 Yeah. Yeah. Okay. Awesome. Yep. All right. So once she hops on, you can make her chair or co-chair, however you want to work it, but have a great meeting. Oh, thank you so much. Hi Nancy. Hi Nancy. I just got a new computer, but it's not working. So I'm using my iPad. How are you? Oh, that I'm good. Just want, you know, we're already recording because Angela already got us hooked up just so. Okay. Yeah. So exciting though. Yes. Yes. Yeah. I attended that webinar last week on. COVID vaccine implementation. I don't know if you've got a chance. I don't know if you've got a chance to get that link out. It was very interesting. Yeah. Unfortunately. Well, yeah, you have a million other things to do. I wish I had lots of time to absorb all of this ever changing information. Yes. Yeah. So I have my notes from that here. I could see a role that the board of health could have in. Using tool kits to educate. Hi, Tim. I know I love it. And the background is great. Yeah, I don't know how to do that. I think my grandchildren do my grandchildren can do now that they're in remote school. They can even the five year old can do stuff. Yeah. We take each one one day a week. So we do remote school three days a week here at our house. Come up at 815 today. Yeah. Yes, he's about awesome. And I, I emailed him this morning and Emma got him the link. So he should be here. But it's not. It's not five o'clock quite yet. Two more minutes. Yeah, I got a new computer, but I can't seem to get the meeting on that. Yeah. Yeah. Well, the trials and tribulations of all these electronics. DJ just emailed saying that. He's on. DJ is not coming. No, no, he's supposed, he's trying to. Here, hold on. Let me find out. DJ. We're getting there. Hi, DJ. You can at least hear me. So that's good. Yeah. I think you had some kind of barrier that you held the public back from. So you did your own thing. Some zoom barrier. Is everybody else here? Right behind me decided when it booted up to do maintenance. So it's like. In the circle of. Not too noticeable. I got a new computer that doesn't seem to be working in zoom. So I'm on my iPad, which is. More frustrating. Such as life. See, I'm not getting that. The Steve here. Sorry. Yep. Oh, okay. Okay. So, um, John here too. Yep. Okay. I have a new computer that's not working. I'm using my iPad. Okay. And it's five o'clock. So I will open the meeting. Here's my pursuant. Here we go. Okay. Pursuant to governor Baker's March 12, 2020 order, suspending certain provisions of the open meeting law, general law chapter 30 a section 18. Okay. So the meeting of the board of health is being conducted via remote participation. So I will have a roll call to make sure everybody is. Working their video and their audio. So John. Everything's working. Steven. Tim. Here. Maureen. Here. Nancy. Did I get everybody? Yeah. Okay. So we're all here. And the first order of business is to review the minutes from. Our November 12th meeting. Which I've done. Any comments. Any changes. Not may have a motion to accept the minutes as. Submitted. I'll move. We accept the minutes of the November 12th board of health meeting. Second. I'll second. Okay. All in favor. Steve. Yes. I. Maureen. I. Tim. John. I. Nancy. I. Okay. So they were. Past. So next on our agenda is we have a guest. We're going to review the regulations of the. Smoking in public places and workplaces. And we have DJ Wilson here to help us. So we're going to move on to the next section. So we have our last. Welcome. It was last November 14th. We had the hearing on our last regulations. So now we're moving on to. These regulations that Maureen has been working on with Steve. Maureen, do you want to just sort of be in. Take charge of this section. I'll see what I can do. Okay. So thank you for being here, DJ. Good afternoon. I'm the host of this. This is an interesting question from like 2011. And I think our major. Effort was to bring them up to date with respect to electronic cigarettes. But there are also other areas that. We should also address, including maybe expansion of some of the areas in which we were restricting smoking in the. Out of doors, like parks and. The other thing was that there's one thing that I found confusing and might look to you for advice about is some of the private private clubs I guess the things like the VFW or wherever that those regulations we don't address. I don't think we address them in our previous ones. And that's something that and looking around there are a lot of towns that that do regulate that. The other question is, you know what I first did before there were that's what the new template was available as I took the definitions from our new tobacco sales regulations for things like electronic cigarettes and just a number of different things that were updated there and I pasted them into our old document update those. I did notice they're, they're slightly different from those in the template now. And I kind of wondered in theory is it better to match them with our other regulations and or just go with how they're written. And the other question that you know I get down into the weeds sometimes but the other question I had was around electronic smoking to back nicotine delivery devices that are allowed for medical use. And I understand why we don't want to regulate them in their sales, but I wondered if they shouldn't be regulated for secondhand exposures because it's not a difference in my mind of those two exposures. And I think what our major job I think at this point is to discuss those those that list that was on the first page of the template of the places we might want to consider regulation so really I think we're. It's not as complicated as our previous job of regular updating the, the tobacco sales regulations but we could probably just use some help and guidance and some of this. Okay, so I should first I have I'm looking at something that was amended in 2010. And we don't upgrade our ETS regulation that much because other than forces from outside, you know, new things that are happening. State has not hasn't really updated much except for this the sales regulation sample that you're looking at probably uses the term electronic nicotine delivery system that is within the new state law ends short. And I'd have to look at that again. But we do have, you know, you do not. Okay, so we do in the sample, have E cigarette in there and we don't have an exemption. We do. We say and the electronic device not approved by the US Food and Drug Administration. And so, you know, for E cigarette use, and for secondhand smoke use, we could be probably more liberal than it is in the sales regulation and say it doesn't matter. If they approve it or not, you know, you just don't want it being used in public. So let me just write that note down. Okay, so. Yeah, they're just for some small wording things that didn't match. And I feel like they probably that's probably your rebel. At some point we need to, I say we there's about four of us that review this, these samples, and we need to go through it and kind of match it up better to the news, the latest state law just to make sure there's no discrepancy. Yeah. One first question. So I should say, one thing that has not changed is that you at this point in time, match the 100 200 300 dollar finding system with the two years. Tolling period that still remains in the state law and it makes sense just to do. Okay, so I can go down the, the list about it starts advance smoking locally in and then we have a yes now. So smoking bars which is cigar bars, hookah bars, and vape bars now that has been included in the latest state law. I haven't seen any because this of course started just about the same time COVID did so. Regular cigar bars and hookah bars, having a tough time without having people tried to open a vape bar that makes no sense in the time that they can't open smoking bars are in face for the governor's response. And we had banned those in the tobacco sales regulations. One thing would be to make sure it's in the have it here too. Okay. So that makes sense. I will say, I had done the sales right in front of me. In the beginning we did this wonky legal. There can be no smoking and smoking bars. But the state law was anti preemptive and letting cities and towns go further, but further for us meant that you can decide if those smoking or not. But we have had a handful of cities and towns actually by now is probably a couple dozen. Number one being the city of Medford that accidentally did it and they just banned smoking bars and there's been no legal challenges so we feel confident just to say there's no smoking bars period. No, no smoking and smoking bars, but just no smoking bars. Private clubs. I'll jump around a little private clubs. You know at the beginning of this this is when restaurants and bars was most went smoke free. And a number of communities, they marched to the board health and demanded that private clubs also be made smoke free, because we had the instances where private clubs are acting like public bars that they would have kind of fake weekend memberships for people and you know who could come in and go to a battle of bands on a Friday for five bucks that was a membership for the week. And then leave and so, you know, certainly bars and restaurants felt that they were stealing business from them, especially when private clubs typically are cheaper places to drink they have they sometimes have a cheaper liquor life. And I should also say the private clubs are have been consistently struggling with trying to stay in business. I was just reading one here locally that you know nights of clumps is probably close up. But so after that settled down, and the town of Athol got sued, and went to the state's highest Supreme Court Supreme Judicial Court and Athol one. We had a bunch of cities and towns put in