Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES Virtual Meeting held via Zoom and Recorded by SATV March 9, 2021 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, Patricia 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 7:03pm J. Schiller pointed out that it has been one year of the pandemic and one year of our virtual meetings. 2. Approval of Minutes S. Moore motioned to approve the minutes. D. Elias 2 nd. All in favor. (February 9, 2021) Motion passed. 3. Updates on COVID-19 D. Greenbaum reported that Salem’s numbers went down again last week. We are at a positivity rate of 2.27% and have an average daily case count of 21 over the last 14 days. Our numbers fluctuate day-to-day but are trending in the right direction overall. The State has taken away our local ability to offer first dose vaccination clinics, so we are focusing primarily on second dose clinics. We are starting to vaccinate our Salem Housing Authority partners. Last week we did a clinic at Pioneer Terrace and tomorrow we will be doing a clinic at 27 Charter Street for the housing authority residents. We will also be working with Fairweather Apartments on Highland Avenue to vaccinate their residents. We will be working with our partners in Peabody, Beverly, and Danvers to work with their Fairweather Apartments as well. We are working with the City and the State to determine the best way to go forward vaccinating homebound patients. Plans are being formulated. The State is going to have a program that we can opt into and the State will take over and run that program, or we can do it locally. If we do it locally, he thinks we should hire a vendor, which would more than likely be Cataldo Ambulance who is doing the vaccination clinics, to go around an do the in- home piece for us. It would be much easier for them to do it than to have S. Darmody going out every single day doing a few appointments in people’s apartments. We would need to have an ambulance or EMT with EpiPens with us anyway, so they may as well run it. The more people that get vaccinated, the better off we will be. If vaccination rates are up and 1|Page infection rates are down, this summer will be much brighter than last summer. J. Schiller said he encourages everyone to look at the dashboard on the situation report. The data is promising. We had a day where there were zero cases. D. Greenbaum said because the State is not allowing us to do anything but low-income housing, we are getting limited vaccine, so we are doing much smaller clinics than the clinics we did for first responders. The Housing Authority has to make the request to the Executive Office of Elder Affairs, and they transfer the request to DPH to get us vaccine. They need to have a partner like us or an ambulance company to be able to do it. The Housing Authority estimated they would have about 400 residents that would want to be vaccinated, but there were much less. Either the residents have skepticism about the vaccine, or they have been vaccinated and did not report it. Getting people to trust the vaccine is going to be the biggest thing at this point. S. Darmody said with all available vaccination sources there are about 1,000 Salem residents being vaccinated each week. D. Greenbaum said the Governor announced the Stop the Spread testing will be extended through June 30th. S. Moore asked how testing is going in the schools and whether or not most families are opting into it. D. Greenbaum said he does not know because we do not have a lot of involvement in it, but he has heard there is a large participation rate. S. Moore said it seems like the district is doing an amazing job with the protocols in place and the rates of school spread. J. Schiller said the unemployment rate is still dramatically high as compared to previous years. The case counts are down, the positivity rate is down, vaccinations are up and yet the unemployment rate has not changed and that is disturbing. That has a dramatic effect on public health issues in our city. P. Morsillo has had constituents asking what is going on with the Salem State University vaccination site. D. Greenbaum said we have been in close contact with Cataldo because there have been some hiccups with receiving second dose vaccines for both Cataldo and ourselves. We have had to transfer vaccines between us on a couple of occasions. Right now, the State is only providing second dose vaccine, not just to us but to any provider. They are not giving vaccine to do first doses. We have submitted a request to the State to review Salem State as a regional site, but we have not heard back on that yet. If they determine there is a need, they will set up a clinic site. If they decide there are other providers that are close enough and have vaccine, they may not approve it. The Mayor is working closely with Health and Human Services and DPH. D. Greenbaum said he has been in contact with DPH to try to expedite it. He hopes to hear something