County commission votes to step up enforcement of mask order

BY JENNIFER CABRERA

During their regular meeting on June 23, the Alachua County Commission decided to step up enforcement of their facial covering mandate.

Paul Myers, the Florida Department of Health Administrator for Alachua County, shared some information on the current COVID-19 situation in Alachua County. Our daily updates contain most of the information he shared, so this article will only include information that isn’t in our daily updates.

Regarding the recent uptick in positive tests, Myers said it started with the outbreak in the agricultural community, “where we had a very remarkable 90% positivity rate in just one group of those individuals… Most of these individuals, the vast majority of them, were asymptomatic. They reported being ill a month or more ago, before they came to Alachua County, and I think this really highlights one of the facts of this disease that we’re starting to realize, and that’s the best test we have is the PCR test. We cannot differentiate between current infection with this test and, basically, a person who is continuing to excrete viral debris, which is not infectious. This test is very sensitive but not very specific, in that regard.”

Then, speaking of the high number of positive tests in the past week or so, Myers said, “That is really the 20-25-year-olds, who for various reasons are being tested. None of them are being hospitalized. They’re being tested, a lot at the University of Florida, they’re being tested at outpatient clinics, they’re being tested through our drive-through for various reasons.”

While discussing contact tracing, Myers said his office is able to make contact with 80% of positive tests within 24 hours, and they follow up over the next two weeks. 

“The house parties over the past two weeks is accounting for much of this”

Commissioner Ken Cornell asked for more information about the latest positive tests. Myers said, “The reasons that are being revealed in our investigation, in terms of where these individuals are reporting being—they’re house parties. They are other social gatherings. I can’t tie them back to a particular establishment such as a bar—that’s not coming out in our investigation. These are clusters; many of theses are household contacts of previously-known contacts, but the house parties over the past two weeks is accounting for much of this, in addition to the asymptomatic screening for reasons such as internships, health-related fields where people are being compelled to be tested, so that’s what we’re seeing in terms of this latest increase.”

On the above slide, Myers pointed out that Alachua County’s positive test rate, percentage of COVID-19 cases resulting in death, population mortality rate, and median age of cases are all significantly lower than those metrics for the state of Florida.

On the above slide, Myers pointed out that although we’ve had a high number of cases in June, the percent of positive tests is actually lower than it was in April, because of much higher testing volume.

Note on the above slide that hospitalizations are down overall since early April, and the numbers of patients in ICU and/or on ventilators with COVID-19 are significantly down.

In spite of the large number of new cases, the hospitalization trend continues in a downward direction.

Alachua County currently leads all medium- and large-sized counties in state testing thresholds. The number of tests far exceeds the recommendation to test 2% of the population per month.

This slide compares Alachua County’s testing to several other counties in Florida. We have tested 5.98% of the population, while the next highest county on the slide has tested 3.43%.

The main point of this slide is that 0.3% of Alachua County’s long-term care population has died from COVID-19, compared to 1.1% in the full state. Also, 82% of Alachua County’s COVID-19 fatalities were in long-term care, specifically from one facility, Parklands Care Center.

Myers warned that patients should not avoid emergency rooms, pointing out that emergency visits for heart attacks, strokes, and uncontrolled high blood sugar dropped significantly in the 10 weeks following the declaration of the COVID-19 national emergency.

“… these students, who are clearly not practicing the social distancing.” 

Cornell asked what Myers would recommend in terms of policy, but Myers said his role is to advise the commission on the characteristics of the disease, not to recommend policies. “Now that said, I do understand that you all are getting phone calls, particularly the last two weeks, with this increase in cases, tremendous amount of pressure being put on all five of you, to do something, and I get that… it’s a very difficult time to be in public health… because we have to walk a very fine line in terms of communicating the daily increase in understanding of this disease… That said, I am in discussions with the University of Florida, in terms of what we can do to leverage whatever we can with these students, who are clearly not practicing the social distancing.” 

Cornell proposed directing all of their code enforcement officers to enforcing the facial covering mandate 7 days a week for the foreseeable future. “Now is the time to do it… we’re going to start to see a lot more [students coming back], and the reason I’m really, really passionate about this is that I believe that the opening up of our economy is dependent on this. We’ve seen a marked increase in folks expressing concerns within our community, and when people are concerned, they don’t go shopping. They don’t go out, and that affects our economy, and so I think it’s not just public health any more. It’s critical to the functioning of our economy that people follow the law.”