place I think we're a little over 100 maybe. And we kind of adopted and then actually oddly enough we started saying some private clubs coming to a to the board health and asking, can you force us to be smoke free because we are doing we constantly have this in fighting amongst our smoking members and our non smoking members about it. So that's also all settled down so the way we've left it and this is up. This is, this is for you to know what private clubs you have any immersed. If they are private, if they are smoke free on their own. Sometimes the town has fewer than they think and then the ones that they have are already smoke free so it's not a heavy lift. I believe we only have one. That's the American region. What was that. I believe we only have one club left and that's the American region because the VFW closed. Yeah. And so you know, you can just, you can figure out because you know your local politics better than me. You can figure out if it makes sense to have a discussion with them first. They might be like yeah, we're fine. And so but we typically in other cities and towns with this more than one. We do say, you know, if you're public. If you're bars and restaurant community aren't complaining about the private private club. Then we kind of let it go, especially, you know, you might want to say when you're talking to American Legion you want it may want to ask them what is your guest policy can I see it can I see how this roles. And if you think it's stringent enough that they're really not letting anybody in other than members and bona fide guests, then you know, you might want to let it go, but it's your call you like I said you will understand the personalities, the makeup of the club and your politics better than me. Yeah, but it's something that is court tested, and it's perfectly fine to do. When I noticed other regulations about private clubs, there were more strict definition of what it meant to be a member you had to be a member for at least like 90 days there you know there weren't shorter if you were you hosting a different event. Like a more that was more open to the public than the, the regular that you couldn't have smoking inside when that was happening and that part of the building or when that was happening so they're pretty complicated. You know, sort of trying to dice it a little bit so when it's really private, you can do what you want when it's not really private. You can't. So, I don't know of any problems with American. Yeah, and I should say that was a DPH regulation that got promulgated about six months after the state law went to effect with the two biggest problems that we were just seeing in the cities and towns, which is private clubs and what a, what a smoke, you know what an outdoor space how much enclosed how much of an enclosure can you allow, and then also a dining space before they really are indoors and shouldn't allow smoking. Oddly enough, it's a calculation. That I think is actually valid in COVID days it's a very it's probably still a good calculation to figure out air flow for for COVID reasons. Yes, but we do have cities and towns that also have further you know that have allowed smoking but they put some additional conditions on them, you know, having to do with. Again, this goes down to the private the that your one private clubs physical layout, you know, if you go out and visit it and you say there's no way you can have a kids party birthday party here and expect people to smoke in the bar and it's not going to migrate to the kids party. So you might have something when rented when a portion is rented out the whole place must be smoke free during that duration. And like I said, looking at their guest policy might be very helpful. And I can help you, you know, if you feel like you don't want to go the ban smoking route, but you want to add additional conditions. I can gather some of the ones that I know I can put together and figure out what what what makes me make sense. I see hotels motels you say at least 50% of all in bed and breakfast hotel and motel rooms. We do have a handful of towns, it's more than a handful it's probably maybe even up to 2000, including the city of Boston that do ban smoking in hotel rooms completely. I, we don't have a lot of hotels in Amherst and one is on the UMass campus which is smoke free campus the other one. I couldn't even tell if it's operating and it seemed to be no, they didn't seem to have smoking rooms. I looked at the Airbnb's bed and breakfasts and most of them didn't have indoor smoking. So I don't know that, you know, we might survey them and ask them what they have because it wasn't so I didn't call I just looked at websites to see what's happening but it it seems like going all smoke free doesn't does no harm. I don't know the way it is. No, that's, you know, that's good. And so, yep. And so outdoor restaurant bar locations. We actually like our shorthand for we have about six different ways to cut and dice if if smoking is allowed in an outdoor dining section. And one of the most popular we actually call shorthand the Amherst decision. So it's the one you have. And, you know, yours is formulated to really follow the intent of the state's smoke free workplace law and that was protect workers. And so just as a reminder you say, if there's waitstaff you need to be smoke free if there's no waitstaff it's okay. So, you know, the three tables outside of Starbucks. Don't care about people can sit there and smoke. It's nice if they were quite a little further away from the door sometimes, but they can smoke there, but once you start having weight weight staff then you need to be smoke free. You know, you know, you know, you're not city of Boston that is, you know, has a people walking out the front door and they're on the sidewalk in a lot of spaces. You know, transportation, bus and taxi waiting. We don't have that. No, we have the enclosures and I've seen people smoking in those bus enclosures I saw it up. I'm saying we don't regulate that that's what I meant to say. Okay. Okay, but yes I agree there are those like three sided enclosures and I think that would be reasonable to not have to be next to someone smoking in the rain or some right. Yeah, so I think we should include that. So bus stop enclosures it's important. Yes. And on the buses themselves and we regulate that or is that I mean the PVTA is the bus system. That's, I mean, old state law that predates the 2004 law that we've been referencing already says no smoking on, you know, MBTA and every other authority, and that's if you've ever taken the ferry to one of the islands you see the inside or outside, and because they lump all the state and regional transportation authorities together. So already this should be prohibited. Okay. What about things like Uber and Lyft and that kind of thing that is that not something we have jurisdiction over do we. I mean you can all of this make all this is kind of an enforcement difficulty, but you know a lot of times it's really just putting up a sign gets you about you know somewhere between 70 and 90% compliance. So you certainly could add it. I mean I don't think that there's anything that says no. Okay. We'll find out what the generic name is for these companies. The office sounds around municipal building entrances. I don't know if you want to talk about just. Yeah, you did public. Okay. Was it publicly owned or we did do it in public buildings. Okay. You know the typical range is 15 to 25 feet. We have that liberal range because you know if you've been to DPH in Boston you know that 15 feet away from the building is in the middle of the street. You know towns like you know tiny towns out your way like, you know, leverage Monterey that you know, you can be, you can basically walk in the cow fields while you're having a cigarette. So 15 to 25 so it really comes down to what you think makes sense. I mean I know your town hall I know the building that you normally meet in. So, you know, so that's just a matter of thinking, thinking of through and what 15 and 25 means to you. Usually our most difficult. Municipal building being smoke free indoors and having people outdoors being far enough away is your DPW barn or shed or department or wherever they keep vehicles. So just keep, keep thinking about that, think about their physical layout when you're thinking about the different different distance. So you right now have 20 so you're smack them in the middle of the two. It may still make that still may make the most sense to you. Since this has been in place. Do you have any recollection of complaints about people smoking near municipal building doorways. And kids hanging out by the front of the bangs community center, but I think pre covered they've moved to off, but they had been a few years ago hanging out there. And it was a problem because there's an overhang in its outdoors work right and there's, there's some benches right by the entrance to bangs. Okay. I think I noticed some regulations in towns that seem to regulate smoking within a certain distance of the school property. I don't know if my, my recollection is correct on that you could you probably know that better than I do. Is that anything. Yeah. So the 2019 update. The 2019 to 2019 updates the state law. Kind of streamlined smoking on schools it was all over the place it mattered if it was private public buses, it was crazy. But right now it's all uniform that on property on buses and buildings and at school. School events, even off site and private and public schools must all be smoke free. So, but you know this is an issue at most schools high schools that kids, you know, learn where that zone is and they walk 20 feet away. Usually the way it happens is that, you know, you, my membership select man town counselors will get a call from a person who says my these kids are