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Informal Meeting Minutes Monday, December 07, 2020 Board Members 9:30 AM Clint Hickman, Chairman, District 4 Jack Sellers, Vice Chairman, District 1 BOARD OF SUPERVISORS Steve Chucri, District 2 Maricopa County, Arizona Bill Gates, District 3 (and the Boards of Directors of the Flood Control District, Steve Gallardo, District 5 Library District, Stadium District, Improvement Districts, Housing Authority of Maricopa County and/or Board of Deposit) County Manager Joy Rich Clerk of the Board "The mission of Maricopa County is to Fran McCarroll provide regional leadership and fiscally responsible, necessary public services to its residents so they can enjoy living in Meeting Location healthy and safe communities” Supervisors’ Conference Room 301 W Jefferson, 10th Floor Phoenix, AZ 85003 BOARD OF SUPERVISORS The Board of Supervisors of Maricopa County, Phoenix, Arizona, convened in an Informal Session at 9:30 AM on Monday, December 7, 2020, in the Supervisors’ Conference Room 301 W Jefferson, 10th Floor Phoenix, AZ 85003, with the following members present: Clint Hickman, Chairman, District 4; Jack Sellers, Vice Chairman, District 1; Bill Gates, Supervisor, District 3; Steve Chucri, Supervisor, District 2 (telephonically); Steve Gallardo, Supervisor, District 5 (telephonically). Also present: Fran McCarroll, Clerk; Joy Rich, County Manager; Andrea Cummings, Legal Counsel (telephonically); Maria Ceaglske, Minutes Coordinator. PRESENTATION 1. PRESENTATION AND UPDATE ON COVID AND VACCINE DISTRIBUTION PLAN Presentation from Public Health on the current status of the COVID-19 Pandemic and Vaccine Distribution Plan. Marcy Flanagan, Executive Director of Public Health (C-95-20-009-X-00) Chairman Hickman called the meeting to order and asked Marcy Flanagan, Executive Director of Public Health to present the COVID-19 General Update and the Vaccine Distribution Plan. Ms. Flanagan noted that the first slide had been updated to show the most current data regarding the number of COVID-19 cases. The following slide regarding the EPI curve shows that the numbers have been going up rapidly similar to the peak that happened at the end of June. There is a concern that the current rising number of cases may exceed the previous peak. She mentioned that the case count depicted on the slide probably does not yet show the effect of the Thanksgiving holiday gatherings. The next slide which indicates hospitalization rates in the central region of Arizona is increasing faster than what happened in the summer months. Ms. Flanagan pointed out the comparison of the rates compared to when the mask mandate went into place. The following slide showed projections from ASU and UofA which indicate that hospitalization capacity, even with surge capacity, may be exceeded, possibly within the next few weeks. Other scenarios are shown to indicate possible case numbers if strict mitigation efforts are instituted. She added that upcoming slides would review enhanced mitigation efforts. Ms. Flanagan moved on to death projections which could be as high as between 600 to 1,200 above the current projections. Additional slides dealt with possible mitigation efforts. Ms. Flanagan explained that the information represented was gathered from worldwide data and was listed in order of effectiveness. The first two were “cancellation of small gatherings” and “closing of ALL educational institutions.” Contract tracing and tracking fell to #28 as many times people did not or would not disclose those they had been with recently. The following slide gave a more complete description of “small gatherings.” This included public areas and numbers of persons in a household gathering. The following slides reviewed additional data from studies regarding where the highest rate of “spreading” the virus occurs which included densely crowded areas and a ranking of retail businesses and other places where people gather. Ms. Flanagan commented that the studies showed that reducing capacity in places such as restaurants to 20% could also have similar abilities to reduce the spread the same as full shut down measures. In response to a question from Supervisor Sellers about whether the studies looked at the difference between indoor and outdoor dining related to restaurants, Ms. Flanagan noted that the study looked at indoor dining. She also commented that any outdoor activities have a lower rate of transmission. The following slide dealt with information that often those in lower socio-economic categories, especially those that have to go to work to do their job have a higher rate of infection than others. Some individuals in this category are restaurant workers. Wearing masks helps to protect the workers and the patrons. Ms. Flanagan then moved to the next slide dealing with masks. Early studies did not analyze the effectiveness of wearing masks. However, now there are studies regarding this. The masks block the spreading of particles which is source control. Multi-layered cloth masks also help to protect the wearer. The following slide tracked the number of COVID cases before and after the Maricopa County mask resolution was put in place. Also, the following three slides provided data from over 45 studies which show a similar decrease in cases or deaths when mask regulations were instituted. Chairman Hickman asked if there