Board of Health: February 2, 2021

Transcript machine-generated with Whisper speech recognition (the source video has no caption track). No speaker labels; proper names and dollar figures occasionally misheard. Click any timecode to jump to that moment in the source video.

0:00 Let’s call the meeting to order. Welcome, everybody. First item is the minutes of, let’s see, December 15th. If you have a chance to look them over. Yes, I did. Would you like the motion to approve them? Yes, please. So moved. I’ll second. Okay, Andrew? Ms. Hazlett? In favor? Ms. Gottlieb? In favor? Dr. Belspecker? In favor. And then the minutes of December 22nd? Go ahead, Michelle. I’ll make a motion to approve. Is there a second? Second. Yes, second. Ms. Gottlieb? In favor. Ms. Hazlett? In favor. Dr. Belspecker? In favor. Excuse me. So the COVID update, please, Andrew. Right. So as of Friday, January 29th, and please remember that we pulled data from the state that comes on Wednesday. We pulled data on Thursday. We have reached a mile marker of we’ve had we had a total of 1000 cases so far. We had 92 active cases for the week, and we’re still sitting at 31 deaths. I did have a chance to review the certificates for the last month. And I did not see any additional COVID cases that were attributed to the death.

1:35 We continue to see a very high number of cases in the lower age groups. So zero to 19, 17 cases for the last two weeks. 32 for 20 to 29. For 30 to 39, we had a total of 16. For 40 to 49, a total of 17. For 50 and 59, a total of 23. For 60 to 69, a total of 16. 70 to 79, 12 and 80 plus 4. We’re still seeing a lot of cases in that zero to 19, 20 to 29. And that 50 to 59 is tends to be a very high number of cases. Our average daily incident rate per 100,000 did drop down this week. We’re down to 47.3. That’s still a red category. A total test taken so far for Marblehead is 29,055. A total test in the last 14 days is 3,893. The percent positive for the last 14 days was 3.67. Again, that’s lower from the week before, and that’s in the yellow category. So we stay in the yellow category at this point. We continue to have quite a few cases that come in. Some days it’s quite a few, and some days it’s four or six, but we’re still seeing quite a few cases. Have you seen any variants?

3:11 So we don’t get notified of the variants. So when people go to get tests, they’re just, are you positive or not? They’re not, we don’t see the variant results. You have to pull the data out of that and then send it to a different lab to get, you know, we’re not the ones that are doing that. The labs are kind of the state. If they’re going to do investigations into the variants, they take a look at that stuff. So that means we will not see them? We will, you know, we won’t see them in the data at this point. No. So people over the age of 65 and people who are underline health conditions, who are at high risk for COVID-19 should continue to stay home, except for essential errands such as going to the grocery store and attend to health care needs. All residents are advised to leave home only for health care, worship and permitted work, shopping activities. When going to the pharmacy, ask if you can fill your prescription for 90 days if possible. For some medication, this may not be allowed. If you’re a high risk, try to use mail order service. All residents are required to wear face masks or cloth face coverings in all public places, whether indoors or outdoors, even where they’re able to maintain six feet of distance from others. Parents should limit play dates for children. All residents are advised to wash their hands frequently for at least 20 seconds with soapy water. All residents are advised to be vigilant, monitor for symptoms and stay home if you feel sick. Use remote modes of communication

4:47 like phone or video chat instead of visiting friends or family who are high risk for COVID-19. Obviously, we continue to talk about travelers, so please remember to visit the state website COVID-19 and filling out your travel form and making sure that you’re abiding by all the state rules for travel. Negative test results before you’re returning to Massachusetts. That includes Massachusetts residents. If you’re unable to have a test before, then you need to test once you get back. Talking about vaccinations, or I guess I’ll continue on with some of the case numbers. The total cases so far in the state of Massachusetts are 500,415. Today, there were a total of 2,270. That is slightly down for our average. But again, we’re still seeing a high number of cases in the state of those younger two age brackets. So in the state of Massachusetts, the 0 to 19 had 11,400 and 33. The 20 to 29, 10,337. So those age brackets are getting hit pretty hard. We just need to remember that. We need to make sure, like I said, everybody still needs to stay vigilant, wear your mask, especially if you’re with somebody outside your family, and take all necessary precautions. Vaccination. So we’re really running in parallel tracks right