staying on my front yard. So, and so, so it does become more difficult to do that kind of beyond school yard enforcement because the principal, we just, we get a little nervous when we think that a principal is going to walk across the street and give out tickets. You know, but a principal could, could apply the school rules to these kids. You know, in fact, your school book may already say, during school hours these apply no matter no smoking, regardless. And so, but then, you know, then the flip side you think well the enforcers then would be police and these generally allows to do this. You know, at the height of this the industry really likes to say to have possession laws. And we fought them back a lot of times but a lot of times they get put in place because of the kids standing across the street. And I'll be leaving this for this meeting for my six o'clock at the Malden Board of Health where I'm a member, and Malden had precisely that kids are walking right across the street and seeing on the wall the library. So the police chief, he was a, he was the cop in school at the time he's now our police chief, had an ordinance put in place. You know, but once you go to court a couple times and the, you know, clerk magistrate looks at you and you know with a raging mad parent and the clerk magistrate looks at you like you're insane to think we're going to do this. So we've seen we only have all the ones that have been put in place I think we have to North Attleboro and maybe Harwich or Brewster that enforces it, nobody else does. So, so that's a difficulty. So I would say, it'd be more an issue if you had complaints about that to make sure the schoolbook says no smoking during the school day or vaping, regardless of where the kid is. And so, you know, if a principal saw them across the street on a resident's yard, they could say you're subject to whatever the schoolbook says. And then you can ask, you know, your police chief if you wanted to but they generally aren't interested in walking up to a group of kids and, and asking for ID, if they have such a thing. And also we also get some complaints that you know it's selective enforcement so it's just another way for cops go after big bad kids. So, so that's why we stand with that. Yeah. So you have playgrounds and swimming areas already. You can athletic fields, so athletic fields are those, you know, non-school athletic fields. So these are the people smoking at the Little League game. Parks you can add, you can either add them by just saying parks or listing them by their name. And retail tobacco stores I don't know if you already, you don't. You already say no smoking in retail tobacco stores. And then you're expanding to include e-cigarettes certainly we can do that. Right, right. Yeah, you know just wherever they're smoking there are smoking is not allowed. You know, vaping is not allowed or e-cigarettes aren't allowed. I don't think we had nursing homes in our list, but I have no idea what the policies are around nursing homes. Yeah, so the, the state law says no smoking in nursing homes, unless the nursing home comes to the Board of Health for permission to have a separate room only for residents, not for staff, not for visitors. You can only be for full-time residents. And this is a term I was familiar with when I was a student social worker at West Brose State Hospital 100 million years ago. And so that means the staff member can't smoke a patient. And that's where the staff member actually holds a cigarette in the mouth of the patient. Fortunately, I never had to do that. That was a... Anyway, so, so they can't, they can't do that either. And so I actually do think for those entities that officially call themselves nursing homes, a lot of them belong to a national group, and then national group membership relies on that you be smoke free anyways. So does he get another thing that if you could look at your, what you got in town and see what they're doing, and you may already find out, pleasantly surprised that they allows no smoking. Yeah, I wouldn't be surprised. I had to laugh when I was looking at the state regulations of the two exemptions is one where the soldiers homes. Yes, it makes me cringe every time I see a news report of COVID cases at the soldiers homes. I know, I know, you know, right up front there. And so these, you know, these 70 year old plus guys are smoking in their beds and it's all such a big huge surprise that they easily catch COVID. And I'm trying, I don't think we... We didn't regulate the common in the last round. And Nancy brought up that one of the, one of the issues that was that drove that was this event called the extravaganja. I remember this painful conversation. And, you know, I think that was captured by that registered events in J. Yeah. And so, but my understanding is that it was, and that was a way to get around from actually saying that the comments have to be smoke free. But my understanding is that they have since moved on to private land. Yeah, yeah. Which I can't believe your police chief or fire chief didn't say, Oh, no, no, this is over. Um, took some like 25 years and they finally said, uh-uh. Yeah. I think that you please be signing up on this every year. It's like... Anyways, so, so, um, so we... The philosophical thing I was wondering about is, you know, if there's a public park and it's generally, you know, people go there a little bit, you know, they, it's not right in the downtown area. It's kind of off in sort of the more rural areas and sometimes people take a walk there. Sometimes they might go have a little picnic. But usually if you go there, most times there are probably three or fewer people in the place and a couple of acres. The point of regulating smoking in an area like that is... Yeah, I mean, it's partially, this goes along with beaches too. Part of it is secondhand smoke. And part of it from our academic wonky stance is it's not emulate, you know, kids aren't watching this happen, but a lot of it has to do with trash. So the first town that, you know, said no smoking on parks, it was because a kid put his a cigarette button in their mouth and the mother went to town meeting and ended that. I would say, I'm like thinking to myself, who has this? The city of Maldon, again, has a smoke-free parks. And Austin Commons is smoke-free. And so what it does mean is that, you know, we... DPH used to have and may still have nice dirty metal signs that say no smoking. And again, it gets to a spot where a non-smoker could just point to the sign on a beach or at a park and say, you know, you're not supposed to smoke. And, you know, you can go a fair long way doing that. It's, again, spectacularly rare for a cop to care about enforcing any of this. And they're even on Boston Commons if they've given out a ticket, but I... But someone reported back to me because our office is only about four blocks away. That, you know, they walked through and there was a huge sign on a, like a sandwich board reminding people they couldn't smoke tobacco on the parks, but of course, you know, you have pot smoking everywhere. Well, that's what I was going to say. The other upside of this is when you do see people smoking, they're smoking all kinds of things in the same kind of park. Yeah, no. When they're in their cars, a lot of people will be in their cars and smoking. But my grandchild, when I used to bring my grandchild into golf park and war memorial park when they were little, I would see cigarette butts and I'd pick them up because I was afraid the kids would pick them up and put them in their mouths. Yeah. So it was a concern of the butts. I mean, that's the reason why beaches, you know, most the Cape by this point, most Cape towns have been smoking on the beaches as well as the state beaches and as well as the national seashore have all been smoking on the beaches. But, you know, enforcement, national seashore actually may have the best enforcement because they have ranges that are higher to go up and down the beaches. But it is, you know, it's, you know, ponder it whether or not you want to say smoke food comments is a good thing. And, you know, the, the kind of purpose there would be don't want to emulate smoking for kids we don't want cigarette butts and we don't people, exposes agony and smoke. So those public health messages are also something we can. We can regulate or regulate to achieve. That's what I wondered if it was just the hazard of the second hand smoke itself that gave us the right to regulate this but obviously we can do it in a broader way. Yeah. I think those were the questions that I had when I went through some of these options. I don't know if anyone else has looked at them or thought about some of these as well and have questions. Steve, Tim or john, do you have questions. I do not. Our steps would be to come up next with a draft and talk through it, you know, review what we actually want to do more. I would offer first that I would send Emma, some of the questions that came up how do you, what do you call what's the generic term for Uber lift a sentence for bus stop enclosures. I think it's easy to say all, you know, the sentence for all hotels is easy. I would expand this to include ends or E cigarettes. I think what that was one of the things I noticed is that it just I think this, the template had just E cigarettes as opposed to ends in the definitions and I wondered if I thought that maybe that whole ends thing should be what we're, we're talking about. I'll review it just because I just want to double check to make sure it doesn't have something that interferes with this better clean air, but was great for the sales part of tobacco. Yeah. I have a question. What is ETS stand for environmental tobacco smoke. I got it wonky term that we've always gone back and forth and use that ETS and secondhand smoke, kind of