Lake County Board of Health Met Dec. 16

By Kristine Gonzales-Abella

Feb 22, 2021

Lake County Board of Health Met Dec. 16.

Here is the minutes provided by the board:

1. Call to Order

President Sashko called the meeting to order at 6:03 p.m.

Present 10 - Member Cesnovar, Member Maine, President Sashko, Member Rheault Ph.D., Vice President Hagstrom D.D.S., Member-at-Large Ehrlich M.D., Member Belmonte D.O., Member Schultz, Secretary DeVaux and Member Johnson Jones Ed.D.

Absent 2 - Member-at-Large Carlson and Member Mittl Pollina Psy.D.

2. Pledge of Allegiance

This matter was presented

3. Approval of Minutes

3.1 November 18, 2020 Meeting Minutes

A motion was made by Member Rheault, seconded by Member Johnson Jones, that the minutes of the November 18, 2020 meeting be approved.

Aye: 10 - Member Cesnovar, Member Maine, President Sashko, Member Rheault Ph.D., Vice President Hagstrom D.D.S., Member-at-Large Ehrlich M.D., Member Belmonte D.O., Member Schultz, Secretary DeVaux and Member Johnson Jones Ed.D.

Absent: 2 - Member-at-Large Carlson and Member Mittl Pollina Psy.D.

4. Public Comment to the Board

Mr. James D'Angelo submitted the following public comment via email on Tuesday, December 15, 2020:

"Dear Dr. Pfister and Members of the Board of Health,

I'm here again to discuss what the Lake County Department of Health is doing to get our kids back in school. As I have shown to all of you previously, the vast majority of evidence supports opening our schools, at least those that can successfully implement the key risk mitigation strategies. What is being done by the Health Department to make any progress on this? I have not seen any time at any of these meetings devoted to this extremely crucial topic. I know Dr. Pfister regularly meets with school boards and superintendents, but again, no progress has been shared with the public.

The Lake County "Return to School Metrics" have seemingly not been revised or discussed since August. This is completely unacceptable - we know so much more about the virus now. We have evidence from thousands of schools across Illinois. There is no question that for children under 10, the risk of transmission is extremely low. And even for children over 10, when safety protocols are followed, risk of transmission in schools is extremely low. How can you justify guidance applying to all ages across the county without any reference to the new facts and data that we now have?

At the very least, the Lake County Health Department should convene an emergency panel to investigate the schools guidance and issue updated recommendations before 2nd semester starts after the holidays. Now is the time to let schools open back up, so that it has a minimal impact on their schedule. As you all know, keeping kids out of school is having serious detrimental health effects. We can't let our focus on the virus blind us from risks of depression, suicide, loneliness and other serious social-emotional issues that all of our students are suffering from.

Schools are clearly safe. The Health Department's inability to provide any evidence to the contrary is telling. Without evidence of danger, our schools must be open.

Please take action before it's too late. Our children are counting on you."

Parliamentarian Lisle Stalter stated that the public comment will be entered in to the minutes of this meeting, pursuant to the rules, but will not be read aloud due to the absence of Mr. James D'Angelo.

5. Awards, Recognitions, Appointments and Reappointments

None

6. Presentations

None

Absent 2 - Member-at-Large Carlson and Member Mittl Pollina Psy.D.

7. President’s Report

President Sashko reported on the following:

• He thanked everyone for their support, kind words, thoughts, and prayers during his recent hospitalization, surgery, and recovery resulting from a brain tumor. • He recognized Member Steve Carlson for his 20 years of service to the Board of Health and highlighted just some of his numerous contributions and accomplishments: -Tobacco 21

-The response to COVID-19

-The launch of the school-based health center in Round Lake

-A multitude of capital projects for 3010 Grand and the Zion Health Center -EtO

-Lake County Veterans and Family Services Foundation

-2-1-1

-Mental Health Coalition

-Naloxone Project

Steve's passion for service and his dedication and commitment to his work on behalf of the residents of Lake County is truly impressive. What he does is never for personal gain or glory, but rather all about serving others. He is never fearful of asking questions and contributing ideas and suggestions and as a result has fostered some truly impressive and noteworthy accomplishments. He is a passionate, caring person that really is a professional in what he does in carrying out the mission. And he is going to continue to do that as he has already been tapped by Senator Melinda Bush to look at a statewide 2-1-1 system.

Member Maine informed the Board that Member Carlson was not in attendance this evening as he underwent an outpatient surgical procedure today.

