Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES SPECIAL MEETING Virtual Meeting via Zoom and Recorded by SATV December 22, 2021 MEMBERS PRESENT: Dr. Jeremy Schiller, Paul Kirby, Geraldine Yuhas, Sara Moore, Datanis Elias OTHERS PRESENT: David Greenbaum, Health Agent, Maureen Davis, Clerk of the Board 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 7:16pm (after technical difficulties) 2. In accordance with M.G.L. c. 111, J. Schiller said we dedicated our last meeting to over two hours of robust ss 31 the Board will vote on the discussion about tonight’s topics. We could not have taken a vote at that following; time because it needs to be posted that a vote will take place. The meeting  A determination that a public included the presence of Dr. Dave Roberts from Salem Hospital who was health emergency exists due to imploring this Board to enact mitigation measures based on the current the current state of the state of affairs at Salem Hospital and all regional hospitals. He said Dr. COVID-19 pandemic Roberts talked about what he himself sees as a physician who sees COVID  A mandatory indoor mask patients literally every day, and that is that resources are slim, staffing is a requirement in all public real issue, and we are seeing unprecedented numbers of cases. It is not just indoor spaces the increase in positive cases, there are also increased admissions on top of the catch-up problem from 2020 when people were not screened for cancers and all sorts of routine medical care. As a board, we need to act in a way that is in accordance with what is being requested by our local hospital and our local community health center, which is imploring us to do something. To him it would be irresponsible to not do something. The things that we know that work, in lieu of shutting down businesses, are vaccines and masks. Masks work, N95 masks work better than cloth masks, but even cloth masks are better than no mask. There is data to support that. Vaccines clearly work and prevent people from going to the hospital or dying. Vaccines also have a second purpose, not just to the individual. There is data that is clear that the virus is less transmitted by someone who is vaccinated and for a shorter duration of time. So, someone who is unvaccinated can transmit the virus for twice as long as someone who is vaccinated. That doesn’t even take into account the boosters. The early data is suggesting that the boosters are going to be even more efficacious. D. Greenbaum said the enabled Q&A function at the bottom of the page of the meeting was part of the technical difficulties. As it was posted on the 1|Page agenda, we will not be responding to any questions or comments in the Q&A. J. Schiller also wanted to address that. He understands there are a lot of people that are upset about that. We have received so many emails from all different angles regarding this. He said this is a public health emergency that we are dealing with. No one wants to be in this situation where a local board of health is responsible for making these decisions because these decisions are not being made at the state level. That is a failure. These decisions should be statewide or regional. Boston already had a mask mandate, and he recently attended a meeting where Boston was announcing their requirement for proof of vaccination. All the regional towns and cities are struggling with the same decisions as Salem is. P. Kirby said it has been a journey the past couple of weeks, especially since our last meeting, and Dr. Roberts’ presentation was stark and sobering. He agrees that it is an emergency, and it is the responsible thing for us to do something. He likes that we are following Boston’s approach because he thinks the resources of the Boston Health Commission are really substantial. He supports taking these actions tonight. J. Schiller added that this Board has been responsive in a dynamic way to this pandemic. This is not a linear problem. It is based on variants, shut- downs when needed, and relaxed measures when warranted. We had an extremely successful Halloween season both from a public health standpoint and also from a business and economic standpoint. Now we are dealing with an unprecedented situation in the context of our local health officials imploring us to do something. Should the situation improve, we can then relax those measures. If therapeutics become available, then we can revisit vaccines. Right now, the data is clear that masks and vaccines work. S. Moore echoed their statements and said she fully supports both measures regarding masking indoors as well as mandated vaccine requirement to enter public spaces. The Board has been receiving messages about an issue with racial equity. We do know that vaccination rates are lower in our city’s Black and Latin X Communities. This is not something that is designed to discriminate against those communities. We also know that