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HomeMy WebLinkAbout2020_09_02 CC PKTCity Council City of Brookings Meeting Agenda - Final-revised Brookings City Council Brookings City & County Government Center 520 3rd St., Suite 230 Brookings, SD 57006 Phone: (605) 692-6281 Fax: (605) 692-6907 "We are an inclusive, diverse, connected community that fuels the creative class, embraces sustainability and pursues a complete lifestyle. We are committed to building a bright future through dedication, generosity and authenticity. Bring your dreams!" Council Chambers7:00 PMWednesday, September 2, 2020 Special Meeting The City of Brookings is committed to providing a high quality of life for its citizens and fostering a diverse economic base through innovative thinking, strategic planning, and proactive, fiscally responsible municipal management. 7:00 PM SPECIAL MEETING 1. Call to Order / Pledge of Allegiance. 2. Record of Council Attendance. 3. Action to approve the agenda. 4.ORD 20-017 Second Reading and Action on Ordinance 20-017, an Ordinance Amending Ordinance 20-010 to Extend the Provisions Regarding a Public Health Crisis and to Revise Certain Measures which have been deemed necessary to slow the Community Spread of Coronavirus (COVID-19) in the City of Brookings, South Dakota. Memo - 9/2/2020 Memo -8/25/2020 Ordinance 8/25/2020 Summary of COVID Triggers - 9/2/2020 Attachments: Action: Motion to Approve, Request Public Comment, Roll Call Legislative History 8/25/20 City Council read into the record 5.ORD 20-019 Introduction and First Reading on Ordinance 20-019 an ordinance to revise certain measures which have been deemed necessary to slow the Page 1 City of Brookings September 2, 2020City Council Meeting Agenda - Final-revised Community Spread of Coronavirus (COVID-19) in the City of Brookings, South Dakota. Second Reading: September 8, 2020 Memo Ordinance 9/8/2020 clean Ordinance 9/8/2020 marked Ordinance 9/2/2020 Summary of COVID Triggers Attachments: The title of the Ordinance is read. No vote is required on the first reading of an Ordinance. Public Comment and Council discussion is permitted. The date for the second reading is announced. 6.RES 20-072 Action on Resolution 20-072, an Emergency Resolution of the City Council of the City of Brookings, South Dakota, to address a public health crisis. Memo Resolution Summary of COVID Triggers Attachments: Action: Motion to Approve, Request Public Comment, Roll Call 7. City Council member introduction of topics for future discussion. Any Council Member may request discussion of any issue at a future meeting only. Items cannot be added for action at this meeting. A motion and second is required stating the issue, requested outcome, and time. A majority vote is required. 8. Adjourn. Brookings City Council: Keith Corbett, Mayor; Patty Bacon, Deputy Mayor Council Members Leah Brink, Joey Collins, Ope Niemeyer, Holly Tilton Byrne, and Nick Wendell Council Staff: Paul M. Briseno, City Manager Steven Britzman, City Attorney Bonnie Foster, City Clerk View the City Council Meeting Live on the City Government Access Channel 9. Rebroadcast Schedule: Wednesday 1:00pm/Thursday 7:00pm/Friday 9:00pm/Saturday 1:00pm The complete City Council agenda packet is available on the city website: www.cityofbrookings.org Assisted Listening Systems (ALS) are available upon request by contacting (605) 692-6281. If you require additional assistance, alternative formats, and/or accessible locations consistent with the Americans with Disabilities Act, please contact Susan Rotert, City Human Resources Director and ADA Coordinator at (605) 692-6281 at least three working days prior to the meeting. Page 2 City of Brookings City of Brookings Staff Report Brookings City & County Government Center, 520 Third Street Brookings, SD 57006 (605) 692-6281 phone (605) 692-6907 fax File #:ORD 20-017,Version:2 Second Reading and Action on Ordinance 20-017, an Ordinance Amending Ordinance 20-010 to Extend the Provisions Regarding a Public Health Crisis and to Revise Certain Measures which have been deemed necessary to slow the Community Spread of Coronavirus (COVID-19) in the City of Brookings, South Dakota. Summary: Brookings COVID numbers have increased dramatically over the past week. The guiding metrics have all been triggered with the exception of hospitalization. The current Ordinance (Phase 3) regulates bars, restaurants, salons, and retail. Additional regulations is needed to mitigate the increase in cases. Staff recommends extending the existing ordinance and necessary amendments including regulating residential gatherings to ten or less and ceasing the sale of alcohol past 10 p.m. Thursday - Saturday. Background: The City of Brookings is currently under Phase 3 with substantial conditions based on the past weeks data. As of Monday the seven-day positive rate is 34%. The desired rate is 5%. As of Monday Brookings County had 321 cases with 183 recovered or 138 active. This past week there have been substantial increases. At the last City Council meeting thresholds and metrics were provided as guidance for Council and the public of existing conditions. This information is provided by local professionals and weighs metrics such as test positive rates, health care capacity, testing scope and capacity. As of the last report the only metric met was the capacity of hospitalization available. The existing Ordinance 20-010 is set to expire September 8th. Recommendation: Staff recommends approval. Attachments: Memo - 9/2/2020 Memo - 8/25/2020 Ordinance 8/25/2020 Summary of COVID Triggers - 9/2/2020 City of Brookings Printed on 12/2/2020Page 1 of 1 powered by Legistar™ City Council Agenda Memo From: Paul Briseno, City Manager Council Meeting: September 2, 2020 Subject: COVID Ordinance Amendments Person(s) Responsible: Paul Briseno, City Manager Summary: Brookings COVID numbers have increased dramatically over the past week. The guiding metrics have all been triggered with the exception of hospitalization. The current Ordinance (Phase 3) regulates bars, restaurants, salons, and retail. Additional regulations is needed to mitigate the increase in cases. Staff recommends extending the existing ordinance and necessary amendments including regulating residential gatherings to ten or less and ceasing the sale of alcohol past 10 p.m. Thursday - Saturday. Background: The City of Brookings is currently under Phase 3 with substantial conditions based on the past weeks data. As of Monday the seven-day positive rate is 34%. The desired rate is 5%. As of Monday Brookings County had 321 cases with 183 recovere d or 138 active. This past week there have been substantial increases. At the last City Council meeting thresholds and metrics were provided as guidance for Council and the public of existing conditions. This information is provided by local professionals and weighs metrics such as test positive rates, health care capacity, testing scope and capacity. As of the last report the only metric met was the capacity of hospitalization available. The existing ordinance 20-010 is set to expire September 8th. Discussion: Current conditions warrant the extension of the COVID19 Phase 3 ordinance. Criteria of test positive rates, health care capacity, testing scope and capacity as well as the commencement of SDSU and the public schools should be considered in the determination of necessary phases and amendments. Amendments for consideration include:  Place restrictions on all residential gatherings larger than ten (10) people  Limit the sale of alcohol to 10 p.m. Thursday, Friday and Saturday  Require masks for events that require a city permit where six (6) foot social distancing cannot be achieved  Require masks in all public places where six (6) foot social distancing cannot b e achieved The item is presented to City Council for action. The current ordinance will expire September 8th. City Council is provided with healthcare insight of local conditions. Based on this information and business/residential concerns, Council is asked to approve the extension and amendments. The summary of the recent COVID triggers is attached. Legal Consideration: None. Financial Consideration: None. Options: The City Council has the following options: 1. Approve as presented 2. Amend 3. Deny 4. Do nothing Staff recommends approval of the ordinance extension and any additional amendments. Supporting Documentation: 1. Resolution 2. Ordinance 3. Summary of COVID Triggers Ordinance 20-017 An Ordinance Amending Ordinance 20-010 to Extend the Provisions Regarding a Public Health Crisis and to Revise Certain Measures which have been deemed necessary to slow the Community Spread of Coronavirus (COVID- 19) in the City of Brookings, South Dakota. Be It Ordained and Enacted by the Council of the City of Brookings, State of South Dakota, as follows: I. That Ordinance 20-010 is amended to extend the period Ordinance 20 -010 is effective, and accordingly Section 9 is amended as follows: Ordinance 20-010 shall remain in effect for an additional period of sixty (60) days, at which time it shall be automatically repealed unless specifically readopted for an additional period of time by the City Council. Any dates identified in this ordinance may be adjusted at any time within the sixty (60) day period covered by this ordinance. II. Any or all ordinances in conflict herewith are hereby repealed. First Reading: August 25, 2020 Second Reading: September 2, 2020 Published: CITY OF BROOKINGS, SOUTH DAKOTA Keith W. Corbett, Mayor ATTEST: Bonnie Foster, City Clerk For week ending August 28, 2020 Summary of Brookings COVID-19 Public Health Thresholds Week Ending 8/28/2020 1. Is the epidemic controlled? No 2. Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Yes 3. Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases in Brookings? a. Mitigation Level: No b. Suppression Level: No c. Approximate time to receive test results: about 1-2 days DATA: 1. Is the epidemic controlled? Rt evaluated weekly. If Rt is <1.0 for 14 days or longer this would be a ‘yes’, otherwise it would be a ‘no’. Rt has exceeded 1.0 for the last 14 days. Below are the Rt based on number of cases in Brookings for 106 days ending on 8/28/20. Rt for the most recent 14 days (based on data from the previous week): Based on Data for Week Ending: Brookings South Dakota 8/15 1.31 1.07 8/16 1.17 1.10 8/17 1.12 1.13 8/18 1.09 1.17 8/19 1.24 1.18 8/20 1.40 1.25 8/21 1.45 1.33 8/22 1.37 1.55 8/23 1.62 1.49 8/24 1.78 1.53 8/25 2.24 1.54 8/26 2.52 1.71 8/27 2.74 1.88 8/28 2.94 1.93 Notes: • The closer Rt is to 0, the sooner transmission control will be attained. • Super spreader events are not predicted by Rt and can rapidly affect transmission trajectories. |--------- June -------|-------- July --------|---- August ---- -August For week ending August 28, 2020 2. Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Evaluate hospital bed and ICU availability and determine whether an increase of 20% in the number of cases can be absorbed within the health system. If health system can absorb increase than ‘yes’, otherwise ‘no’. Yes. The number of new cases in Brookings reported for the seven days up to and including 8/28/20 was 68. Adding an additional 20% is 82. Brookings Health System has a surge capacity of 80 beds and the personnel to easily handle 45 beds. Based on the current numbers of hospitalizations per day (statewide 7-day running average of 6.7), it is felt that the Brookings Health System can handle the anticipated number of possible admissions. 3. Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? Evaluate whether the mitigation and suppression levels of testing are being met. Mitigation level of testing uses the total number of tests completed in Brookings in the previous seven days and determines whether it is equal to or greater than the total number of new cases identified plus ten times the number of new cases. The number of tests completed does not include targeted testing (i.e., public health surveillance or sentinel testing in nursing homes or on campus). Suppression level of testing is being met when the percentage of positive test results in the previous seven days is equal to or less than 3.0%. If mitigation and suppression levels of testing are being met than this would be ‘yes’, otherwise it would be ‘no’. Mitigation & Suppression Levels of Testing. Testing data for the previous seven days: Total # of cases Ten times number of new cases: Tests needed to meet mitigation level: Tests completed (mitigation): % Test Positivity (suppression) Brookings Health System Dashboard as of 8/25/20:* Brookings 68 680 748 409 18.1% South Dakota Department of Health Dashboard as of 8/28/20:** Brookings 68 680 748 279 25.4% South Dakota 1,633 16,330 17,963 7,310 22.3% * Brookings data are based on number of tests completed, not the number of people tested. Data for a particular date are not reported until all test results are back. ** Includes sentinel surveillance tests (e.g., nursing homes, first responders, etc.) and is based on number of people tested, not the number of tests. Approximate time to receive test results as of 8/28/20 (Brookings): 1-2 days For week ending August 28, 2020 Brookings COVID-19 Thresholds Overview of Public Health Criteria Used to Control Transmission of COVID-19 The World Health Organization (WHO) uses three criteria for consideration in adjusting public health and social measures related to COVID-19 and suggests measures that can be used for evaluating these criteria1: 1. Epidemiology - Is the epidemic controlled? 2. Health System Capacity - Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? 3. Public Health Surveillance - Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? The various measures suggested by the WHO for evaluating the above criteria are given at the end of this summary as an Appendix. The ones given below are those that are locally available. Epidemiology The key measure for assessing whether the epidemic is controlled is the effective reproduction number (Rt). Rt represents the number of secondary cases for each infectious case and a value below 1 is the best indication that the epidemic is controlled and declining. The closer Rt is to 0, the sooner transmission control will be attained. The Rt depends on factors related to the number of susceptible individuals and their potential contact with infectious persons. It should be noted that superspreader events are not predicted by Rt and can rapidly affect transmission trajectories. A Rt of less than 1 for at least two weeks is used to indicate the epidemic is controlled. An algorithm is available that will calculate an estimate for Rt if case surveillance data are available.2 Brookings Measure: Is the epidemic controlled? Rt evaluated weekly. If Rt is <1.0 for 14 days or longer this would be a ‘yes’, otherwise it would be a ‘no’. Health System Capacity A key measure for assessing whether the health system is able to cope with a resurgence of cases is that the number of new cases requiring hospitalization is smaller than the estimated maximum hospital and ICU bed capacity of the health system (i.e. the health system can cope with new hospitalizations without becoming overwhelmed while maintaining delivery of essential health services). One of the criteria used is that the health system can absorb or expand to cope with at least a 20% increase in COVID-19 case load. Brookings Measure: Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Evaluate hospital bed and ICU availability and determine whether an increase of 20% in the number of cases can be absorbed within the health system. If health system can absorb increase than ‘yes’, otherwise ‘no’. 1 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social-measures-in-the-context- of-covid-19 2 https://academic.oup.com/aje/article/178/9/1505/89262 For week ending August 28, 2020 Public Health Surveillance There are several criteria listed under public health surveillance, including surveillance systems, case investigation and contact tracing. Many of these measures are not known at a county level; however, the number of tests and test positivity are known. The Harvard Global Health Institute has established targets for assessing the adequacy of testing at both the mitigation level and the suppression level:3 Mitigation level testing: Mitigation focuses on reducing the spread of the virus through broad testing of symptomatic people, tracing and testing a recommended 10 contacts per new case, isolating positive contacts, social distancing, mask-wearing or stay-at-home orders as necessary. Testing targets for mitigation is set as the sum of symptomatic cases and 10 times the number of cases (to cover the contacts) and does not include targeted testing (sentinel testing of nursing homes, schools, etc.). Suppression level testing: Suppression allows a community to quickly find and isolate new cases before they lead to a wider outbreak, with an aim of keeping new case levels at or near zero. A test positivity rate of 3% or less can be used as an indicator of progress towards suppression level testing. Suppression level testing requires testing of asymptomatic people in high-risk environments including nursing homes, colleges, etc. Brookings Measure: Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? Evaluate whether mitigation and suppression levels of testing are being met using the total number of tests completed and test positivity in Brookings during the previous week and approximate length of time for test results to received back in the clinics. For mitigation level of testing the number of tests completed should be equal to or greater than the total number of new cases identified plus ten times the number of new cases. For suppression level testing, the test positivity should be 3% or less. It will be noted whether the mitigation and suppression levels of testing are being met, as well as the approximate length of time between samples being submitted by local labs and test results being received. Additional notes Caveats regarding the data: • The number of cases by day that are used in calculating Rt are based on the numbers posted to the SDDOH dashboard. These dates are not the date symptoms appeared and not necessarily the date the test sample was obtained or the test was conducted; they are the date that the test results were reported to SDDOH. This is the best information that is available. • The number of tests conducted in Brookings are not the number of individuals tested, but the number of tests performed, which may include repeated testing of the same individual. Committee Members: Bonny Specker, MS, PhD (epidemiologist), Chris Chase, DVM, PhD (virologist), Gary Gackstetter, DVM, MPH, PhD (epidemiologist), Amy Hockett, RN (Sanford Brookings Clinic Manager), Adam Hoppe, PhD (cell biologist, immunologist), Victor Huber, PhD (virologist, immunologist), Jason Merkley (President, Brookings Health System), Natalie Thiex, MPH, PhD (epidemiologist, toxicologist), Xiuging Wang, PhD (virologist, cell biologist) 3 https://globalepidemics.org/testing-targets/ For week ending August 28, 2020 APPENDIX: Criteria recommended by the WHO4 Table 1. WHO Criteria for Epidemiological Control Epidemiological Criteria Explanation Decline of at least 50% over a 3-week period since the latest peak and continuous decline in the observed incidence of confirmed and probable cases ° This indicates a decline in transmission equivalent to a halving time of three weeks or less since the latest peak, when the testing strategy is maintained or strengthened to test a greater % of suspected cases. Less than 5% of samples positive for COVID-19, at least for the last 2 weeks, ° assuming that surveillance for suspected cases is comprehensive The % positive samples can be interpreted only with comprehensive surveillance and testing of suspect cases, in the order of 1/1000 population/week Less than 5% of samples positive for COVID-19, at least for the last 2 weeks°, among influenza-like-illness (ILI) samples tested at sentinel surveillance sites Through