Mass Gathering Guidance

Guidance on Mass Gatherings

November 9, 2020

All social interaction has some level of risk for contracting COVID-19.  The best way to protect yourself and others is to:

  • Maintain your physical distance from other people
  • Stay away from large groups
  • Stay home when you are sick
  • Wash your hands, and
  • Wear a cloth face covering

All Iowa County residents, organizations and facilities must be diligent now. Every person and every practice is critical to our goal of not overwhelming our local hospitals and those we count on to care for us if we are very, very sick. Keep your circle very small, mask up, physically distance yourself from others and wash hands often.  A vital message to residents who are high risk (60 years and older or have a chronic medical condition or compromised immune status)… please take extra precautions to reduce your exposure.

“We are experiencing the highest volume of cases in Iowa County yet and it is not slowing down”, reports Debbie Siegenthaler, Director, Iowa County Health Department.  In just over four weeks, our case count has nearly tripled from 236 on October 6th to 685, November 6th. Our average case increase each day is 16.86 and percent positive tests is 11.37%, both with a red status. In a month, we have also had three deaths in Iowa County.  Iowa County status remains classified as VERY HIGH activity.

 

With 73 new cases this weekend, the ability we have to keep up with contact tracing is greatly diminished”, noted Debbie Siegenthaler, Director, Iowa County Health Department.  The Health Department has implemented crisis standards for contact tracing protocol which means that their priority is to contact positive cases only.  As a result, they are unable to reach out to close contacts.  If you are awaiting a test result, please be sure to remain quarantined.  If you test positive, please isolate yourself and let your close contacts know to self-quarantine for 14 days and consider being tested. For more information visit https://www.dhs.wisconsin.gov/publications/p02599.pdf

“The rate of increasing cases is a concern on several additional fronts”, continued Siegenthaler. “We continue to be very concerned about hospital capacity, locally and regionally.  At Uplands Hills Health in Dodgeville, the metric for staffing status indicates the number of available staff to care for the volume of patients, and this metric is red.  Even more troubling, is the regional hospital rate capacity metrics and that some of the hospitals that serve our residents are reporting difficulty getting supplies they need, staff shortages and limited bed capacity.”  The regional health care infrastructure metric represents regional hospital bed use and is currently yellow, as 84% of regional hospital beds are in use.  In addition, 85% of total regional ICU beds are in use.  Regional hospital capacity and staffing status are monitored on the DHS website https://www.dhs.wisconsin.gov/covid-19/disease.htm  

“The fast spread of the virus is making it difficult for schools, healthcare facilities and businesses to run effectively. We have 42% of recent cases who have no idea where they contracted the virus.  Anytime you leave your home, you should anticipate that you will come in contact with coronavirus.  If you are in a high risk category, staying home as much as you can is extraordinarily important.   To add to the concern, heading into flu season with influenza on top of Covid-19 is a dangerous scenario”, stated Debbie Siegenthaler, Director, Iowa County Health Department. What we do today, will impact our health care systems ability to keep up with the increasing demand.

A critical message to reinforce is that this virus is very efficient at finding people to infect.  As a result, any time people come together, the virus has a chance to find a new person to infect. A question we continue to receive is regarding planning for large events, including large gatherings such as weddings or community events such as fairs or festivals.  At this time, we strongly advise against large gatherings that bring people together. 

Current Recommendation

11/9/2020

Recommendations are informed by the status of Iowa County COVID-19 dashboard metrics over time, Iowa County School Capacity Indicators and DHS guidance.

 Key data monitored includes:

  • Percent positive tests
  • Local health and response system capacity
  • Community spread
  • Management of outbreaks

Public health experts agree that large gatherings of people in sustained, close contact greatly increases the risk for spread of the virus among those who attend the events and to the communities these individuals return to after the event. The communal nature of such events makes it especially challenging to accommodate the physical distancing and sanitation recommendations required to slow the spread of disease.

With eight of our 13 COVID-19 Dashboard metrics being red or yellow, it is clear that our county must act now to slow spread of COVID-19.   Therefore, we are recommending Iowa County move to back to Phase 1.  “We had been in Phase 2 since September 30, yet it seems many are not changing their behavior to slow the spread.  Many of our cases report attending group gatherings in the days before symptoms began.  With the Holidays coming, we plead with our community to do your part in slowing the spread”, said Siegenthaler.