6:21 now. We’re obviously doing disease surveillance, tracking the disease, identifying cases, making sure we identify contacts while we are moving into vaccination. So we have moved through all of phase one, but this group is still able to get vaccinated. So anybody that’s in phase one that has not been vaccinated is still eligible to get vaccinated. On Monday, the state moved into, we allowed to start to vaccinate the first group in phase two. So the first group in phase two is individuals age 75 plus. So they’re now able to get vaccinated. There’s many, many different ways to get vaccinated. Unfortunately, right now, vaccine is a little scarce in the state of Massachusetts. I’m unable to get Moderna. I was supposed to get some Pfizer today, but we are unable, the shipment didn’t come in. We were dealing with that this week. We hope to have it by the end of the week. But it’s really important that you pay attention. So you can go to the state website to mass.gov vaccine and sign up for a vaccination. You should check with your pharmacists or CVS, Walgreens. You should also check with your doctor. Partners started over the weekend to start to push out information to their patients on links where to go to sign up. And you could make a lot of appointments this week. So, you know, people that I know who are partners, people

7:53 were notified over the weekend and they actually able to set up their shots for this week, Monday, Wednesday, and stuff like that. So when we do this rollout, you don’t want to continue to look in the same place all the time. You really need to look in a variety of places. We have vaccinated a total of approximately 1200 people so far. We had a large vaccination clinic for first responders. We are working with surrounding communities to help assist with this. So we’re working with Salem, Swam Scott, Danvers, and Beverly. This way we are able to pool our resources together, including nurses and other people to allow these clinics to move forward. Our plan is to hold clinics every week, most likely on Tuesdays and Thursdays, for the general public essentially. We want to try to fit in people that are having a hard time getting vaccine, but we’re not going to limit to certain people. We’re really going to try to hit a certain population, but they’re all open to the whole community per se. Last week we did hold clinics at Salem State South Campus. We were hoping to have clinics in Salem State South Campus this week, but unfortunately our vaccine didn’t come in. We no longer have any Moderna. We’re hoping to use Pfizer. We have an agreement with the hospital to store a vaccine there. We can pick it up, thaw it out, and vaccinate, but unfortunately it was unable to come in. We have talked with Cataldo, and we are trying to bring Cataldo in, and they have agreed

9:29 to do that, to add to the number of vaccines that we can administer every week. So Cataldo, we will be handing over the South Salem State site to them in the next week. We do have to go back there and pull back from them a little bit to give our second doses to people that we gave out to, but we’re hoping that Cataldo will really be able to fill in a big need for us in this North Shore, in our area. They’re going to start out with a couple of clinics a week, but we’re really hoping that we can ramp them up to five days a week, Monday through Friday, beat another site where you can get vaccine. You know, again, you know, we have megasites in Danvers. There’s all the student megasites in Boston, but we’re trying to have a different areas that people can get vaccinated from. The coalition that I just talked about with the health departments, once we finish up our first responders, we have a second dose that we’ll be administering to them, the week of February 8th, that will be five days of vaccine for that group. We will begin to move town to town to start to vaccinate the certain populations that are eligible at that time. We are only going to be allotted 100 doses per community for our group, so a total of 500 doses per week that we will be able to give out. Now, obviously, a lot of people are trying to get the vaccine as quickly as possible. I know there’s been a question about teachers, will we be able to hold

10:59 clinics for them? We don’t believe that’s going to be the case for that large group. You need to understand that the group three of phase two is a very, very large group. Early education, K-12 workers, transit, grocery, utility, food and agriculture, sanitation, public works, and public health workers, those are all part of group three. That’s a very large group. When we look at just the employees for the five communities, that’s over 5,000 employees. So, really, people are going to need to look at a variety of different areas. Like I said, we will be holding small clinics for people that are unsuccessful or having a hard time traveling to these other areas. So, please look at a variety of different areas to get your shot. And really, mass.gov vaccine is the best place to understand all the different locations. There’s also a lot of other information on the mass.gov, you know, vaccine updates. The other piece that a lot of people have been talking about is senior housing. We are hoping that CVS pharmacies or other pharmacies like them will be able to assist in getting senior housing vaccinated. And, you know, hopefully, we’ll continue to work with them to get that taken care of. And if there are people that are unable to travel or unable to get to some of these sites for that group, I’m sure that we’ll be trying to assist in making sure that that population gets vaccinated when they’re eligible.

12:32 So, senior housing is going to be part of group two and phase two. So, they’re not eligible currently. It’s just individuals age 75 plus. But the next group that is eligible will be the 65 plus and individuals with two plus co-morbidities along with that senior housing and low-income housing for that group. So, I just want to make sure I kind of cover up, you know, talk about some of that stuff. Is there any idea at this point when the shortages will get worked out? The shortage is going to take some time. We feel that it’s really going to take the month of February to work some of that stuff out, Todd. Yes, we will have some Pfizer available to us, but we’re not sure how much. And one of the things that we can’t do is we can’t mix a clinic with Moderna and Pfizer. So, it becomes complicated when you have, it’s a two-dose series. So, I have clinics for Moderna one week and 28 days later, you have to get your second shot for Pfizer. It’s 21 days later. So, it’s not the same math. And so, we just have to make sure that they can’t cross over. You know, people, when they’re ready, they’re going to need to be ready. And we can’t be administering Pfizer and Moderna in the same clinic at the same time. It’s just not worth the risk. So, we would be holding separate days if we had to deal with two