simultaneously. So I guess that's what has added another wonky term, but the wonky term they added ends is actually more used. We're getting there. The normal name for that is ride sharing right. By sharing service. They were right during service. Yeah. I probably want some state bill and shows a state bill that is always a state bill that wants to further restrict them. So I'll go on the state bill and find out what the comments, but it's probably right sharing. You're right. Tim, do you have any questions. Just just came to mind, you know, right sharing can be like Uber, but also right sharing can be like private people just combining and taking a ride. Is it something we should also include there. Well, I'm sure this is something with profit making somewhere in the error. Correct. Yeah. We don't need to reinvent the wheel because there's lots of places that are trying to limit their reach and the traffic jams they cause they used to cause. Another thing that we didn't talk about it might be covered under more housing. Regulations, a different regulation is the public areas of apartment buildings are common places in multi family dwellings or something. Is that a different regulation altogether. I'm going to go in this public areas of multi private housing. So, it's easy to do that with town financed housing. So if you have a housing authority. It's an easier thing to do. It's a little more of an uphill battle, but I have a feeling that this is a town somewhere out your way. That says no smoking on apartment building grounds. I'll look into it. Okay. Is that something you're seeing other towns regulate in terms of. I'm just curious for me if the town regulated it or the apartment. Building owners did. So I'll have to look into that because this gentleman I work with that works on this but a lot of times he spends as much time just convincing big apartment complex owners to do to go smoke free as he does. You know with cities and towns I want to do something but I'll look into it. Thank you. It wouldn't surprise me if some for fire regulations or fire insurance for large for apartment buildings might might prohibit smoking in the public places in the private. I don't know how that works, but. No, you're correct. You know, I think. Yeah, and then. Yeah. We recently moved and we were in a swank apartment complex in Malden, and they made you sign a thing that you would not smoke marijuana in your apartment, but they weren't smoke free building. But you know it's it was just filled with millennials for lack of a better term. So very, very, very few smoke is all together. And then you'd smell pot and okay, where's the police on this. It was mostly high school kids standing outside and it was just coming up the window. So. Well, that's helpful. Okay. Okay. Thank you very, very much. You're very welcome. How often do you meet just out of curiosity. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. Okay. I'll definitely get to this. I'll get to the suit. These ideas to you. I'm not probably within a week. Oh, thank you. Thank you. I'd say that and people think I don't. I have no short. Memory. So I'll forget what I talked about. Unless I do it. I hope your mold and board of health meeting goes well. Yeah, I think so. Yeah. Yeah. Yeah. Yeah. Yeah. So it's time. All right. So is the American club in. In Maldon smoke free. Now we, we have about four private clubs. You know, at the time. So this is one of the, you know, It's a high big political issue, right? So what happened is that. The mayor gets wind of it and usually the mayor belongs to half of them, you know, for political. And so they got caboched early on. We are now two mayors out from that. But I, you know, but I know that. A handful just like everywhere else have shut down for. You know, not being able to pay rent. And then I think a handful gone smoke for you on their own. So I wouldn't be surprised if we did a survey to find. You know, it's only one or two that are allowing smoking. So it just hasn't risen to the, we just haven't done, done it since, but it, you know, it's, it's. It's a political issue. That's why we kind of land on. If the restaurant bar community is complaining you, the board of health has a political leg to stand on, because you want to respond to that problem. And it's, you know, but if everybody's happy. Kind of let it go. Thank you. Okay. Very good. Good night. You too. Bye. Bye bye. Okay. So Maureen, will you work on a draft? Yeah. Do we. You know, I guess we didn't decide to change really anything right here tonight, but I will, I will just. Update the draft that I put out this week. Okay. And to send it again. I don't think. Unless we want to think about. Adding certain. Things like parks or, you know, or that's more of a discussion. That's more of a discussion, but I would really like to add the parks because of those butts. I think that's a good question. Do we think we want to. Survey like our. Bed and breakfast or hotels to see what their policies are, or before making any changes about a hundred percent. Smoke free room inside indoor spaces. You know, I guess the question is when. When do we. Talk about the things that we might want to change and should I, should we just, you know, there's, I've already updated the drafts. With the template in mind. And, you know, with the electronics, electronic cigarettes and all of that. And it's what's outstanding really are those decisions, I think more than the. The text. Yeah. Well, for the. Hotels motels. We have what used to be the Lord Jeff. I can never, the in on. On. I think that's. College. And then. Yeah. The wall, not in the campus center. Which is UMass. Which is UMass. And then the university. Which is now the homeless shelter. Is it just the homeless shelter? That's what I couldn't tell. That's all they're doing right now. Yeah. And then there's like the Allen house, I think, and. That's right. Stand or something. I forget. There are a few other air. There are a few other BNBs. And some had. Policies on their websites, but I think a couple. Yeah. By the way, don't assume with, I'm sure that I assume the. The X Laura Jeff is smoke-free, but it's not owned by Amherst college anymore. It's not anymore. It's very associated with Amherst. They hire the people to run it, but it is not owned. It's a separate company now. Is it, is the property owned by Amherst college? I doubt it. Anyway, it's smoke-free, but I felt like. Yeah. I felt like it had something to do with it. But it's not. Yeah. I don't know if I should have put a lot of pressure to make that happen, but I'm just, just as a fact, it's not really owned by the college. Okay. And the last time we worked on these. Most. Hotels. And lodging places do not want smoking because. It's terrible to clean the rooms. Yeah. Yes. Yes. Yeah. Just. That's, that's what we got, you know, in 2010 that. You know, they're all for no smoking. Okay. So we probably don't need to worry about that. But that was my sense is we probably don't need to worry about that too much and probably be welcome. If it's not already enforced. Yeah. Owners. Because that. What? But having, having the saying that you can have 50% is kind of encouraging something that maybe we don't want to encourage. Maybe better to say nothing. Right. That's what I was thinking. Yeah. Yeah. Yeah. There's no smoking. I think one of the. Just guides a place where people can smoke outside. You know, the one down on main street. On the right side. The Allen. Yeah. And then there's another one down farther that they are up higher that they own. It's the same people. It's more cross from the Dickinson house. Yeah. Yeah. But the Allen house people own that one too. Yeah. You know, there's going to be a new supportive housing on North Hampton road. And by far the most contentious issue. I was very involved going. Monitoring it. The most contentious issue before the ZBA was, but what about smoking? Obviously there'd be no smoking inside, but should you put it outside? Or will people just then go to the street and the neighbors. And so they're going to have a smoking pavilion outside. So it's, it's a very conservative issue. I'm just wondering what would you say? I think it's a very subjective hours of discussion. And was there a better bed and breakfast right in that. It was. That's not any more. It's prior. Willber's house. Wilbur's not doing. They're still there, but they don't do the B and B, right? Okay. So. So I'll, I'll make a few executive decisions that then we, go for it. Go for it. All yours, Maureen. All right. This is Maureen. OK, so we'll move on to new business. And Emma, do you want to present about the physician need for COVID vaccines? Yeah, so part of us getting up and running with being part of the state vaccine distribution plan is us having a provider that will sign off on those standing orders so we can enroll in that program. This has been something that Jen Brown and I have been working feverishly on, not to say feverishly, like we're symptomatic, but really excited and eager about. And I'm really excited to announce that we finally were able to have a great partner that's willing to do this for the town of Amherst and give back. And I'm so excited about that. And it's Dr. Kate Atkinson. I have to say that I didn't look at the agenda until today. But I did find, kind of by chance, I just signed up. I delayed this because I was working for a college and I thought all my emergency issues I would work with them on. But I signed for the Massachusetts Medical Reserve Corps. And in looking at documents there, I found something in the general law of Massachusetts that indemnifies people when they're providing vaccines. Correct. And the reason I didn't sign standing orders before was I did not have malpractice insurance. So I could do it. But if Kate's doing it, I have no problem with that. But