Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES Virtual Meeting held via Zoom and Recorded by SATV August 10, 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: (Please see minutes) 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 2. Approval of Minutes G. Yuhas motioned to approve the minutes. P. Kirby 2 nd. (July 7, 2021) Roll call vote: G. Yuhas – approve S. Moore – approve P. Kirby – approve D. Elias – approve J. Schiller – approve Motion passed unanimously by a vote of 5 to 0. 3. Discussion and Updates on J. Schiller said the Delta Variant, a variant of COVID-19, is now the COVID-19, including recent majority virus within this country. increases in cases, the Delta D. Greenbaum said what we know is that approximately 81% of cases in Variant and possible mitigation Massachusetts are the Delta Variant. We are seeing Delta in Salem, as well strategies as most communities in the Commonwealth. We have definitely seen an uptick in cases over the last six weeks; about 100 cases since the beginning of July, so we are on pace for a little over two cases a day. It doesn’t seem like a lot, but we are a tourist community, and we are seeing a lot of people from outside of our state coming from areas that don’t have the vaccination rates that we have in Massachusetts. It is concerning to him that this is taking place at this point. He, like most people, thought we were past this. Unfortunately, the Delta Variant is much more transmissible. This variant is very dangerous. We are in a position now where we might be able to prevent this from spreading too much further. Hopefully we can do that as a community and put this behind us again as we have done in the past. J. Schiller said what happened in Provincetown was with breakthrough infections the variant was infecting both vaccinated and unvaccinated. There is still a lot of data that is not known, but we always like to follow 1|Page the science as best we can. The science from what happened in Provincetown clearly shows that people who are vaccinated still can get the virus, although the impact and the risk of hospitalization and death upon those who are vaccinated is multiple times less, so vaccinations clearly work. The problem with the Delta Variant is it still can be spread among the vaccinated, based on the data from Provincetown. We are here tonight to talk about what we can potentially do to limit spread in Salem, specifically in anticipation of well over 100,000 people coming to the City over the next two months. We are unique in that way. D. Greenbaum agreed. He said in the month of July we had 59 cases. 25 of those cases were fully vaccinated and 17 of those were identified as Delta Variant. There were probably more cases of the Delta Variant because the State does a random survey of positive cases to test for the variant, so it was probably more than 17. We know that if one person in a household had Delta, then everyone else who tested positive in that household probably had Delta. In the ten days of August so far, we have had 37 cases and 13 of those were fully vaccinated. They have not identified any Delta to date in the month of August. J. Schiller said he and D. Greenbaum met with the Mayor and the Superintendent last Thursday. The School Committee will require indoor masking within the schools, and the Mayor will be mandating masking within the municipal buildings throughout Salem. In addition, people who work in schools or in municipal buildings will be required to be vaccinated, and if not vaccinated will be required to be tested at least twice a week. As a Board we can also limit the increase in cases among residents in Salem, anticipating the density of people coming here not just from around the country, but potentially around the world where we know the vaccination rates vary widely. None of this is pleasant, but we have the opportunity to take some proactive measures to continue the success we have achieved in Salem. We have done very well throughout the past year and a half. The economy is doing well in Salem. People are coming back to Salem, which is what we want, but we want to do it in the safest way possible. The idea of an indoor mask mandate was discussed. Sometime after Halloween seems like a natural end date for an indoor mask mandate. S. Moore said she appreciates the mitigation efforts the public schools are making. She thinks that is really important since it is very concerning that children under the age of 12 don’t have access to vaccine at this point. Very recently we took away the mask mandate based on the data we had at the time. The data we are seeing now shows a rise in case counts. Understanding what Halloween in Salem looks like makes us a unique place to be. She doesn’t know if other communities are having discussions about mask mandates, but we are unique and there are a lot of people coming in from out of town. She feels in order to make sure we can keep our businesses open we need to put some strategies in place. She is in full support of the indoor mask mandate. Nobody loves wearing a mask, but masking is not a big ask for the health of our community and especially the health of children and people who are immunocompromised. D. Greenbaum said he knows other communities are having discussions internally