in the next few weeks. He said unfortunately the State has told us not to expect any more first dose clinics so people should not expect that there are going to be first dose clinics at Salem State at this point. Cataldo is meeting with Salem State officials this week to assess the O’Keefe Center to provide a larger through port to reach the 750 dose per day requirement the State has set in order to hold a clinic. They will 2|Page  evaluate the site based on a number of criteria and one of them is proximity to other providers like mass vaccination sites and pharmacies. If there are other sites within a 30-minute drive, they may not approve the clinic. S. Moore said it is really frustrating that this is the way the State has decided to move forward when thinking about equity and issues of transportation and the amount of vaccine distrust. People would be much more likely to be trusting of a vaccine at a local clinic or a local pharmacy or their doctor’s office rather than at a hotel in Danvers. D. Greenbaum said it is important to note that after 911, the federal government created a public health emergency preparedness grant through the CDC that was funneled through every state DPH in the country. In MA it funneled down to local public health. We have been planning for a pandemic response of this nature for nearly 20 years. We have plans in place for emergency dispensing sites to get vaccinations out quickly and in large numbers. We deployed it during H1N1 over 11 years ago. He assumed that was how we would be getting vaccine out, but the State has decided having 351 municipalities operating dispensing sites is not the most effective way to distribute vaccine. He would love to do a dispensing site in Salem, but the State has gone away from the mass dispensing site model. We were ready to do that. The vaccine supply dried up. His hope is that Johnson & Johnson can ramp up manufacturing and we can get to a point where we are seeing 500,000 doses per week or more. He said in reality Massachusetts is in a good place right now with over two million people having received at least one dose of vaccine and that is two thirds of our population. If we can get that number to 85-90% we will be in good shape. J. Schiller said he was surprised to see data showing that the U.S. is actually doing very well with vaccinations worldwide. The U.S. is third worldwide. D. Greenbaum said local public health is the #3 provider in Massachusetts for vaccinations. S. Darmody said pharmacies and mass vaccination sites are ahead of us. J. Schiller said it will be interesting to see the impact that big numbers of vaccinations have on the positivity rate. D. Greenbaum said the CDC released guidelines for those fully vaccinated. There is some good news, such as being able to gather with people in your family that you have not seen in a year. Grandparents can visit their grandkids and be unmasked and hug them. Hopefully as we move through the vaccination process, we start to see more and more good news. P. Morsillo asked if the City has a percentage goal for vaccinated residents. D. Greenbaum said if you ask him, his goal would be 100%. He feels strongly that the only real way out of this is to get the highest percentage possible of every population vaccinated. The experts say if you get 75- 85% you are in a really good place. Most vaccines only see a vaccination rate of around 50-60%. Herd immunity will take place at the 75-85% rate with the COVID vaccine. Right now, the vaccines are only approved for 18 years of age and older. 4. Budget Update D. Greenbaum provided an update that budgets have been sent out. He submitted the Board of Health budget last week. He made some requests for increases in expense line items, in particular Household Hazardous Waste Day and rodent control. He also requested a part-time employee be 3|Page  made full-time. We are going to have some temporary staff shortages. We have an employee who will be out on maternity leave beginning in May. He feels strongly that is something we will need in this budget. He has asked for it for the last couple of years. He thought maybe he would get it last year, but with COVID it did not happen. He is hopeful it will happen this year. He will keep everybody posted. He has his budget meeting with the Mayor on Friday, March 26th. J. Schiller asked if he would get a sense of what the budget will be from that meeting. D. Greenbaum said the meeting is to plead his case for what he is asking for, as the other department heads will also do. He is hopeful. We have a legitimate argument for why we need the additional staffing. As we go into the summer months with outdoor dining and all the other things that are going to come with the reopening process, we are going to need the additional help. He feels like it is warranted. J. Schiller said if there is anything the Board can do to support his budget request, they are all there for him. 5. Discussion on Health