By Bradon C. Bradford, MSPH, MPA, REHS
Southeast Utah Health Department Health Officer
As we approach the time to review the Public Health Order issued last month, I wanted to let you know what goes into the thought process and planning for how we will move forward in our area and give you a chance to plan for what we continue to ask of our community.
Let me go back a little bit to when the order was first issued. It happened extremely suddenly, which is something I both regret and know was necessary. Southeast Utah was about to see tens of thousands of tourists passing through and staying in our area. Even though the message about staying home was becoming more prevalent, it quickly became evident that people cannot seem to stay away from Southeast Utah in the springtime. Normally, that is a great boon for us, but this spring, it posed a danger. Utah did not yet have good testing capacity. Utah did not have sufficient personal protective equipment (PPE). We still did not know enough about the disease. What we did know was that healthy people carried and transmitted the disease to both healthy and high-risk populations. So, that spring influx of people posed a danger to us all.
It’s important to know that, even with current social distancing guidelines, directives and restrictions in place, we are starting to better understand how to mitigate some of those dangers and we’ve had time to properly prepare for others. I’d like to update you on some of those things: what plans are beginning to look like and how we’ll address those issues in the coming order and beyond. I would also like to remind community members that continued extreme social distancing can be as hazardous to each of our communities as a complete lack of social distancing. If COVID-19 is never introduced into the community, then people don’t build up the immunity they need and we’ll never gain what is termed “herd immunity” or the ability for enough of people to become immune to a disease that it protects those that do not have that ability. For most diseases, that is obtained through vaccination. For COVID-19, we do not yet have that option. So, what is best for public health is to have a controlled way of introducing disease into a community, done in such a way as to protect our most vulnerable populations and maintain the integrity of our healthcare systems.
With that in mind, here are some of the updates and plans in regards to the Southeast Utah Health Department Amended Public Health Order SEUHD2020-02:
TESTING (this will not be a part of the order, but is relevant to the order):
As of today, we have tested approximately 1% of our community in four weeks. We would like to test an additional 1% in the next two weeks. This must be done in an organized fashion and we are working with hospitals and labs to determine how it can be done. Increased testing will help us know to an even greater extent how much the disease is moving throughout our community.
HEALTHCARE CAPACITY (this will not be a part of the order, but is relevant to the order):
Our healthcare providers and their associated facilities have worked incredibly hard over the past several weeks to treat those who they would normally see as well as those suffering from COVID-19 like symptoms. While doing this, they have also begun to implement plans about increasing their capacity. They, along with the local and state health departments, are doing everything they can to appropriately reuse PPE and order new stock when available. Generally speaking, our healthcare system knows much more about how to handle people with current symptoms and what their capacity might be in case of a local or statewide surge of patients.
EPIDEMIOLOGY (This will not be a part of the order, but is relevant to the order):
The health department has only dealt with five positive cases thus far, but they have been in a wide variety of unique situations and resulted in over 150 close contacts that have needed isolation or quarantine. Over 95% of this contact tracing has happened within 24 hours, greatly outpacing the 72 hours that is anticipated for most contact tracing. SEUHD staff has responded well and is prepared to continue rapid and effective contact tracing in the upcoming weeks.
COMMUNITY RESPONSE (There may be elements of this in the amended/continued order):
We want to see continued social distancing, increased use of masks in public spaces and increased awareness of high-risk groups to reduce their social interaction. In addition, we are communicating with the National Parks about what their future looks like and how it will affect our local communities when they begin to transition to normal operations.
Expect the following to be in place until May 4, 2020:
FOOD SERVICE RESTRICTIONS: The order issued by the Utah Department of Health will be our guide in Southeast Utah and the language in our order will mimic that of the State to the greatest extent possible. In the future, I envision opening restaurants to interior dining for 30% of capacity, growing to 50%, 75% and 100% capacity (those numbers are not definite, but represent what a gradual return to normal might look like).
LODGING RESTRICTIONS: Current lodging restrictions will remain in place. As we near May 4, if we continue to see positive developments in the country, some changes that could be implemented are as follows: Short-term nightly rentals reopening with no in-person check in, grocery pick-up only, groups smaller than 10 people. Campground and RV parks opening a certain percentage of available spaces in order to maintain social distancing guidelines. Hotels able to reserve a percentage of rooms while closing public spaces a limiting the ability to gather. These examples are not intended as guarantee of change but are examples of what might be necessary to implement in order to best balance health, safety and economic concerns.
OTHER BUSINESS: I encourage every other business that has been directly closed as a result of SEUHD202-02 (salons, barber shops, nail parlors, gyms, studios, etc.) to prepare a COVID-19 mitigation plan to submit to the health department. Due to the fact that these businesses primarily serve our local population and each has an opportunity to implement appropriate measures to protect staff and patrons, submission of a plan that includes social distancing guidelines, staff protection plans, sanitation plans, etc., may result in receiving approval from SEUHD to reopen in a limited fashion. Businesses that generally cater to groups of more than 10 people (theaters, bowling alleys, etc.) are also encouraged to prepare to submit a plan for when the restriction on groups of people gathering gradually begins to lift.
Constructive feedback to this notice may be submitted to bbradfor@utah.gov. A formal amendment to the current order will be issued next week and will be in place until May 4.