
Date of illness onset
Case
COVID-19 in Washington State counties
Number of individuals Tested by Specimen Collection Date !.?anon County v
[Iota as of May 01,2020 11:59PM PT
2.2% of individuals test positive Data may be
incomplete for the
mot recent dates.
•Positive+Negative
a
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a
31
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a
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Jn
Mar 2.520 Apr'202D flay 2r_0
Specimen Collection Date
Case Calculations for Release
Using CDC recommendations of.77 new cases per ioo,000 people and applying that to Mason County
we show the following calculation.Convert.77/ioo,000 to x/64,000(Mason Population)= .45/64,000
cases per day. From March i'to May in=64 days. 25 cases/64 days=.38 cases per day,well below
CDC recommendations.
DAVID WINDOM 4
Hospitalizations
As of May i1, Mason County has had two patients hospitalized in hospitals outside of Mason County.
Mason General Hospital has had no in-patient cases of COVID-ig. Mason General Hospital currently has
capacity far more than what has been required for both COVID-ig and general patients.
Physical Distancing Adherence Trends
DOH does not maintain the same detailed set of adherence data for small counties as it does for greater
Puget Sound urban communities.An extrapolation could be made using Seattle data for Mason County
due to its proximity."Based on the aggregated Facebook data, we can say with confidence mobility
behavior in the greater Seattle area has reduced dramatically since early March,when it first became
clear community transmission of COVID-19 was occurring in the area.Significantly fewer people are
commuting to work, and many more people are spending their days at home. However,we see evidence
of inconsistency, particularly during weekends. Mobility is not a direct measure of social distancing;
while these data indicate people are spending much more time at home and away from shared spaces
(which has been shown to reduce disease transmission), we cannot use it to determine the percent
reduction in social contact.See the follow-up report to learn how these changes in mobility relate to
reductions inCOVID-19 transmission."z
Long Term Care Facilities
Since the very beginning of the COVID-ig crisis, Mason County long term care facilities have been our
highest priority prevention effort.To date, no instances of infection have occurred in our LTC facilities.
Readiness and Capabilities Needed
Healthcare System Readiness
Bed Availability
Throughout the COVID response Mason County has never reached or exceeded bed capability either
for COVID patients or patients requiring hospital beds for other reasons.Currently Mason General
stands mostly empty.
Current Availability as of May 3, 2020
Within county:233.beds
Mason General Hospital
• 26 beds available
• 20 additional expansion beds
In addition to hospital facilities, Mason County Community Services(MCCS)also has a ioo bed
Alternate Care Facility ready to deploy to the middle school directly behind Mason General Hospital to
provide further capability. MCCS also provided support to Community Lifeline to add a ten-bed
capacity to care for ill homeless.County owned Building io converted to an isolation/quarantine facility
2https://covid.idmod.org/data/Understanding—impact—of COVID_policy_change_Seattle.pdf
DAVID WINDOM 5
with 75 beds,showers,and porta-potties to handle an outbreak within the homeless population should
one occur.
Outside of county bed availability generally:
• Thurston Capitol average 25 available
• Thurston St. Pete average 37 Available
• Kitsap Harrison 14-20
Ventilators
Mason General currently has 3 ventilators with 4 on order and two bipap(non-invasive)machines which
can be converted
PPE
• Mason General currently has adequate PPE for both COVID-ig response and clinical operations
• Area Command has PPE for EMS, law enforcement and emergency management.The pipeline
continues to fill
• Mason General has the ability to surge within its own facility as well as having access to ioo
beds in a public health provided Alternate Care Facility
Testing Capacity and Availability
As noted in the graph above, Mason County continues to maintain adequate capacity for testing.
Mason General Hospital conducts daily drive-through testing averaging 25-35 tests per day. Other
testing capacity exists with Harrison Hospital, Port Orchard, as well as Peninsula Health Care Systems
in Belfair and Kitsap County. Laboratory resources are adequate through the public health lab and
private labs.Total tests average 25-35 per day.Tests are geographically and economically available to
all populations.
Case and Contact Investigations
Mason County Department of Community Services, Public Health and Human Services Division
maintains a highly trained communicable disease staff with experience in contacts investigations.