Disparities D. Greenbaum said the health subcommittee has met several times and they and Race Equity were having a community forum. S. Moore said there was a community-wide forum where the task force was updating people on some of the priority areas the different subcommittees identified. They will start thinking about strategies to address issues in those areas. She feels like she learned a lot. J. Schiller asked if there were any discussions on vaccinations and issues of mistrust and education or information about vaccinations with communities that may be more apt to not get vaccinated. S. Moore said when she brought it up during the last subcommittee meeting, Ana Nuncio said she was hearing that most folks were eager to get the vaccine. D. Greenbaum said he personally has not heard a lot of distrust for the vaccine, but maybe on some level there is some of that based on the numbers that we thought were going to be involved in the Housing Authority clinics. S. Moore said there is some interesting tension she is starting to see as more people are getting vaccinated. For example, at the Danvers site there were a significant number of doses that were about to expire that needed to get used, so some people who were not on the priority lists were able to go and get a vaccine. There was a lot of discussion on social media about it. There was pushback from priority groups. D. Greenbaum said as far as last-minute doses go, the vaccine is something that we have right now to help us get through this pandemic and, in his opinion, to waste even one dose is not okay. If we need to call somebody to come and get a vaccine so we can use it and not waste it, then we have to do that. If we have extra doses available, we will try to go to the next nearest priority group or the previous priority group and get somebody in that group, but if we cannot and somebody is nearby and they can get the vaccine, we are going to use it for them. It is better to use a dose no matter who it is on than to waste it. He does not want to have to report to the State that we had to waste vaccines. Then we would have to justify why we deserve to get more vaccine if we are wasting vaccine. To him, wasting vaccine is worse than having to have people wait to get a vaccine. 4|Page  J. Schiller said the ultimate goal is to vaccinate everybody. Attendee Alan Hanscom asked how those who have already been vaccinated can volunteer to help out with the vaccination effort. D. Greenbaum said all of our volunteer efforts are organized by our Medical Reserve Corps (MRC). Those wishing to volunteer can register through maresponds.org. The MRC will do background checks, etc. S. Moore said if people have been fully vaccinated, they can also volunteer at public facing sites, such as Salem Food Pantry. J. Schiller said the amount of donations at the Salem Food Pantry have increased significantly. It is good to see. J. Schiller said there is a lot that goes into getting vaccinated. We all need to do it. D. Greenbaum agreed and said as a Board and as a Department, the more we can do to put people’s fears at ease about getting vaccinated and about side effects the better so that they will want to get vaccinated. There is a fraction of the population that is not ready yet. The more knowledge we can give people to get them there will be huge. The more people that get vaccinated the better. J. Schiller said we have the added benefit with the CDC guidelines that shows people that their world can be opened up with non-isolation possibilities, etc. 6. Chairperson Communications J. Schiller said this is the one-year anniversary of our virtual meetings. He thanked the Department and shared the Board’s gratitude for all the work D. Greenbaum and his staff have been doing under extraordinary circumstances. S. Darmody said it is really nice that we have had such a supportive Board this whole time and she knows everybody in the Department feels the same way. D. Greenbaum agreed and said we could not have done what we did if the Board was not as supportive as they were. He thanked the Board for their support. J. Schiller said we have dealt with a lot of complex issues over the last year and although everyone has their own individual process, we all have the same goal in mind, and it makes it enjoyable to work with everybody and he is appreciative of that. P. Kirby said the group has a good mix of perspectives that blends together nicely. 7. Monthly Reports-Updates a. Public Health Nurse’s Report Report not available. b. Health Agent’s Report Weekly situation reports were sent to the Board. c. Administrative Report Copy available at BOH office. d. Council Liaison Updates P. Morsillo reported that last night there was a committee meeting for Public Health Safety and the Environment on the agriculture ordinance. It was a kick-off meeting to figure out how to move forward and get the people involved that need to get involved to come to our meetings and answer questions and give their input. 