14:04 groups coming together at the same time. We would be holding clinics, you know, Tuesday, Thursday for one group and Wednesday, Friday for the other to make sure that we weren’t crossing anything over. Helene, yes, you know, they’ve been talking about now three different variants. And they’re trying to get away from, you know, us calling it the UK variant, the South African variant, and now the Brazil variant. They really want us to start to use the numbers, you know, the B111. So, you’ll hear us start to kind of shift over. I’m sure it’s going to be really impossible to get rid of us talking about the UK variant versus the South African variant. Now, they will continue to take a look at making sure that the vaccine that they have developed, you know, they’re saying at this point we’ll cover that stuff, but they will continue to do the research to make sure that it’s covering all variants. Obviously, with a, you know, with a virus that’s changing course at times, this is typical. But unfortunately, we have these new variants. They do seem that they’re more transmissible. So, there is concern about that at this time. What we are seeing is that once it’s getting into a household, people are not able to, you know, it’s spreading like wildfire through the household. So, it gets into the house and five days later it seems like everybody in the house had it. Before, in the springtime, when it got into a household, you know, we always try to remind them, try to stay separated from each other, stay isolated, stay in your bedroom, you know,

15:38 have somebody deliver food to you, but not face-to-face contact. Try to, you know, you need to use a separate bathroom, otherwise there’s a lot of crossover. But unfortunately, people need to be very vigilant about that. Unfortunately, we are seeing a lot of transmission in the households. So, that’s a big piece to that. And unfortunately, that’s going to continue and we’re just going to have to do more research as we go on and see how it goes. Now, once you are vaccinated, they still need to learn everything. They are concerned that you could still be a carrier and they have been talking a lot about, if I have to travel, am I going to be required to get tested? And at this point, it’s very possible, yes, you’re going to continue enough to get tested until they come up with a, like a kind of a national policy to say, you have a vaccine card, you can carry that and there’s no concern. We’re still too early into this pandemic to deal with some of that stuff. So, there’s a little, there’s still a lot of unknowns at this time with how the vaccine is going to work and the concern of these variants. Any questions? I’ve also heard, I don’t know if you have, that some of these variants could be more harmful to children than the previous ones. That’s nice. Yeah, so there is a concern about that Todd. We’re definitely, you know, it seems like it has shifted from the older population getting hit in the very first round and now we are seeing the younger population having a lot more

17:09 cases than we did in the springtime. So, we are concerned that that population could be affected. Excuse me, Andrew. There’s somebody named Emily. If you don’t mind putting yourself on mute, please, we can hear a lot of background noise. Thank you. So, you know, obviously new variants of the virus of COVID that causes COVID-19. Information about the characteristics of this variant is rapidly emerging. Scientists are working to learn more about how easily they spread, whether they could cause more severe illness, and whether currently authorized vaccines will protect people against them. Scientists are working to learn more about these variants and more studies are needed to understand how widely these new variants have spread, how the disease caused by these new variants differs from the disease caused by other variants that are currently circulating, how these variants may affect existing therapies, vaccines, and tests. So, what does it mean? Public health officials are studying these variants quickly to learn more to control their spread. They want to understand whether the variants spread more easily from person to person, cause milder or more severe disease in people, are detected by currently available viral tests, respond to medicines currently being used to treat people of COVID-19, and change effectiveness of COVID-19 vaccines. Obviously, the CDC is collaborating with other public health agencies and monitoring the situation closely. CDC is working to monitor

18:40 the spread of identified variants, characterize and merge viral variants, and expand its abilities to find new COVID SARS-2 variants. So, that’s kind of the update on that. A question, John. Andrew, you touched upon the fact about the Moderna and the Pfizer and that you’re not going to mix them and all, but you also said that you were running out of vaccine. Did you hold the Moderna back for next week’s clinic? We did. So, we have to save the Moderna for our second dose for our first responders. We have received that. I’m not so sure we have received all of it, but the state has promised that we’ll receive that. So, knowing that, we were trying to continue with clinics this week. So, we had signed up to get Pfizer. It is more of a challenge to handle. We do have a good partnership with Salem Hospital. They were able to store it for us in these really super cold temperatures. They would remove it from the freezer for us in the morning when we were having clinics. It’s got a thaw, and then we could, there’s some other procedures that we have to do to administer that. But, unfortunately, our shipment of Pfizer did not arrive today. So, we are hoping to have a clinic tomorrow that has been canceled. We never really put it out there in our community. And we’re planning to have a clinic on Friday as long as we get vaccine from Pfizer. We won’t post anything until we get it, though.