Three full time staff are dedicated to current investigations with an additional staffing of seven
investigators available should the need arise.At the peak in March, Mason County did not exceed the
capacity of the first line series of investigators.ioo percent of positive cases are investigated within 24
hours.
Investigators maintain communication with positive cases throughout their case progression to ensure
that positive cases have the resources needed through recovery.
All cases with the exception of the two cases hospitalized outside of Mason County, all cases have
isolated and recovered at home.The county has the capability to isolate/quarantine an additional 170
cases utilizing the alternate care facility and the Building io isolation and quarantine facility.
Should the need arise, DOH maintains strike teams that would support Mason County Staff in contact
tracing and tracking.
DAVID WINDOM 6
Ability to Protect High-risk Populations
Mason County maintains the ability to immediately respond to outbreaks in congregate settings such
as long-term care facilities, homeless shelters,jails,and works with Department of Corrections for
prison facilities.
• To date,there have been no cases within the long-term care facilities in Mason County.
Outreach to LTC's was the very first priority.
• Mason County maintains internal capacity to respond to outbreaks within 24 hours and has the
ability to reach out to DOH strike teams if needed.
• Through local positive case reports and monitoring of the DOH website3, Mason County
maintains situational awareness of cases and works with partners such as the Squaxin Tribe and
Skokomish Tribe to ensure that vulnerable populations receive protection.
Social Considerations
The stress put upon the population from the"Stay Home, Stay Healthy"is beginning to takes its toll.
Suicide rates since the lock down began have doubled past normal expectations.Though it can't be
definitively listed as causation,there is a very high and suggestive correlation.
The population sees the allowed activities as arbitrary and capricious.Anger continues to grow
amongst those that were initially supportive of policies to reduce the effects of the virus. Lives and
livelihoods are severely impacted. If restrictions cannot be relaxed in a controlled way immediately,
public support may well vanish by the end of May.
r
3'l�C�c"t"Iyi+%°�'.CC'1."1? QDV;u:'1=rCailCi�St`.,,Q'�;'ictJlrliS
DAVID WINDOM 7
Mason County is Ready
PlwsR i Phase 2
High Risk Populations Conflaru to Stay Home,Stay Healthy Continut is Stay Nome,Stay Nealthy
{Golf,fishing,hunting.boating, All outdoor recreation Involvingfewer
Recreation _._-;?ukr! __..._._._ .__._.wlthM5 people twzside your household
_
_. Hone- ..__...
,Drive-in spiritual services with one Gatherwith no more than 5 people foam
6adarbo bouseholdpervehicle o,tsideyourhouseholdpetweek
.......... _._...._.
Limit nonresseotial travel within proximity
a Travel Only essential travel of yourhome
New mastructlon
Remaining htanufacturing
Esstentiat businmes open to-home domestic services
Existingconstrsction that meets Retail in-store
criteria Real Estate
Landscaping professional Services/office based
Automobile Sales businesses
Curb-side retail Salonsand Barbers
Car washes Housecleaning
Mness/Employers Petwalkers Restaurants<SIX
_ . . !tY
We have all the policies and support systems in place to move forward into Phase z.Our case peak
happened over a month ago.Cases per day are at.38 which is well below CDC recommendations of.77
cases per day/ioo,000. Our businesses and communities are prepared with great,common sense
interventions of their own that fully support the effort to prevent a second wave(as an example,see
Annex A).The Emergency Operations Center stands ready to implement the move to Phase z as soon
as possible.
Timeline(Tentative):
• Monday May 41h, present to Area Command and key partners
• Tuesday May St',send to Board of Health and County Commissioners
• Wednesday May 6th, request letter of support from Mason General Hospital
• Wednesday May 62h, request special meetings of the BOH and BOCC
• Monday May iith,submit completed packet to John Wiesman, Secretary of Health.
Summary
Mason County strongly believes to have addressed each item in Governor Inslee's Plan to Re-open
Washington at the state level based on county capabilities and data.We kindly request to be consider
ed and approved to allow Mason County tojoin our neighboring counties of Grays Harbor and Jefferson
in moving into Phase z.
DAVID WINDOM 8