We are asking the Iowa County community to:

•     Limit indoor gatherings to 10 people or less.

•     Limit outdoor gatherings to 25 people or less.

•     Post-pone or cancel all non-essential events, gatherings and travel

In addition, we reiterate diligence in the following:

  • Wear a cloth face covering in public settings, especially when difficult to practice physical distancing.
  • Stay at least 6 feet away from other people when you leave your home.
  • Wash your hands regularly for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.

School Recommendation

The Iowa County School Capacity Indicator Dashboard https://www.iowacounty.org/COVID-19IowaCountySchoolGuidance has 6 of the 10 metrics either red or yellow, and 5 of these 6 metrics are red.

The new case rate is 99.3 per 10,000, up significantly from the previous value of 66.5. Cases among school age children has also increased. 

With cases increasing so drastically, we recommend that schools consider moving to virtual instruction for middle and high school students, and consider doing so for the entire district as operationally necessary.  In addition, we recommend that schools postpone all contact sports.  We recommend these measures be in place until at least December 4,, 2020.  At which time we will evaluate the status of metrics.  Several school boards and districts have made a pivot to virtual and we completely support these decisions.  

Below are trends in key areas of our local dashboard since mid-July.

Date dashboard was updated

Percent of  tests that are positive

Average number of cases reported per day

Average number of tests per day

Outbreaks metric

Percentage of cases contracted by community spread

July 20

1.45%

.92

42.8

Red

46%

July 27

2.1%

.71

33.1

Red

30%

August 3

2.6%

1.0

37.7

Red

42%

August 10

3.9%

1.71

43.6

Red

38%

August 17

4.2%

2.5

60

Red

54%

August 24

3.8%

2.0

53

Red

46%

August 31

3.3%

1.5

45

Red

43%

September 8

2.0%

0.93

45.4

Red

38%

September 14

1.3%

0.64

49.7

Red

40%

September 21

2.6%

1.79

70

Red

64%

September 28

3.5%

3.79

107.5

Red

60%

October 5

4.8%

5.57

116.5

Red

51%

October 12

6.8%

8.21

121

Red

43%

October 19

7.5%

11.58

153.8

Red

41%

October 23*

7.9%

11.35

142.9

Red

43%

October 30

8.4%

11.29

133.7

Red

42%

November 6

11.37%

16.86

148.3

Red

42%

*Shift in day of dashboard update due to data availability.

At this time, DHS does not advise large gatherings, and there is no projected timeframe available as to when this advisory would change. This includes but is not limited to fairs, festivals, parades, and conferences.  https://www.dhs.wisconsin.gov/covid-19/distance.htm    

In terms of planning events for this winter and into 2021, the best guidance is to proceed with extraordinary caution. Begin with asking how you will ensure physical distancing and sanitation and other protective measure recommendations required to slow the spread of disease. Also, consider attendees who are high risk, such as grandparents or those with chronic medical conditions. They should not be asked to choose between putting their health at risk or missing an important memory.

Any entity that is organizing an event should check with their legal counsel and insurance company to be sure they are operating on a firm understanding of their liabilities. Likewise, any municipality that is issuing a license or permit for these types of events should check with their legal counsel and insurance company to be sure they are operating on a firm understanding of their liabilities. If an entity makes the determination to not follow current recommendations, that is their prerogative, but an outbreak attributed to that event may be the burden of the promoters.  Furthermore, if an entity does decide to proceed with an event, how will the safety of participants be planned for, managed, enforced and assured? 

A COVID-19 Safety Plan should indicate:

Social Distancing: How will social distancing be planned for and assured?  Will capacity be limited? What if larger than expected crowds occur, how will this be managed?

Face Coverings/Masks: On July 30, Gov. Evers issued Executive Order #82 to declare a public health emergency as a result of a spike in COVID-19 cases in counties throughout the state. At the same time, Gov. Evers issued a statewide face covering mandate. New cases of COVID-19 slowed down in August as a result of the mandate, but as campuses reopened the last several weeks, there has been a new surge in cases across our state. Yesterday, Gov. Tony Evers declared a new public health emergency in Wisconsin due to recent surge in cases among young people and issued a new face coverings order effective immediately. Orders will expire after sixty days or with a subsequent superseding order.  With yesterday’s new face covering order, Wisconsin residents ages five and older are required to wear a face covering when they are indoors or in an enclosed space with anyone outside their household or living unit. Visit https://evers.wi.gov/Pages/Home.aspx  to view Executive Order #90 and Emergency Order #1.