20:14 So, can you still go on an appointment basis or are you going, just having people come and stand at mine? No, we only do appointment basis. We need to know exactly how many people, we know exactly how many people we can handle for a certain period of time. And because I have to, you know, you have to remove it from the freezer. You have to thaw it out and have to be prepared. You have to administer the shots in a certain period of time. So, you can’t just pull everything out of the freezer and be like, all right, maybe I’m going to do 500, and you don’t get there. You have to, everything has to be precisely calculated out of what you’re going to be giving. So, we need to know exactly how many people are coming to that clinic. That’s why you have to pre-register. If you don’t have a Friday clinic scheduled, you’re just telling people that were Tuesdays and Thursdays to come or how you weren’t managing that. No, so eventually you’ll be able to, like I said, everything’s done through the state website. So, you’ll be able to go onto the state website and you’ll see the different clinics all over the state and you could try to get into different ones. Can you explain, can you say something about the Cataldo? If you were able to transfer over what, as you suggested to Cataldo, where will they be holding that? They’ll be holding the clinics in the South Salem, Salem State site that we’ve been using for the last week. Okay, so they, it’s the same site, they would just be coordinating it. Correct, they’ll be taking over that site. Yep. Another one. Oh, go ahead.

21:48 Sorry, and then I just, there was something that I wanted to clarify and maybe this is shifting, which seems like everything is shifting fans right now. So, but I attended that state sponsored, like senior citizen, COA webinar last, I can’t keep track of the days, maybe it was last Friday. And they were encouraging, they were discouraging people from calling their physicians to make appointments at that time. But that was probably before partners did this big rollout. So I’m just wondering about that piece, because at that point they were saying, it’s possible that, you know, people will be able to get, people will be able to get vaccines from your, you know, from your physicians. But at this point, only contact your physician as a resource for getting the vaccine. If you are, have an allergy or you’re specifically at risk for some particular reason that you would need to go to your physician. Otherwise, don’t be contacting your physician as a resource for getting the vaccine. But that’s different from

23:21 what the guidance you gave is. So I’m just, I just want to clarify. Yeah, it’s, you know, yes, it’s challenging because partners who is, you know, a medical provider began to push stuff out to their patients. So if you go to a partner’s practice, they are emailing your patients, obviously, depending on what group you fall into, you might see an email from them to say, you can now sign up through us to get a vaccine. So it really depends on who your provider is. Yeah, this is just a morass. But obviously with partners, it’s easier for some of the elderly people to sign up. When you go onto the state website, there are some challenging pieces to it. You need to upload a copy of your medical card. And that can be very challenging. All right, I’ll hold on the piece I wanted to say about the senior citizen community until we get through the rest of the report and other questions, etc. Any other questions?

24:33 Looks like Sarah. Are you taking audience questions? I’m going to do that at the end of the report, like usual. Okay, all right. I see you, Sarah. No, that’s it for now. Michelle, did you want to discuss masks again? Right now, on the mask front, I want to hold because the lady that there’s a lot of like everything, it’s a bit of a morass, there’s a lot of current kind of controversy even around Fauci and the CDC around the double masking front. And given the comment I’m going to make later regarding having some kind of public communication around other things, I think I want to hold on that right now and have us really just focus on where we have been around masking and just general, our continued prudence around masking and hold off right now. Because I just feel like there’s a lot of even questions where Fauci is getting himself in controversial situations around that. And I feel like for us, I think we should just press pause for at least just the next week around any specific guidance on that. But be poised and ready to go if we feel like it makes sense. So I’ll hold on that.

26:04 But are you taking questions just on COVID? Or are you going on to the next item on the agenda? And then take questions? No, we’ll just, we’ll do, no, I don’t think many people want to talk about the budget compared to COVID. So when we’re done with the COVID, we’ll take questions and move on to the budget. Okay, because I just want to make a brief statement about the reopening committee and do want, is that okay? Now, as opposed to the questions that you’re, because that’s jumping a little bit. The reopening committee has changed their date of meeting. And I, from what I understand, it was to be cooperative with us, because we are looking toward their new minutes. And it just was impossible to get them done in less than 24 hours. So the reopening committee is now meeting on Thursday mornings, which will at 9am instead of Monday. And that will give them the opportunity to get the minutes to us by the following week for us the following Tuesday. So it gives them a little breathing room. And I truly appreciate, I’m sure that the committee appreciates that the board appreciates it, because it will be very helpful to have those minutes, because then we can respond to whatever is that may be relevant to us. And for any conversation that we would like to have. Now, Dr. Bucky’s office, Dr. Bucky and the office very kindly got the minutes out to us about 6.15 tonight.

