Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES Virtual Meeting held via Zoom and Recorded by SATV December 8, 2020 MEMBERS PRESENT: Dr. Jeremy Schiller, Paul Kirby, Geraldine Yuhas, Sara Moore, Datanis Elias OTHERS PRESENT: David Greenbaum, Health Agent, Suzanne Darmody, Public Health Nurse, Maureen Davis, Clerk of the Board, Patti Morsillo, City Council Liaison ATTENDEES ADDRESSED: Alan Hanscom, SATV and resident TOPIC DISCUSSION/ACTION J. Schiller read aloud that, pursuant to Governor Baker’s orders, there exists COVID-19 Emergency Open Meeting Law Guidance regarding the implementation of virtual public meetings, etc. 1. Call to Order 7:02pm 2. Approval of Minutes G. Yuhas motioned to approve the minutes of the Special Meeting on (10/21/20 Special Meeting 10/21/20. S. Moore 2nd. All in favor. Motion passed. and 11/10/20 Regular Meeting) P. Kirby motioned to approve the minutes of 11/10/20. G. Yuhas 2 nd. All in favor. Motion passed. 3. Updates on COVID-19 D. Greenbaum said we are in a pretty big surge right now, both locally and nationally. We’ve seen our numbers double in the last month to six weeks. As of today, we have 1,800+ cases total, over 300 active cases and 52 total deaths. Today the Governor announced some rollback of reopening back to Phase 3, Step 1 and included additional restrictions that were not initially part of Phase 3, Step 1. He listed the changes announced by the Governor. There will be no more indoor performances at restaurants. The Governor reduced the number of people at a table from ten to six. There will be a 90- minute time limit at tables, so people won’t be lingering. There are additional requirements such as mask wearing at all times in gyms and updated face covering requirements in office spaces. Tele- working is encouraged. He said we are seeing some of the impacts of Thanksgiving that we were expecting, and with the holiday season approaching he feels it’s only going to get worse instead of better. J. Schiller asked what triggered the rollbacks by the Governor. What determines whether we get rolled back further? Is it positivity rates? D. Greenbaum said he heard it had something to do with an increase in the amount of hospitalizations and ICU capacities. He was a little surprised that the rollbacks didn’t happen sooner. He said people need to be aware that the vaccine is not a cure; it will help increase immunity, but it is not a silver bullet that is going to end this. We will not immediately be back to normal living once the vaccine is out. We are told we are going to get an allotment to distribute to the general 1|Page public and we are starting to think about vaccine distribution. S. Moore said she is wondering if there will be any issues, for example with DACA students. Will there be a need for id in order to receive vaccinations and what kinds of rules or policies will be in place as far as who gets them. D. Greenbaum said distribution will all be dictated by the federal government, but his intention is to give the vaccine to everyone who wants it and not to turn anyone away. Again, while it is not a cure, he feels the vaccine is the best thing we have right now and the only thing that is going to slow this virus down. S. Darmody said historically the way MA has done vaccines is, anyone who is underinsured or uninsured can get free state-supplied vaccine, regardless of age. All children under 19 years old can get free vaccine. She anticipates they will do the same with this vaccine. G. Yuhas asked how we will keep track of giving the second dose. D. Greenbaum said it is a work in progress. He has heard there will be a reminder system and people will receive text messages or email reminders. There may also be vaccination cards provided by the federal government, like an appointment card, that people will receive on the day of their first vaccination. Tracking second doses can be a challenge, but we did two doses with the H1N1 vaccine and had a pretty high rate of people coming back for their second dose. S. Darmody said the MIIS (MA Immunization Information System) is a database system that tracks all vaccines in one place. The requirement is to have all the vaccines submitted to the system within 24 hours of the vaccine being given. The State talked about a system called PrepMod where people would be registering in real time and the information would go straight into the MIIS and remind people when it is time for their second shot. She is not sure if the system will be active by the time we get the vaccine. D. Greenbaum said the first doses in MA will go to first responders and other priority groups. He hopes that process will be done quickly, but he doesn’t see the vaccine being broadly distributed for at least three months. J. Schiller asked if D. Greenbaum has heard of an education campaign. D. Greenbaum said he heard that the federal government was planning PR campaigns around getting people to have trust in the vaccine and when it comes out, they should get it. He imagines the State will encourage people to get vaccinated, just as they encouraged people to get tested. J. Schiller said the hospitalizations are up to the numbers we saw in May. D. Greenbaum said people must realize that if they