ILI sentinel surveillance, a low % of positive samples indicates low community transmission* At least 80% of cases are from contact lists and can be linked to known clusters This indicates that most transmission chains have been identified, offering the opportunity for follow-up. This may be limited by the fact that the information will certainly not have been collected at the height of the epidemic. Decline in the number of deaths among confirmed and probable cases at least for the last 3 weeks ° This will indicate, with an approximately 3-week lag-time, that the total number of cases is decreasing. If testing has decreased, then the number of deaths in probable cases will be more accurate. Continuous decline in the number of hospitalization and ICU admissions of confirmed and probable cases at least for the last 2 weeks° This indicates, with an approximately 1-week lag-time and providing that the criteria for hospitalization have not changed, a decline in the number of cases. Decline in the age-stratified excess mortality due to pneumonia When pneumonia cases cannot be systematically tested, a decline in the mortality of pneumonia would indirectly indicate a reduction in the excess mortality due to COVID-19. * Trend evaluation requires that no changes occurred in testing or measurement strategy ° 2-week period corresponds to the maximum incubation period and is the minimum period on which to assess changes in trends. Table 2. WHO Criteria for Health System Capacity Health System Criteria Explanation All COVID-19 patients can be managed according to national standard This indicates that the health system has returned to a state where all conditions (staff, beds, drugs, equipment, etc.) are there to provide the same standard of care that existed before the crisis. All other patients with a severe non-COVID-19 condition can be managed according to national standard There is no increase in intra-hospital mortality due to non-COVID-19 conditions The health system can absorb or can expand to cope with at least a 20% increase in COVID-19 case load This indicates that the system would be sustainable even if it had to absorb a surge in cases resulting from loosening public health and social measures. This includes sufficient staff, equipment, beds, etc. An Infection, Prevention and Control (IPC) focal point is available in all health facilities (1 full-time trained IPC focal point per 250 beds) and at district level This indicates strong capacity for coordination, supervision and training on IPC activities, including in primary health facilities. All health facilities have screening for COVID-19 This is for ensuring that all patients who come to a facility are assessed for COVID-19 in order to prevent health associated infections. All acute health facilities have a mechanism for isolating people with suspected COVID-19 The health system has sufficient capacity to isolate all patients with COVID-19 4 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social-measures-in-the-context- of-covid-19 For week ending August 28, 2020 Table 3. WHO Criteria for Public Health Surveillance Public Health Surveillance Criteria Explanation Public Health Surveillance Systems New cases can be identified, reported, and data included in epidemiological analysis within 24 hours A surveillance system for COVID-19 is in place that is geographically comprehensive and covers all persons and communities at risk. Comprehensive surveillance includes surveillance at the community level, primary care level, in hospitals, and through sentinel surveillance sites for influenza and other respiratory diseases, where they exist. Immediate reporting of probable and confirmed cases of COVID-19 is mandated within national notifiable disease with requirements This indicates that appropriate public health policies are in place for immediate notification of cases of COVID-19 from all health facilities. Enhanced surveillance is implemented in closed residential settings and for vulnerable groups This indicates that public health authorities have identified populations who live in residential settings or are vulnerable and that enhanced surveillance is put in place for these populations. Mortality surveillance is conducted for COVID-19 related deaths in hospitals and in the community This indicates the ability to rapidly and reliably track the number of deaths related to COVID-19. Where possible, medical certificate of death for COVID-19 deaths should be issued. Other approaches for mortality surveillance may be considered, such as reports from religious centres or burial sites. The total number of laboratory tests conducted for COVID-19 virus is reported each day Knowing the testing denominator can indicate the level of surveillance activity and the proportion of tests positive can indicate the intensity of transmission among symptomatic individuals. Case Investigation Public health rapid response teams are functional at all appropriate administrative levels A measure of the capability to rapidly investigate cases and clusters of COVID-19. 90% of suspect cases are isolated and confirmed/released within 48 hours of symptom onset This indicates that investigation and isolation of new cases is sufficiently rapid to minimize the generation of secondary cases. Contact Tracing At least 80% of new cases have their close contacts traced and in quarantine within 72 hours of case confirmation These indicate that the capacity to conduct contact tracing is sufficient for the number of cases and contacts. At least 80% of contacts of new cases are monitored for 14 days Contacts should be contacted each day during the 14-day period and ideally no more than two days should elapse without feedback from a contact. Information and data management systems are in place to manage contact tracing and other related data While contact tracing data can be managed on paper at a small scale, large- scale contact tracing can be supported by electronic tools such as the Go.Data contact tracing software. City of Brookings Staff Report Brookings City & County Government Center, 520 Third Street Brookings, SD 57006 (605) 692-6281 phone (605) 692-6907 fax File #:ORD 20-019,Version:2 Second Reading and Action on Ordinance 20-019, an Ordinance to Revise Certain Measures Which Have Been Deemed Necessary to Slow the Community Spread of Coronavirus (COVID-19) in the City of Brookings, South Dakota. Summary: Brookings COVID numbers have increased dramatically. The guiding metrics have all been triggered with the exception of hospitalization. The current Ordinance (Phase 3) regulates bars, restaurants, salons, and retail and was extended at the September 2nd meeting. Additional regulations are needed to mitigate the increase in cases. Staff recommends approval of Ordinance 20-019 which requires masks for city-permitted events and inside business / public places when six feet social distancing cannot be achieved. Background: The City of Brookings is currently under Phase 3. On Thursday, the seven-day positive rate was 35.4%. The desired rate is 5%. As of Friday, Brookings County had 431 cases with 248 recovered or 183 active. There has been substantial increases in the past two weeks. Thresholds and metrics were provided as guidance for Council and the public of existing conditions. This information is provided by local professionals and weighs metrics such as test positive rates, health care capacity, testing scope and mitigation measures. As of the last report, the only metric met was the capacity of hospitalization available. Recommendation: Staff recommends approval. Attachments: Memo Ordinance 9/8/2020 clean Ordinance 9/8/2020 marked Ordinance 9/2/2020 Summary of COVID Triggers City of Brookings Printed on 12/2/2020Page 1 of 1 powered by Legistar™ City Council Agenda Memo From: Paul Briseno, City Manager Council Meeting: September 2, 2020 Subject: COVID Ordinance 20-019 Person(s) Responsible: Paul Briseno, City Manager Summary: Brookings COVID numbers have increased dramatically. The guiding metrics have all been triggered with the exception of hospitalization. The current Ordinance (Phase 3) regulates bars, restaurants, salons, and retail and was extended at the September 2nd meeting. Additional regulations are needed to mitigate the increase in cases. Staff recommends approval of Ordinance 20-019 which requires masks for city-permitted events and inside business / public places when six feet social distancing cannot be achieved. Background: The City of Brookings is currently under Phase 3. On Thursday, the seven-day positive rate was 35.4%. The desired rate is 5%. As of Friday, Brookings County had 431 cases with 248 recovered or 183 active. There has been substantial increases in the past two weeks. Thresholds and metrics were provided as guidance for Council and the public of existing conditions. This information is provided by local professionals and weighs metrics such as test positive rates, health care capacity, testing scope and mitigation measures. As of the last report, the only metric met was the capacity of hospitalization available. Item Details: Current conditions warrant additional measures to the COVID19 Phase Three (3) Ordinance. Criteria of test positive rates, health care capacity, testing scope, capacity and mitigation ability should be considered when evaluating additional regulations designed to curb the spread. Specific language for consideration include:  Require masks for events that require a city permit where six (6) foot social distancing cannot be achieved  Require masks in all public places where six (6) foot social distancing cannot be achieved The item is presented to City Council for action. The current ordinance regulates bars, restaurants, salons, and retail. The existing ordinance also requires employees of certain businesses to wear masks. City Council is provided with healthcare insight of local conditions. Based on this information and business/residential concerns, Council is asked to approve Ordinance 20-019. The summary of the recent COVID