both in our region and statewide Black and Latin X people are also testing positive at higher rates and dying at higher rates. These measures are designed to reduce community transmission and hopefully also encourage vaccination. We are trying to avoid the overwhelming capacity that healthcare facilities are experiencing right now. She hopes it encourages people to get vaccinated, especially because overwhelmed hospitals are a negative consequence for unvaccinated individuals coming to the hospital with COVID, but also for other people showing up at the Emergency Room with any other issues. Not being able to be seen in the Emergency Room can be a life-or-death issue, whether or not you feel you can’t go into a restaurant is not a life-or-death issue. We have vaccines available. As a Board of Health, we are looking out for public health policy. At this moment, this is an important step to take. J. Schiller added that he has empathy for people’s positions, but we have received some very disrespectful comments. We are volunteers. We have a well-represented Board, and we are left with this decision due to lack of state guidance, and we all are trying to make the best decision possible in an almost impossible situation. If our local health officials are imploring us 2|Page  to act, it changes the calculus. We have no decision other than to act with what we know works. He would say to the people who are upset about this or can’t see this perspective, we are like you; we live here, and we care about what is best for the public health of Salem, and we are doing the best we can. We are all neighbors, and we are all part of the same community. He wears a mask all day at work, and he hates wearing a mask, but he wears it because it is important for him, for his family, and his community. D. Elias said as the Board has determined that the current state of the COVID-19 pandemic constitutes a public health emergency, she moved to institute a mask mandate in all indoor spaces in the City of Salem. G. Yuhas 2nd. J. Schiller suggested an expiration date be put in the motion. He thinks we can revisit the mask mandate in March when indoor activities are waning and when we are hopefully beyond this latest surge. D. Elias also motioned that this Emergency Order shall be effective immediately and shall remain in effect until at least March 8, 2022, when the Board will assess the state of the COVID-19 pandemic and determine if the order should be extended, modified, or rescinded by the Board of Health. G. Yuhas 2nd. Roll call vote: S. Moore – yes G. Yuhas – yes P. Kirby – yes D. Elias – yes J. Schiller – yes Motion passed by a vote of 5 to 0.  Institution of a vaccine D. Greenbaum shared his screen of the temporary order requiring COVID- requirement in order to enter 19 vaccination for indoor entertainment, recreation, dining, and fitness certain businesses settings. J. Schiller read portions of the order that described what places would be included. This is modeled on Boston where the first date would be January 15 th when proof of at least one dose of vaccination would be required to enter a premises. It is implemented in phases. J. Schiller said this is instituted in New York City, in San Francisco, it is being entertained in Boston and many other places are now considering this. It is feasible. He thinks this is a reasonable course of action given our current state of affairs of a public health emergency. S. Moore asked about the challenges businesses may face and what guidance we will be providing. D. Greenbaum reported that the city will be hosting a webinar and Q&A series with businesses on January 4th organized through the Economic Development Recovery Group out of the Planning Department. He imagines we will have Salem-specific guidance based on tools and 3|Page resources Boston has created. G. Yuhas asked if we know what surrounding communities are doing. J. Schiller said Peabody just voted to institute a mask mandate today. D. Greenbaum said Lynn, Peabody, and Swampscott have instituted a mask mandate. Beverly met this morning and discussed it and will meet again next week and will probably institute a mask mandate. This is happening in a number of communities in the region. S. Moore said there have been some concerns about disclosing private medical information, so she wants to be clear that proof of vaccination is not meant to capture personal information. There will be no checking vaccination cards against a photo ID. J. Schiller added that should anything develop therapeutic-wise where vaccines are not one of the best tools we have, we can revisit this. D. Greenbaum said there will be some information coming forward to help people understand what the expectation is. In New York they had some bumps in the road at first, but it has been very successful over the last several months and it has actually increased their vaccination rates by 20 points. J. Schiller