I know. But yeah, no, that is wonderful to hear. I'm so excited about that because we are going to need other standing orders looking towards 2021. Right. Or influenza have a. Oh, it was news. It was good. I thought it was. Whoa. Now, the other thing is I have to check because I let a couple of things expire, which I don't know if I need a mass controlled substances. Right. In order to do that or not. So I'll do a little more research. But that was something I thought, oh, I could do this. No, I love that. I love the eagerness to look into it and the commitment to our community. Right. Right. Well, that's why I signed up for this medical reserve corps. I thought, we've got a lot of vaccines to put out there. That's right. Some people. I want to be ready to help with that. We have a lot of good work to do. Right. That's amazing. So Emma, this so this physician standing order is to allow who to do what. So it's to allow the town of Amherst Health Department to be able to receive the vaccines from the state when they're distributed. And then once the parameters are met for the different phases of the population that are going to be identified to get them, that Amherst Public Health vetted staff, which we are going to go work with the MRC. So I'm really excited to hear that you reached out to them, Maureen, because the MRC is great, because they can do a background check and vet everyone's credentials. So that way, we've already had an overwhelming amount of volunteers come forward that are wanting to help with our population. But certainly wanting to make sure that people have been trained and have good practice and have had backgrounds as a big part of that too. So to administer the vaccine. Yeah, to administer the vaccines and then also maybe help with flow of people if they're not necessarily a paramedic or a doctor or a nurse, right? It takes a lot of people. There's many other roles that are going to be needed to be part of this to make everything successful. And I know that we're going to have many opportunities to exercise dispensing vaccines. It's not going to be a one and done. This is going to be like a building project over the next year. And I think as long as we're open to feedback and suggestions and accepting those volunteers, I think it's going to be good. To what point of vaccine distribution is your understanding that the minus 81C requirement holds for the Pfizer vaccine? Where does that end in time and space? I don't know the exact time of that. But I do know is that the Pfizer vaccine is really going to be the capability of being able to distribute that effectively is really going to be limited to acute care hospitals. OK. And those settings because it happens. I do know that some other community facilities are purchasing those ultra-frozen, those ultra-low vaccines. We have our great new refrigerator that we purchased with grant money. We're so gracious. And then I also purchased for our department a new freezer that can at least go to down below 40, but not that deep, deep low temperature. So we won't be able to do it. But I want to put there. Yeah. But at least now we can have that, right? That's great. Yeah. Well, it seems like I attended this. OK. You can talk more in and then I'll say why I sent out a webinar. I went to be limited in general, in terms of the numbers into the first phases. Now they're thinking 100,000. Yeah. And so we're not going to probably see that again until much later in the process. Right. But I know we're down those coming down and to the other players. So we're going to come with this story. So I attended this COVID vaccine webinar that Nancy Messinger from CDC and Dr. Amanda Cone from the Immunization Corps talked about and they said initially the Pfizer comes in 975 doses per shipment. And those are really going to be the hospital ones. But when the DERNA comes out, that comes in 100 doses per shipment. And that's what we will see more in the spring for the general population. My meeting is closed. What, Fros? No. And I'm the host. But one thing that kept coming up. I need people off the internet. Got a bandwidth issue going on, huh? The Board of Health probably they'll be developing lots of vaccine communication tools. And I think one role the Board of Health might have is communicating that to the public and helping with the communication of that. Because that's going to be a big factor in whether people are going to get this vaccine or not. Dr. Fauci and Joe Biden also just said that they'll be the first in line to get it. So did Andrew Cuomo. And so the first group is December through March, if we're lucky. And then the second phase will come after that. And that will be the non-healthcare, critical workers, congregate settings, other older adults. And then the third will be, phase will be the other general public. And they do say people who've had COVID should get the vaccine, but they should be in the fourth phase. And a lot of what was said in this has been out in the public media. But they are going to enroll providers, train the providers. There's lots of toolkits and materials for providers. And then the Vaccine Averse Event Reporting System is with the CDC and FDA. But it is an opt-in. This Vaccine Safe is a new smartphone-based monitoring. And that's an opt-in rather than an opt-out reporting. And really helping people understand what mRNA is. And there are going to be ready-made materials and toolkits that will be coming out with all of this vaccine. That's what I got out of it. And you're going to be getting a shop card for your first and second. The big thing is, do we have adequate monitoring systems? And how do we get people back for their second dose? Which is three weeks later. There was another one yesterday webinar, but I missed it because I was doing the remote. We do remote school for three days a week. We take one grandson each day and do the school for them. So I'm not as free. Emma, are you back? Yeah, I'm sorry. I lost connectivity. Oh, that's OK. The joys of meetings, right? Of the Zoom stuff. OK, so you have the doctor. Do you want to give us a report? Yeah. So wow, I've been here a little bit over a month. Can you believe it? By everything that's gone on, I feel like I've been here for years. No, I mean, it is a whirlwind, but I feel really blessed to do the job and be here. Just trying to organize what we're doing to get ready to deploy that vaccine and making sure that we're set up to do that. Planning for it, I know that with our continued COVID response relationship building with UMass and really making sure that with their planned additional students this spring that we're going to have a successful hopefully seamless contact tracing program with them. I'm really trying to work on that. We have a meeting next week with Ann and her team. Also, we're hoping to increase our local contact tracing ability with the volunteers of the school nurses for Amherst Regional Public Schools. We've been in talks with them, and they've been talking with the union for that to make sure that we're all being following the rules with that. But they have this skill set, and we're excited to have them. Shelter, shelter is going well with Craig's door. There are definitely unique challenges this year with the homeless population, with COVID. I know that Pam Schwartz for the Western Mass Housing First group has been having great meetings. So we've been able to strategize and problem solve with other shelters in the area and municipalities throughout Western Mass to be able to mitigate how are they dealing with COVID and all of the challenges with that. Great news is that Western Mass is going to be having a quarantine and isolation hotel out here in Western Mass. I believe Pittsfield was finally approved for that. So that'll be good. I think a lot of the population feels strongly about staying in Western Mass. It's an area that we're comfortable in. I know that you get me out east past 495. I don't know what to do with myself. There's more than three lanes of traffic, and I get anxious. So there's been a lot of good work being done. They're using the hot yoga studio for those showers. During the day, they've been very thankful for that. Craig's doors has been managing that environment to make sure that it's clean and safe and during the agreed upon times. Our pre-admission testing policy for them, for COVID samples before the guests go into the UU, has worked really, really well. In addition to that, we're doing every four week surveillance testing with the assistance of Dr. Bossi, who's helping coordinate that. What else have we been doing? Yes. Who's doing the- Dr. Monseranti? No, Dr. Bossi from Health Care for the Homeless. I had reached out to the Music Anti-Center, but unfortunately they're having some operational challenges and their space is so narrow down there that it makes it hard to be able to do that. Emma, who's doing the analytical work on the testing you're doing on the guests at the Homeless shelter? Yeah, so Cooley Dickinson is doing it. Dr. Bossi is the ordering provider. So Dr. Bossi gets called with the results, which is great because she has good relationships, with each one of the patients. That's probably why we're gonna stay with this model of testing for the Homeless shelter because we're able to actively monitor those results as they come in and respond accordingly. With the UMass asymptomatic testing, it's a great resource, but you have to, there's a couple barriers that would make it challenging for that population to get their results. And Dr. Bossi wouldn't be the ordering provider. So we wouldn't get direct results from them for that. Now, is the initial test a rapid one or is it just the same PCR? So it's, we try to order the expedited one. I think that's what they call it. I don't know all the options. Yeah, that's what we try to order. I