“… maybe there are some high-school-age students working at Publix or someplace like that, who then might be put in a position to have to confront patrons coming into the business”

County Manager Michele Lieberman said she’d spoken to the municipalities that morning. “Obviously, we have had a request directly by the City of Gainesville, who’s asked us to be hand in hand with enforcement of this issue and asked us to consider enforcement mechanisms today, especially as it relates to facial coverings, but we also have had some concerns expressed by some of the other municipalities regarding putting the onus on business and the concern that we might have… people who have to stand at the front, that would be put in an awkward position themselves, such as maybe there are some high-school-age students working at Publix or someplace like that, who then might be put in a position to have to confront patrons coming into the business… but there was also concern expressed by another of the small municipalities that confronting individuals was more problematic.”

Commissioner Marihelen Wheeler said they should hold businesses “responsible for setting people in place who are not kids, who are not vulnerable to that kind of kickback from their clients… if we could go back to… making the stores responsible for the behavior of their… customers… they’ve proved that they can do it, and they can do it again.”

“It’s gonna get ugly”

Commissioner Mike Byerly said, “It’s gonna get ugly… the more we do, the more divisiveness we will create, the more it will become a political rallying point…” He said that if you drive outside the county, you’ll see “we are very unusual, VERY unusual… In the grocery stores, in the restaurants [in other counties], very few people wearing masks…” He added that it will “very rapidly become common knowledge that all you have to do” is state that you have an exempt medical condition. 

Commission Chair Robert Hutchinson said most people who aren’t wearing masks are healthy. “I’ve walked around the stores, I’m looking at these dudes… sheets of plywood, stuff like that, and they don’t have health conditions.” He said it’s got to be a “carrot and a stick.” Code enforcement officers can offer them a mask, but if they refuse to wear it, it’s “Sorry, that’s against the law in Alachua County, and we’re issuing you a citation if you’re going into the store.”

When asked what would happen if someone told the code enforcement officer they’re medically exempt, he said, “They can explain that to the hearing officer.”

Hutchinson said they could also hire off-duty ASO and GPD officers to “stand by in the event that person takes a swing at them.” He said that the facial covering enforcement is more important than other things codes enforcement is doing right now, like parking tickets or making sure people pull their garbage cans off the street. 

He proposed issuing warnings only for the first couple of weeks: “Next time this will be a citation, sir. And the word will get out, and it will get them used to the pattern.” He thinks students will start wearing masks once they are warned. “People who believe that their constitutional rights are somehow being violated by this, that’s a different argument, and I think that’s a relatively smaller percentage of folks.”

Cornell made the following motion:

1. Staff should move forward with increasing their code enforcement efforts and report back to the board on their activities regarding warnings and citations issued. Also require businesses to post a sign saying masks are required, along with information about other hygiene and social distancing recommendations.
2. Staff should begin implementing Level 2 compliance, where Level 2 means defining priority locations, giving an enforcement reminder and education outside establishments, and issuing a warning that closely resembles an official citation and includes a statement why the requirement is in place.
3. Staff should develop a plan for making face coverings available to those businesses that request them. 

The County plans to enforce the mandate only in the unincorporated area except the City of Waldo, which has requested assistance. Municipalities are responsible for deciding on their own level of enforcement. 

Byerly asked County Attorney Sylvia Torres to read the exemptions to the facial covering order, which are, “A facial covering shall not be required for children under six, persons who have trouble breathing due to a chronic pre-existing condition or individuals with a documented or demonstrable medical problem. It is the intent of this provision that those individuals who cannot tolerate a facial covering for a medical, sensory or any other condition which makes it difficult for them to utilize a facial covering and function in public are not required to wear one. It is recognized that this requirement is broader than what might be considered to be a covered condition under the Americans with Disabilities Act.”

Byerly said, “So basically, from that language, if it bothers you when you wear it, you don’t have to wear it.”

Torres said, “It says, ‘cannot tolerate.’ It isn’t ‘bother.’”

Byerly said, and Torres agreed, that you can’t legally define that. Byerly added, “So basically our code allows people, if they basically don’t like wearing masks, they don’t have to wear it, and I just want to know if we’re going to tell people that.”

Byerly said their other codes are clear about where the lines are, but now the County is sending out code enforcement officers into tense situations without clear direction. 

The motion passed unanimously.