27:40 And I had a chance to glance at them. I don’t know if anybody else did. So if you had any questions, the meeting was pretty cut and dried and more about, we’re concerned about the snow day today and few things like that. So, but there was a little, there was more meat to it than that. But I, if you haven’t had enough time to read it, we can address them next week. But I think that that’s enough said for tonight. Thank you. Unless Michelle, O’Tod, do you have any questions? Did you help? Were you able to read them? Or Andrew? I didn’t know they were out yet. I didn’t have a chance. Andrew? I have not read them fully. Yeah, I just glanced at them. But so thank you for just letting me give that brief report. And thank you, Dr. Bucky, for getting them out. That was very, very, that was wonderful. Very helpful. Give me a thumbs up. Okay, in the corner. Okay. I’ll give them two thumbs up. Michelle, did you want to talk about communication before we open up to the public? Or do you want to? Why don’t we do the questions? And then I can do that. I feel like, I don’t know, whatever you want. So I just, as always, I’ll, if I see your hand up, I’ll call you in order I see it. And if you don’t mind putting your camera on, that makes it helpful, helpful for us to interact. So Sarah, you’re so far, the only person raising a hand.

29:15 Thank you, Todd. And forgive me for the camera. There’s a lot of, a lot going on with a lot of kids right now. So I’m going to leave it all. But I, speaking to the clinics, I know that Andrew said he had held back enough to have that second round for first responders for this week. But I believe the clinic all the way up through last Thursday was the Moderna as well. Will you, do you at this time have enough Moderna on hand, on hand to give those people what they need? Or do you at least have a commitment from the state that they will be getting you enough Moderna to complete that group?

30:31 Is there a way that those people can kind of get some help? Yeah, so obviously we have partnered with the COA, so if you’re really struggling or you need some assistance with that, you can call in there. We’re also working with the Medical Reserve Corps to set up a call center also, and that’s hopefully going to be up and running by the end of this week. Our goal is to have a total of 250 individuals at this call centers and the COA’s to assist with people to sign up for vaccine. And the state is also working on the call center too, but we wanted to make sure we try to get ahead of this. So, you know, obviously we always partner with the senior center. They’re their people. We want to help them as much as possible, and we work really well with them. And as soon as we have, you know, if we have this call center up and running on Friday, we will all obviously be posting those numbers, or having the COA share those numbers too. Yeah, and when I talked to Lisa Hooper from the COA, she said that they have a bunch of quarried volunteers that are available to field calls and help the seniors do all the things that they need to do to be able to log on. I mean, one of the things that, you know, sometimes I think some of the seniors might call us and not want to call the COA.

32:08 So that was one of the questions I had, Andrew, was like, if folks did call us, would we just funnel them to the COA to do that? Or, you know, is that our, or would we ever be, you know, interested in having a volunteer that could help people? Because sometimes they think, oh, I only want to call the Board of Health, you know, if we had folks that were available through the MRC once they become quarried, etc. So unfortunately, with the phone traffic that we get in our office, we only have two lines. And those lines are usually full, and the rest of us are often working on our cell phones at this point. Yeah. Okay. Anyway, so yeah, but Lisa did say that, like, right now they have more, you know, volunteers signed up, and those folks are registered and available to help, like with sensitive information and everything. So that reminds me about something, Todd, that goes back to the vaccination. A lot of people have offered to help with that. And Todd, Andrew said they had to go through what’s called a vaccine. What’s the name of the? So the Medical Reserve Corps, the Mass Response. Yeah. So, but are we utilizing those people? Because there’s been some very, very well trained people that have called me asking to help. And I have sent them there because I had the notes last week. Yeah, so we use those volunteers every week. So we’re using those volunteers all the time in our clinics currently.

33:46 And obviously, the Medical Reserve Corps is using them all the time for various different things, and we’ll be using them also to set up this call center. Oh, good. All right. Sorry to go backwards. I’m glad that those services are available so that people can get the help. Great. Erin, you had a question? Hi, Erin. Hi, thanks, Todd. My question was for Andrew, and I think it’s just a point of clarification. When you were talking about or mentioned that we’re not going to prioritize teachers. I’m not putting words in, but you’re talking about the teachers. I think what I was understanding is that we’re not going, you’re not responsible for vaccinating all of Marblehead’s teachers, like employees. And the idea is that those teachers would then, like if you were a teacher, you go to your home district as a teacher and get prioritized. Is that right? No. So teachers fall within group three. So in group three, it says other workers. So it comprises of early education, transit, grocery, utility, food, agriculture, restaurant, cafe workers, employees across food, beverage, agriculture, consumer goods, retail, food service sectors, meat packers, sanitation, vaccine development workers. It’s a huge, huge group. And even if we were trying to vaccinate just town employees in itself, that’s a really, really large clinic in itself.