triggers is attached. Legal Consideration: None. Financial Consideration: None. Options and Recommendation: The City Council has the following options: 1. Approve as presented 2. Amend 3. Refer to a Study Session 4. Deny 5. Do nothing Staff recommends approval of the ordinance extension and any additional amendments. Supporting Documentation: Memo Ordinance 9/8/2020 clean Ordinance 9/8/2020 marked Ordinance 9/2/2020 Summary of COVID Triggers Ordinance 20-019 An Ordinance Amending Ordinance 20-010 to Revise Certain Measures Which Have Been Deemed Necessary to Slow the Community Spread of Coronavirus (Covid-19) in the City of Brookings, South Dakota. Be It Ordained And Enacted By The Council Of The City Of Brookings, State Of South Dakota, As Follows: I. That Ordinance 20-010 is also amended as follows: Section 2 of Ordinance 20-010 is amended to include the following Section 2(x): 2(x). Masks Required at City-Sanctioned Events. Masks which cover a person’s nose and mouth are required for all persons attending or working at events which require a City permit when a minimum six-foot distance cannot be maintained or achieved. That Ordinance 20-010 is amended to include the following Section 12: 12. Face Masks/Face Coverings Required. Within the City of Brookings, all persons except those under the age of five (5) and those with a medical condition, mental health condition, or disability that makes it unreasonable for the individual to maintain a face covering, must wear a face mask/face covering in indoor businesses and indoor public places where six (6) foot social distancing cannot be achieved or maintained. A “face covering” or “mask” must be worn to cover the nose and mouth completely, and can include a paper or disposable face mask, a cloth mask, a scarf, a bandanna, or neck gaiter. II. Any or all ordinances in conflict herewith are hereby repealed. First Reading: September 2, 2020 Second Reading: September 8, 2020 Published: CITY OF BROOKINGS, SD Keith W. Corbett, Mayor ATTEST: Bonnie Foster, City Clerk Ordinance 20-019 An Ordinance Amending Ordinance 20-010 to Revise Certain Measures Which Have Been Deemed Necessary to Slow the Community Spread of Coronavirus (Covid-19) in the City of Brookings, South Dakota. Be It Ordained And Enacted By The Council Of The City Of Brookings, State Of South Dakota, As Follows: I. That Ordinance 20-010 is also amended as follows: Section 7 of Ordinance 20-010 is amended to include the following Section 7(a): 7(a). Social Gatherings Restricted. All indoor and outdoor social gatherings of more than 10 people within residential dwelling units and the lots they are located upon are prohibited. Social gatherings are groups of individuals who are not members of the same residential dwelling unit, congregated together both within a dwelling and upon the real property a residential dwelling unit is located upon, for a common or coordinated social, community or leisure purpose, even if social distancing can be maintained. This prohibition includes planned and spontaneous gatherings as well as public and private gatherings within residential dwellings in the City of Brookings and the real property they are located upon. Gatherings of more than 10 persons who are related by blood or law (as defined in §94-1 of the Brookings Code of Ordinances) shall be permitted notwithstanding this provision. Section 2(c) of Ordinance 20-010 is amended to include the following Section 2(c)(i): 2(c)(i). Hours of Alcoholic Beverage Sales and Consumption During Pandemic. No on-sale or off-sale alcoholic beverage licensee may sell, serve, or allow to be consumed on the premises covered by the license, any alcoholic beverages between the hours of 10:00 p.m. and 7:00 a.m. on Thursday, Friday and Saturday. This requirement does not require the licensee to close, but rather prohibits the sale of alcoholic beverages after 10:00 p.m. on Thursday, Friday and Saturday. Section 2 of Ordinance 20-010 is amended to include the following Section 2(x): 2(x). Masks Required at City-Sanctioned Events. Masks which cover a person’s nose and mouth are required for all persons attending or working at events which require a City permit when a minimum six-foot distance cannot be maintained or achieved. That Ordinance 20-010 is amended to include the following Section 12: 12. Face Masks/Face Coverings Required. Within the City of Brookings, all persons except those under the age of five (5) and those with a medical condition, mental health condition, or disability that makes it unreasonable for the individual to mainta in a face covering, must wear a face mask/face covering in indoor businesses and indoor public places where six (6) foot social distancing cannot be achieved or maintained. A “face covering” or “mask” must be worn to cover the nose and mouth completely, and can include a paper or disposable face mask, a cloth mask, a scarf, a bandanna, or neck gaiter. II. Any or all ordinances in conflict herewith are hereby repealed. First Reading: September 2, 2020 Second Reading: September 8, 2020 Published: CITY OF BROOKINGS, SD Keith W. Corbett, Mayor ATTEST: Bonnie Foster, City Clerk Ordinance 20-019 An Ordinance Amending Ordinance 20-010 to Revise Certain Measures Which Have Been Deemed Necessary to Slow the Community Spread of Coronavirus (Covid-19) in the City of Brookings, South Dakota. Be It Ordained and Enacted by the Council of the City of Brookings, State of South Dakota, as follows: I. That Ordinance 20-010 is also amended as follows: Section 7 of Ordinance 20-010 is amended to include the following Section 7(a): 7(a). Social Gatherings Restricted. All indoor and outdoor social gatherings of more than 10 people within residential dwelling units and the lots they are located upon are prohibited. Social gatherings are groups of individuals who are not members of the same residential dwelling unit, congregated together both within a dwelling and upon the real property a residential dwelling unit is located upon, for a common or coordinated social, community or leisure purpose, even if social distancing can be maintained. This prohibition includes planned and spontaneous gatherings as well as public and private gatherings within residential dwellings in the City of Brookings and the real property they are located upon. Gatherings of more than 10 persons who are related by blood or law (as defined in §94-1 of the Brookings Code of Ordinances) shall be permitted notwithstanding this provision. Section 2(c) of Ordinance 20-010 is amended to include the following Section 2(c)(i): 2(c)(i). Hours of Alcoholic Beverage Sales and Consumption During Pandemic. No on-sale or off-sale alcoholic beverage licensee may sell, serve, or allow to be consumed on the premises covered by the license, any alcoholic beverages between the hours of 10:00 p.m. and 7:00 a.m. on Thursday, Friday and Saturday. This requirement does not require the licensee to close, but rather prohibits the sale of alcoholic beverages after 10:00 p.m. on Thursday, Friday and Saturday. Section 2 of Ordinance 20-010 is amended to include the following Section 2(x): 2(x). Masks Required at City-Sanctioned Events. Masks which cover a person’s nose and mouth are required for all persons attending or working at events which require a City permit when a minimum six-foot distance cannot be maintained or achieved. That Ordinance 20-010 is amended to include the following Section 12: 12. Face Masks/Face Coverings Required. Within the City of Brookings, all persons except those under the age of five (5) and those with a medical condition, mental health condition, or disability that makes it unreasonable for the individual to mainta in a face covering, must wear a face mask/face covering in indoor businesses and indoor public places where six (6) foot social distancing cannot be achieved or maintained. A “face covering” or “mask” must be worn to cover the nose and mouth completely, and can include a paper or disposable face mask, a cloth mask, a scarf, a bandanna, or neck gaiter. II. Any or all ordinances in conflict herewith are hereby repealed. First Reading: September 2, 2020 Second Reading: Published: CITY OF BROOKINGS, SD Keith W. Corbett, Mayor ATTEST: Bonnie Foster, City Clerk For week ending September 4, 2020 Summary of Brookings COVID-19 Public Health Thresholds Week Ending 9/4/2020 1. Is the epidemic controlled? No 2. Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Yes 3. Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases in Brookings? a. Mitigation Level: No b. Suppression Level: No c. Approximate time to receive test results: about 2-3 days DATA: 1. Is the epidemic controlled? Rt evaluated weekly. If Rt is <1.0 for 14 days or longer this would be a ‘yes’, otherwise it would be a ‘no’. Rt has exceeded 1.0 for the last 14 days. Below are the Rt based on number of cases in Brookings for 106 days ending on 9/4/20. Rt for the most recent 14 days (based on data from the prior week): Based on Data for Week Ending: Brookings South Dakota 8/22 1.37 1.54 8/23 1.62 1.48 8/24 1.78 1.53 8/25 2.24 1.54 8/26 2.52 1.69 8/27 2.74 1.87 8/28 2.94 1.92 8/29 3.55 2.00 8/30 4.16 2.11 8/31 3.80 1.99 9/1 3.41 1.91 9/2 3.02 1.72 9/3 2.99 1.56 9/4 2.74 1.39 Notes: • The closer Rt is to 0, the sooner transmission control will be attained. • Super spreader events are not predicted by Rt and can rapidly affect transmission trajectories. |--------- June -------|-------- July --------|----- August ----| For week ending September 4, 2020 2. Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Evaluate hospital bed and ICU availability and determine whether an increase of 20% in the number of cases can be absorbed within the health system. If health system can absorb increase than ‘yes’, otherwise ‘no’. Yes. The number of new cases in Brookings reported for the seven days up to and including 9/4/20 was 191. Adding an additional 20% is 229. Statewide, 7.5% of cases have been hospitalized as of 9/1/20. Assuming that a similar hospitalization rate is observed in Brookings, it is estimated that there will be 229 cases * 7.5% hospitalization = 17 hospitalizations in the near future. Brookings Health System has a surge capacity of 80 beds and the personnel to easily handle 45 beds. Based on current census, Brookings Health System felt they could handle the anticipated number of admissions (n=17). 3. Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? Evaluate whether the mitigation and suppression levels of testing are being met. Mitigation level of testing uses the total number of tests completed in Brookings in the previous seven days and determines whether it is equal to or greater than the total number of new cases identified plus ten times the number of new cases. The number of tests completed does not include targeted testing (i.e., public health surveillance or sentinel testing in nursing homes or on campus). Suppression level of testing is being met when the percentage of positive test results in the previous seven days is equal to or less than 3.0%. If mitigation and suppression levels of testing are being met than this would be ‘yes’, otherwise it would be ‘no’. Mitigation & Suppression Levels of Testing. Testing data for the previous seven days: Total # of cases Ten times number of new cases: Tests needed to meet mitigation level: Tests completed (mitigation): % Test Positivity (suppression) Brookings Health System Dashboard as of 8/31/20:* Brookings 191 1910 2,101 633 35.4% South Dakota Department of Health Dashboard as of 9/4/20:** Brookings 191 1910 2,101 406 47.0% South Dakota 2,079 20,790 22,869 9,353 26.7% * Brookings data are based on number of tests completed, not the number of people tested. Data for a particular date are not reported until all test results are back. ** Includes sentinel surveillance tests (e.g., nursing homes, first responders, etc.) and is based on number of people tested, not the number of tests. Approximate time to receive test results as of 9/4/20 (Brookings): 2-3 days For week ending September 4, 2020 Brookings COVID-19 Thresholds Overview of Public Health Criteria Used to Control Transmission of COVID-19 The World Health Organization (WHO) uses three criteria for consideration in adjusting public health and social measures related to COVID-19 and suggests measures that can be used for evaluating these criteria1: 1. Epidemiology - Is the epidemic controlled? 2. Health System Capacity - Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? 3. Public Health Surveillance - Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? The various measures suggested by the WHO for evaluating the above criteria are given at the end of this summary as an Appendix. The ones given below are those that are locally available. Epidemiology The key measure for assessing whether the epidemic is controlled is the effective reproduction number (Rt). Rt represents the number of secondary cases for each infectious case and a value below 1 is the best indication that the epidemic is controlled and declining. The closer Rt is to 0, the sooner transmission control will be attained. The Rt depends on factors related to the number of susceptible individuals and their potential contact with infectious persons. It should be noted that superspreader events are not predicted by Rt and can rapidly affect transmission trajectories. A Rt of less than 1 for at least two weeks is used to indicate the epidemic is controlled. An algorithm is available that will calculate an estimate for Rt if case surveillance data are available.2 Brookings Measure: Is the epidemic controlled? Rt evaluated weekly. If Rt is <1.0 for 14 days or longer this would be a ‘yes’, otherwise it would be a ‘no’. Health System Capacity A key measure for assessing whether the health system is able to cope with a resurgence of cases is that the number of new cases requiring hospitalization is smaller than the estimated maximum hospital and ICU bed capacity of the health system (i.e. the health system can cope with new hospitalizations without becoming overwhelmed while maintaining delivery of essential health services). One of the criteria used is that the health system can absorb or expand to cope with at least a 20% increase in COVID-19 case load. Brookings Measure: Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Evaluate hospital bed and ICU availability and determine whether an increase of 20% in the number of cases can be absorbed within the health system. If health system can absorb increase than ‘yes’, otherwise ‘no’. 1 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social-measures-in-the-context- of-covid-19 2 https://academic.oup.com/aje/article/178/9/1505/89262 For week ending September 4, 2020 Public Health Surveillance There are several criteria listed under public health surveillance, including surveillance systems, case investigation and contact tracing. Many of these measures are not known at a county level; however, the number of tests and test positivity are known. The Harvard Global Health Institute has established targets for assessing the adequacy of testing at both the mitigation level and the suppression level:3 Mitigation level testing: Mitigation focuses on reducing the spread of the virus through broad testing of symptomatic people, tracing and testing a recommended 10 contacts per new case, isolating positive contacts, social distancing, mask-wearing or stay-at-home orders as necessary. Testing targets for mitigation is set as the sum of symptomatic cases and 10 times the number of cases (to cover the contacts) and does not include targeted testing (sentinel testing of nursing homes, schools, etc.). Suppression level testing: Suppression allows a community to quickly find and isolate new cases before they lead to a wider outbreak, with an aim of keeping new case levels at or near zero. A test positivity rate of 3% or less can be used as an indicator of progress towards suppression level testing. Suppression level testing requires testing of asymptomatic people in high-risk environments including nursing homes, colleges, etc. Brookings Measure: Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? Evaluate whether mitigation and suppression levels of testing are being met using the total number of tests completed and test positivity in Brookings during the previous week and approximate length of time for test results to received back in the clinics. For mitigation level of testing the number of tests completed should be equal to or greater than the total number of new cases identified plus ten times the number of new cases. For suppression level testing, the test positivity should be 3% or less. It will be noted whether the mitigation and suppression levels of testing are being met, as well as the approximate length of time between samples being submitted by local labs and test results being received. Additional notes Caveats regarding the data: • The number of cases by day that are used in calculating Rt are based on the numbers posted to the SDDOH dashboard. These dates are not the date symptoms appeared and not necessarily the date the test sample was obtained or the test was conducted; they are the date that the test results were reported to SDDOH. This is the best information that is available. • The number of tests conducted in Brookings are not the number of individuals tested, but the number of tests performed, which may include repeated testing of the same individual. Committee Members: Bonny Specker, MS, PhD (epidemiologist), Chris Chase, DVM, PhD (virologist), Gary Gackstetter, DVM, MPH, PhD (epidemiologist), Amy Hockett, RN (Sanford Brookings Clinic Manager), Adam Hoppe, PhD (cell biologist, immunologist), Victor Huber, PhD (virologist, immunologist), Jason Merkley (President, Brookings Health System), Natalie Thiex, MPH, PhD (epidemiologist, toxicologist), Xiuging Wang, PhD (virologist, cell biologist) 3 https://globalepidemics.org/testing-targets/ For week ending September 4, 2020 APPENDIX: Criteria recommended by the WHO4 Table 1. WHO Criteria for Epidemiological Control Epidemiological Criteria Explanation Decline of at least 50% over a 3-week period since the latest peak and continuous decline in the observed incidence of confirmed and probable cases ° This indicates a decline in transmission equivalent to a halving time of three weeks or less since the latest peak, when the testing strategy is maintained or strengthened to test a greater % of suspected cases. Less than 5% of samples positive for COVID-19, at least for the last 2 weeks, ° assuming that surveillance for suspected cases is comprehensive The % positive samples can be interpreted only with comprehensive surveillance and testing of suspect cases, in the order of 1/1000 population/week Less than 5% of samples positive for COVID-19, at least for the last 2 weeks°, among influenza-like-illness (ILI) samples tested at sentinel surveillance sites Through ILI sentinel surveillance, a low % of positive samples indicates low community transmission* At least 80% of cases are from contact lists and can be linked to known clusters This indicates that most transmission chains have been identified, offering the opportunity for follow-up. This may be limited by the fact that the information will certainly not have been collected at the height of the epidemic. Decline in the number of deaths among confirmed and probable cases at least for the last 3 weeks ° This will indicate, with an approximately 3-week lag-time, that the total number of cases is decreasing. If testing has decreased, then the number of deaths in probable cases will be more accurate. Continuous decline in the number of hospitalization and ICU admissions of confirmed and probable cases at least for the last 2 weeks° This indicates, with an approximately 1-week lag-time and providing that the criteria for hospitalization have not changed, a decline in the number of cases. Decline in the age-stratified excess mortality due to pneumonia When pneumonia cases cannot be systematically tested, a decline in the mortality of pneumonia would