[Editor's Note: This is part 2 of the Commission work session on Sept. 15, 2020.]

By Mary Alice Murphy

The next presentation at the Grant County Commission work session on Sept. 15, 2020 addressed an update from the New Mexico Department of Health, with presenters Salina Torres, DOH PhD epidemiologist with a master's degree in public health, and Ken Sexton, PhD with also a master's of science in public health, and Renee Depres, PhD and MPH, who work with the Grant County public health office.

Torres said her brief update would address Grant County and the southwest region.

On the first slide of her presentation, she pointed out the case count for the southwest region by collection date with the 7-day moving average as of Sept. 8, 2020. She noted a spike in June in federal detention centers. Since a general population spike in mid-July, cases have trended downward.

The first case by day of symptom onset was in mid-March, with the largest spike in July and several smaller spikes since then. The test positivity rate in the southwest region, again on a 7-day average, showed the highest number in mid-July, with the trend downward until a small spike in early September.

The largest numbers of cases and their causes, determined after contact tracing, show the most cases are related to travel, with the next largest number as a result of attending other gatherings such as large family groups. Visits to restaurants in July saw larger numbers trending downward since. Visits to places of worship showed a flat trend since July, and visits to gyms showed the lowest and flat trend since July.

Sexton and Despres talked about the Grant County Coronavirus Prevention and Coordination Committee.

Sexton described himself as a retired professor in public health from the University of North Carolina who moved to Silver City. "We suggest this new task force be supported by the county commissioners. We have received support from the Grant County Community Health Council as the Grant County COVID-19 Prevention and Coordination Task Force. Our goal is to achieve community recovery in the context of COVID-19. We request the appointment of a cross-sectoral task force that integrates local governments and different stakeholders in the community to address the threat of emerging infectious disease. The Coronavirus Prevention Committee stands ready to provide technical assistance."

The fiscal impact of the request includes businesses reopening sooner and more safely; having the labor force less likely to relocate to find work; providing better use of available fiscal and other resources; increasing the capacity to identify and pursue funding across sectors, all of which allow the local economy to rebound sooner.

Sexton commended the Commission for passing an emergency resolution. He described COVID-19 as "an emergency like none other in its breadth, duration and complexity," and said epidemiological models suggest the spread of disease in Grant County could worsen quickly, with potentially devastating health, societal and economic impacts.

To address the "complex problem," he said it would require an organized community-wide response, integrating with the county's and town's ongoing emergency response, with better utilization of resources. He noted also that nearby counties impact Grant County and vice versa.

Sexton said he spent much of the summer in Phoenix, Arizona, due to medical issues, and saw the response there. The city believed its preparations were adequate, but cases from COVID-19 increased from 50 to 145 in four months, with a slow increase at first and then a surge on health services, with some cases being moved to New Mexico hospitals, and causing businesses to have to close twice.

Hidalgo County had almost 100 cases due to one large event, a family and friends party. This number in a community of 4,500 people.

Sexton said the potential spread of COVID-19 in Grant County has as risks: reopening businesses; face-to-face classes; visitors from hot spots; the beginning of flu season, with a typically low vaccination rate in New Mexico; cold weather which brings more respiratory disease spread; "super-spreader" events, such as family gatherings, holidays and travel.

The major risk factors include the age of the population. Grant County has 28 percent over the age of 65, with 35 percent in Silver City. Another risk is multi-generational households, a high percentage of low-income population and limited health care and other resources.

Secondary impacts in Grant County, which are increasing, include food insecurity, businesses closing, job loss, income loss, loss of tax revenue, children home from school, less access to primary, behavioral health and dental care, violence including domestic and child abuse, mental and behavioral health, substance abuse disorders, suicide, increase in overall crime and divorce.

"How can we help?" Sexton asked and answered. "We can use public health prevention measures to keep numbers low; we can prepare for a sudden increase in numbers; we can mitigate disease and secondary impacts; and plan for the recovery phase."

Depres presented the phases of disaster response, which move from preparedness with no cases, to containment of sporadic cases and clusters of cases, to mitigation of local transmission to widespread transmission, to suppressing with declining transmission and finally to recovery.

"We are asking for county support of the task force," Depres said. "We are way past the preparedness stage to having become a very large, global disease. We are in a long-term event, which may last a long time. In Grant County we have not reached the widespread transmission. The longer we can keep the cases low, the better. It doesn't mean we won't see waves or spikes, but we are still in mitigation and suppression, not yet in recovery, but we need to prepare for recovery."

Despres said she thinks Grant County can be a role model for the state and maybe the country. "We need a cross-sector task force to reopen safely and appropriately, while reducing suffering and death, and enhancing public health preparedness measures in the future, with the health council partnership."

Collective impact to organize the response include a common agenda, shared measurement, mutually reinforcing activity, continuous communication and backbone support.

She presented some sample priorities for the task force. They include preventing spread by testing, and risk communications. Other priorities for the task force include addressing all levels of schooling, physical and mental health, access to social services, public safety and economic recovery.

Despres presented a long list of COVID-19 prevention committee skills and experience, including epidemiological modeling, pandemic preparedness, clinic care, public health, indoor air quality and ventilation assessment, GIS mapping, health policy, education/pedagogies, community planning and organizing, health literacy, strategic planning, non-profit planning and bilingual expertise.

To a question from District 2 Commissioner Javier "Harvey" Salas about what was being asked from the commissioners, Despres said: "Support and participation from the county. One of the essential things to prepare for a potential surge is an external care center, which will require county assistance for those, for instance in multi-generational households or those who live by themselves and need a place to recover. The county emergency manager should be ready to push the button when such a place is needed. We need the county at the table for this response."

The next presentations will address a request for an additional fire station for the Pinos Altos Volunteer Fire and Rescue Department and a response to questions from commissioners on the HVAC systems in county buildings.