about masks. He believes that at some point the other communities around Salem are going to institute similar measures. He thinks we need to act now because of our unique position in Salem with tourism and the amount of people coming into the City even now. He 2|Page thinks the other communities will follow suit, it is just a matter of when and what their numbers look like. J. Schiller added that the Board has done all it can to maximize public health throughout this pandemic, while at the same time taking into account people’s concerns and people’s liberties and walking an almost impossible fine line between those two things. He said he agrees with S. Moore that masks are not a big ask. We are trying to hopefully prevent limiting businesses or shutting businesses down by protecting all of us. We received several emails on both sides. G. Yuhas said putting a mask on is a simple thing to do and a kind thing to do to protect the community. We are hoping to do this simple thing to prevent us from doing a big thing like closing down for Halloween again. P. Kirby agreed. He said knowing human nature, we would like to think that people would be honest, but the CDC’s voluntary honor system recommendations for wearing masks based on vaccination status were never really workable, particularly once Delta arrived. That is the reasoning and logic behind the idea of an indoor mask mandate. J. Schiller said we know what works by following the science. Vaccinations work, so people need to get vaccinated. It prevents hospitalizations and death by multiple, multiple folds as compared to people who are not vaccinated. We also know that masking works. We also know with our recent data from Provincetown that people who are vaccinated potentially can spread the virus. The uptick of virus prevalence within MA, which has increased dramatically over the last two months even though we are still fairly low in the 2 ½% range, is worrisome for us as a community anticipating the influx of people that we know we are going to get. That is the science that we have to go on. Everything else is difficult to predict. D. Greenbaum said the Provincetown cluster had nearly 1,000 cases; seven people were hospitalized, and they were unvaccinated. Everybody else that was vaccinated recovered at home with minor illness. At this point the best defenses are vaccines and masking for those that either can’t get the vaccine or won’t get the vaccine. Wearing a mask is not something everybody wants to do or likes to do but it is necessary. P. Morsillo said some of the comments she is hearing are that restaurants and bars feel it is more pro forma requiring people to wear a mask to walk in only to take it off to eat or sit at the bar. There is a lot of pushback. There are also questions about a concept in New York state where someone could check a database to see if someone has been vaccinated and those people would be allowed to make a reservation in a restaurant or attend a play. She asked if there are any plans along those lines in MA. J. Schiller said that New York’s concept did come up at their meeting with the Mayor, but he does not know how New York is going to enforce that. D. Greenbaum said if the Board were to vote to issue a mask mandate, it would be very hard to separate it into one category or another – it is a slippery slope. He understands the pro forma argument from the restaurants and bars, but it could be worse – it could be that we are saying no more indoor dining and limiting dining to only outdoors. As far as what is going on in New York, he agrees with J. Schiller that it would be difficult to enforce. At this time there is no talk about doing any sort of vaccine passport system in MA. Of course, that could change if things progress and continue to get worse. The Governor said he intends to 3|Page take no action at this time on anything, which is unfortunate because that leaves boards of health having to deal with these situations and make decisions that could just as easily have been made at the state level and then boards could augment them as they see fit. S. Moore added that with regard to the restaurants and bars, the 15-minute close proximity rule with the initial strain has changed. With the Delta Variant that time period is much lower, so maybe the minute or two that it takes to wait for a table will play a role in a way that it would not have before, so that is something to consider also. J. Schiller said, as a Board, we do the best we can do and to do nothing, given what we are anticipating and what we know based on the science, would be irresponsible. D. Greenbaum said at this point we anticipate an end date some time in November, after the Halloween festivities end. Based on what we have seen in other parts of the world like in England and India, and even in Provincetown, these Delta Variant spikes rise like a rocket and fall like a rocket. Provincetown went from 15% positivity to 4% in a matter of weeks. He feels that a mask mandate can help prevent Salem from having those rocket-like increases and keep us on a plateau. J. Schiller said there are well over 70 people attending the meeting so comments will need to be limited to two minutes. D. Greenbaum said we have received some very nasty and inappropriate phone calls to