35:19 And so the whole idea for the health departments is to fill into small niche sectors of the community, not these thousand employees a week and stuff like that. We just don’t have the capacity to do that. So if you’re a teacher in Marblehead, you wouldn’t look to Marblehead Board of Health for your vaccine. You would look to, you know, wherever you’re, wherever you are located. You look to the state just like everybody else. So you’re going to be looking to, yeah, your doctor, your pharmacists, mass vaccination sites. So they have these mega sites. They’re currently, I believe five sites. They want to have a total of seven up and running. So this is the Danvers site. This is the Fenway site, the Gillette site, Western Mass sites. They can vaccinate at least a thousand people a day. And that’s a pretty large toll to be able to do that. We’re doing smaller groups, obviously. We’re, you know, we kind of max out at 250 people per day. And we’re pooling our resources through the five communities on the North Shore. So, you know, once we get through our first responders, our idea is that we’ll be going town to town at the COAs and trying to vaccinate small populations that are having a hard time getting vaccinated. Oh, okay. All right. I understand. So, I mean, this phase two, part three is a huge group. Correct. And so what are you hearing from the state public health and your conversations with the state around expectations for that group in terms of getting these vaccines?

37:05 At this point, we haven’t even put, I don’t even have a date of when we would get to group three. Do you have a date when you would get to group two? So, yeah. So, I don’t have a date yet, but they’re looking at February, March for group two. So it’s possible that we would not even, the state would not be even in accepting phase group three, which is the early ed, the transit, the grocery, the utility, the food and agriculture and public works people. It’s possible that we would not even be like thinking about vaccinating those people until the end of March and April. It’s really hard to say. Like right now, we’re just having a vaccine shortage. Yeah. So, you know, I can’t get maternal. I’m stuck with trying to get Pfizer and we’re still having even a hard time getting that. And we believe that it’s going to continue through the month of February, having a little bit of a vaccine shortage. Now, what does it look after that? It’s really hard to say. And obviously, the capacity of all these vaccination sites will increase over time. So for me to say what’s going to happen in March is not really a good idea. Obviously, the idea is to try to get shots in the arm to as many people as quickly as possible. Okay. Thank you. Thanks. Tom, I see your hand up. I actually have a question for a process. Could you just briefly tell us what happens when you show up?

38:42 I mean, like walk us through the steps of what happens when you go to have your vaccination. You sign in, et cetera. What are the actual steps that go on? It’s pretty basic. So you sign online, you get an appointment. They’re usually separated by 10 minute increments. So I have a 11 55 or 11 50 appointment. I show up to the clinic. There’s a greeter at the front door. They’re going to have you ask a couple of questions. What is your appointment for? You know, making sure that you’re truly signed up. I only have so many vaccines. I need to make sure that you’re on that list. So I’m going to verify that you’re on the list. And then I’m going to push you through to a medical screener. So the medical screeners going to ask you all these different questions. It’s actually online so we can track everybody. Make sure we have your insurance card. If you have insurance, if you don’t, we’re going to continue on. But we’re going to ask you a series of questions. You know, is this the first time you’ve had the shot? Do you have any allergies? There’s a whole series of questions that they’re going to get you through. Once you pass that medical screener, next is the vaccination station. You’re going to sit there with a vaccinator. You’re also going to be sitting with a person that’s going to take some more information and log this into the online system. This allows us to potentially get some reimbursement through insurance and also making sure that you can get your next shot if that’s something that we need to follow up with you, stuff like that. Once you actually get through the vaccination, you’re going to be sitting in the holding area.

40:18 So because this is a new vaccine for all of us, we have to sit there for at least 15 minutes. We do have a paramedic and an EMT on site to make sure. And we usually have an ambulance sitting there to just cover all our bases, to make sure that there’s no concerns or issues. You know, this is a very emotional time for people right now. So even just the emotions of getting your shot, knowing that you have received your first dose of this vaccine can be very overwhelming for people. So, you know, we just want to make sure that they are okay, that they don’t also have any, you know, allergic reactions to it. Once you pass your 15 minutes, you’re free to go. You’re going to receive a vaccination card that says what type of shot you receive. So, a Moderna, the lot number on it, and then when you need to come back to get your second dose, or this is your final, you know, your second dose and you’re all set. So we look at throughput. So in a really good, you know, if I don’t have a line, I can get you through in five to 11 minutes pretty well. And obviously then you’re sitting for 15 minutes. But I can move people through pretty quickly. We usually like to have at least five vaccination stations. Sometimes we’re only able to operate four at a time, depending on volunteers and stuff like that. It takes about 22 volunteers to really run a really good clinic. Obviously, we have security there to deal with any issues, but that’s kind of the general feel of it at this point.