leave their house, they run the risk of getting COVID-19. J. Schiller asked what the compliance for social distancing and mask- wearing is downtown. When he has been out it seems very good. D. Greenbaum said he thinks it is good. The biggest crowd we get downtown is the line for testing at Old Town Hall. He is very impressed with what a great job Fallon Ambulance is doing moving the lines quickly. J. Schiller asked how the Department is doing. D. Greenbaum said we are doing okay, but it has not been an easy time and we are getting run down. There is some burnout, particularly with the public health nurses. They are facing an onslaught of cases and contact tracing just isn’t working anymore. We are sending most of our cases to the CTC for contact tracing. The CTC at the State is overwhelmed. It is 2|Page disheartening. He has a call with the State tomorrow and he will discuss this with them. There are just too many cases for us to contact every case and all their contacts. The nurses are also taking some abuse from some of the people they are contacting. The State needs to evaluate and change how they are operating as far as contact tracing goes. S. Darmody said she is worried about how many hospitalizations there are now. It is so much different than in the spring because back then there were about 15 cases per day and there were only household contacts. Now there are so many more cases, and each case has so many contacts because people are out and about. D. Greenbaum said what we are seeing is when someone in a household gets it, the whole household gets it. We want to make sure we try to prevent the spread in the schools. S. Dermody said the school nurses, led by School Nurse Leader, Charlene Moske-Webber, are an amazing team. In full PPE they have had to remove kids from school that have tested positive and have followed up on all the contacts. They have been dealing with time-sensitive issues and have really stepped up. She really appreciates them and all they have done. D. Greenbaum said they are certainly doing things they never would have imagined they would be doing when they signed up to be a school nurse. P. Kirby asked if kids are getting upset when they get taken out of school by people in PPE gowns, etc. D. Greenbaum said he hasn’t heard that it has been an issue. J. Schiller asked if we are getting any help with contact tracings from the restaurants’ QR codes. D. Greenbaum said we haven’t had a ton of restaurants with cases lately. People are definitely filling it out. We had over 800 entries the first week. We have had some pushback from restaurants stating that it is inconvenient and some of the questions are too intrusive to their customers. He is going to work with IT about making some of the questions optional rather than mandatory. He will also look into getting a Spanish version. P. Morsillo asked if there are any plans to do testing at some of the buildings like Salem Heights and Pequot Highlands. She said she heard Boston has a mobile van to do testing. D. Greenbaum said there are no plans to do that. In the summer and early fall we offered them all testing through the State’s Stop the Spread testing and Loring Towers and Pequot Highlands took us up on it. Salem Heights and 40 rear Highland Avenue said they didn’t want us on the property. The City is doing some wastewater COVID surveillance in those areas and if we notice an increase in the levels of COVID in the wastewater, there will be an educational campaign to encourage people who live in those locations to get tested at one of the Stop the Spread testing sites or the CLC. He has asked for additional Stop the Spread testing from the State, but they are not providing it at this time. P. Morsillo also heard that there are no more walk-ups allowed at the Salem High School testing site. That limits the options for testing for people who don’t have cars. D. Greenbaum said walk-ups became too much of a public safety issue with people walking up and it was unfair for people who had been waiting in line in their cars for sometimes several hours. They can go to either Old Town Hall or the CLC walk-up sites if they are a Salem resident. S. Moore asked if the School Committee or Health Department has 3|Page  provided any benchmarks or guidelines for when schools would have to go back to fully remote learning. It seems like there is more community spread than school spread. D. Greenbaum said DESE has not issued any guidelines. They are leaving it up to the school districts to determine those benchmarks and are telling them to call their local boards of health to decide. He is uncomfortable with that. He feels it should be in consultation with the School Committee and the Superintendent. He had a meeting with the Return to School Committee on Friday and the Superintendent was there. They talked about a potential joint meeting with the School Committee, the Superintendent and the Board of Health. He told the Superintendent he would bring it up to the Board at tonight’s meeting to see if there may be an opportunity to meet after the holidays and before the students go back to school, if possible. We are fortunate to have multiple elementary schools in Salem., so if a school needed to