 Welcome to Sheboygan County government working for you. My name is Adam Payne, County Administrator and co-host of this program. Though I don't have my partner in crime next to me, Chairman Tom Wagner's sheltering in place as so many people are in Sheboygan County and throughout the world. So we'll miss Tom today, but we're so pleased to have two key people from our Health and Human Services Public Health here today to talk about the Coronavirus, to talk about COVID-19, what's happening in Sheboygan County, our plans, our preparations. As you know, this is a fascinating time, a scary time, an extraordinary time for all of us. Everyone in this community is feeling some stress and some angst. Some of you are sheltered at home with little to do, and there are others who are working 24-7 around the clock to keep this community safe and provide information. Today I'm very proud to introduce two key players in Sheboygan County government again, Public Health Star Grossman who is our Public Health Officer and Libby Jacobs who is our Public Health Information Professional. I got that wrong, Information Officer. These two have just been outstanding with the leadership that they're providing. So I'm so looking forward to introducing them in a moment here, and you're getting to know two are real important people in county government working for you. So let's start with you. Please share just a little bit about yourself. How long have you been with Sheboygan County? What's your role today? Sure. So I started with Sheboygan County in 2013. I was hired during the TV outbreak that was happening back then. So I started off as a public health nurse, I'm a nurse by trade, and after a couple of years, I was hired on as a full-time nurse, or no, I was hired on as a program supervisor, and then just three weeks ago became the Public Health Officer for Sheboygan County. Three weeks ago. So talk about a challenging time not only to take on a new role, but to be thrown into one of the more critical health crises that we've ever experienced. It's been a learning experience, but I'm really enjoying it being able to help the community. Yeah. Well, you've been outstanding. You've been outstanding. We'll turn to Libby. Libby Jacobs has been with us for a little while as well, and I've had a chance to see her grow as a professional over the years, continues to help make good things happen. Libby, please introduce yourself. Yes. Thank you. I have been with the department for five and a half years. Six and a half years ago, I was an intern during the TV outbreaks. I'm also familiar with outbreaks and working within those, and I've had the privilege of working with Star for the entire duration of both of our times. We've gotten to partner and team together. So I've been with the department for five and a half years officially, and I am the department's health strategist. So I get to do public information, I get to do grant writing, program evaluation, our community health needs assessment, evaluation, so looking at health and all policies and strategy. One of the reasons I worked with you a little bit more, or have observed you a little bit more, is you worked with Kristen Blanchard-Sterns, and you've been out in the community a little bit more. Community conversation, things of that. Yes. So I run our health needs assessment. So every three years, we do a mass data collection collaboratively, and the health department is a lead in that. So I co-chair Healthy Sheboygan County 2020's Leadership Council with Kristen Sterns, who is the CEO of Lakeshore Community Health Care. Yeah, yeah, she's a rock star. You two make such a good team, and it was surprising to almost hear you say, Star, you're enjoying this. It is invigorating, isn't it? I mean, we're just bouncing all over the place, it's all consuming, but you two have shown such poise and professionalism through this, and I know we're only into three weeks or so. And let me tell you, these folks, they've been working through all day, into the evening, over the weekends, and it's just been remarkable, your dedication and professionalism. So thank you. So let's start with the question that hopefully most of our viewers know at this point, but we'll start with the basics and then get into our response, our preparations. What is COVID-19? So COVID-19 is a respiratory illness. It is an illness that causes fever, cough, and shortness of breath, and yeah, that's the basics about it. That's the basics, and how is it spread? It is spread through cough, so if you're in close contact with somebody who has the illness, cough or respiratory droplets are what is how it's primarily spread. And when you think about, when our viewers watch this and how it's spread and we keep emphasizing the importance of washing hands and being mindful of your cough, all of that, can it also be spread on surfaces? Do we need to be mindful of that? It can be spread on surfaces. That's not the primary way that it's spread, but it's certainly a good idea to wash or clean off surfaces that you use regularly, especially like doorknobs, telephones, things that you are touching on the regular to practice mindfulness about cleaning those types of things is important. If one thing's gonna come out of this, sir, individual hygiene and the cleanliness of the community as a whole is gonna be ramped up to a whole new level. Hopefully we'll keep those practices in place because it's good for the flu and everything else. So start talk a little bit about the timeline that's unfolded here in Sheboygan County. When did you really first getting engaged with this