Board of Health

CITY OF SALEM BOARD OF HEALTH MEETING MINUTES Virtual Meeting held via Zoom and Recorded by SATV February 8, 2022 MEMBERS PRESENT: Dr. Jeremy Schiller, Chair, 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, Megan Riccardi, City Council Liaison, Kerry Murphy, Health & Wellness Coordinator ATTENDEES ADDRESSED: (Please see minutes) TOPIC DISCUSSION/ACTION J. Schiller read the portion of the agenda regarding remote participation of the meeting, etc. 1. Call to Order 7:01pm 2. Approval of Minutes (January 11, 2022) S. Moore moved to approve the January 11, 2022 meeting minutes. G. Yuhas 2nd. Roll call vote: G. Yuhas – yes D. Elias – yes S. Moore – yes P. Kirby – yes J. Schiller - yes Motion passed by a vote of 5 to 0. 3. Discussion and vote to either maintain or rescind the current J. Schiller shared his screen showing a graph “Northeast Massachusetts proof of vaccination requirement Region – ICU Occupancy (7-day rolling average) 11/1/21–2/7/22”, as well to enter certain businesses as a table of related data showing different metrics. J. Schiller said the latest variant we have seen with COVID, the Omicron variant, was unprecedented. The WHO described the first case out of South Africa on November 24th. The first case in the U.S. was on December 1st. Within the second week of December, 90% of cases in the U.S. were Omicron. Compared to the Delta variant, the rapid spread and the infectious nature of the Omicron variant was alarming. The Board met on December 14th to discuss Omicron and the implications of it. Referring to the graph on the screen, he said ICU capacity is a critical metric this Board has used and will continue to use. As you can see, we were approaching above 95% capacity in the ICU at the December 14 th meeting. In close consultation with Dr. Roberts, President of Salem Hospital, and with data from other regional hospitals, a critical stage was reached at the hospital. ICU capacity is such a critical metric because if there are no ICU beds available, then basic medical care cannot exist and that is basically a failure of our medical system. If this is happening region-wide or state-wide, this 1|Page is a crisis. That is what made the Board meet again on December 22 nd to take action. Again, in close consultation with the Mayor, and with Dr. Roberts we felt that we had no other alternative other than to institute the mitigation measures that we know work; they are not perfect, but they do work. On the 22nd, the curve was above the critical threshold of 95%. This threshold affects all of us. There are hospital staff shortages, in addition to all of the delayed medical care that has been happening throughout the pandemic such as routine screening mammograms, colonoscopies, elective procedures, etc. He sees it firsthand working in the hospital. The National Guard was deployed in the hospitals. We were truly dealing with a crisis that was different than it was throughout this pandemic. That is what prompted the mitigation measures. This Board has been incredibly vigilant about watching the data and these metrics. The precipitous nature of the onset throughout the U.S. was a precipitous fall. It was unpredictable. We did not know in December that Omicron was not going to be as virulent as Delta. The high vaccination rate, despite still being able to get the virus if you are vaccinated, prevented a huge amount of death and illness throughout Omicron. Citing the graph, he said you will note that starting towards the end of January it rapidly fell, which is great news. ICU capacity was completely full on January 15th when the vaccine mandate went into effect. We are in a much better situation which brings us to tonight. He is proud of how this Board has always acted based on the metrics and based on the data. We have been bold as far as enacting the mitigation measures in the beginning of the pandemic, and for Halloween but we have also been just as responsive about relaxing these measures when we say we are going to do it or when we can do it based on the data, like tonight. His feeling is we put these measures into place due to a crisis and this crisis is now abated. That does not mean we are out of the pandemic and hopefully this pandemic will turn into more of an endemic virus like other viruses have. We are approaching spring in much better shape. P. Kirby agreed completely about relaxing the measures we put into place. S. Moore echoed J. Schiller and said this pandemic is dynamic. We now have tools such as wearing high-quality masks and vaccinations. She feels we absolutely made the right decision, and the numbers speak clearly to that. She also agreed there has been a drastic decrease and she would feel comfortable rescinding the mandates. G. Yuhas said some people told her they would be more upset if we were to rescind the mandate. People have to understand that if they are more comfortable wearing a mask, please do so. J. Schiller agreed and reiterated that we know what mitigation measures work and people are going to have to take them upon themselves, and businesses as well if they wish to do that. D. Greenbaum said this Board acted aggressively to try and slow the spread and stop the spread when we entered this surge. As we have seen here, around the state, across the country and other parts of the world, this went up rapidly and came down rapidly. We anticipated that would happen and that is what precipitated these items being on the agenda for the meeting tonight as opposed to waiting until March. J. Schiller reiterated what D. Greenbaum said that we based this on the data. When we saw the first data mark of a dramatic decline on January 24th, we had to ensure that that was a stable decline and once we did, we 2|Page  chose to revisit these mandates