In the news
Public Health Order #2020-05
May 3, 2020
Effective tonight at midnight, Public Health Order #2020-05 lifts some of the restrictions on business and social activities that have been in place for several weeks.
Here are some of the most important changes:
- Most non-retail businesses can re-open while observing social distancing requirements;
- Most retail businesses, as well as restaurants and gyms, can re-open while observing reduced occupancy limits and social distancing;
- Churches can re-open and religious services are allowed while observing reduced occupancy limits and social distancing;
- Businesses in which social distancing cannot be maintained, such as personal care services, must require employees to wear a mask;
- Bars, movie theaters, playgrounds, spray-grounds, and hot tubs must remain closed for now;
- Swimming pools must have an approved disinfection plan and observe social distancing;
- Other public and private gatherings are limited to ten persons
For more detailed information, please review:
This order represents the first step in Phase 2 of the Roadmap to Re-Opening Framework, which consists of:
- Phase 1: Slow the spread
- Phase 2: Re-open, community by community, and implement disease surveillance
- Phase 3: Establish protection, then lift all restrictions
- Phase 4: Rebuild readiness for the next pandemic
All of these documents and many more are available and organized on the City/County Coronavirus web page.
Testing, Contact-Tracing, and Isolation Capacity
Success of the Roadmap to Re-Opening Framework depends on being able to quickly identify and respond effectively to COVID-19 outbreaks that are likely to occur as people start interacting again. That requires public health professionals to have the capacity to test and trace the contacts of a certain number of positive cases every day, and to isolate individuals who cannot isolate at home.
With that in mind, I asked Stephanie Browning, Director of the Columbia and Boone County Department of Public Health and Human Services, about the Boone County's current testing, contact-tracing, and isolation capacity, and what capacities she considers necessary to manage future "spikes" in cases. Here are her responses.
- What is Boone County's current testing capacity (number of tests per day that can be performed over an extended time period)?
- Testing is primarily being accomplished by the hospitals, Urgent Care facilities, and some providers. Beginning next week, we are partnering with MUHC, BHC, and VA to begin outreach testing in Ashland, Hallsville, and Centralia and are planning to expand testing in some vulnerable populations beginning the following week. The hospitals have ample capacity to test extra people if we see a spike in cases. In addition, GeneTrait, our local testing site has indicated they are ramping up to 1,000 specimens per day. We can also test through the state public health lab. Quest and LabCorp are two reference labs also used by local providers.
- What is our current contact-tracing capacity (number of positive cases per day, all of whose at-risk contacts can be traced, over an extended time period)?
- The Columbia and Boone County Department of Public Health and Human Services has grown the epidemiology team from three people to nine over the past several weeks. This additional staff allows us the ability to effectively investigate 35-40 cases per day. We also have other staff in our department that can be trained up to investigate and contract trace. We have the ability to bring back some of our retired staff too. Yesterday, I participated in a call with the Governor and State Health Director. They indicated there will be funding available to hire additional contact tracers.
- What is our current isolation capacity (number of hotel/motel rooms, etc. that can be used for positive cases who cannot isolate at home)?
- We are currently taking this one case at a time. We have no current needs for a quarantine or isolation facility. All current cases and contacts are able to isolate and quarantine on their own. We did put out an RFP for a quarantine and isolation facility in a hotel and received one bid. That bid was not responsive to the request. We have had a need to isolate some individuals during the pandemic and have been successful in doing so by using hotel rooms. For the time being, that is our current plan for moving forward. We have also approached the Missouri Department of Health and Senior Services about establishing some regional isolation and quarantine facilities. We have not received a response from them yet.
- What levels of testing, contact-tracing, and isolation capacity do you consider necessary to manage future “spikes" in cases?
- This would depend on the size of the spike. We feel pretty comfortable with the level of testing that's available. As stated earlier, we have the current capacity to handle 35-40 cases per day. If needed, we can also get contact tracer assistance from the Missouri Department of Health and Senior Services (DHSS). From the call yesterday, DHSS has indicated we may be receiving some funds that would allow us to hire up to 30 contact tracers per 100,000 population. We have not been guaranteed that funding at this point, but it would obviously add significant contact tracing abilities. The isolation capacity is really not possible to predict. We could have a large spike, but all the cases and contacts may be able to safely isolate and quarantine on their own, meaning we would need no capacity. We could also have a smaller spike, but could end up with numerous contacts that needed to be quarantined.
Here are two additional resources that include similar analyses and recommendations for the national response:
- Key to Re-Opening the Economy: Test, Trace, and Self-Isolate (Scott Gottlieb, former Food and Drug Administration chief for President Trump, and Andy Slavitt, former Director of Medicare and Medicaid in the Obama administration)
- Roadmap to Pandemic Resilience: Massive Scale Testing, Tracing, and Supported Isolation as the Path to Pandemic Resilience for a Free Society (Edmond J. Safra Center for Ethics at Harvard University)
And, finally, here's a longer-term projection for the likely course of COVID-19:
- The Future of the COVID-19 Pandemic: Lessons from Pandemic Influenza (Center for Infectious Disease Research and Policy)
It is clear that we should prepare for multiple waves of this disease over the next few years, and that the next wave could be more severe than the current one. Given the disproportionate health and economic impacts being wrought on low-income residents and people of color, I believe we must start restructuring our economy with a strong "equity" focus.
My thanks to many of you for sharing your personal definitions of "the economy." By way of a follow-up question, "What would you say are the characteristics of a successful economy versus one that doesn’t work or creates undesirable outcomes – what are we, as a nation, striving to achieve with the economy?"
I will return to this discussion in an upcoming newsletter.
I will hold Constituent Conversations ONLINE and ON THE PHONE this afternoon and again on Sunday, May 17th from 2-4 pm, using the following videoconference/dial-in links:
Zoom Meeting https://zoom.us/j/99360231538 or phone 1-312-626-6799, Meeting ID: 993-6023-1538
Upcoming dates are always available at my web site.