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Guidance on Mass Gatherings

April 7, 2021

All social interaction has some level of risk for contracting COVID-19. The risk is decreasing as our vaccination rate increases, but 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

The most recent dashboard update (4.5.21) saw the percentage of positive cases decrease again to 2.1 %. The average cases reported daily metric also continues in a downward trend to 1.6. “The metrics are going in a favorable direction,” states Debbie Siegenthaler, Director, Iowa County Health Department. “This is terrific news but Wisconsin is experiencing a rise in new cases and additionally detected the P.1 variant last week. This means all three variants are currently present in Wisconsin”, Siegenthaler added.

On March 25 2021, the Wisconsin Department of Health Services and laboratory partners confirmed a third variant strain of SARS-CoV-2, the virus that causes COVID-19, in Wisconsin. This variant strain, referred to as P.1, differs from variant B.1.1.7 and B.1.351, which have both previously been confirmed in Wisconsin.

The newest variant P.1, was first discovered in 4 travelers from Brazil who were tested at an airport near Tokyo, Japan in early January. According to epidemiologic and modeling studies, researchers have found that this new strain, similar to B.1.1.7 and B.1.351, spreads more rapidly and easily than the original strain of SARS-CoV-2. However, this variant has unique mutations that may affect the ability of antibodies, generated through previous COVID-19 infection or through vaccination, to recognize and fight off the virus. This means variant P.1 may be able to more easily infect people.

“We must continue to remain careful and diligent in the prevention measures we know work, such as mask wearing, physical distancing, avoiding large gatherings and washing our hands… If we are, it is reasonable to be optimistic about the summer of 2021” added Siegenthaler. Individuals who are fully vaccinated should refer to DHS Post Vaccination Guidance at https://www.dhs.wisconsin.gov/covid-19/vaccine-after.htm

Iowa County continues to make good progress with vaccination. As of April 5, 2021, 38.9% (9,221) of Iowa County residents have received at least one dose of the COVID-19 vaccine and 25.3% (5,979) residents have completed the vaccine series. In addition, 85.3% of those age 65+ have received at least one dose of vaccine, and 78.5% are fully vaccinated. You can view the interactive DHS data dashboard on the COVID-19 Vaccine Data page. See the graph below to visualize Iowa County’s progress.

An important message we must continue to reinforce is that this virus is very efficient. It has found ways to change into new strains and infect more people. As such, the concern remains as it relates to planning for large events. We continue to move forward cautiously, especially as it relates to events that are very large in nature and bring hundreds from all over the region, state or farther away.

Current Recommendation

4/7/2021

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
COVID-19 Vaccination Rates

Public health experts agree that large gatherings of people in sustained, close contact 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.

Iowa County experienced a notable uptick in cases in early March, 2021, which we have been monitoring over the last several weeks. Currently, several factors are trending favorably which cumulatively contribute to the decision to move to Phase 3. These factors include:

several weeks of downward trends in key metrics,
several key metrics at green status, notably hospitalizations locally, regionally and statewide.
excellent progress on vaccination rates, especially with our 65+ population. We have 85.3% of this population who have received at least one dose of vaccine, and 78.5% are fully vaccinated (as of 4/5/2021)

Iowa County has been in Phase 2 since February 16, 2021. This move forward to Phase 3 proceeds with caution as there remains concern with variant strains, discussed on page one. In addition, Iowa County continues to be classified by DHS as having a high disease activity level with a rate of 96.6 cases per 100,000 for the two week period ending 3/31/21. This metric has decreased significantly from its status on 2/16/21 which was 193.3 cases per 100,000 https://www.dhs.wisconsin.gov/covid-19/disease.htm

These points confirm our sustained recommendations for the use of mitigation measures.

We are asking the Iowa County community to:

• Limit indoor gatherings to 200 people or less (see detail below).

• Limit outdoor gatherings to 500 people or less (see detail below).

• Use caution with travel and avoid non-essential travel

In addition, we reiterate diligence in the following:

Wear a cloth face covering in public settings, especially when difficult to practice physical distancing. If vaccinated
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.

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

COVID-19: Staying Safe in Your Community | Wisconsin Department of Health Services

https://www.dhs.wisconsin.gov/covid-19/distance.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 3 of 4:

Recommendations may move forward or back as we monitor the status of our dashboard metrics. Some key data we are monitoring includes the percent of positive tests, local health and response system capacity, community spread and progress with vaccination. See the full COVID-19 Dashboard at the Iowa County website.