• The data breach reported on by Jerry Nordstrom, Director of Business Operations, at the November 18, 2020 meeting, is under control and there has been no further contact with the Feds. Jerry added that during the month of November, nine people reached out to the Privacy Officer as a result of a letter sent to them by the Health Department notifying them of the breach. Since the end of November the Privacy Officer has not received any additional inquiries.

• He displayed the Health Department COVID-19 magazine he received in the mail and recognized all those involved in it's creation for the unbelievable job they did.

• He announced that today is Assistant County Administrator Cassandra Torstenson's birthday.

8. Action Items

8.1 State CARES Pandemic Related Stability Payments Program for Funds Made Available Through the Federal CARES Act - $1,242,621.77 - Grant Approval - Burke

Kim Burke, Director of Healthcare Operations, reviewed this item as summarized in the agenda packet. Member DeVaux noted that these are the expenses up until December 30, 2020, and asked what money was being used to pay for everything not being compensated for. Kim explained that these are additional funds received from HFS is September to help offset these expenses. These dollars must be spent by December 30, 2020 because that is when the CARES Act funding ends for the current period.

A motion was made by Member DeVaux, seconded by Member Schultz, that this item be approved. Roll call vote taken, all in favor, motion carried.

Absent: 2 - Member-at-Large Carlson and Member Mittl Pollina Psy.D.

8.2 City of Chicago, Ryan White Part A CARES Funds - $11,414 - Grant Approval - Kritz

Lisa Kritz, Director of Prevention, reviewed this item as summarized in the agenda packet.

A motion was made by Member Rheault, seconded by Member Belmonte, that this item be approved. Roll call vote taken, all in favor, motion carried.

Absent: 2 - Member-at-Large Carlson and Member Mittl Pollina Psy.D.

8.3 Illinois Department of Human Services, Prescription Drug Overdose program, Additional Funding $280,150 - Grant Approval - Johnson-Maurello

Sam Johnson-Maurello, Director of Behavioral Health, reviewed this item as summarized in the agenda packet.

A motion was made by Member Hagstrom, seconded by Member Johnson Jones, that this item be approved. Roll call vote taken, all in favor, motion carried.

Absent: 2 - Member-at-Large Carlson and Member Mittl Pollina Psy.D.

9. Discussion Items

None

10. Attachments for Board Review

10.1 Media Placement Highlights - Nordstrom

Attachments: Media Placement Highlights - November 2020

This matter was presented

11. Lake County Community Health Center Governing Council Update

Dr. Les Zun, Medical Director, informed the Board that the Respiratory Illness Clinic (RIC) reopened in the parking lot of the North Chicago health center one week ago. Six heated mobile mini storage units have been rented to serve as COVID-19 exam rooms and team rooms so as to not disrupt the regular services being provided in the clinic. To date, 111 patients have been seen in the RIC. Having the RIC reduces the exposure to other patients and staff and concentrates the staff with COVID-19 expertise in one location. The RIC will continue until case numbers decrease or everyone gets immunized. Dr. Belmonte asked if there is a specific check-in process for the RIC that is different from the norm. Dr. Zun explained that patients begin by calling the Patient Access Center (PAC), the PAC asks them specific questions to see if they fit in to the category of COVID or COVID-like symptoms, if they do then the patient is scheduled for an appointment at the RIC, the patient is then instructed to call the nurse when they drive up to the RIC, at which time RIC staff will either see the patient in their vehicle or place them in one of the mobile unit exam rooms. Kim added that registration and intake are all done telephonically to limit face-to-face interaction.

At this point, Member Carlson joined the meeting and President Sashko reiterated his sentiments from his President's report. Steve thanked everyone for their kind words and well wishes.

12. Lake County Tuberculosis Board Update

Lisa Kritz informed the Board that the TB Board last met on November 16, 2020. Their new member, Dr. Mukesh Chaudhry, was present. There are currently 13 active TB cases compared to 9 in 2019. As of November 16, 2020, there were 943 INEDSS cases to follow up on and as of today there are 990, so TB staff are very busy.

