County commission discusses COVID, mask enforcement

BY JENNIFER CABRERA

During the Alachua County Commission meeting on August 11, Paul Myers, Administrator for the Florida Department of Health in Alachua County, gave a presentation about COVID-19 in Alachua County.

Over a quarter of Alachua County residents have now been tested at some point. Over the 2 weeks preceding the presentation, there was a 6.3% positivity rate. 

Another slide compared Alachua County’s metrics to Florida’s metrics, showing that Alachua County’s hospitalization rate, case fatality rate, and population mortality rate are lower than the state as a whole. This may be partially because the median age of cases is younger than the state’s median age. 

Myers also compared pediatric metrics:

For every metric except the percentage of total deaths from long-term care facilities, Alachua County’s metrics for long-term care are also better than the state’s:

Myers showed the distribution by age of the deaths. Of the 26 deaths at the time, he said 11 were from long-term care facilities and 15 were from the community at large. He added, “Because I see the Medical Examiner’s reports, much of that is household transmission. And everybody with underlying health conditions, at least two or more.” 

One interesting slide showed the percentage of COVID-19 fatalities with various pre-existing conditions:

Hospitalizations were 6 times higher and deaths were 12 times higher for COVID-19 patients with reported underlying conditions, compared to those who reported no underlying health conditions. The most frequently-reported underlying conditions are cardiovascular disease, diabetes, and chronic lung disease. 

Myers said that test results ordered by the health department (not including outside labs) are now coming back within 24-48 hours. The Health Department attempts to contact every case within 48 hours, and 83% of cases are successfully interviewed within 48 hours. Out of 2,539 positive cases between July 6 and August 10, 759 individuals were identified and/or contacted via tracing efforts. Myers said they’re continuing to see a lot of household transmission, and that’s part of why the number of contacts is low: they tend to get infected and turn into cases. 

Myers also emphasized that anyone who is symptomatic should stay home. 

Myers said Alachua County meets reopening criteria for cases and hospitalizations but not for COVID-like illness or influenza-like illness, but he only had access to that data through August 2. Now that we have the data through August 9, we can see that both were lower on August 9 than they were 14 days before that.

The final slide gave recommendations for screening K-12 students:

In the discussion after the presentation, Myers was asked whether students’ test results will be reported to their home counties or to Alachua County. He said the reports go to the county of the address given by the person who is tested. However, any testing ordered by the University of Florida for its students will be reported to UF and then to the County. 

Myers also said that 30%-40% of Alachua County’s cases (people with a positive test) have been asymptomatic. 

Commissioner Ken Cornell asked Myers about the story reported by newspapers last week that county health directors had been instructed by the Florida Department of Health to not offer opinions on whether schools could safely reopen. Myers responded, “Let me just tell you all unequivocally right now, I have never been told to be quiet. Many out there probably want me to be quiet sometimes, but I’ve never been told to be quiet. My approach with the school board and my approach with the board has always been the same, and that is to provide you with situational awareness, the best advice I possibly can, and emerging science so that you as policymakers can make decisions. I’ve never told you what businesses to open or close, very early on in this event we had this conversation. I’m not in a position to tell the school board when to open or close. So even places that we license, we issue licenses and revoke licenses. Only a judge can shut somebody down, so I have never had the authority to do that. The authority I have in the schools is to exclude kids during a vaccine-preventable disease outbreak—and I have done this—who are not vaccinated. So that article was not only inflammatory, it was inaccurate; I’ve never been told to be quiet by anybody in a position of leadership in the department of health or anybody else.”

Commission Chair Robert Hutchinson asked Myers whether he could provide any guidance on what to do if cases increase after the students come back: “At what point do, since we can’t seem to come up with specific metrics, at what point if, after the students come back, we see a considerable spike in cases, do we start to go back to a Phase 1-type shutdown, whether it’s occupancy limits, whether it’s closing certain kinds of businesses, whether it’s curfews, whether it’s any of those things, and right now everybody seems perfectly happy with not being the seat-of-the-pants decision made by the Chair of the County Commission—except for one person, that’s me. And it would be better if we had mutually agreed-upon goals so the university’s not surprised when they get a call that says we’re going to put a fence around the university.”

Hutchinson continued, “Well, one of the things that I have heard is the ‘flattening the curve to protect hospital capacity’ is no longer as good an indicator, particularly in a place like this where we are perhaps over-stocked with medical capacity, compared to many other places. So I don’t know what the metric is. It seems like percentage of positives is as good as anything because that at least tells you from one day or week to the next whether transmission is accelerating or decelerating.”

Myers responded, “I don’t think there is any one metric that is, you know, perfect, but certainly we have enough smart people in this town to where we can have some metrics that we can look at to better inform your decisions, much like we did with the schools, and we’ll be publishing that this afternoon.”

Mask compliance

Growth Management Director Missy Daniels reported that code enforcement has been seeing 99.1% compliance with the mask mandate. They haven’t started issuing citations yet. She said that a very few businesses are either not displaying the mandatory sign or having their employees wear masks, “So if you guys decide to go to where we’re going to be issuing citations, those would be where we would go back first.”

Regarding customer compliance, Daniels said that if someone isn’t wearing a mask, the code enforcement officers tell them what the rules are and ask them to wear a mask. “If the customer refuses because of a medical exemption, that’s pretty much the end of the interaction.” She said that when they refuse, those are the times they would need law enforcement because code enforcement officers can’t detain them to get enough information to give them a citation. 

She said the Sheriff’s Office has said they will help, but “I don’t know that they’re real interested in going this route.”

However, the City of Gainesville is issuing citations, and they are reportedly unhappy because the County is not enforcing the mask mandate as strongly. Hutchinson said he felt that “the people in Gainesville are much more concerned about masks, and so they call in. Whereas the people that are more rural, they’re not going to call in and complain if they don’t see masks, and so we don’t get the calls.”

The commissioners, however, generally agreed that there was no need to step up enforcement with 99% compliance. 

Joint City/County/UF meeting

The commissioners next discussed the joint meeting with the City of Gainesville and the University of Florida that was to be held the next day. The meeting conflicted with a school board meeting regarding reopening, and the commissioners thought it was more important for the school board meeting to be on Cox Channel 12, but Mayor Lauren Poe said their rules don’t allow them to meet if they can’t be on TV. Hutchinson said he had a letter from the City Attorney saying they can meet if it’s not on TV, but the Mayor disagreed. The commission voted unanimously (with Commissioner Marihelen Wheeler absent) to cancel and reschedule the meeting and let the school board have the TV slot. 

Central Receiving Unit

Following a presentation from Don Savoy, President and CEO of Meridian Behavioral Health Care, Commissioner Cornell moved that the commission express their intention to provide one-time matching funding of $250,000 to build a Central Receiving Unit and ask staff to work with the various stakeholders and Meridian to develop an operational plan and governance structure. A Central Receiving Unit is a place for people with a substance abuse or mental health crisis to get help without going to jail or going to an emergency room. The motion passed 5-0 (Wheeler arrived during the discussion of this item; she had been at a Canvassing Board meeting.)