Recommendations for Indoor gatherings; public or private:

Phase 1 guidance:

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

Phase 3 guidance: (4/7/2021)

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

For large indoor recreational spaces such as gymnasiums, capacity should be limited to 50% capacity so long as adequate ventilation, social distancing, and adequate masking can be maintained.

*See COVID-19: Staying Safe in Your Community | Wisconsin Department of Health Services

Phase 4 guidance:

(TBD) people maximum; physical distancing and protective measures must be maintained.

Recommendations for Outdoor gatherings; public or private:

Phase 1 guidance:

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: (current phase 4/7/2021)

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

For large outdoor recreational spaces such as concert venues or bleacher seating, etc, capacity should be sure to allow for maintenance of social distancing. Attendees should also wear a mask or appropriate cloth face covering at public events.

*See COVID-19: Staying Safe in Your Community | Wisconsin Department of Health Services

Phase 4 guidance:

(TBD) people maximum; physical distancing and protective measures must be maintained

*Recently Updated DHS Guidance on Summer Activities

See the DHS page COVID-19: Staying Safe in Your Community | Wisconsin Department of Health Services with several links to CDC guidance. The page details recommendations for specific activities such as “events, festivals”. Mitigation measures still include masking at public events as well as recommending 6 feet distancing with public events. There is additional gathering guidance which speaks to vaccinated individuals, for occasions when you know precisely what households you are gathering with and what their vaccination status and risk are. More open and public events open the transmission risk up more broadly making it impossible to know the vaccination or risk status of those who are gathering, hence the reasons for the continued masking and distancing.

General guidance for all residents:

Physical Distancing and Protective Measures*

*Individuals who are at higher risk and not yet vaccinated (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

COVID-19: Staying Safe in Your Community | Wisconsin Department of Health Services

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 while in public spaces

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

Physical distancing to 6 feet

*See COVID-19: Staying Safe in Your Community | Wisconsin Department of Health Services

In terms of planning events for 2021, the best guidance continues to be to proceed with caution. Be sure there are plans to ensure physical distancing and sanitation and other protective measures. 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: The Iowa County Health Department continues to strongly advise that residents wear a mask while in public spaces. Individuals should wear masks or face coverings that cover their mouth and nose when around non-household members following current State and CDC guidance. In general, this means masking when around others who are not fully vaccinated for COVID-19 or are of unknown vaccination status with few exceptions (https://www.cdc.gov/.../vaccines/fully-vaccinated.html). It is important to note that businesses and schools can still require masks without a State order. For additional information visit https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html

· 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 assured sanitizing will occur.

· Food: Buffet type food serving systems are discouraged.

Below are trends in key areas of our local dashboard since September, 2020.

*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*	*School Capacity metric: new case rate per 10,000*
September 8	2.0%	0.93	45.4	Red	38%	5
September 14	1.3%	0.64	49.7	Red	40%	4
September 21	2.6%	1.79	70	Red	64%	11
September 28	3.5%	3.79	107.5	Red	60%	22
October 5	4.8%	5.57	116.5	Red	51%	33
October 12	6.8%	8.21	121	Red	43%	49
October 19	7.5%	11.58	153.8	Red	41%	59
October 23*	7.9%	11.35	142.9	Red	43%	67
October 30	8.4%	11.29	133.7	Red	42%	67
November 6	11.4%	16.86	148.3	Red	42%	99
November 13	14.5%	26.36	181.8	Red	41%	155
November 20	14.7%	30.14	205.7	Red	43%	178
November 27	12.5%	26.86	215.1	Red	44%	158
December 4	9.8%	16.64	169.4	Red	43%	98
December 11	8.1%	11.9	147	Red	46%	70
December 18	9.6%	14.43	150	Red	46%	85
December 28	9.3%	14.64	156.8	Red	40%	86
January 4	8.6%	11.14	129.8	Red	44%	66
January 8	8.5%	7.5	89	Red	53%	44
January 15	5.6%	5.5	97	Red	49%	32
January 22	3.8%	4.2	112	Red	36%	25
January 29	3.3%	3.4	102	Red	31%	20
February 5	2.1%	2.3	111	Red	30%	13.5
February 12	2.8%	2.9	104	Green	34%	16.8
February 19	2.8%	2.6	96	Green	44%	15.6
February 26	2%	1.7	85	Green	57%	10.1
March 5	2.4%	2.1	87	Green	77%	12.2
March 12	3.8%	3.4	90	Green	57%	20.2
March 19	5.9%	4.7	80	Green	39%	27.8
March 26	4.2%	3.4	79	Yellow	39%	19.8
April 2	2.1%	1.6	79	Yellow	39%	10