13. Added to Agenda Items

President Sashko turned the floor over to Mark Pfister, Executive Director, for an update on the status of the COVID-19 vaccination process. Mark informed the Board that the Health Department was slated to receive 6,825 doses of the Pfizer vaccine, those doses were expected to arrive on Tuesday, December 15, but that was pushed back to tomorrow, Thursday, December 17, and we are still waiting on the final shipping information. Initially the State was going to deliver to us vaccine that they had received frozen and then repackaged which meant it would have been received thawed. That's a problem with the Pfizer vaccine because in a thawed state we would have only 5 days in which to utilize it. We convinced the State to change it's plan and now the four counties receiving the vaccine, Lake, Cook, Madison, and St. Clair, will be receiving it directly from Pfizer in an ultra-cold frozen state. In Phase 1A, all of the doses the Lake County Health Department receives will be repackaged and picked up by six local hospitals under police escort. We have been working with those hospitals for weeks so they already have plans and processes in place to receive it and begin vaccinating. In fact, they were very disappointed not to have received the vaccine yesterday as they had to reschedule people who were already scheduled to receive it. If all goes well, we will be receiving the vaccine tomorrow morning, between 8:45 and 10:45, repackaging it into ultra-cold coolers, and distributing it to those six local hospitals who will begin vaccinating the health care workers of Lake County by tomorrow afternoon. The Health Department will receive another shipment next week and that is when we can start vaccinating those other health care workers outside of the hospital system. Those other health care workers could be independent providers, EMS, Health Department providers, MA's, and other individuals that provide direct patient care. A tent, which will have power and heat, was set up today in our parking lot for a drive-thru vaccination for those other health care workers. Another facet of the Pfizer vaccine that makes it more complicated is that every vial, which contains 5 doses, has to be mixed with a diluent of sodium chloride, inverted 10 times, and then as soon as a syringe is drawn it has to be administered. This is unlike the flu vaccine where we can have a line-up of pre-loaded syringes ready to go. We will probably not get through Phase 1A until mid-January at the earliest. We will not be vaccinating the residents and staff of those long-term care (LTC) facilities that have signed up with the State as the Federal government has a contract with Walgreen's and CVS to provide them with vaccine and they will go out and administer those vaccinations. For those LTC facilities not signed up, we will be working with them to get them enrolled and if they can't be enrolled then they will be our responsibility to ensure their residents and staff are vaccinated. We do not anticipate moving to Phase 1B, which is frontline and essential workers, until February because those vaccinated in Phase 1A still need to receive a second dose within 21 days of receiving their first. If the Moderna vaccine is approved this week, there may be 20 million doses coming through across the US. The Moderna vaccine is the less challenging vaccine in that it doesn't have to be stored at ultra-cold temperatures, it can be stored in a regular freezer, it does not have to be mixed with a diluent, and it has a longer shelf life. Like the Pfizer vaccines, Moderna is also a two dose, but that second dose has to be within 28 days. Jefferson McMillan-Wilhoit and Patti Corn, our Emergency Response Coordinator, have done an awesome job in making sure the vaccines are color coded and that we're able to track which vaccine an individual receives. Also, whatever the supply currently is in the US, remember that a second dose may need to be held back. If they say 20 million doses are available, that actually means only 10 million people will be vaccinated within a month. The Lake County Health Department team has been phenomenal. For every challenge we've had the team has reacted extremely well and Patti Corn has us more organized than we have ever been. She has MOU's in place with all of the high schools and other entities should we need to move mass vaccination indoors. She has MOU's in place with local public works that can offer drive-thru vaccinations in their facilities. Jefferson and his team created an entire system for vaccination registration and we are the only county in IL that we are aware of, and potentially in the nation, that has the AllVax system. This system will, regardless of the type of vaccine they receive, notify people when their vaccination phase comes up, allow them to schedule their appointment for a mass vaccination open POD, and remind them when they need to come back to receive their second dose. The Public Health Emergency Operations Center (PHEOC) was re-activated last Friday and the team is working together exceptionally well. He thanked the Board of Health for their support and the County Board, as well, for approving the CARES Act funding used to pay for the AllVax system and a lot of the other efforts. Lisa Kritz, Director of Prevention, and Patti were brilliant in having the foresight to purchase an ultra-cold freezer despite CDC and IDPH telling us not to. And now CDC and IDPH are telling others to purchase them. And that is what we are here for, to prepare. To make sure our county can get vaccinated in a timely, efficient, and effective way. President Sashko asked for the current AllVax numbers. Jefferson stated that AllVax registration is currently at 115,407. Mark added that what the Health Department is going to need from the Board of Health, the County Board, and everyone who is involved is the communication of the facts and the truth about these vaccines. He stated that Member Maine previously pointed out to him that the first Nobel Prize for medicine and science was someone who worked on a vaccine situation. This