right away. That is the prudent and scientific way to do these things. P. Kirby shared that Dr. Roberts wrote a very convincing letter that was not in opposition of dropping the mandates. J. Schiller said again that this is in close consultation with Dr. Roberts who has been a wonderful partner for the Salem Board of Health and for Salem. We are lucky to have someone who is engaged and is smart and prudent as Dr. Roberts. We would be irresponsible if our decisions were made without consultation with Dr. Roberts and what is going on at the hospital. D. Elias said she is also in agreement with everybody’s sentiment regarding the information that has been shared today and thinks it is very understandable that it is a good mark to be able to support relaxing the mandates that we have. P. Kirby moved that we rescind the proof of vaccination order instituted on December 22, 2021, effective immediately. G. Yuhas 2 nd. Roll call vote: G. Yuhas – yes S. Moore – yes D. Elias – yes P. Kirby – yes J. Schiller - yes Motion passed by a vote of 5 to 0. 4. Discussion and vote to either maintain or rescind the current G. Yuhas moved to rescind the mask mandate instituted on December indoor mask mandate 22, 2021 in all indoor spaces in the City of Salem, effective immediately. P. Kirby 2nd. Roll call vote: S. Moore – yes G. Yuhas – yes D. Elias – yes P. Kirby – yes J. Schiller - yes Motion passed by a vote of 5 to 0. J. Schiller acknowledged that this has been tough for everybody. We are truly all in this together and we are affected by it in many ways, with work life, personal life, social life, etc. He feels extremely fortunate that we have D. Greenbaum at the helm of the Department of Health and that the Health Department is staffed with wonderful, talented, dedicated people. We cannot measure the tremendous amount of support we have received as a Board from the people throughout Salem. It is a challenging task to be on a board of health during a pandemic. We are doing the best that we can do. He feels proud of the work we have been doing to keep Salem safe. We live in a wonderful place, and we should all feel lucky about the community that has supported this Board and supported the measures we put into place. 3|Page  He looks forward to working with everyone going forward and hopefully to better days in the spring. P. Kirby agreed with what he said about D. Greenbaum and complimented J. Schiller for his leadership and the incredible amount of work he has put into this. He thanked him and said he has done a fantastic job. The meeting opened up for public comment. Public comment was made by the following: June Waterford, Endicott Street, Salem, MA Michelle Efendi, Randolph, MA Lisa Johnson (with Dianna), Brookfield, MA (spoke twice) Donna Loiacano, Beverly, MA Scott Sheehan, 39 Harbor Street, Salem, MA Benjamin Selecky,Vampfangs, Salem, MA Nicole Cohen, Marblehead, MA Greg Ballard, Lafayette Street, Salem, MA Tom Hickey, Winthrop Street, Salem, MA Alan Hanscom, 82 Washington Square, Salem, MA David Cutler, business owner in Salem, MA Susan Cooke, Brown Street, Salem, MA John McHarrie Harrison Schell, 170 North Street, Salem, MA Erin Waltz, Beverly, MA Armerys Suarez, Lafayette Street, Salem, MA Mi Free, Peabody, MA Toby Channen, 38 Station Road, Salem, MA Daryl Bennett, business owner in Salem, MA Josh Turiel, Lafayette Street, Salem, MA 5. Update and discussion on the M. Riccardi said in 2021 the Public Health, Safety & Environment Urban Agriculture Regulations Committee was reviewing an urban agriculture ordinance draft. The Committee reviewed the ordinance draft, had recommendations, and submitted it to Council at the start of this year to go to a joint public hearing with the Planning Board. She believes the public hearing will be in mid-March. The draft ordinance references a Board of Health regulation. J. Schiller shared his screen of the draft Board of Health regulation. K. Murphy explained that the regulation is expanding what we already have regarding chickens. Residents will be able to sell unprocessed produce, eggs, and honey. It also allows for beekeeping. She discussed the section of the draft regarding soil testing if people will be selling produce. Attendee Andy Varela, 23 Cedarcrest Avenue, wanted to make it clear he is speaking as a resident of Salem, not as a City Councilor. Being a farmer in the community, he believes testing for lead year after year on a small plot in someone’s back yard might be unreasonable. Lead would not continue to accumulate from anything ambient. If there is lead in the soil, it is from past uses. He believes it would be cost prohibitive and believes the intention of this ordinance is to incentivize our residents to grow food for themselves and their neighbors. S. Moore asked if we would be testing for more than lead. If the soil would not commonly change year after year, then testing would not be necessary 4|Page  every year. A. Varela said someone would have to grow large amounts of something that takes up a lot of nutrients, like soybeans or corn, year after year, and even then, it would take three to five years for the soil to change on a molecular level for safety. D. Greenbaum said he would need to look into exposure limits, etc. A. Varela said lead is a huge issue, but other metals like aluminum do not leech and would correlate more to acidity which could be remediated with things like adding lime to the soil. J. Schiller asked what the process is going forward. M. Riccardi said because this is a zoning ordinance change, it needs to go to the Planning Board for a joint public hearing with the Council and the Planning Board and then public comment. Once the joint public hearing is closed the Planning Board reviews the ordinance and makes a recommendation back