close, we do have some options. DESE is pushing to go back to full in-person learning but are not willing to provide guidance on when a school or school district should go remote. To put that on the local board of health is disingenuous. S. Moore said as a parent, she is comfortable with the protocols in place protecting students, but it concerns her not having benchmarks established before everybody returns. D. Greenbaum said winter sports in schools are scheduled to begin next week. He had a conversation with the Superintendent and the Mayor about maybe delaying that. His point of view, and the point of view of a lot of health agents and boards of health in the region, is if the goal is to have students in front of teachers, why do we want to risk spread with indoor team sports? If the Board discusses this and supports the decision to delay indoor sports, it would be helpful. S. Moore and J. Schiller said they would absolutely support that. G. Yuhas said where her son lives, if any athlete played sports with other schools, they could not go in-class – they had to be taught virtually. So, they could have contact with their team, but not the other students. D. Greenbaum said he has a lot of concerns about sports because in the fall we had issues with soccer and a couple of other things. He is even more concerned knowing that these sports are going to be played indoors. He met with other health agents and directors in our district, and through the North Shore Shared Public Health Services there are eight communities involved with the District Incentive Grant which has been extended due to COVID. They are all in favor of delaying indoor sports, so he hopes to decide on a regional level with boards of health, school committees, superintendents, mayors and managers. He thinks it will have more weight if people know that it’s not just one community deciding to delay sports. S. Moore said if our priorities are to keep people healthy and give children the education they deserve equitably, she feels sports and gyms seem secondary. D. Greenbaum said he understands that gyms and sports are a release and can take your mind off of things, but if the goal is to have students in front of teachers with in-person learning, then minimizing risk to prevent the spread is really what needs to be the focus at this point. 4. Discussion on Health Disparities and Race Equity S. Moore said subcommittees were tasked with providing a report to the larger task force about where they are at looking at their respective issues. 4|Page  It sounds like the health subcommittee has identified some core issues they are interested in looking at a little deeper. One of those issues has to do with housing; not just affordable housing but the disparities that exist with quality, safe, healthy housing. They were also looking at issues with mental health and stigma and the intersection of race, with LGBTQIA plus people of color, and the challenges that that community faces. They seem to be at a place where they are trying to figure out how to collect data to figure out what is happening in the community and try to identify what issues could be addressed sooner and then work on some long-term goals. P. Morsillo said the groups seem to understand what a big issue this is. Narrowing the issues down in order to accomplish something is important for these committees to have deliverable results. J. Schiller asked how they are going to get the data. S. Moore said the committees are collectively forwarding questions that could be put together on a survey that would be distributed to the community to collect some information about the experiences of people of color. They are hoping to get more Salem-specific data on issues. They have Friday afternoon meetings every week, so she will try to attend as often as she can. She said she and P. Morsillo were there and about five others. Dr. Roberts from the hospital is part of it. Various experts are invited to attend meetings as well. J. Schiller thanked them and asked that they continue to update the Board so we can be useful in any way possible. 5. Chairperson Communications J. Schiller said we should put reorganization of the Board on the January agenda. 6. Monthly Reports-Updates a. Public Health Report not available. Nurse’s Report b. Health Agent’s Report D. Greenbaum said he will continue to send a copy of the weekly situation report to the Board. It will really give a good history of what took place during this time period. c. Administrative Report Report not available. J. Schiller said if generating the reports is too much of a burden right now with COVID, we totally understand. We can request reports when needed. The Board wants to empower you to do the reports at your own discretion. At the very least, for due diligence, we should have the administrative report, if you can get to it. P. Kirby said maybe in the future we should reconsider how much routine reporting we as a Board really need to see. S. Darmody and M. Davis thanked the Board for their understanding. D. Greenbaum said the inspectors are doing more inspections to be sure businesses are complying with the ever-changing guidelines and requirements rather than routine inspections, which is both frightening and unfortunate. P. Kirby asked if our eviction moratorium is still active. D. Greenbaum said the City did our moratorium before the State did theirs. 