PLACEMENT: Departmental
TITLE:
title
CORONAVIRUS (COVID-19) UPDATE AND DISCUSSION
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EXECUTIVE SUMMARY:
executive summary
On September 15, 2020 the Board of County Commissioners (Board) requested an agenda item to provide an update on Martin County’s (County) status on COVID-19 and discuss measures to proceed with the mandatory mask mandate.
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DEPARTMENT: Administration
PREPARED BY: Name: Taryn G. Kryzda
Title: County Administrator
REQUESTED BY: Commissioner Stacey Hetherington, District 2
PRESET:
PROCEDURES: None
BACKGROUND/RELATED STRATEGIC GOAL:
On August 25, 2020 the Board adopted an ordinance to require face coverings in public areas. Prior to the adoption of the mask ordinance, staff was asked to provide metrics for the County to utilize and measure the County’s progress in relation to effectively managing the spread of the virus (COVID-19). The Governor of Florida, Ron DeSantis, created a Re-Open Florida Task Force (Task Force) to make recommendations on COVID-19 (report attached). Within their report (page 9), they reference benchmarks, the following chart reflects those benchmarks and the metrics assigned to each:
|
Benchmark |
Syndromic Surveillance |
Epidemiology & Outbreak Decline |
Health Care Capability |
|
Metric A |
Downward trajectory of influenza-like illnesses AND |
Downward trajectory of documented COVID-19 cases OR |
Capability to treat all patients without triggering surge capacity AND |
|
Metric B |
Downward trajectory of COVID-19-like illnesses (fever, cough, shortness of breath) |
Downward trajectory of positive tests as a percent of total tests (flat or increasing volume of tests) |
Robust testing program in place for at-risk healthcare workers, including emerging antibody testing |
The report indicates the White House Guidelines for Opening Up America Again was used as a baseline. The report further elaborates in each of the benchmarks as follows:
• Syndromic Surveillance - Syndromic Surveillance methods look at individual and population health indicators (such as characteristic symptoms of a particular disease). The objective of this surveillance system is to provide the data and analytical tools needed to identify the outbreaks or unusual trends more rapidly, leading to timely public health responses.
• Epidemiology & Outbreak Decline - Outbreak data captures actual reports of positive cases and traces the causes of health outcomes and diseases. It includes the study of the distribution (frequency, pattern) and determinants (causes, risk factors) of diseases. The objective of monitoring the data is to ensure the state is managing the spread of COVID-19 and employing effective mitigation measures.
• Health Care Capability - Data about hospital capacity and readiness shows whether the health care system is ready to respond in the event of an unexpected surge of COVID-19 illness. The ideal situation is for the system to be able to treat all patients without needing to use emergency surge plans and to have a robust COVID-19 testing program in place.
The report further defines the health care capability with additional requirements. Essentially, the report recognizes the importance of the capacity of the hospital and their ability to effectively manage patients and adequacy of supplies to protect staff and patients. Having adequate Personal Protection Equipment (PPE), N95 masks, surgical masks, gloves, surgical gowns, and other critical resources is also a requirement. The next section of the report has general mitigation guidance for individuals and employers. Both circumstances recommend social distancing and wearing cloth face coverings or other PPE while inside or in close proximity to members of the public. Next, the report identifies the various phases for a ‘Safe. Smart. Step-by-Step Plan for Florida’s Recovery’ as presented by Governor DeSantis. Currently, Martin County is in Phase 2. Recently, the Governor indicated a willingness to move Florida to Phase 3, but to date, that has not occurred.
Based upon the benchmarks and metrics defined within the Task Force’s report and data that is available from the Florida Department of Health (FDOH) website, the following charts were taken from FDOH’s COVID-19 webpage and is Martin County specific. The first chart reflects the Emergency Department (ED) Visits with Influenza Like Illness (upper left corner), Documented New Cases (upper right corner), ED Visits with COVID Like Illness (lower left corner), and Percent Positive for Laboratory Testing (lower right corner).