the office the last couple of days, so we ask that people be respectful and if things get out of control, we will cut people off from speaking any further. Attendee Patrick Dooley, 33 Bow Street, acknowledged there are no easy answers and there are risks and benefits to whatever decision is made. He is a transplant that has been here for a while and said he can tell us that everybody knows Salem, just as everyone knows other major cities like Boston. Salem is a unique and very famous town. He sees we have an opportunity to take a real leadership position in how we deal with COVID in our community. As a former small family-owned business owner he always leans toward the less restrictive measures. He said masks are imperfect; they are uncomfortable, increase carbon dioxide in the bloodstream, increase facial acne, decrease oxygen intake which can lead to increased stress and increased vulnerability to disease in general, and he thinks a lot about the kids. There is a false sense of security in masks. Masks are not an end-all, be-all in preventing methods of entry into the human body. Exposed skin, and especially the eyes are also entry points. He would like to see more of an acknowledgement that there are lots of data points to consider. We are going so quickly back to mask mandates without an equal increase in other measures such as preventive methods, treatments, and an increase in public service announcement measures to increase the information to individuals about what they should be doing to stay healthy; better diet, more sunshine, solid rest, increased exercise, staying home when you’re sick, etc. He appreciates that we are taking on great responsibility at the government level for keeping ourselves safe, but at some point, it has to go back to the individual. This virus is here to stay, and we have to learn to live with it. Attendee Lynn Connor, 190 Bridge Street, questioned the support of businesses from the Health Department. A year ago, it was universal worldwide that everyone had a mask with them 24/7. That is no longer the 4|Page case. There will be people visiting Salem coming from communities that haven’t worn masks in months. She hopes businesses will not be required to provide PPE or turn away visitors who don’t have a mask with them. She is curious if the Board of Health has thought that through so businesses don’t end up taking a toll by this new mandate. D. Greenbaum said the City as a whole has had great discussions about how to support the businesses. We have masks and signage that we can provide. We have been there all along to support the businesses so we will continue to do that. If any business needs masks they can contact the Health Department or the Fire Department. We are doing our best to help the business community get through this period as smoothly as possible. S. Moore added that, as G. Yuhas rightfully pointed out, masking is both a kindness and a small ask. She feels if we can implement masking as an intervention as opposed to implementing several other interventions all at once, we can really see the effectiveness of masks. There is plenty of research that shows that masks are very effective at preventing transmission – there just is. She sees this as an effort to not have to restrict capacity in businesses. The idea is to try to keep transmission rates low so everything can run as normally as possible. She understands the concerns of business owners but sees masks as a way to get ahead of what could be a significant problem, and if what happened in Provincetown happens here, that could be really damaging for our businesses. Attendee Harrison Schell, 170 North Street, said he works two jobs and one of them is at a restaurant in downtown Salem. Last March he got a text saying the next day the restaurant was going to be closed. He said he believes over 4 million people to date have received two doses of the vaccine in MA. He is glad that MA is second in the country behind VT. We are also low in percentage of COVID cases behind VT. We have done a great job. We deserve to reduce restrictions with masking. As a speaker said earlier, there are risks to both decisions. Those at risk have taken it upon themselves to do what’s right and get vaccinated and he encourages everyone to do the same. He feels that, until now, there was some misinformation about people not knowing they could get the Coronoavirus again. It’s about getting the vaccine to prevent against its symptoms if you do get it. He quoted from an article in Atlantic Magazine regarding the Phase 3 Pfizer vaccine clinical trial. The article stated that most vaccines do not typically prevent a person from getting infected, they simply make that infection less consequential and enable the body to clear it more quickly. He said that’s why everyone should get the vaccine in the first place. That’s why we should not be worried about case numbers but the vaccination rates. He said we deserve to not be going back in time and we need to take the hard leadership role in ensuring that wo do not go back to that time we succeeded through. Attendee Daryl Bennett, 2 ½ Mt Vernon Street, said she has spoken in the past about what could be helpful regarding protocol. She spoke about Ivermectin. J. Schiller apologized for interrupting her and