to Council within a certain number of days. The Council has to take a vote within a certain number of days. J. Schiller asked how the Board can help. M. Riccardi said the final approval of the regulation will be at the purview of the Board. S. Moore asked if it would be helpful if the Board were to draft a letter in support of the ordinance and offered to create the draft. K. Murphy said the support of the Board of Health would be very helpful. She asked who would be responsible for inspections of chicken coops and beehives. D. Greenbaum said he believes inspections must be performed by a certified animal inspector with the state. He said Don Famico, the City’s animal control officer, is the only certified animal inspector right now. If the need arises, we can look into getting a staff member trained and certified through the state as well. J. Schiller said we can plan to put the regulation up for a vote in March and make sure it is on the agenda. There seems to be overwhelming support on the Board for it. Attendee Steve Kapantis, 23 Wisteria Street, talked about soil testing. He does not think it would be a financial burden for those who would be selling produce. 6. Chairperson Communications Nothing further than discussed. 7. Public Health Announcements /Reports/Updates a. Public Health The Board welcomed S. Darmody back. Nurse Report Copy available at BOH office. b. Health Agent Report D. Greenbaum said the City Engineer’s office has been working on an ordinance change related to maintenance of Fats, Oils & Grease (FOG) being discharged into City sewers and the infrastructure. We are working on a Board of Health regulation for food service establishments. That will be coming out in the next couple of months. We will do a public hearing for that as well. Currently the regulations are in front of the City Solicitor’s office for legal review. He reported that budget season is starting up. He will be working on the 5|Page  budget in the next couple of weeks to get it finalized and submitted to Finance and then to the Mayor for approval. He will keep the Board updated. J. Schiller said he thinks we need to revisit the opioid issues. D. Greenbaum said a lot of good work is being done around opioids with the Healing Communities Study. He can update the Board next month or the month after. P. Kirby said he would like to have an update soon on the syringe exchange program that Healthy Streets has been running. He is curious to know how things have gone over the last two years. D. Greenbaum said that we have seen an increase in opioid-related overdoses and fatalities in the City in the last two years. As part of the Healing Communities Study, the needle exchange program has been able to purchase a mobile unit. They drive around the City and do their needle exchange and speak to people. He will contact Mary Wheeler from Healthy Streets to see if we can get her on the agenda for late spring or early summer. G. Yuhas asked if there have been any discussions about possible safe injection sites. D. Greenbaum said there have not been discussions since before COVID. Part of the problem is that it is against federal law to allow people to have places to go to use drugs, so there is some legal maneuvering that needs to go on around that. S. Moore said she has been working on a couple of program evaluations with the city of Lynn around opioid overdose prevention. Data from Lynn and Salem showed that Lynn had a record high number of overdoses and a 12% fatality rate. Salem had a lower number of overdoses, but one in four people died. In addition to prevention, we should also be looking into what is happening to cause such an exponential increase in our mortality rate among people who overdose. P. Kirby wondered if the evaluations would be helpful in answering that question. S. Moore said one project is looking at overdose prevention among the Black and Latin X communities in Lynn, Salem, and Peabody. They want to identify barriers to treatment because they are so disproportionately represented among people who have negative outcomes when it comes to overdoses. They will also be looking at what the substance use histories look like to see if they can identify some patterns. The other project is looking at coexisting mental health and substance misuse issues among young adults in the 18-24-year-old population, and ways in which providers could work together better to identify potential substance misuse issues and the root causes of substance misuse. Healthy Streets is also part of their team. She will keep the Board posted as they start doing analysis of the data. D. Greenbaum said Healthy Streets is part of the Healing Communities Coalition as well. There is a lot of substance abuse work going on now particularly around opioid use disorder and prevention. c. Administrative Report Copies available at BOH office. d. Council Liaison Updates Nothing more to add. 6|Page  D. Elias motioned to approve the reports and updates. S. Moore 2 nd. Roll call vote: S. Moore – yes P. Kirby – yes D. Elias – yes G. Yuhas - yes J. Schiller – yes Motion passed by a vote of 5 to 0. 8. New Business/Scheduling of Future Agenda Items J. Schiller said the Urban Agriculture Regulations will be on the March  Items that could not be agenda. anticipated prior to the D. Greenbaum said it would be beneficial to have Mary Wheeler from posting of the agenda Healthy Streets come to an in-person meeting in the spring. MEETING ADJOURNED: G. Yuhas motioned to adjourn. P. Kirby 2nd. Roll call vote: G. Yuhas - yes S. Moore – yes J. Schiller – yes P. Kirby – yes D. Elias – yes Motion passed by a vote of 5 to 0. 8:23pm Respectfully submitted, Maureen Davis Next regularly scheduled meeting is Clerk of the Board Tuesday, March 8, 2022 at 7:00pm 7|Page