The second chart is also from the FDOH website, and is also Martin County specific, this chart represents testing data. The laboratories (labs) that are doing any COVID-19 testing are required to report their testing results to the Department of Health (DOH). There have been issues with that reporting mechanism, as some labs were not automated, so the ability to get the data in a reasonable amount of time was in some cases compromised, and therefore, less reliable. The FDOH strives to rectify any issues with the data to ensure what is being reflected for Martin County is accurate and reliable, to date, that has been a challenge. The Governor severed all ties with one lab, Quest, due to a data dump of more than 75,000 cases that were either never initially reported (for many months), or were re-reported, and duplicated. Due to the unreliable number of actual cases, the County felt that the data should not be reflected on the County’s website. The County is working on the ability to manage the data better and have it reflected on our website in the near future.
The third chart from the FDOH website reflects Martin County’s age distribution and daily positive cases. Accessing the chart via FDOH website, allows an individual to ‘hover’ on the graphs and retain the actual data point for positive cases or individuals in an age group.
The last chart reflects Martin County’s positive cases for the last thirty days (of when this item was created) and the availability of hospital beds throughout the County during the same timeframe.
The Governor’s office issues a daily report of COVID-19 (included) and has various charts with data. The percent positivity for new cases in Florida residents chart shows at the State level, the positivity rate has ranged between 3.85% to 5.92%. Martin County was at 7.96% on September 22, 2020 (when agenda item was created). The positivity rate is impacted by how many COVID-19 tests are performed. The World Health Organization (WHO) recommends that before reopening, a State’s rate of positivity for COVID-19 testing (i.e. out of all tests conducted, how many came back positive for COVID-19) should remain at five percent (5%) or lower for at least fourteen (14) days. Initially when testing began in Florida, the State focused on a positivity rate of ten percent (10%) or lower. Florida’s Governor, Ron DeSantis initiated a phased plan for the State to re-open, establishing protocols and limitations on capacities in public establishments and places, but no specific targets were defined. On June 5, 2020 the Governor issued an executive order to move Florida (excluding counties south of Martin County) to Phase 2.
Staff was not able to identify a specific data point or recommendation that would define when Martin County should proceed in one manner or another. The County is reliant upon the Health Department and hospital (Cleveland Clinic Martin Health) to provide guidance on best practice(s) for managing the pandemic. Both entities, the CDC, and the Governor’s office, recommend practicing social distancing, frequent hand washing and sanitation, stay home when sick, and wear a mask in public settings. These mitigation strategies have been in place since the pandemic began. The County has been fortunate (to date) that the hospital availability has been manageable. In mid-June, the availability rate dipped to their lowest rate of 41.9%. The hospital has indicated that they saw a correlation between availability of beds and the mask requirement. They support the County as do others in having the mask mandate regulated by the Board rather than on a case-by-case or individual basis. Palm Beach County has extended their mask mandate until October 22, 2020 and St. Lucie County’s mask mandate remains in effect as long as they have a declared Local State of Emergency (LSE), which is similar to what Martin County currently has in place.
Staff is providing this information for the benefit of the Board as requested and seeks further direction. Staff will have the latest data points and will verbalize them during this item being heard.
ISSUES:
There have been indications from the public that the County established a ten percent positivity threshold in conjunction to the mask mandate, which is not accurate. To date, the County has not defined a specific threshold, but rather continues to monitor the data with our health partners. The County, Health Department, and Cleveland Clinic Martin Health routinely and regularly meet to discuss COVID-19 issues as they arise. Martin County is not a chartered County and therefore is governed by the State and Florida Statutes.
LEGAL SUFFICIENCY REVIEW:
None
RECOMMENDED ACTION:
RECOMMENDATION
Move the Board provide staff with direction based upon the information provided.
ALTERNATIVE RECOMMENDATIONS
None
FISCAL IMPACT:
RECOMMENDATION
None
ALTERNATIVE RECOMMENDATIONS
None
DOCUMENT(S) REQUIRING ACTION:
☐Budget Transfer / Amendment ☐ Chair Letter ☐Contract / Agreement
☐Grant / Application ☐Notice ☐Ordinance ☐Resolution
☐Other:
This document may be reproduced upon request in an alternative format by contacting the County ADA Coordinator (772) 320-3131, the County Administration Office (772) 288-5400, Florida Relay 711, or by completing our accessibility feedback form at www.martin.fl.us/accessibility-feedback <http://www.martin.fl.us/accessibility-feedback>.