current vaccine will probably be a Nobel Prize and has been worked on for a decade, but it really came to light when the genomic aspect of COVID-19 was determined and the scientists working on these vaccines were able to build the shape to fit appropriately. That is why we need to make sure the public is getting the facts and understands how valuable it is to have this vaccine to stop the spread of COVID-19 and build immunity because getting the disease and building herd immunity is not the way to go. Once we get people vaccinated we can restart our lives, which is what we all want, but it is going to take everyone of us to knock down the concepts that are being pushed out. We need to say the truth, which is that the vaccine is effective and that the benefits far outweigh the risks. It's great to have vaccines but if people don't get vaccinated, then we are not going to win the war. President Sashko added that in the Health Department magazine he mentioned earlier, Patti Corn has a great Q&A piece on the vaccine and what to expect that Board members can refer to for talking points. Member Maine stated that the 115,407 represents about 15% of the county population but since children cannot get vaccinated, she asked Jefferson what percent of the county has actually enrolled. Jefferson stated there are a little over 23,000 registrants under the age of 18, but that he would have to get back to her with a more definitive answer. She stated it would be the demographics of what percent of the Lake County population is actually eligible to be vaccinated and what percent of those eligible could actually get vaccinated. She then asked Mark what are some of the outreach programs going be done to reach those communities most impacted by COVID-19, also often people of color with a reason of mistreatment in the medical system are more hesitant. Mark informed the Board that the communication process actually began in the spring of 2020 when staff had the idea to form the African American Community Partnership Group and Association Communitaria Latina. Trusted members of the communities were brought in and have been working directly with us on different communication messages. Those groups test drove our AllVax system and came up with some good ideas and suggestions. Staff have been working with them to come up with exact messages we can deliver and having the faith-based communities and trusted community organizations deliver those messages. We have also been working with the Alliance for Human Services across the county as we really want that individual touch where trusted leaders are having those conversations out in the communities. We are meeting with them this Friday to go through those messages to make sure they understand and are delivering them in certain ways. We really need to start talking about racial equity, because if you can't talk about racial equity you are not going to get over that hump of vaccine hesitancy. This will be a county-wide effort with multiple community organizations, such as Mano-a-Mano, AHA in Antioch, and Waukegan Public Library, that are trusted by the residents who seek out their services. People are getting tired of listening to public health and scientists. This changes the message from a scientific one to here are the reasons why it is important for you to get the vaccine to protect your community and your loved ones. Member Maine then asked if it would be beneficial to have some of those trusted and respected community leaders get publicly vaccinated. Mark stated that he has had that conversation with the hospital presidents about who they choose to have vaccinated first in the hospitals, who are those trusted leaders of color that work within their organizations that could bring that message back out. Recently, Dr. Ahmed presented to the Health Department providers, and he, Dr. Zun, and Kim Burke were there, and they all said to those providers that as soon as vaccine is available to them they are going to get vaccinated. Several of those providers actually said that was a powerful message to hear that all four of us are going to get it as soon as it's available to us, but that we would be in line behind them since they are the ones with direct patient contact. We want to put an equity lens on this that shows them that this is not for those at the top of the food chain, that it is for individuals living in communities that don't necessarily have the same political power as others, or the resources to get access to these vaccines. Member Rheault added that Rosalind Franklin has their Care Coach that goes out in to the communities and if the Health Department has materials to be distributed, to please send them and they will distribute them. She added that they also have a COVID-19 clinic and asked when those providers and students, since they are not part of a hospital system, will be made aware of when they can get vaccinated. Mark instructed her to have everyone, whether they live or work in Lake County, register in the AllVax system. Updates are going to be consistently made to the AllVax system, so once ACIP says there are subcategories to the essential workers, we're going to add those and registrants can go back in and select one of those subcategories. Mark clarified that Phase 1A also includes anybody that works in the health care field that may have indirect contact through COVID-19 materials or waste. Dr. Zun added that he has been working with Sandra Larson of Rosalind Franklin on assistance with the Health Department's mass vaccination plans, that the pharmacy school has stepped up to provide students and pharmacists to help out, and registration in the AllVax system has been recommended to all of them.

14. Old Business

None

15. New Business

None

16. Executive Session

None

17. Adjournment

A motion was made by Member Ehrlich, seconded by Member Belmonte, that this meeting be adjourned. President Sashko adjourned the meeting at 7:01 p.m.

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Lake County Board of Health

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