said that information is not accurate and has been debunked. He referred her to a recent JAM article about a randomized controlled study comparing Ivermectin to placebo that showed that Ivermectin did not show a positive result. D. Bennett said she would like to continue communicating with him about it. 5|Page J. Schiller agreed to discuss it with her at another time but said this was not the forum for the discussion. Attendee Jeff Cohen, 12 Hancock Street, wants to reinforce what S. Moore and D. Greenbaum said that if we enact the policy of masks we will potentially get through this sooner together. The concept people have been talking about individual rights or decision making in some ways conflicts with individual responsibility. We are part of a community, and many people who are in Salem are not from Salem. It is hard to monitor where they come from or what their situations are. He is asking people in the public to think about what D. Greenbaum said that this could potentially shorten our time of having to try to mitigate this problem. The Delta Variant is many times more contagious and studies in the south have shown a significant ratio of people in the hospital from COVID are children, lots of them two years old or younger. This is not about our discomfort or our freedom, this is about working together to get through something so at some point we can all throw our masks away. Attendee Andrew Meegan (no address provided) wanted to express his concerns about considering masks at all. He wanted to echo the first three speakers. He said anybody who has not been vaccinated who has lived through the last 18 months who is not participating understands their risk. It is up to us to take care of ourselves. Through that we will be taking care of our community. He feels we are headed in the wrong direction with masks. D. Greenbaum pointed out that this is not just about those that refuse to get vaccinated, it is also about those that can’t. We have a population of people who are immunocompromised and have been advised by their physician not to get vaccinated. We also have a population of children under 12 who are not eligible to be vaccinated which is why the schools have taken the action they have. S. Moore asked about lead time, so businesses have time to prepare. The municipal policy begins on August 23rd. D. Greenbaum said he thinks we should be in sync with the municipal policy. Initially they thought maybe September 1 st, but if we are trying to do a mitigation effort to get ahead of something it seems counterintuitive to wait longer. Attendee Benjamin Selecky, 244 Essex Street, Vampfangs, said he appreciates the work the Board is doing and understands the last year and a half has been difficult for all of us. If we go back to an indoor mask mandate, they will handle it the same way they did last time. They will put up signage that has a respectful tone, they will engage with their customers with firm kindness and empathy. He is happy to report they had virtually zero instances of issues with masks, and he believes it is because of how they handled it with being very respectful. One concern he has is the Safe to Open campaign around whether or not a business had a vaccine mandate for their employees. He believes all businesses in Salem are safe or the City would not allow them to operate. He is concerned from a customer facing standpoint that it could lead to a misperception. D. Greenbaum said he appreciates him bringing it up and he will reiterate his thoughts to the people operating that campaign. The Board of Health is not pushing that campaign forward at this stage. He said it is not just about vaccinations, it’s about if employees don’t want to get vaccinated or can’t get vaccinated, they will get tested on a regular basis. 6|Page J. Schiller thanked the public for their attendance and comments. He said he values and appreciates hearing other points of view, whether in agreement or not. We are still left having to make a decision. We have received many emails on both sides that have been enlightening as to how people are experiencing this pandemic from various angles; it has affected everybody. He said this Board has always tried to do the right thing, coming from the right place, based on the data that we have that we know is reliable. He said the proposal is in concert with what the Mayor is doing in municipal buildings and what the schools are going to do. He agrees with S. Moore and G. Yuhas that masking a small ask. It is something we are already used to doing. He said in addition to vaccines, masks work indoors, and we know that. His view is that he doesn’t think we have a real choice. Masking is a small ask and it can have a potentially big impact on the fact that we may never realize what happened in Provincetown in Salem, which protects our businesses economically and protects the public health within the City. D. Greenbaum said this is strictly about masks inside enclosed spaces, but this is all subject to change. If there is an incredible increase in cases where this is not working, then other mitigation efforts may take place. He doesn’t foresee that happening. If the Board chooses to do this mask mandate, he hopes it will keep us on the plateau we are on or flatten our curve quicker than