·      Hand Washing and Hand Sanitizing: It should include hand sanitizing stations or hand washing stations generously distributed throughout the event area.

·      Surface Sanitizing: Sanitizing frequently touched surfaces. Sanitizing portable toilets and sitting areas and tables should be frequent. The plan should indicate how they will assure sanitizing will occur.

·      Food: Buffet type food serving systems are strongly discouraged.

Limits on Gatherings*

*Individuals who are at higher risk should consider taking additional precautions

Guidance to follow:

DHS Interim guidance: https://www.dhs.wisconsin.gov/covid-19/protect.htm  

CDC: https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/index.html

CDC: https://content.govdelivery.com/attachments/topic_files/WIDHS/WIDHS_172/2020/05/15/file_attachments/1452257/CDC-reopen-decision-trees__1452257.pdf

Iowa County is currently in Phase 1 of 4: Recommendations may move forward or back as we monitor the status of our dashboard metrics each week. Some of the key data we are monitoring includes the percent of positive tests, local health and response system capacity, community spread and management of outbreaks. See the full COVID-19 Dashboard at the Iowa County website.

Recommendations for Indoor gatherings; public or private:

Phase 1 guidance: (current phase 11/9/2020)

10 people maximum (not including employees); must maintain physical distancing & protective measures

Phase 2 guidance:

25 people maximum; physical distancing and protective measures must be maintained

For large indoor recreational spaces such as gymnasiums, capacity should be limited to 25% capacity so long as adequate ventilation, social distancing, and adequate masking can be maintained

Phase 3 guidance:

50 people maximum; physical distancing and protective measures must be maintained

Phase 4 guidance:

100 people maximum; physical distancing and protective measures must be maintained

Recommendations for Outdoor gatherings; public or private:

Phase 1 guidance: (current phase 11/9/2020)

25 people maximum (not including employees); must maintain physical distancing & protective measures

Phase 2 guidance:

50 people maximum; physical distancing and protective measures must be maintained

Phase 3 guidance:

100 people maximum; physical distancing and protective measures must be maintained

Phase 4 guidance:

250 people maximum; physical distancing and protective measures must be maintained

General guidance for all residents:

Physical Distancing and Protective Measures*

*Individuals who are at higher risk (those over 60 and/or with underlying medical conditions) should consider taking additional precautions; telework & tele-education, limiting time outside their home, avoiding crowds of people is encouraged

Guidance to follow:

WEDC: https://wedc.org/reopen-guidelines/

CDC: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

DHS: https://www.dhs.wisconsin.gov/covid-19/protect.htm

Maintain physical distancing and protective measures in all phases

Wash hands often

Cover coughs

Don’t go out if ill, contact provider about being tested for COVID-19

Use of mask or cloth face covering

Surface and object cleaning

Isolation of positive cases

Quarantine of contacts of positive cases

Don’t gather in large groups or create crowds

Voluntary quarantine of travelers from high-risk areas

Physical distancing to 6 feet

COVID 19 Resources

What is COVID-19? How it is Spread and Who’s at Risk?

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

How can I protect myself and others around me?

Does a mask protect me?  Do I need to wash my groceries?

What about gatherings of people?

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

https://www.dhs.wisconsin.gov/covid-19/protect.htm

Staying safe at work and taking care of yourself

https://www.dhs.wisconsin.gov/covid-19/employers.htm

https://www.cdc.gov/coronavirus/2019-ncov/community/index.html

Travel

https://www.dhs.wisconsin.gov/covid-19/travel.htm

https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

Additional Important Sources of Information

  • COVID 19 Dashboard (updated each Friday)
  • School Capacity Indicators (updated each Friday)
  • Daily Iowa County Case Count (updated Monday-Friday)

https://www.cdc.gov/coronavirus/2019-ncov/index.html

Social Media sites:

Iowa County Public Health on Facebook - https://www.facebook.com/iowacountyhealthdepartment/

Upland Hills Health on Facebook - https://www.facebook.com/UplandHillsHealthHospital/

Iowa County Emergency Management on Twitter - https://twitter.com/ICEMWI

Iowa County Emergency Management on Facebook - https://www.facebook.com/icemwi/