have been any studies showing data from Arizona counties regarding the effectiveness of masks wearing. He noted that it may be difficult to do comparisons due to the different climate patterns and different population bases. Ms. Flanagan replied that she had heard that both ASU and UofA are looking into those questions, but she would need to check on the status of their work. The Chairman further commented that there have been similar public statements in the past dealing with the need to wear seatbelt, making sure we have clean water, and similarly working on clear air issues. As these slides show the decrease in cases and deaths as mitigation efforts are put in place, there are many similarities with prior safeguarding issues. Supervisor Chucri asked Ms. Flanagan some questions related to school attendance. He provided two anecdotes related to his experiences at his children’s schools and a question regarding returning to school after the holidays. Ms. Flanagan replied that schools have being doing a very good job of social distancing and other measures to keep the students and the staff safe. She commented that most of the cases they have seen related to schools have not been exposures related to activities that happened at school, but rather activities outside of school. The greatest majority of school-age cases are high school age students as these students have a more social network and social events they can attend outside of the home. Often the difficultly that is happening regarding schools staying open is not the number of cases, but rather quarantine issues of teachers being exposed and then having to quarantine. This creates an issue of not having enough staff to keep the schools open. The schools are very aware that keeping the schools open especially for elementary-age students is most beneficial to those children as the virtual schooling is more difficult in the younger grades. Supervisor Gates asked a follow-up question related to the steady increase in hospital cases even though the mask mandate has been put in place. Some might say that the mask mandate has not helped. Ms. Flanagan responded that many in the public health arena believe that the mandate is what has helped to keep the valley hospitals from actually reaching capacity. The continued incline may be more attributable to the reopening of school, the recent holidays and the increased social involvement related to those events. People just seem anxious to “get back to normal,” and have just a few friends or family members over, but this decision is repeated by the 4 million people in Maricopa County. In the final slide of this section Ms. Flanagan reviewed the going-forward best practices being recommended by many. These include a continued mask mandate, reducing indoor dining capacity to 20%, restricting gatherings of greater than 25 persons, posting gatherings of more than 25 on municipal websites for transparency, stopping group athletic activities including club sports, and possibly instituting curfews for non-essential activities. Supervisor Chucri asked another question regarding guidelines for quarantining. He stated that after an incident at his son’s school there were new CDC guidelines regarding length of quarantine time sent to parents. He asked about these guidelines. Ms. Flanagan responded that it was true that the CDC ad issued new guidelines which Maricopa County was now following. These include shortening the quarantine to 10 days from the last exposure. Even this can be shortened to 7 days if you receive a negative COVID test after 5 days. Research shows that after 10 days in quarantine with no sign of COVID the risk is less than 1%. Supervisor Gates asked Ms. Flanagan if she had seen the recent letter from December 3, 2020, from the Greater Phoenix Leadership Health Task Force signed by basically the CEOs of all of the hospitals in town. This recommendations in this letter seem to track with the recommendations on your last slide. Ms. Flanagan stated that she had seen that letter which was very similar to one the University of Arizona, ASU and the Arizona Public Health Association are working on requesting similar mitigation efforts. VACCINE DISTRIBUTION PLAN Ms. Flanagan then noted that she would be moving on to the part of her presentation regarding the plans for distribution of the vaccine which is now becoming available. She indicated that the CDC had written the “playbook” for all jurisdictions to follow. This plan was based on the two leading vaccines. Ms. Flanagan then proceeded to explain these types of vaccines which are mRNA. Her presentation is detailed on the following slides which include information on: The make-up of the vaccines How the vaccine works in our bodies What this type of vaccine does and does not do Side effects which may occur How the plan for distribution was developed The plan for the rollout based on when availability is expected The various population groups included in the Phases A tentative timeline regarding the Phases rollout Estimated numbers of population in the various phase groups Planning for the rollout to the 1a phase group Explanation of the Vaccine Management System which includes pre-registration and prioritization Placement of 5 POD cites in Maricopa County Who will staff the PODs A Screening Process Plans for further rollout timing Timing and how information will be