Provincetown did and get us through the busiest months of the year downtown and throughout Salem so we can move past this and hopefully not have to worry about masks again. J. Schiller said if we adopt this and make a motion to proceed with an indoor mask mandate, he strongly encourages we have an expiration date, so it is not an open-ended mask mandate. D. Greenbaum advised the Board that there is a two-week incubation period, so two weeks post-Halloween might make sense as an expiration date. D. Elias said she definitely supports indoor masking. She believes it is a preventive measure – with emphasis on preventive. She thinks we should double down on masking, vaccinations, and social distancing. The population of kids under 12 years old that don’t have the vaccine are accompanied by adults who may be exposed to the variant and because we are vaccinated and not showing symptoms, we can carry it and spread it. This variant is highly contagious. She agrees we should have an end date. We can check the data in November to see where we are at. Right now, this will help keep us healthy and safe. That is what the Board of Health is all about. We are not limiting businesses, we are not shutting down, we are just trying to keep people safe. J. Schiller said it seems like the members of the Board all feel similarly. He said he would like to lobby for it to begin in a week since we have masks now, however logistically the start date should be the same as the City. He knows there are restaurants that already institute a mask mandate for workers. D. Greenbaum said there are a number of businesses downtown that require masks for everybody. P. Kirby moved that the Board adopt an indoor mask mandate for all businesses beginning Monday, August 23, 2021 and ending Saturday, November 13, 2021. G. Yuhas 2nd. 7|Page  Roll call vote: G. Yuhas – approve P. Kirby – approve S. Moore – approve D. Elias – approve J. Schiller – approve Motion passed unanimously by a vote of 5 to 0. J. Schiller thanked everybody for their input. This is not an easy decision. It is not what anyone wants but it is what we need to do. P. Kirby thanked J. Schiller for his leadership. Attendee Andrew Meegan spoke again. He said he was concerned you were going to put this to a vote right now. This was supposed to be a discussion for you all to learn about the topic and make a decision and right here you just went right straight to the end game. J. Schiller said with all due respect, it says mitigation efforts on the agenda. He said both he and the Board members have individually put many hours into reading about this, in addition to public comment via emails and correspondence, as well as tonight. He asked if he was suggesting otherwise. A. Meegan said he is suggesting that this was held out here as though it was an open discussion and you all just put it to a vote. Based on the calls tonight he can’t say the public is totally supportive of the current decision. J. Schiller said we don’t take a public vote on how we determine what’s best for public health. A. Meegan said he understands that. The decision has been made. He is just expressing his displeasure. 4. Chairperson Communications Nothing further than discussed. 5. Monthly Reports-Updates a. Public Health Nurse’s Report Report not available. b. Health Agent’s Report Report not available. c. Administrative Report Copy available at BOH office. d. Council Liaison Updates P. Morsillo said the Council is getting ready for the elections in September. P. Kirby motioned to approve the reports. S. Moore 2 nd. Roll call vote: G. Yuhas – approve P. Kirby – approve S. Moore – approve D. Elias – approve 8|Page  J. Schiller – approve Motion passed unanimously by a vote of 5 to 0. 6. New Business/Scheduling of Future J. Schiller said we need to talk about whether we want to still meet virtually Agenda Items or in-person. D. Greenbaum said the Governor’s Acts extended the virtual meetings until April of 2022. The recommendation from the City is that boards and commissions stay remote until we can get the technology that is being put into the meeting rooms in the City Hall Annex installed and ready to use for hybrid meetings of in-person boards with the public being able to call in and hear the meeting remotely. That could change in October or November. J. Schiller said we will still stay remote in compliance with that recommendation. G. Yuhas said we may need to change the meeting date for September because the primaries are the 14th, and she works the polls. She will email the Board about possible dates. Attendee Arielle Kaplan, Creative Collectives, 265 Essex Street, gave the Board the Jewish holiday dates to assist with scheduling of the meeting date. Attendee John Andrews, 265 Essex Street, asked for clarification for indoor events and asked if all the guests at all indoor events will have to be masked. D. Greenbaum said if they are indoors, then yes. MEETING ADJOURNED: G. Yuhas motioned to adjourn. D. Elias 2nd. 8:13pm Roll call vote: G. Yuhas – approve P. Kirby – approve S. Moore – approve D. Elias – approve J. Schiller – approve Motion passed unanimously by a vote of 5 to 0. Respectfully submitted, Next regularly scheduled meeting is Tuesday, September 14, 2021 at 7:00pm Maureen Davis Clerk of the Board 9|Page