do know that what I agreed with Craig's door is that they could as if someone has a pending test, they could stay in a UML room if it was an exceptionally cold night during that time while it was pending. I see. So that way they would be housed, but certainly in a contained area to reduce transmission and everything like that. Sounds like a really good plan. Yeah. Yeah. Is expedited QPCR or is it antigen? Nope, it's PCR. It's a rapid PCR. That's a great question. It's just getting it fast enough. I mean, the technique can only be done so fast. Yeah. But the results come quickly. By getting in the queue, getting in the queue. Yeah, it's like ordering a stat rather than a routine lab, right? Yeah. In terms of, what else? Jen Brown did another flu clinic today at an elementary school for Amherst regional students. I'm not sure how that was attended, but that was happening at about 4 p.m. as I was coming home to plan for this meeting. And we've been just really trying to figure out what's our long-term goal gonna be. I know that's something I'm really excited to talk with you all about. In terms of what does the board of health and our health department wanna see our future vision be? Trying to, while COVID is like the really intense work that we're doing right now, that long-term goal, kind of looking on the other side of that is also something that I'm really excited for. So, does anybody have questions? I can talk forever. You don't want me to talk forever. I actually have a very specific question related to contact tracing. And it's contextual in that I'm a department head here at UMass and we had a asymptomatic positive test in one of our grad students in a lab, okay? So, there's a path and I get lots of stuff happen, starts happening. But I will say, I'm curious to know, so without prejudicing anything at Amherst. When, and my understanding is that's handled by the university, by our public health nurse at UHS, right? Right, the on-campus testing done by faculty, staff, and students are handled by UMass. Right, so- The asymptomatic testing that'll be done for community members will be handled by municipalities. In terms of contact tracing, follow-up. Yes, yeah. So, if you guys, if we get a, you get a positive test result, right? And it comes in through MAVEN or whatever the system is, you guys get it. And Jen, maybe follows up with the contact tracing or someone else does. What kind of questions does that person ask the person who tested positive? Oh, sure. There's a whole, I can actually, I could probably email you the materials, the material for that. It's a whole preset template of interview questions that we have to ask. And it has really evolved since this all started in March. There has been many different renditions. And the most recent one focuses more on where people have been and what kind of contact they've had, really focusing on household. Have you been around someone inside your household or outside your household without a mask? Have you been to a gym? Have you been to a religious service? Have you been to some other kind of performance? But if you work in healthcare or a daycare facility or another group institution like a university or college or high school? Let me give you a scenario. And what you haven't said yet is something I'm very curious about. So let's say I was in the lab for three hours. We're both face masks, but we were working in the lab with a person. Yep. With the contact tracer. I've always thought the contact tracer would get the name of that person and follow up in some manner with that person that you were in contact with. Am I completely wrong in that? Well, I think that philosophically, it sounds really easy, right? And very clear. And then when we get down the pathway of were you within six feet of that individual? And when you were within that six feet of the individual, was it for a total cumulative of 15 minutes over a 24-hour period? I heard 10, okay, 15. Yeah, whether you're wearing a mask or not. So those are the things. And what social behavior and memory makes things very less concrete to people. And it makes it really challenging for contact tracing. I think that we are learning new things every day about this virus. I think that six feet and 15 minutes is a good marker right now, but I know that there was just an article that I saw this morning out of a study done I believe in South Korea where someone was only around an infected individual for about five minutes and the feet was much greater than six feet. So I think we're learning more each day. But I just wanna get to this. So no, if you weren't within six feet for 15 minutes or more identified by the individual who's positive, then you wouldn't be identified as a close contact and you would not be notified. Okay, let me just say that in the UMass contacts, there were students who worked in the same workspace that were shocked that they weren't contacted by contact tracing. And the person who was positive told me, told not me, but another person, that they were not asked the names of the people that they were in contact with. And that part blew me away. Yeah, that would definitely be concerning. I mean, contact with a space in a room, who cares? It's about people and transmission. So I was really surprised, but maybe what you're telling me is if the person who was positive did not convey, there's some triggers that would convey the contact tracer asking for the name. And it sounds like it's pretty high bar to ask for the name, which is what I'm hearing you say. Yeah, I do know other countries, not the United States, but have instituted tracking ability. I know that there's something that you can have on your iPhone, but inherently that that's very, that kind of goes against a lot of people's beliefs here in the United States in terms of specific freedoms. But I do know that that has made contact tracing in other countries much easier. We found ourselves debating myself and my colleagues, just this ethical dilemma between HIPAA and privacy and public health. Because we wanna protect other students in our labs. And in this case, I would say other students, and we're lucky, students can go get tested twice a week, three times probably if they wanted to under these cases. And because the person was positive, communicated with individuals, they took action, but it had nothing to do with the contact tracing system. It really was based on that individual sharing. What I ended up doing was cutting them off emails that went to a whole bunch of people with people's names. I just said, listen, no names here. If you wanna type the name, let's phone or text me, but no emails with lots of people and let's figure out how we share and whatever. But it created, you know, it's this place where students were, okay, so who's gonna say we can go in the lab or not in the lab? You know, the last stuff. So far it seems that that incident did not lead to any other of our students being infected and may have been related to an outside activity and a other kind of activity of the sorts you mentioned. Yeah, but certainly I can bring back this kind of case report, this individual story back to the UMass contact tracing team at the meeting that we're gonna have. But just not, but I think we all kind of share these stories or have heard second or third hand of these stories. And I think that there's room for improvement. And it's not that we're trying to get anybody in trouble. We're trying to improve the response for our community. So sooner than later, we can stop wearing masks all in public and social distancing and then get back together as soon as we can when it's safe. The person who made this, and oh, the other question I have for you, and this is this, I don't know how you answer this. So the person who was surprised they weren't contacted had spent four hours inside a place in a lab setting, but about four or five days prior to the positive result being known, right? So how far back, that's a question. I like, where do you start? Because the person who got tested, there's a window. You may have been positive for a long time prior to that, just become positive. What's the guideline there? I'm just curious from a science perspective. Yeah, so it's two days before when the test was administered, not resulted, right? Because there's delays in processing that. So back to when the test was performed or the onset of symptoms. Yeah, and this is an asymptomatic situation. Yep, so we would only go back to two days before that test was administered. Okay, okay. Yep, it's a great question. These are questions we get all day long, John. I love these questions. Can someone be asymptomatic infectious for two weeks or 10 days or what's the thinking? Yeah, so I think that's what's hard. There's definitely the possibility. I know that there's people that are asymptomatic throughout their entire time period, but they've shown that the viral load is highest in the peripheral period with the two days before the onset of symptoms. And when that PCR would come back, there aren't perfect answers with this. No, no, no, I was trying to struggle with this. Oh, but I know it's so hard for me. I just love clear stuff. Yeah, so there's things that we're learning every day. Yeah, so I think this person's contact of that duration was more like four or five days before the test was administered. It's like the Wednesday before Thanksgiving. This was a test given a Monday after Thanksgiving positive result Tuesday. So it was too far ahead to be a concern. Another person walked probably outside for a half an hour or 20 minutes with this person, distance with masks, also probably not an issue. So we were, I don't think there was any, and the person was so surprised as no idea how they became positive actually. Yeah. Really dumb. And I think that's definitely a story that we're hearing