and what does that look like? So we had our first cases in Sheboygan County as a result of an Egyptian cruise. They were members from our community that had gone on that cruise and became ill with the virus. They were tested and we were notified of their results on Friday, March 13th. And when they were, they're actually tested in a different county than ours. When they were tested, they were told to go home and self-isolate. And when we got the results on Friday, March 13th, we went ahead and started to follow up with them. Since that time, we've had additional cases that have been added through our contact investigation process and other travelers, both domestic and international. So we have a total of 10 cases right now in Sheboygan County. And some of our viewers might be pleased to see that unlike some of the counties around us, we seem to be holding our own. It was as little as two weeks ago. We had, I think, four or five positive cases. We're now up to 10. And of course, we're seeing some of the counties around us see that escalate a lot more quickly. And of course, the more dense populations of Madison, Milwaukee, we're seeing that grow even faster. What do you attribute some of our success or good fortune or however you want to characterize it for at this point, holding our own pretty well with keeping or seeing those cases down? I think that it's multifaceted. I think it certainly is encouraging to see people following the safer at home practices, practicing social distancing, good hand hygiene, all those things are helping to curb the number of cases that we have in our community. And then we do very good contact tracing within our division of public health have been working long hours to make sure that we are contacting people that are suspected to have COVID. As people are getting tested, we're reaching out to them to make sure that they know that they should be staying home, asking them about their family members. If any family members are ill, making sure that those persons are also staying home. So the more that we can reach out and do those contacts and that contact tracing, the safer our community is. So the Egyptian cruise line that was, when did we first get notification of that? So actually we were notified of that cruise and of the results on the same day on the Friday, March 13th. Friday, March 13th, so I mean, it's March 31st today at the taping of this program. You might see a little bit later, but on the March 13th, we hear about this. You get engaged. On March 17th, the County Board took action very quickly to pass a resolution, a state of emergency in Sheboygan County following the federal government, the state government and their guidance. And really what that did is empowered us all, as you know, to be able to respond more quickly for the health, the welfare of the community. It really gave powers to the County Administrator position. Our County Board chair position, to rather than go through the normal committee structure, our County Board process. If there's a need, we can act quickly to provide resources. And there's been things we've been doing as you both know very well, working with our Purchase Agent, our Emergency Management Director to gather supplies, identify resource needs and prioritize. So good things are happening and no doubt there'll be more of those kind of decisions ahead. So that was just on March 17th. That's also when the governor came out with another order to shut down non-essential businesses and he followed up very quickly thereafter about shelter in place or safer at home. So a lot of activity the last couple of weeks. And so we know we have these individuals that have the coronavirus. You've been working closely with them, helping them shelter in place and being sure they get better, tracing who they may have come in contact with and then of course we have the question of, well, community spread. Libby, what is community spread? How do, what's the definition of community spread? So community spread, if you've heard that term, you've probably been watching the news and seeing that we had in the state of Wisconsin a few communities that were designated to have community spread. And now we've seen that designation kind of fall away from all of the reports because Wisconsin in every community is experiencing low level community spread. So your question of what does that mean? Community spread essentially means to go off of what Starr had said about the Egyptian crews. When those individuals came back, we were able to do contact tracing and investigation to figure out who they were in close contact with, who they exposed, who they put at risk. So what community spread means is that we have confirmed positive cases that we cannot trace back to those individuals. So essentially what that means is they are positive, confirmed case of COVID that we cannot trace back to an existing, therefore they got it through the community spread of the virus. Excellent. So for the most part, the individuals we've identified were directly linked to that crews traveling abroad. Either to that crews directly or had other known travel either internationally or domestic outside the state of Wisconsin. But if we don't see any connection to someone that has the coronavirus, if we can't trace them back to anyone, that's community spread. And at this point, do we have any individuals that fall into that definition? Yes. One or two or? We have one individual that falls into it. It's very limited, right? Yes, yes, so far so good. So question for both of you and I'll start with Starr. So what's the role