indirectly indicate a reduction in the excess mortality due to COVID-19. * Trend evaluation requires that no changes occurred in testing or measurement strategy ° 2-week period corresponds to the maximum incubation period and is the minimum period on which to assess changes in trends. Table 2. WHO Criteria for Health System Capacity Health System Criteria Explanation All COVID-19 patients can be managed according to national standard This indicates that the health system has returned to a state where all conditions (staff, beds, drugs, equipment, etc.) are there to provide the same standard of care that existed before the crisis. All other patients with a severe non-COVID-19 condition can be managed according to national standard There is no increase in intra-hospital mortality due to non-COVID-19 conditions The health system can absorb or can expand to cope with at least a 20% increase in COVID-19 case load This indicates that the system would be sustainable even if it had to absorb a surge in cases resulting from loosening public health and social measures. This includes sufficient staff, equipment, beds, etc. An Infection, Prevention and Control (IPC) focal point is available in all health facilities (1 full-time trained IPC focal point per 250 beds) and at district level This indicates strong capacity for coordination, supervision and training on IPC activities, including in primary health facilities. All health facilities have screening for COVID-19 This is for ensuring that all patients who come to a facility are assessed for COVID-19 in order to prevent health associated infections. All acute health facilities have a mechanism for isolating people with suspected COVID-19 The health system has sufficient capacity to isolate all patients with COVID-19 4 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social-measures-in-the-context- of-covid-19 For week ending September 4, 2020 Table 3. WHO Criteria for Public Health Surveillance Public Health Surveillance Criteria Explanation Public Health Surveillance Systems New cases can be identified, reported, and data included in epidemiological analysis within 24 hours A surveillance system for COVID-19 is in place that is geographically comprehensive and covers all persons and communities at risk. Comprehensive surveillance includes surveillance at the community level, primary care level, in hospitals, and through sentinel surveillance sites for influenza and other respiratory diseases, where they exist. Immediate reporting of probable and confirmed cases of COVID-19 is mandated within national notifiable disease with requirements This indicates that appropriate public health policies are in place for immediate notification of cases of COVID-19 from all health facilities. Enhanced surveillance is implemented in closed residential settings and for vulnerable groups This indicates that public health authorities have identified populations who live in residential settings or are vulnerable and that enhanced surveillance is put in place for these populations. Mortality surveillance is conducted for COVID-19 related deaths in hospitals and in the community This indicates the ability to rapidly and reliably track the number of deaths related to COVID-19. Where possible, medical certificate of death for COVID-19 deaths should be issued. Other approaches for mortality surveillance may be considered, such as reports from religious centres or burial sites. The total number of laboratory tests conducted for COVID-19 virus is reported each day Knowing the testing denominator can indicate the level of surveillance activity and the proportion of tests positive can indicate the intensity of transmission among symptomatic individuals. Case Investigation Public health rapid response teams are functional at all appropriate administrative levels A measure of the capability to rapidly investigate cases and clusters of COVID-19. 90% of suspect cases are isolated and confirmed/released within 48 hours of symptom onset This indicates that investigation and isolation of new cases is sufficiently rapid to minimize the generation of secondary cases. Contact Tracing At least 80% of new cases have their close contacts traced and in quarantine within 72 hours of case confirmation These indicate that the capacity to conduct contact tracing is sufficient for the number of cases and contacts. At least 80% of contacts of new cases are monitored for 14 days Contacts should be contacted each day during the 14-day period and ideally no more than two days should elapse without feedback from a contact. Information and data management systems are in place to manage contact tracing and other related data While contact tracing data can be managed on paper at a small scale, large- scale contact tracing can be supported by electronic tools such as the Go.Data contact tracing software. City of Brookings Staff Report Brookings City & County Government Center, 520 Third Street Brookings, SD 57006 (605) 692-6281 phone (605) 692-6907 fax File #:RES 20-072,Version:1 Action on Resolution 20-072, an Emergency Resolution of the City Council of the City of Brookings, South Dakota, to address a public health crisis. Summary: Brookings COVID numbers have increased dramatically over the past week. The guiding metrics have all been triggered with the exception of hospitalization. The current Ordinance (Phase 3) regulates bars, restaurants, salons, and retail. Additional regulations is needed to mitigate the increase in cases. Staff recommends extending the existing ordinance and necessary amendments including regulating residential gatherings to ten or less and ceasing the sale of alcohol past 10 p.m. Thursday - Saturday. Background: The City of Brookings is currently under Phase 3 with substantial conditions based on the past weeks data. As of Monday the seven-day positive rate is 34%. The desired rate is 5%. As of Monday Brookings County had 321 cases with 183 recovered or 138 active. This past week there have been substantial increases. At the last City Council meeting thresholds and metrics were provided as guidance for Council and the public of existing conditions. This information is provided by local professionals and weighs metrics such as test positive rates, health care capacity, testing scope and capacity. As of the last report the only metric met was the capacity of hospitalization available. The existing Ordinance is set to expire September 8th. Fiscal Impact: None. Staff recommends approval of the Resolution. Attachments: Memo Resolution Summary of COVID Triggers City of Brookings Printed on 12/2/2020Page 1 of 1 powered by Legistar™ City Council Agenda Memo From: Paul Briseno, City Manager Council Meeting: September 2, 2020 Subject: COVID Ordinance Amendments Person(s) Responsible: Paul Briseno, City Manager Summary: Brookings COVID numbers have increased dramatically over the past week. The guiding metrics have all been triggered with the exception of hospitalization. The current Ordinance (Phase 3) regulates bars, restaurants, salons, and retail. Additional regulations is needed to mitigate the increase in cases. Staff recommends extending the existing ordinance and necessary amendments including regulating residential gatherings to ten or less and ceasing the sale of alcohol past 10 p.m. Thursday - Saturday. Background: The City of Brookings is currently under Phase 3 with substantial conditions based on the past weeks data. As of Monday the seven-day positive rate is 34%. The desired rate is 5%. As of Monday Brookings County had 321 cases with 183 recovere d or 138 active. This past week there have been substantial increases. At the last City Council meeting thresholds and metrics were provided as guidance for Council and the public of existing conditions. This information is provided by local professionals and weighs metrics such as test positive rates, health care capacity, testing scope and capacity. As of the last report the only metric met was the capacity of hospitalization available. The existing ordinance is set to expire September 8 th. Discussion: Current conditions warrant the extension of the COVID19 Phase 3 ordinance. Criteria of test positive rates, health care capacity, testing scope and capacity as well as the commencement of SDSU and the public schools should be considered in the determination of necessary phases and amendments. Amendments for consideration include:  Place restrictions on all residential gatherings larger than ten (10) people  Limit hours of bars and restaurants to 10 p.m. Thursday, Friday and Saturday  Limit the sale of alcohol to 10 p.m. Thursday, Friday and Saturday  Require masks for all events that require a permit where six (6) foot social distancing cannot be achieved  Require masks in public places where six (6) foot social distancing cannot be achieved The item is presented to City Council for action. The current ordinance will expire September 8th. City Council is provided with healthcare insight of local conditions. Based on this information and business/residential concerns, Council is asked to approve the extension and amendments. The summary of the recent COVID triggers is attached. Legal Consideration: None. Financial Consideration: None. Options: The City Council has the following options: 1. Approve as presented 2. Amend 3. Deny 4. Do nothing Staff recommends approval of the ordinance extension and any additional amendments. Supporting Documentation: 1. Resolution 2. Ordinance 3. Summary of COVID Triggers RESOLUTION 20-072 AN EMERGENCY RESOLUTION OF THE CITY COUNCIL OF THE CITY OF BROOKINGS, SOUTH DAKOTA, TO ADDRESS A PUBLIC HEALTH CRISIS. WHEREAS, the City of Brookings has the authority pursuant to SDCL 9-29-1 and SDCL 9-32-1 to pass resolutions and ordinances for the purpose of promoting the health, safety, and general welfare of the community, and to do what may be necessary for the promotion of health or the suppression of diseases; and WHEREAS, pursuant to Ordinance 20-010, the City Council may by resolution modify the mandatory