41:50 Great. That’s very helpful. I’m not sure everybody knows what that actual experience is like. Thank you. Sarah, you have another question? Yes, I do. But first I wanted to say having had a family member go to the clinic in Salem on Thursday, the feedback I got was it was extremely well run. It moved very easily. Everyone, you know, was prepared and it was just a really positive experience. So, you know, there’s that. But then having spoken to providers as recently as Thursday, I will say in the office of the providers, they’re still saying they have no idea when they will have access to any vaccines for, you know, my question is those high risk comorbidity groups. So there does still seem to be a little bit of a disconnect of how when you have those cold morbidities, you will facilitate getting it. So as far as like, you know, if you have two comorbidities and, you know, obviously you your doctor talked about this and he’s like, you need to get vaccinated. You fall within phase, phase two, group two. When you go online to, you know, once the state opens up that group, when you go online to fill out for a clinic, you have to fill out an attestation form.

43:26 So you are attesting that you fall within that category. Now, that’s under the pains and perks, you know, that’s where we kind of catch you at that point. And if you’re unable to attest that you fall within that, you’re not allowed to proceed through booking a shot for the ethnic clinic. Okay. So it looks like there’s no more public participation tonight. So Michelle, you wanted to discuss before we move on to the budget, you want to discuss more communications. Yeah, I had mentioned this to Andrew, and I wanted to propose that reinvigorating something that we had done earlier in last spring, earlier in the pandemic that I think had been helpful to the community. Not everybody has access to this, but I think it’s a broader group that generally comes to these meetings. While we like the crew that does come to these meetings, I think it would be a good time to have another version of our kind of town hall, Facebook live kind of meeting where we share some of this kind of information regarding access to the vaccine. Maybe something particularly focused around senior citizens, COA, as we’re in this phase where we’re starting to roll out to the general public, the over 75, these other categories that are going to come on online soon.

45:13 It just feels like a good time for Andrew, perhaps the director of the COA or one of her staff members, maybe Jason Silva, just to talk about kind of the state of things in the town and allow people to come on. Obviously, I think I’m thinking Facebook live, it’s just questions in the chat, but just to kind of do that like round table town hall type thing to share information. I mean, we get a lot of good updates here and we share minutes, but it’s not something that goes out to the community. The only other way that we really share our information is kind of through these static formats like our website or code reds or our Facebook page. I just think now’s the time where people are really anxious, things with the vaccine rollout are really, really confusing. As much information as we can share right now, I think would be really, really helpful. I wanted to propose that. Andrew seemed, I think he seemed game to do it. I’m just putting that out there. I think any information that can be given to the broader citizenry, I think that it would be helpful. I know that early on we did some code reds, but I don’t know whether that would fit in.

46:50 Michelle, are you talking more about putting a little bit more information on Facebook or on maybe doing a report or just a variety of places? Yeah, I mean, I think it would be, you know, sure, we could, you know, do something on the report or we can, you know, I can certainly put updates on the Facebook page, but I’m talking about an actual something that we advertise where it’s a live event. That we do, like on a, you know, a lunchtime, you know, a midday thing on a kind of a Thursday at noon or something where Andrew logs on, you know, Lisa Hooper from the COA is there, Jason is there and they’re all there, whether it’s a Zoom or Facebook. You know, a Zoom allows people to interact, Facebook doesn’t, we can decide on the best format. We don’t have to figure out the details now, but like a town hall where people can actually, you know, state of the, you know, what’s going on. People can hear about, you know, even if, you know, not all the seniors, this may not be the best format for them, but at least people who are interested in volunteering can hear. We can put up the website so that, you know, people know how to log on to the Medical Reserve Corps. Andrew can give an update on what’s going on with the trends with COVID.

48:25 He can talk about what’s going on with the vaccine. He can share the challenges that we’re having with vaccine rollout. Like not everybody’s tuned into what was happening on this meeting. I mean, look at how many people are here. Like a lot of people do not know this information. I think that a lot of people would tune into something like that where they’re not going to necessarily come to a Board of Health meeting. Is that something that if there’s not a give and take, MHTV could take something like that too, couldn’t they? John, you know, he’s shaking his head. Yeah, so the idea is that… What, John? Yeah, we could do something like that, sure. As long as it’s not a question and answer kind of thing. Because you’re not right. If you did something like on Zoom like this, we could record it as we do these meetings and then put it on the channel or put it on our website as well on our Facebook page and everything. Sure. Yeah, I think the idea is to kind of work with the COA, with the Council on Aging, with Lisa Hooper and maybe some of their board members to try to reach that group and have them feel comfortable and, you know, possibly ask questions. And obviously, you know, we want to try to make it as easy as possible for them. So the idea is just to try to reach a different group. I didn’t recall that we did this in the spring, though. Maybe I just wasn’t in attendance. Did you do it without the board? Yeah, we did a whole bunch of different episodes with Jack Atridge on All Marblehead, you know, with Jason Silva, you know, the police chief.