of public health? Talk a little bit about what you've been involved in and what you've been doing to help keep the community safe. Sure, so I touched a little bit on contact tracing. That's one of our primary roles is making sure that we are following up with individuals who are confirmed cases and tracing their contact. So basically when we have someone who's ill, we follow up with them, we ask them who you've been, ask them questions about their symptoms, when their symptoms started, who they might have been in contact with over the last two weeks. And we're defining contact as within six feet for 10 minutes or more. So anybody that they've spent time with 10 minutes or more that they were in close proximity to, those are the people, those are the list of names that we ask and gather from the individual. And then we start to follow up. So we'll follow up with everybody that they give us the name of. And then we interview those people as well. So we ask about symptoms, ask how they're feeling, learn a little bit about where they're working to see if there's any kind of risk of further exposure should they become ill. And then we place them in either isolation or quarantine. Isolation is where you take people who are ill and you make them, have them stay home away from other people so they don't spread infection. And quarantine is where you take well people, people who don't have any symptoms at all and you say, well, you've been exposed to this virus. There's a possibility you could become ill. And so you need to stay home for the next 14 days, which is the incubation period for this virus to make sure that if you do become ill, you have limited the number of people that you've been in contact with. And as the public health officer, you have the authority essentially to tell someone they need to shelter in place. Most people are gonna cooperate and they're gonna wanna do the right thing. But you have that authority if they suggest that no, they're not gonna follow the rules. Yes, under state statute, I can order someone to be in isolation or quarantine. Okay, and for the most part, are you getting good cooperation? Absolutely, people wanna protect the community and protect their families. And Libby, you've been in the front lines trying to keep the community informed every day, sending out an update as to where we're at with their numbers. I think the information that our Sheboygan County website has on the public health page has been outstanding. As I've talked to my peers across the state and more and more I'm hearing, wow, I checked out your county website and what the public health division's doing there and just hear nothing but compliments. So Libby, share a little bit about what those other steps are with your team and the information you're providing. So it's a twofold situation. So in public health, we do all of the behind the scenes work with the contact investigation and tracing. But it's also working collaboratively with our community partners. So everyone from our healthcare systems, our long-term care, our schools, our law enforcement, everyone that has kind of stake in the game to make sure that we keep our community safe. So immediately when we were notified that COVID was coming to our community, we set up what we call a joint information system. And essentially what this does is it gathers credible verified information from all of these community partners so that we all are sharing information but so that also we can be responsive to the public. So what our job is in Sheboygan and the division of public health is to get that credible information verified and out to the community so they can best protect themselves. So within that joint information system, we have daily briefings where we have all of those key partners call in, give us their most up-to-date verified messages and then we wanna be timely and responsive to the needs of the community. We also talk about what are the trending topics. So for example, you brought up the safer at home. Immediately when that was issued, my team got on right away of the frequently asked questions so that we could be immediate and responsive to answer the questions. It is our goal to be as transparent and as informative as we can for the community to give them all the information that we know, make sure that it's verified credible so that people are able to protect themselves. So as you talk about the team and the engagement of the community, we have this pandemic administrative panel and then you have other key players, both internally and Sheboygan County and externally, touch a little bit on the role of, for example, the emergency management director in this pandemic administrative panel. So public health, we are prepared for this type of thing. We have an emergency preparedness component to all of the work that we do. So I think it's also important to recognize that this is not, although it's extreme circumstances, that we work with our emergency partners all the time in Sheboygan County. So we are prepared in handling situations like this. So we have a really good response network of a pandemic plan. We work with our emergency manager on a very frequent basis. We have our emergency preparedness connections within our healthcare system. So we set up this emergency operations center or an EOC with an administrative panel that brings all of those partners together in an incident command structure. So we have clear organized guidelines, briefings, what people's roles are. We bring out these plans, we execute them. So we are prepared for this. It's just this is a time where