5|Page  He heard that if the next federal relief package goes through it will include a national eviction moratorium, so that would be an additional safety for tenants that might be in jeopardy. d. Council Liaison Updates P. Morsillo said at the last Council meeting of the year on Thursday they will hopefully be voting on the Signature Parks Fund, which is 16.1 million dollars to be used over several years to upgrade six of the parks in Salem. It is kind of a birthday present for Salem’s 400th year as they are scheduled to be completed in 2026. There is some pushback, so it is questionable whether it will be approved. The argument is COVID, which is a curious argument because COVID has pointed out how important our parks are. Parks are for everyone and it is an equity issue for everyone in Salem that they have parks in their neighborhoods and can be outside in a safe space. The majority of the bond is for the new pool at Forest River, which again is an equity issue. If we can get this bond to go through, it is scheduled to be completed for next summer. Not everyone can have a pool in their backyard or the ability to pay for a membership to the Y or a private pool, so this really is an equity issue. Everyone will be able to go to the pool. No one will be excluded. She was hoping she could ask the Board to either submit a letter to the City Council as a Board and/or individually to encourage them to vote for this bond. It is important to get these programs going. The other thing to keep in mind is that Forest River will provide employment opportunities for high school and college students whose job have disappeared completely due to COVID. We will need to be staffing the pool and the park programs. D. Greenbaum asked if the vote doesn’t go through, does that mean no pool at Forest River? P. Morsillo said it is a slow process and she guesses the Mayor would come back next year with a bond specifically for the pool. The pool is about $10 million of the $16 million for the project. The slower the process, the more construction costs increase. J. Schiller said he thinks the Board should be 100% behind the project. He thinks the City owes its citizens a public good for everyone. P. Morsillo said the other part of the Forest River project is a community room that will be added to the changing area. Kids can use it for summer camp, so if it rains, they can run the program every day. P. Kirby asked how soon she would need the letter. P. Morsillo said as soon as possible because the vote is on Thursday. They need eight votes to pass it. They are one vote short. S. Moore offered to draft the letter for the Board and submit it to the City Clerk for the Council members. J. Schiller asked what are the arguments against it? P. Morsillo said that people feel that having a bond means that it will affect tax rates. It is not entirely true because we are also writing off some of the bonds we currently have. The other argument is that people are losing their jobs and the future is so uncertain and adding more debt to the City is not a good thing right now. P. Kirby said but money is also practically free right now. P. Morsillo agreed and said the interest rate is so low and we have such a fantastic bond rating right now so it makes so much sense and will save us so much money in the long run. These are capital projects and they will 6|Page  happen at some point. P. Kirby pointed out that these projects also create jobs. J. Schiller said this Board has made equity a priority and equity is a public health issue. J. Schiller announced that after discussion, this issue has the unanimous support of the Board. S. Moore will draft something and send it to the other Board members for comment. She will send the final letter to D. Greenbaum who will send it to both the City Clerk and City Council President, Bob McCarthy. She said we should post the letter on the BOH Facebook page. D. Greenbaum said he will send the final letter to the Mayor and she will post it on Facebook. 7. New Business/Scheduling of Attendee Alan Hanscom, Washington Square, wanted to thank the Board of Future Agenda Items Health and the City for what they did to prevent Halloween from becoming a disaster. Things are still bad with the Coronavirus, but all things considered he feels the City did a good job to save lives. D. Greenbaum wants to be sure the Board supports his position on winter sports. He also informed the Board he will be trying to take some time off during the holidays. He said he will be reachable and most likely working from home. He hopes in the not-too-distant future we can get back to our lives with some sense of normalcy. J. Schiller wished everyone a good holiday season. It is nice to have our important people in our world and we are all here for each other. MEETING ADJOURNED: P. Kirby motioned to adjourn. G. Yuhas 2nd. All in favor. Motion passed. 8:05pm Respectfully submitted, Maureen Davis Next regularly scheduled meeting is Clerk of the Board Tuesday, January 12, 2021 at 7:00pm Virtual Meeting Via Zoom 7|Page