a lot too, is just people really not knowing. The statistics coming out are still showing that the majority of transmission right now is occurring in households, small gatherings, people that you're comfortable with, those close friends that you have, not necessarily any of you, but just in general. The people that we let our guard down with, most traditionally, and that we all have to assume or take precautions and be alert that anyone around us at this point could be a carrier. Even if they're not displaying symptoms. And just because you have a test today and it's negative, that's a picture, that's a snapshot, that's a moment in time. And so many people will go, but I had a negative test yesterday. So there's, I think there's lots that people are learning. And I think a lot of people never realized how little they washed their hands before 2020. I had a couple of questions about this. In some time in a man's room, you'll know. I'm tracing. I wondered, it's how cooperative you're finding people are in this area in terms of responding to your questions. Oh, I love that question. Some days it's hard, right? Cause we feel like telemarketers and that in general, people really don't like to answer the phone and or answer hard personal questions with this person I don't even know who's like all of a sudden asking me these things and why are you calling and who are you? However, I do think it has shifted since March when we started making these calls. I think there's a greater awareness in terms of what contact tracing is and a little bit more acceptance in terms of how valuable it is. Being on the front lines of this, of course I wish there was more engagement back in March but I'm really happy we have the engagement that we do now. I do think our community in the Pioneer Valley is sounds from the incidental reports from my other health directors and other places in the state. People seem more receptive here than in other areas. So I'm encouraged by that. The second question I have is when I look at those weekly state reports that give the clusters and where they're occurring, that seems to account for about 25% of the number of cases. So is it just the people just don't know anyone? They don't have any contact that's known? Yeah, they report that it's not known, right? Is a cluster just... So a cluster is two positive cases of five people in each area that have a common link? Oh, I thought it was just two, like you could... Yeah, I didn't quite understand the definition on the website. Yeah, I am. It's the cluster is five people. I believe the last time I looked I don't have it pulled up right now but that was five people. Okay, so that explains it a little better to me because I was thinking it was just they knew like these two people in a household that was a cluster. No, cause it has to be two different settings. So say that there is like if there was two children and a family whose parent ended up positive a day after that would not be considered a cluster cause it's one household. If it carried over to a different household with extended family members from Thanksgiving and another large family group that could be considered a cluster. Another area where it kind of gets a little muddy is with sports. They have changed the definition of a cluster for some sports, including hockey. Recently, there was a cluster identified of three athletes in a team. Yeah. So it kind of varies in households apparently. Yeah. Cause I always remember a cluster often was three but I mean, I guess it depends on how it's transmitted and other things. Yeah. And you know what Maureen, tomorrow what's probably gonna change. Right. Yeah. Yeah. I've only done this limited ways at Mount Holyoke and we had a pretty good handle on, we could get those kids. It was an easier thing to trace. We'd get the class schedule, the roommates, sports teams, it was just a smaller universe for the most part. So I can see how hard this can be and these numbers and this very contagious illness. Yeah. I will say today in the last couple of days we've started to see what I refer to as the flip where we had 19 cases yesterday and only one was associated with college related. Oh. Yeah. And there was 18 in our community and these vary throughout the age span from one and two year olds all the way up to some elderly. And these people are sick and are really needing help and support. A lot of them do have extended family members and friends that can help give them services but we are working with CHD in terms of giving extra supports and connecting people with some social services, that rental assistance. I know that Angela gets a lot of calls on the COVID concerns line and I'm just really happy that Amherst is able to help with that and connect people with those kind of fundamental things that local boards of health are mandated to provide but I know all of us who are on local boards of health feel like the societal need to provide while people are so sick and quarantine and isolation. So. Can I ask one more thing about contact tracing? It's just a general question. So I've heard that in some of the places with even higher prevalence the contact tracing is pretty much impossible. It's just gone beyond any reasonable ability of even a well staffed team to do it. And it does look like Massachusetts as a state is headed towards a much higher level. Are we approaching that? How do you see the next month going? Yeah, I mean, until, you know, the captain's not gonna leave the ship until it's down. That was funny. It was my own internal joke. I'm laughing at my own jokes. That's bad, Steven. We've reached that point in the meeting. We do feel like that might be coming. It is very disheartening to feel that way. But, you know, we're just ready to pivot if the time comes as directed by the state to our mission more on vaccines and doing that outreach rather than this contact tracing. But we're really leaning on the state to kind of give us that guidance. We're not ready to give up. I know that's why we've been working on continuing to build a relationship with UMass before those extra students come back and then also getting on those extra contact tracing. That way we can have the capacity. Because my goodness, I don't know how Jen Brown does it. I covered this past weekend. So she could finally have a day or two off for the like the first time since March and what she just does such a remarkable job. I'm just so glad to have her. Do you think UMass is going to renege on having everybody come back if the numbers keep increasing the way they did in August? I think that that's definitely... Is this a money thing? Well, you know, you're not the only one to ask that question. I do know that we had a meeting with UMass earlier this morning with the town and that was one of the questions. And I think their response was that they're open to possibly moving more students to remote or other ideas as things come, but those are concepts that they're keeping in the back of their mind. That I know that they also reported that they were hoping to bring back over 6,000 students and their response rate from students wanting to come back has not met that full level. It's a couple lower. So I understand their desire to bring back more students, but from a public health standpoint, I can't. I get pleased when the numbers lower, of course, but I also, I feel like that's a little self-centered and biased. Yeah, I don't know if Tim, you went to this, but the provost held a budget forum yesterday for all faculty, staff, and librarians at four o'clock. And with 5,000 students on campus, we still have a $11 million budget deficit to fix. And I asked, actually, the question did get answered. If that's only $1,028 million budget deficit. So, and nobody said how that's gonna be filled, but I'm reading that. So it's very serious. The one good thing, I think, to be shared with the town is around the country, there's not much evidence of serious growth, transmission, whatever, of on-campus students. That's not generally a big issue. At least my read of the Chronicle Higher Red and other stuff that on-campus students, even at pretty high populations, have been managed better than off-campus students. Let's put it that way. So I take that as positive, but yeah, certainly there's nothing that has to raise concern. I can see that big time. But it's right at the economics, public health trade-off that the country's facing, right? And there's things we could not do and do instead, but that's never happened at the federal level, so appropriately, unfortunately. That's great that you're talking about those things. I asked the university, the folks who are doing the dashboard at the university some time ago, and they changed what they did, and I don't know. I wanted to see a plot or the ratio of the fraction of positive tests that were asymptomatic versus symptomatic. And I have to do it piece by piece, and they used to go to a page that said of the three cases, their flavor, they actually stopped doing that. Yeah, and I wondered if there was a HIPAA thing wondering about, in other words, if you knew the test results on this day, and it was two students, and they, I mean, it was a little, maybe it was a little harrowing in too narrow. So instead of giving the thing I asked for, they actually got rid of the whole thing. And changed, added one plot, that table they have, which is a weird table, but anyway. I can bring it up to Ann and see what Ann Becker, or Jeff Pascock are thinking. Have you, I guess my question was, do you know that? Roughly, what do you think from the student testing asymptomatic versus asymptomatic? I have no idea. However, I do know that the symptomatic testing is not done at the Mullen Center that's done through UHS. Yes, it is. It's done at UHS, yes. Right, and so like a totally different flow. And you