we get to take those plans and instead of having them be in a preparedness phase, it's in a mobilization kind of action phase. Right, right. Yeah, this is when all that planning pays off and it's heartwarming to observe the two of you and your team and folks like Steve Steinert, our emergency management director, our purchasing agent, Bernie Romer, Chuck Butler from the city. I mean, I could go on and on. There's so many key leaders and people involved with this collaborative approach and it's really for me then a time of pride because you see people step up. You can plan and you can put it on paper but when things hit the fan, how are people going to respond? And we learn a lot about one another's character and how we do respond in a crisis and what's been just so heartwarming, gratifying for me is that the team has responded so effectively and that's not to say we don't all have good days and bad days and we have our own stuff going on at home, our personal lives, we're just talking off the air about one of our key public health members who has a wedding that they had to make changes. I mean, imagine that, there are a lot of things going on but it's just been wonderful to see the team work together, pull together and help keep this community safe and well informed. So my compliments to both of you. When the governor's order came out, as you know, shelter at home, it shut down non-essential businesses. Of course, we keep our supply chain going with food and key things that we all need but government is exempt from the governor's orders, government as a whole. Why do you think that is? I think that the work that we do in local government is very important to keeping the community running and so Governor Evers includes local government as an essential service to the community. We certainly, throughout all the county departments are being mindful about social distancing, trying to protect the health of the community, encouraging people to call first, make appointments and that's happening not just in health and human services but across multiple departments within our local government. So I think we're taking the steps that we can to protect both the employees of the county but then also the public and also still be responsive and able to meet the needs of those individuals who have needs in our community. Yeah, I mean, to some people it might seem rather obvious that government would be exempt but we have essential functions, we have some functions that are not necessarily essential but just to quickly touch on them, obviously law enforcement is essential, maintaining our corrections department is essential, Rocky Knoll and the people we care for they're essential, health and human service, the staff such as yourself and many others helping people in need, absolutely essential. Those are really the key department's transportation. They continue to have to maintain our transportation system, respond to emergencies, they're essential. So most of our staff are working and continuing to report to work though, as you said, being mindful of social distancing. We have meetings now and we're all six feet apart for the most part. In fact, YouTube probably should be a little farther apart right now, right? But we really have been mindful of that. We have a little over 130 of our employees working from home if they can and then we've asked the public and I'm gonna repeat it, we've asked the public that if you don't have anything critical, I mean, now is not the time to come in to register of deeds and work on your family tree. If you don't have anything critical, do not come to our county facilities. If you do, whether it's needs to be supported because you're a veteran or a family member of a veteran and you need to contact our veteran service department, the courthouse, whatever it may be, please call ahead, please email, go to our website and see if you can get the answers there. But the key is if you call ahead, we can likely help you over the phone. So you're safer and our staff are safer. If you need to come into the office, we'll make an appointment and we'll do it in a manner where we can maintain some social distancing and be mindful of everyone's health. So please consider that as you decide whether or not to come to the county administration building or any other facility. So a shout out to all of our essential functions, our employees out there who are working so hard in law enforcement, health and human services, Rocky Knoll, transportation and other areas as well. Thank you for the important work you do. County government continues to serve this community and our staff, all of our core workers are doing a tremendous job. One of the key questions we continue to hear, you see it every time you turn on the television, we heard it last night at the common council meeting. How do I get tested? How is the testing process working? Are there enough tests? Who does the tests? Lot of questions surrounding testing. Could you touch on first, what makes you eligible or able to get a test? What does that look like? Sure. So the Wisconsin Department of Health Services has issued a prioritization basically tiers about for testing. Right now, those people who are top priority for testing are people who are hospitalized that they with respiratory illness that they are not sure what is causing it. People who live in high risk congregate settings. So people in our long-term care facilities, healthcare workers that work in long-term care or healthcare workers in general that have unexplained respiratory illness. Those are our top tier folks that