5|Page  The group that originally wrote the ordinance is going to meet with the City Solicitor to address the many issues she had with it. It will then go back to committee. After committee, the draft will go to the Board of Health for review and feedback. It is a very broad ordinance. P. Kirby requested a quick overview of what the ordinance is about. P. Morsillo said it is trying to allow residents in Salem to grow food. If they want to sell the food they grow in their gardens they would have that capability. The way it is written right now it would pertain to all resident zones. There are also sections on backyard chickens and honeybees. It touches into zoning ordinances and also setbacks for temporary structures like greenhouses. D. Greenbaum said at the request of Councillor Riccardi he reviewed it and provided some initial comments and questions, but he did let her know he thought the Board should review it as well. He will send the ordinance to the Board. J. Schiller asked what the impetus for this ordinance was. P. Morsillo said it was written by the group that is doing the Mack Park farm and some other people who are interested in creating more food utilizing our land. S. Moore said she was initially part of the group but had to take a step back due to other commitments. Kerry Murphy was really instrumental to helping to make this happen. The group is trying to understand the power of urban agriculture to promote greater equity of food access and food security by encouraging more opportunities for people to grow their own food or sell food. The initial vision was for a way to address some of the disparities that we see with food access in the City. P. Morsillo said Boston, Somerville, Cambridge, and Worcester all have ordinances like this. They are getting us more information so we can look at how they implemented this kind of an ordinance within their residential districts. P. Morsillo said in the Affordable Housing Trust Fund Board they have been talking about working on a housing production plan and the possibility of adding equity issues in housing. She offered that the Board of Health also be involved in that over the next several months. G. Yuhas asked what happened with zoning and the gun shop we discussed at the last meeting? P. Morsillo said they asked for a continuance so they will be before the ZBA on the 17th of March. P. Kirby moved to approve the reports. G. Yuhas 2 nd. All in favor. Motion passed. 8. New Business/Scheduling of Future D. Greenbaum has had some inquiries about orders that were issued Agenda Items throughout the pandemic, in particular the mask order. He does not think we will be repealing the mask order in the near future, but he said he would check with the Board. P. Kirby agreed that it is too soon. It makes him wonder if we need to start thinking about what the metrics would look like on the path to eventually repealing the orders and how we will know when it is time to make those kinds of changes. J. Schiller said luckily, we have the State. The phases are helpful for us. 6|Page  P. Kirby agreed but said he has been disappointed with the State sometimes, but they will probably do a good job. D. Greenbaum said infection rates, vaccination rates, hospitalization rates and ICU admissions will dictate that decision. He thinks it is a little bit too early to be saying that we do not have to continue to do the mitigation strategies that we have been doing all along to prevent the spread. Another order that came up was the contact tracing form. He said that it was going to be in place for the foreseeable future, but he has had some inquiries about it and said he would mention it to the Board. He does think at some point we will have to look at some of the older orders that came out early on in the pandemic to see if we can rescind some of them, for example the ones that were specifically around Halloween. He will review what we have done and maybe in April he can give the Board a list of orders and what they encompass to see what we should potentially rescind or change. J. Schiller said this is another critical time and it is not the time where we want to relax. Vaccinations are going up and infection rates are going down. This is exactly when we want to apply maximum pressure when we can to avoid an outbreak. That would be a disaster. D. Greenbaum agreed and said we are talking about students back in schools, potentially five days a week, in a month or so. We have other reopenings taking place that the Board is going to have to look at and if infection rates go up, we may need to act. This juncture really is probably the most critical time in the pandemic. MEETING ADJOURNED: P. Kirby motioned to adjourn. D. Elias 2 nd. All in favor. Motion passed. 7:57pm Respectfully submitted, Maureen Davis Next regularly scheduled meeting is Clerk of the Board Tuesday, April 13, 2021 at 7:00pm Virtual Meeting Via Zoom 7|Page