said that is ultimately a huge part of what is going to get us through this pandemic. P. Kirby wondered if there are any provisions for people who cannot take the vaccine, for example due to cancer status. J. Schiller said the medical exemptions are listed on the CDC website but are extremely uncommon. P. Kirby said he likes the phasing because it gives people time to get vaccinated. J. Schiller said the hope and goal is that by springtime we are in a much different situation than we are in now. G. Yuhas asked where our vaccine sites are in Salem. D. Greenbaum said the MA General Brigham van runs a site in the Market Basket parking lot every Friday, and they are looking to get an indoor location in that same area. All the pharmacies have vaccine, and he knows they are booked out sometimes for a couple of weeks. There is a mass vax site at North Shore Community College in Danvers on Ferncroft Road. They have vaccine appointments available, and they do take walk-ins. We are working to get some additional vaccination opportunities inside the City of Salem, but it would be a regional use clinic, not just for Salem residents. P. Kirby said he really likes the language that came from Boston in the enforcement section of the order. He thinks people have this sense of police-state and he is sympathetic to concerns about that. That is not what this is. We are just trying to incentivize people and give people additional encouragement to get vaccinated. J. Schiller agreed and said this is not a decision any of us want to make. This is just a terrible situation we find ourselves in. He sees it every day at the hospital, and it is getting worse, and we need mitigation efforts that we know work. To not do anything is irresponsible. S. Moore added that it is important to point out that layered mitigation strategies are important for multiple layers of protection; Masking, testing, and vaccinations are needed. We are seeing shortages in testing regionally. 4|Page J. Schiller said we are dealing with the reality of constraints that have been dealt to all of us. G. Yuhas said she waited in line today for an hour and 45 minutes for a COVID test at St. Peter’s Church. Everyone is trying to get tested before the holidays. J. Schiller said the numbers of positive COVID cases we get on a daily basis are more than we have ever had through this pandemic. That does not take into account the numbers of home tests that are not reported. The numbers are astounding compared to what it was at its worst that we knew prior to this. Personally, what concerns him more than numbers are hospitalizations. Data was published in the NY Times today from England and Scotland that Omicron is much less virulent than Delta, however it is 10 times more infectious, so the numbers resulted in many more people being hospitalized. P. Kirby said he thinks it is important that people know that we as a Board will be actively monitoring the situation so when numbers allow it, we can scale back. He hopes that people understand we don’t relish making these decisions. J. Schiller said that is a really good point and that is why he made a personal call to Dr. Dave Roberts to ask him what metric the Board can use to relax these measures that we don’t want to enact. He said it is based on hospitalizations and hospital capacity. All routine surgeries, screening exams and elective surgeries are being postponed. We have already seen in the catch-up to that when we had a lull in this pandemic that cancer stage rates of people presenting with cancer are at a much later stage than they normally would be because screening tests were not done. We need to mitigate that. It is not just about COVID, it is about public health in general. The delay in medical care will cause an even bigger death toll than possibly the pandemic itself. S. Moore said as the Board has determined the current state of the ongoing COVID-19 pandemic constitutes a public health emergency, she moved to institute a proof of vaccination requirement to enter certain businesses in the City of Salem as outlined by the posted order. G. Yuhas 2nd. Roll call vote: G. Yuhas – yes S. Moore – yes P. Kirby – yes D. Elias – yes J. Schiller – yes Motion passed by a vote of 5 to 0. J. Schiller said he is sorry we have all been put in this position to make these decisions. It is wrenching. He wants people to know that the comments have been divided. For as many people that are upset about this, there are a lot of people that have been very supportive. 5|Page  3. New Business/Scheduling of Future N/A Agenda Items MEETING ADJOURNED: G. Yuhas motioned to adjourn. P. Kirby 2nd. Roll call vote: S. Moore – yes G. Yuhas – yes P. Kirby – yes D. Elias – yes Respectfully submitted, J. Schiller – yes Motion passed by a vote of 5 to 0. Maureen Davis 7:59pm Clerk of the Board Next regularly scheduled meeting is Tuesday, January 11, 2022 at 7:00pm Virtual Meeting Via Zoom 6|Page