are, where most of the concentrated testing is occurring. In order to be tested, you do need a doctor's order for that. And so each of our health systems are managing their triage a little bit differently, but in our daily update that public health puts out, it does share based off of which provider that you prefer to use the best way to contact them and request a triage or ask whether or not you would be eligible or in need of COVID testing. And so the healthcare provider will do that triage and then let you know if you need to be tested and follow the instructions on how to present to the facility for testing. Certainly our discouraging people from just going in and asking for testing, definitely go in and do that triage process, make sure that you would qualify for testing and then follow the directions you're given related to how to show up at the clinics to just to keep everyone safe, including the healthcare providers. And you, you're our community from being exposed. Yeah, good advice. Everyone has a heightened sensitivity right now to any cough, any sore throat, feeling tired, whatever it may be, and it's probably a cold. It might be the flu, right? So if you're sick, stay home. And if those symptoms are to the point where you feel I really need to contact a health provider, call ahead and get that counsel and then the doctor will determine if you should get a test or not, right? So we're not at the point where we're looking for people to line up at the door or come driving up with their car and everyone's gonna get a test. In fact, it's the opposite. We're trying to make sure that we're keeping the limited test supplies we have for people who really need them. Correct. Yeah, good advice, good advice. So we're gonna be wrapping up here in a few minutes. We're starting to wind down with our time, but Libby, I'll turn it to you and I don't think people can hear it enough. What is the best thing people in our community can do to protect themselves and their loved ones? So I think some of the core messages that you've been hearing have been things like, wash your hands, social distance. And I wanna explain why those are so important. We do not have a treatment right now for COVID-19 and we do not have a vaccine. And the virus doesn't move around. People move around. So when we talk about social distancing and why that is so important is because people are spreading the virus. So when we say stay home if you're ill, that is our best defense against this right now. So even when we talk about outings and grocery shopping, don't use that as a time to get out as a family. Take one person to the grocery store, one cart, do your shopping once a week, limit the amount of exposure you have to other people. But that doesn't mean that you can't do phone calls and you can't stay connected in other ways. We're really just asking people to, again, remember the virus doesn't move around. People move around. So that's why safer at home is so important. That's why washing your hands is the best defense. So not touching your mouth, covering your cough. So even when we talk about gloves, wearing gloves out in public, your gloves touch all the things and then you touch all the things. So really it's the washing of your hands that is the most important thing that you can do. Staying home if you're ill is so important. Making sure that you just keep that spread as small and contained as possible. And we can and will get through this all together and we're, we just all have to team. Teamwork, Sheboygan County strong. If you are continuing to work as we are and many other essential employees or functions are, businesses that are producing food and other products that we all need, they especially need to be sure they're being mindful of washing hands and keeping that distance in the workplace to the extent they can, right? Absolutely. Well, thank you both so much for joining us, Star. Libby, I can't tell you how pleased I am with the work you're doing, your leadership in this community. I'm just so grateful for your work. So thank you both for joining us today. If you have questions, do not hesitate to look on our Sheboygan County website, public health webpage. It is excellent, more information than you're certainly gonna be able to read through, but every day Libby and her team is updating that information. So please follow that. And if folks have questions or is there a general line at Health and Human Services that people can call or what do you recommend there? If people have questions and they call the Health and Human Services number, they can be routed to one of our public health nurses. And right now we are experiencing very high call volume. So if you leave a message, we will certainly get back to you as soon as we're able to, but we are answering every message that's left if we don't get to answer the phone right away. So I'd encourage people to leave a message. Yeah, they're working day and night and over the weekend. So if you need to contact someone at Public Health, don't hesitate to do so, but be patient, start with the county website. A lot of information there. So in closing, thanks for joining us today for those watching this. As Libby said, we're better together. Teamwork will get us through this. This will pass, but we all need to be part of the solution. Everybody can help us beat this coronavirus and move back to the days when we can hug one another and get together in large gatherings and watch a football game again, right? So until then, hang in there, be strong, stay safe, and we'll see you next month. Thanks for joining us.