communicated to partners Note: All slides for this presentation are entered here. Discussion and comments follow the slides. Chairman Hickman asked if the vaccine companies also plan to provide educational information about their products, and the safety of these vaccines. Ms. Flanagan responded that they will probably do that and release data about the vaccine products once the FDA has given them final approval. When that data becomes available it will be thoroughly reviewed by independent groups to provide more information about the vaccine. More information will be available once the FDA issues these emergency authorizations. She also mentioned that research regarding mRNA has been going on for decades. Ms. Flanagan stated that after reviewing the populations that are included in group 1a and estimating the numbers of persons in the various categories, it has been determined that the initial focus would be for 123,000 persons. However, it is unlikely there will be enough vaccine in the initial distribution to the County to cover that number. The major prioritization will be on those who are most at risk of infection. ~ Supervisor Chucri left the meeting briefly during this portion of the meeting, and then returned ~ In continuing her presentation, Ms. Flanagan reviewed specifics of the Pfizer vaccine which must be stored at -70 degrees C. She reviewed the process of how the vaccine is monitored as it is shipped, received and then administered to ensure safety. She stated that the general assumptions are that the vaccine will be provided free of charge, insurance could be billed an administrative fee, and the vaccine would not be mandatory. Ms. Flanagan explained that ADHS has procured a vaccine management system which will cover a way to pre-register, a mechanism for contacting the person back for the 2nd dose, and a way to upload the data, all within the system. Via the slides, Ms. Flanagan showed the locations and managers of the various POD sites. There was also information about who will be staffing the PODs to administer the vaccine. At the conclusion of her presentation, Chairman Hickman thanked Ms. Flanagan the information provided adding that the logistics of the vaccine program is a huge undertaking. He also commented that he realizes that although the plan is well-thought-out, depending on the actual distribution details and timing, the plan has to be flexible in order to deal with each of those changes. Supervisor Gates also commented on the magnitude of the vaccination plan which Ms. Flanagan and her team have put together on top of the daily monitoring of the spread of the virus and recommending mitigation measures. He mentioned that he had spoken with officials in other jurisdictions who have mentioned their appreciation of the information the County continues to provide. He felt it would be important for people to know that the County will be the one administering the vaccination program. Although this program is much larger, Public Health administers vaccination programs. He felt the partnerships with the major healthcare providers in the county is one of the strengths of this plan. Supervisor Gallardo agreed that this plan has taken a lot of work and is an excellent plan. He noted that he is always interested in how the information will be communicated as this is often a significant issue in his district. It seems it would be two significant components – why it is important to get the vaccine, and how can a person register. He also mentioned that there could be some issues with cultural differences that would need to be addressed. In the past, he and his staff would go to community events and provide information about county programs, however, in-person contacts are not working during COVID. He said they would need to re- invent some communication methods. He asked if there were some plans for community outreach. Ms. Flanagan said that as some final information comes about the rollout process there will be continued plans for outreach. They are open to having representatives from some of the smaller groups at the planning sessions. Supervisor Gallardo added that most of the communities he referenced trust schools, so he suggested including school personnel in the planning sessions. Supervisor Sellers commented that he was very impressed with the detail provided in this plan. He also mentioned that he was pleased to hear that the planners had already made the arrangements for the ultra-cold storage for the vaccine. Chairman Hickman concluded the meeting by stating that as the vaccine becomes available, and as the plan needs to change that Ms. Flanagan could call on the Board to meet if necessary. 2. EXECUTIVE SESSION Vote to convene in Executive Session to consider the items on the Executive Agenda dated Monday, December 07, 2020, for Board of Supervisors and relevant Special Districts pursuant to the statutory authority listed for each item. Motion to approve by Supervisor Jack Sellers, seconded by Supervisor Bill Gates Ayes: Clint Hickman, Jack Sellers, Bill Gates, Steve Chucri, Steve Gallardo MEETING ADJOURNED After discussion on the Executive Session items and there being no further business to come before the Board, the meeting was adjourned. ______________________________ Clint Hickman, Chairman of the Board ATTEST: ____________________________ Fran McCarroll, Clerk of the Board