closures and enact revised restrictions on public gatherings and public movements it deems necessary to address the current public health emergency. Any revised measures and restrictions, adopted by resolution shall be for a specific duration and shall be periodically reviewed to ensure the continued necessity of such restrictions or closures; and WHEREAS, the following restrictions are necessary to address a public health emergency and shall be effective upon passage of t his Resolution and until the September 3, 2020 amendments to Ordinance 20-010 have been adopted; NOW THEREFORE, BE IT RESOLVED by the City Council of the City of Brookings, South Dakota (the "City") as follows: Social Gatherings Restricted. All indoor and outdoor social gatherings of more than 10 people within residential dwelling units and the lots they are located upon are prohibited. Social gatherings are groups of individuals who are not members of the same residential dwelling unit, congregated together both within a dwelling and upon the real property a residential dwelling unit is located upon, for a common or coordinated social, community or leisure purpose, even if social distancing can be maintained. This prohibition includes planned and spontaneous gatherings as well as public and private gatherings within residential dwellings in the City of Brookings and the real property they are located upon. Gatherings of more than 10 persons who are related by blood or law (as defined in §94-1 of the Brookings Code of Ordinances) shall be permitted notwithstanding this provision. Hours of Alcoholic Beverage Sales and Consumption During Pandemic. No on-sale or off-sale alcoholic beverage licensee may sell, serve, or allow to be consumed on the premises covered by the license, any alcoholic beverages between the hours of 10:00 p.m. and 7:00 a.m. on Thursday, Friday, and Saturday. This requirement does not require the licensee to close, but rather prohibits the sale of alcoholic beverages after 10:00 p.m. on Thursday, Friday, and Saturday. Masks Required at City-Sanctioned Events. Masks which cover a person’s nose and mouth are required for all persons attending or working at events which require a City permit when a minimum six-foot distance cannot be maintained or achieved. Face Masks/Face Coverings Required. Within the City of Brookings, all persons except those under the age of five (5) and those with a medical condition, mental health condition, or disability that makes it unreasonable for the individual to maintain a face covering, must wear a face mask/face covering in indoor businesses and indoor public places where six (6) foot social distancing cannot be achieved or maintained. A “face covering” or “mask” must be worn to cover the nose and mouth completely, and can include a paper or disposable face mask, a cloth mask, a scarf, a bandanna, or neck gaiter. WHEREAS, BE IT FURTHER RESOLVED, that, any violation of this resolution shall constitute a violation of Section 7 of Ordinance 20 -010 and shall be subject to penalty as provided in Section 1.8 of the Code of Ordinances of the City of Brookings; and WHEREAS, BE IT FURTHER RESOLVED, that, pursuant to SDCL 9-19-13, this resolution is necessary for the immediate preservation of the public peace, heal th, safety and welfare of the City and shall become effective immediately upon passage, Dated this ____ day of September, 2020. CITY OF BROOKINGS Keith Corbett, Mayor ATTEST: Bonnie Foster, City Clerk For week ending August 28, 2020 Summary of Brookings COVID-19 Public Health Thresholds Week Ending 8/28/2020 1. Is the epidemic controlled? No 2. Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Yes 3. Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases in Brookings? a. Mitigation Level: No b. Suppression Level: No c. Approximate time to receive test results: about 1-2 days DATA: 1. Is the epidemic controlled? Rt evaluated weekly. If Rt is <1.0 for 14 days or longer this would be a ‘yes’, otherwise it would be a ‘no’. Rt has exceeded 1.0 for the last 14 days. Below are the Rt based on number of cases in Brookings for 106 days ending on 8/28/20. Rt for the most recent 14 days (based on data from the previous week): Based on Data for Week Ending: Brookings South Dakota 8/15 1.31 1.07 8/16 1.17 1.10 8/17 1.12 1.13 8/18 1.09 1.17 8/19 1.24 1.18 8/20 1.40 1.25 8/21 1.45 1.33 8/22 1.37 1.55 8/23 1.62 1.49 8/24 1.78 1.53 8/25 2.24 1.54 8/26 2.52 1.71 8/27 2.74 1.88 8/28 2.94 1.93 Notes: • The closer Rt is to 0, the sooner transmission control will be attained. • Super spreader events are not predicted by Rt and can rapidly affect transmission trajectories. |--------- June -------|-------- July --------|---- August ---- -August For week ending August 28, 2020 2. Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Evaluate hospital bed and ICU availability and determine whether an increase of 20% in the number of cases can be absorbed within the health system. If health system can absorb increase than ‘yes’, otherwise ‘no’. Yes. The number of new cases in Brookings reported for the seven days up to and including 8/28/20 was 68. Adding an additional 20% is 82. Brookings Health System has a surge capacity of 80 beds and the personnel to easily handle 45 beds. Based on the current numbers of hospitalizations per day (statewide 7-day running average of 6.7), it is felt that the Brookings Health System can handle the anticipated number of possible admissions. 3. Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? Evaluate whether the mitigation and suppression levels of testing are being met. Mitigation level of testing uses the total number of tests completed in Brookings in the previous seven days and determines whether it is equal to or greater than the total number of new cases identified plus ten times the number of new cases. The number of tests completed does not include targeted testing (i.e., public health surveillance or sentinel testing in nursing homes or on campus). Suppression level of testing is being met when the percentage of positive test results in the previous seven days is equal to or less than 3.0%. If mitigation and suppression levels of testing are being met than this would be ‘yes’, otherwise it would be ‘no’. Mitigation & Suppression Levels of Testing. Testing data for the previous seven days: Total # of cases Ten times number of new cases: Tests needed to meet mitigation level: Tests completed (mitigation): % Test Positivity (suppression) Brookings Health System Dashboard as of 8/25/20:* Brookings 68 680 748 409 18.1% South Dakota Department of Health Dashboard as of 8/28/20:** Brookings 68 680 748 279 25.4% South Dakota 1,633 16,330 17,963 7,310 22.3% * Brookings data are based on number of tests completed, not the number of people tested. Data for a particular date are not reported until all test results are back. ** Includes sentinel surveillance tests (e.g., nursing homes, first responders, etc.) and is based on number of people tested, not the number of tests. Approximate time to receive test results as of 8/28/20 (Brookings): 1-2 days For week ending August 28, 2020 Brookings COVID-19 Thresholds Overview of Public Health Criteria Used to Control Transmission of COVID-19 The World Health Organization (WHO) uses three criteria for consideration in adjusting public health and social measures related to COVID-19 and suggests measures that can be used for evaluating these criteria1: 1. Epidemiology - Is the epidemic controlled? 2. Health System Capacity - Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? 3. Public Health Surveillance - Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? The various measures suggested by the WHO for evaluating the above criteria are given at the end of this summary as an Appendix. The ones given below are those that are locally available. Epidemiology The key measure for assessing whether the epidemic is controlled is the effective reproduction number (Rt). Rt represents the number of secondary cases for each infectious case and a value below 1 is the best indication that the epidemic is controlled and declining. The closer Rt is to 0, the sooner transmission control will be attained. The Rt depends on factors related to the number of susceptible individuals and their potential contact with infectious persons. It should be noted that superspreader events are not predicted by Rt and can rapidly affect transmission trajectories. A Rt of less than 1 for at least two weeks is used to indicate the epidemic is controlled. An algorithm is available that will calculate an estimate for Rt if case surveillance data are available.2 Brookings Measure: Is the epidemic controlled? Rt evaluated weekly. If Rt is <1.0 for 14 days or longer this would be a ‘yes’, otherwise it would be a ‘no’. Health System Capacity A key measure for assessing whether the health system is able to cope with a resurgence of cases is that the number of new cases requiring hospitalization is smaller than the estimated maximum hospital and ICU bed capacity of the health system (i.e. the health system can cope with new hospitalizations without becoming overwhelmed while maintaining delivery of essential health services). One of the criteria used is that the health system can absorb or expand to cope with at least a 20% increase in COVID-19 case load. Brookings Measure: Is the health system able to cope with a resurgence of COVID-19 cases that may arise after adapting some measures? Evaluate hospital bed and ICU availability and determine whether an increase of 20% in the number of cases can be absorbed within the health system. If health system can absorb increase than ‘yes’, otherwise ‘no’. 