know, they're not doing 20,000 tests a week at UHS. You know, just when I think of the volume of great students I saw standing outside of the Mullen Center. I'm not talking about tests, but positive. So I mean, the vast, vast, vast, vast majority of the asymptomatic tests are negative, which is what we want, but of the positives, there are days, I think more than half are asymptomatic. In fact, I think more like 70%, that's my take on that, but I'm not sure of the positive results. Okay, yeah, I can ask. I just wish I was surprised. There are epidemiologists, faculty who are doing this, and I, anyway, I'd ask a few questions and gotten answers that beat around the bush, but anyway. It sounds like a classic answer for anybody putting up. Yeah. Right. It is so wonderful that this testing center open. Maureen, Leslie's ecstatic. Yeah, no, I know a lot of people are thrilled that there's testing available in this side of the river. So, yeah, that's a real plus. Part of, because they're gonna be able to provide the asymptomatic testing in for 10 and older. I do know that I have been communicating with Meredith O'Leary, the health department director in Northampton, and we were facilitating, planning on facilitating still some mobile health testing for the next three weeks in Northampton and Amherst, certainly I think we have different missions of what we wanna achieve. The gap in service that I'm really identifying for Amherst is gonna be those, the kids under 10 and anybody including that that are possibly in quarantine or have been exposed and identified as a contact and need testing, and then also the people who are symptomatic. So, with some leftover, I hate to say leftover, but some still available COVID, Pioneer Valley Planning Commission money, I'm hoping to have three days of testing, probably about 150 tests each day, which isn't a lot, but it's more than we would have otherwise. And those would be done through our vendor of county ambulance, which is a wraparound service that they're able to provide, have staff come in, be able to have a whole platform where people can sign up before ahead of time. They have a lab where they do the tests and then they're gonna be responsible for reporting those results as well and getting them uploaded to ISIS to May then. So, I am also really, really excited for the UMass site. Hearing that come on board totally changed what the plan was, but I still, I know that there's people in need here. And while the other sites are getting on board throughout the state, I think it would be great to do as kind of a bridge the next couple of weeks. Thank you. I have a completely non-COVID question. It's a very minor point, but the town has a YouTube channel in which all public meetings are posted. I don't think too many people look at it, but the Board of Health is very spotty. Many are missing, we don't have one for November, much other. And I just wonder who is involved? Because I did talk to Brianna at one point, she preferred me to somebody else, but never went anywhere. And also the ones that are there are posted only many weeks after the meeting. Now, I don't care if they're posted at all, but if they're gonna be posted, I would like all of them to be posted and I think they should be posted promptly. So, who could we go do with that? I will follow up with that tomorrow, Steven, because I also agree. You know, I don't wanna be on live, you two. You wanna be able to edit it, no. No, I don't even care about editing. People can hear my blabbering and where I lose my thought. But for me, it is important for us to get the information out there, right? We may only see one person on the meeting while we're doing it, but being able to access things after for our population, I think is really, really valuable. And we're gonna be pretty. So, I'll follow up with that tomorrow. That's a priority item for me. Okay, thanks Emma, yeah. Yeah. One last question is about sports. Going back to sports, I saw something in the paper about how Amherst is going to have basketball and hockey. And I don't, do you know the thinking about sports? I think that there is a lot of passion and family values with sports and athletics, which make it very challenging for people to go away, health risks aside from them. They did, the school committee did ask for my perspective. I gave them my thoughts based off of the guidance that has come out with the MIAA and DPH and then the kind of evolving nature with ice hockey that we're seeing. And you know, they're their own committee and they had an opportunity for feedback. They got a lot of public comment. And so they made their decision. Yeah, okay. Yeah. I found it interesting that school can't be open, but sports can go. Yeah, I think it's really, I think people overall are really looks seeking after things that they can kind of control. And I think that's something that people really are looking to be able to have out there and available despite the health risks. But I do think it's a pretty stark comparison. Nancy, that you're painting and something that I think we can all kind of see in the picture. Yeah, also I read the article that they've hired this special consulting group for their 15 students that they have at school. And I thought, oh man, don't they have enough faculty, staff and knowledge without spending more money for 15 students, but that's life. Yeah, I think that there's challenges with the structure and faculty in the union and coming to mutually agreeable terms. So, well, I would love simple answers. Sometimes things aren't so simple. Yeah. I had one question and one comment. Emma, I'm wondering if you got an email that was sent to health agents and board of health directors from MassDP about the PFAS testing in private wells. Did you get that? I did get that. Good, I'm glad to hear that. Okay. Yeah. All right, okay. We're not a community that's more than, that has a high percentage of people on private wells. So we're not a target of our program, but of the program, MassDP, UMass, my colleague that we're working on. But anyway, I was curious if that, if you got- Yeah, I was on that list. And I know that it's also coming up in terms of not just the wells. I know the wells with that program, but with our sewer as well, it's coming to our water. I had the opportunity to briefly speak with Amy Brzezinski. I'm probably saying her name wrong. Who's the answer? But about- Of course, she was married, it was Laine. It was really easy, Amy Laine. But anyway, that's who I knew her. She was my student. Amy Brzezinski, yeah. I know that we're engaged with sewer stuff, we're engaged with, this is maybe the stormwater question you were, that might be, that's another area of where COVID is being looked at. Oh, well PFAS is being looked at, excuse me. I'm mixing up- There's so many things, John. There's so many things. COVID, PFAS, and LEND are all in my head at the moment. I think I had meetings on all of them today, at one point or another. But great, I'm glad you got that. Yeah. And Amherst as a town will be having to do sampling and analysis and there's one free, we're in this program, there's one free round of sampling and as a PWS, they could partake or before they have to or wait till they have to. It's a mixed bag. A lot of people don't wanna know about problems you don't know about. Right. The known unknown situation. And then the last comment is, are you full up with the nativity gigs? Oh, me, yeah. The socially distanced tableau, yeah. He's in the Gazette this morning. The other day, yeah, did you like the lambs? They were wearing masks. Very nice, yeah. Yeah. For good job. Last night I woke up three times having dreams that I was someplace and I forgot my mask. And that's bad, three times. But Nancy, I had to find my mask. But we've all done it. None of us are immune to that, right? Yeah, we gotta have them everywhere. I know, and then you watch, you know, all TV shows and people don't have masks on. They try and get upset that they're talking when they're too close. Right. It's gotten so bad. Okay, I don't have any topics not anticipated. Is there anything else? Any other comments? Next meeting for second Thursday. Yes. Next one is January 1st. I think we went over them. Oh, maybe we just said before, yeah. We might have said before. January 14th, I would say. January 14th. Okay. All right. Okay, well, everybody be safe. Whatever holiday you celebrate or don't celebrate may all be happy. And may 2021 be better than 2020. I miss us all meeting in person and Zoom is okay, but it's getting tiring. Oh, yeah, yeah, isn't it? It is. But I figure we have to do this until, at least until April. Maybe May we'll see some breakthroughs. Oh, you are. But really not until, but it really in reality, not until the end of the summer, but I'm trying to be optimistic. Good for you. At least in April, you can go outside again. Yes. Maybe, maybe we could hold an outside meeting. Sure. Sure. Yeah. But how is it public? You know, public, they're invited. Yeah. We visited some friends a couple of weeks ago and we had, we actually were overnight in their camper van in their driveway, but we had four meals, three meals outside in the driveway around a big wood stove that they happen to have the wheel set, the thing roaring. So you can get one side of your body warm anyway. But that was fun. Okay. All right. Be safe, everybody. Thank you, Emma. Thank Jim for all the work you're doing. Yes, thank you. Yeah, thank you. And Nancy Schroeder, the, our admin assistant just is helping out so much too. Well, thank her too. Yeah. I move way adjourned. Okay. Second. I'll second that. All in favor. Tim. Oh, we have to do this. Maureen. I. Tim. He said, I, he said, I, he said, I. I. Steve. I. John. I. Nancy. I. Okay. The meeting is ended and be safe and see you next year. Yeah. Thank you. Bye everyone. Bye. Bye.