1 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social-measures-in-the-context- of-covid-19 2 https://academic.oup.com/aje/article/178/9/1505/89262 For week ending August 28, 2020 Public Health Surveillance There are several criteria listed under public health surveillance, including surveillance systems, case investigation and contact tracing. Many of these measures are not known at a county level; however, the number of tests and test positivity are known. The Harvard Global Health Institute has established targets for assessing the adequacy of testing at both the mitigation level and the suppression level:3 Mitigation level testing: Mitigation focuses on reducing the spread of the virus through broad testing of symptomatic people, tracing and testing a recommended 10 contacts per new case, isolating positive contacts, social distancing, mask-wearing or stay-at-home orders as necessary. Testing targets for mitigation is set as the sum of symptomatic cases and 10 times the number of cases (to cover the contacts) and does not include targeted testing (sentinel testing of nursing homes, schools, etc.). Suppression level testing: Suppression allows a community to quickly find and isolate new cases before they lead to a wider outbreak, with an aim of keeping new case levels at or near zero. A test positivity rate of 3% or less can be used as an indicator of progress towards suppression level testing. Suppression level testing requires testing of asymptomatic people in high-risk environments including nursing homes, colleges, etc. Brookings Measure: Is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases? Evaluate whether mitigation and suppression levels of testing are being met using the total number of tests completed and test positivity in Brookings during the previous week and approximate length of time for test results to received back in the clinics. For mitigation level of testing the number of tests completed should be equal to or greater than the total number of new cases identified plus ten times the number of new cases. For suppression level testing, the test positivity should be 3% or less. It will be noted whether the mitigation and suppression levels of testing are being met, as well as the approximate length of time between samples being submitted by local labs and test results being received. Additional notes Caveats regarding the data: • The number of cases by day that are used in calculating Rt are based on the numbers posted to the SDDOH dashboard. These dates are not the date symptoms appeared and not necessarily the date the test sample was obtained or the test was conducted; they are the date that the test results were reported to SDDOH. This is the best information that is available. • The number of tests conducted in Brookings are not the number of individuals tested, but the number of tests performed, which may include repeated testing of the same individual. Committee Members: Bonny Specker, MS, PhD (epidemiologist), Chris Chase, DVM, PhD (virologist), Gary Gackstetter, DVM, MPH, PhD (epidemiologist), Amy Hockett, RN (Sanford Brookings Clinic Manager), Adam Hoppe, PhD (cell biologist, immunologist), Victor Huber, PhD (virologist, immunologist), Jason Merkley (President, Brookings Health System), Natalie Thiex, MPH, PhD (epidemiologist, toxicologist), Xiuging Wang, PhD (virologist, cell biologist) 3 https://globalepidemics.org/testing-targets/ For week ending August 28, 2020 APPENDIX: Criteria recommended by the WHO4 Table 1. WHO Criteria for Epidemiological Control Epidemiological Criteria Explanation Decline of at least 50% over a 3-week period since the latest peak and continuous decline in the observed incidence of confirmed and probable cases ° This indicates a decline in transmission equivalent to a halving time of three weeks or less since the latest peak, when the testing strategy is maintained or strengthened to test a greater % of suspected cases. Less than 5% of samples positive for COVID-19, at least for the last 2 weeks, ° assuming that surveillance for suspected cases is comprehensive The % positive samples can be interpreted only with comprehensive surveillance and testing of suspect cases, in the order of 1/1000 population/week Less than 5% of samples positive for COVID-19, at least for the last 2 weeks°, among influenza-like-illness (ILI) samples tested at sentinel surveillance sites Through ILI sentinel surveillance, a low % of positive samples indicates low community transmission* At least 80% of cases are from contact lists and can be linked to known clusters This indicates that most transmission chains have been identified, offering the opportunity for follow-up. This may be limited by the fact that the information will certainly not have been collected at the height of the epidemic. Decline in the number of deaths among confirmed and probable cases at least for the last 3 weeks ° This will indicate, with an approximately 3-week lag-time, that the total number of cases is decreasing. If testing has decreased, then the number of deaths in probable cases will be more accurate. Continuous decline in the number of hospitalization and ICU admissions of confirmed and probable cases at least for the last 2 weeks° This indicates, with an approximately 1-week lag-time and providing that the criteria for hospitalization have not changed, a decline in the number of cases. Decline in the age-stratified excess mortality due to pneumonia When pneumonia cases cannot be systematically tested, a decline in the mortality of pneumonia would indirectly indicate a reduction in the excess mortality due to COVID-19. * Trend evaluation requires that no changes occurred in testing or measurement strategy ° 2-week period corresponds to the maximum incubation period and is the minimum period on which to assess changes in trends. Table 2. WHO Criteria for Health System Capacity Health System Criteria Explanation All COVID-19 patients can be managed according to national standard This indicates that the health system has returned to a state where all conditions (staff, beds, drugs, equipment, etc.) are there to provide the same standard of care that existed before the crisis. All other patients with a severe non-COVID-19 condition can be managed according to national standard There is no increase in intra-hospital mortality due to non-COVID-19 conditions The health system can absorb or can expand to cope with at least a 20% increase in COVID-19 case load This indicates that the system would be sustainable even if it had to absorb a surge in cases resulting from loosening public health and social measures. This includes sufficient staff, equipment, beds, etc. An Infection, Prevention and Control (IPC) focal point is available in all health facilities (1 full-time trained IPC focal point per 250 beds) and at district level This indicates strong capacity for coordination, supervision and training on IPC activities, including in primary health facilities. All health facilities have screening for COVID-19 This is for ensuring that all patients who come to a facility are assessed for COVID-19 in order to prevent health associated infections. All acute health facilities have a mechanism for isolating people with suspected COVID-19 The health system has sufficient capacity to isolate all patients with COVID-19 4 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social-measures-in-the-context- of-covid-19 For week ending August 28, 2020 Table 3. WHO Criteria for Public Health Surveillance Public Health Surveillance Criteria Explanation Public Health Surveillance Systems New cases can be identified, reported, and data included in epidemiological analysis within 24 hours A surveillance system for COVID-19 is in place that is geographically comprehensive and covers all persons and communities at risk. Comprehensive surveillance includes surveillance at the community level, primary care level, in hospitals, and through sentinel surveillance sites for influenza and other respiratory diseases, where they exist. Immediate reporting of probable and confirmed cases of COVID-19 is mandated within national notifiable disease with requirements This indicates that appropriate public health policies are in place for immediate notification of cases of COVID-19 from all health facilities. Enhanced surveillance is implemented in closed residential settings and for vulnerable groups This indicates that public health authorities have identified populations who live in residential settings or are vulnerable and that enhanced surveillance is put in place for these populations. Mortality surveillance is conducted for COVID-19 related deaths in hospitals and in the community This indicates the ability to rapidly and reliably track the number of deaths related to COVID-19. Where possible, medical certificate of death for COVID-19 deaths should be issued. Other approaches for mortality surveillance may be considered, such as reports from religious centres or burial sites. The total number of laboratory tests conducted for COVID-19 virus is reported each day Knowing the testing denominator can indicate the level of surveillance activity and the proportion of tests positive can indicate the intensity of transmission among symptomatic individuals. Case Investigation Public health rapid response teams are functional at all appropriate administrative levels A measure of the capability to rapidly investigate cases and clusters of COVID-19. 90% of suspect cases are isolated and confirmed/released within 48 hours of symptom onset This indicates that investigation and isolation of new cases is sufficiently rapid to minimize the generation of secondary cases. Contact Tracing At least 80% of new cases have their close contacts traced and in quarantine within 72 hours of case confirmation These indicate that the capacity to conduct contact tracing is sufficient for the number of cases and contacts. At least 80% of contacts of new cases are monitored for 14 days Contacts should be contacted each day during the 14-day period and ideally no more than two days should elapse without feedback from a contact. Information and data management systems are in place to manage contact tracing and other related data While contact tracing data can be managed on paper at a small scale, large- scale contact tracing can be supported by electronic tools such as the Go.Data contact tracing software.