50:02 So we did several of those where Jack would ask his questions and people would be able to comment and ask his questions and push out information that way. And that means via Zoom? It was via Zoom. Yeah, that was all via Zoom. Was it Zoom or was it Facebook Live at that time? I think it was Facebook Live. So we were on Zoom and there, you know. It was Facebook. Oh, you logged on via Zoom, but people watched it through Facebook. Exactly. Yeah. And, you know, Jack has like tons of people that follow him, whether I don’t even know if that site. I don’t know. The All Marblehead? Yeah, but All Marblehead still exists, right? Like, you know, but I just think it would be good to reach the, you know, more people in the community. I mean, I would suggest that you talk to Lisa Hooper and Ed Bell. Yeah. So I’ll check in with Lisa. Lisa, it’s a good idea, Michelle. I mean, the more people who are informed, the better. You got the time to do it, Andrew? Another thing on your plate. Yeah, I mean, these, you know, information sessions are always helpful for everybody. You know, I met with Ed Bell, I don’t know, a couple of weeks ago, John. And, you know, it’s all, you know, Chris Stevens and a group of us. So it’s always another opportunity for people to hear a different sign at times. Okay, good. I know you were starring on the League of Women Voters that day.

51:35 Oh, yeah. And we did the League of Women Voters. That was, you know, that was well received. It’s just more of avenues. How do we reach more people in different ways? And I think people tend to feel comfortable with their group. And so they will log on if we’re talking to the League. They all feel comfortable with who’s going to be there. They get, you know, the last questions. So it’s important that we do that stuff. Good, Michelle. I think we need to move on because we still have a lot of budget discussion to have. And this is going to turn into a long meeting if we’re not careful. So I don’t see any more raised hands. I think we can continue this discussion next week. I don’t know if you can hear me. I don’t know how to raise my hand. This is Alexia Kearney. Oh, sure. Go ahead. Sorry. I for some reason the button is missing at the bottom. So I’m sorry to interrupt and not use the proper format. I just had a couple of questions. I just I wanted to find out you mentioned that we rolled out the phase one with the first responders in our community. And I’ve heard and I don’t know if it’s accurate that there’s been some resistance to getting the vaccine, that people are concerned and worried. And so I don’t know. Do we have any reports on how what percent of the first responders in our community have actually received the vaccine? We have a very large turnout, both police and fire. It was a very small, small percentage that did not partake. And it was unclear to me if they were not available at that time. But I all I know is that it was very well received and we had a large participation.

53:12 OK, perfect. And we’re happy to support any efforts you need to educate or spread the word about it. My second question. Thank you. And I you know, this is my first Board of Health meeting. So I’m trying to get the lay of the land in terms of what subcommittees might exist. But I have four children. They’re not in school. I’m seeing some of their peers and my own children struggling with mental health issues. So is there a mental health subcommittee within the Board of Health? Is this an area that’s addressed by the town because having the kids currently out of school is raising a lot of concerns for a lot of people. So I don’t know if that’s something that’s, you know, something that’s being addressed within the town that’s within the Board of Health purview or not. So we speak about mental health issues generally every meeting. We we currently work with the Marblehead Counseling Center. So we encourage residents to contact them if they’re struggling with any issues. Obviously, there’s a high demand for mental health services at this time. So it can be challenging. But there’s also other areas that you can look to. The state of Massachusetts has two one one calls, live chat, non-emergency questions, the crisis counseling assistance program, one eight eight eight two one five four nine two zero. You know, other domestic violence and the sexual assault numbers. I list all these contacts in our weekly case report on the last page.

54:52 So we are all always trying to think of this. It is very challenging times for all of us, especially the younger kids, you know, not able to see their friends. We’re always concerned about everybody. But we understand that, you know, junior seniors in high school are not getting the experience that they thought it was going to be freshman, sophomore in college, not the experience they thought it was going to be. And even, you know, for all of us that are stuck at home, you know, that’s a totally different life. We’re not seeing our friends or not seeing our family. So we often encourage other, you know, uses of communication, FaceTime, you know, video chats to try to help with some of that stuff. But, you know, if you ever in a situation where you are in crisis, you know, yes, you can always reach out to the health department, but there are these other resources available to you. Thank you, Andrea. I appreciate that. Are these reports in terms of the increase in domestic violence, the increase in suicide attempts, the increase in the mental health concerns of our community specifically in Marblehead? Are they being reported? Are these numbers accessible to people in the community? Is anyone tracking this? Is anyone surveying the kids in the schools to find out how they’re feeling? How this is negatively impacting their mental health? This is a big concern of mine. I see a lot of kids come through my house and I’m worried about the kids in our community. So the only way that I’m tracking it through our office is that we do work with Marblehead Counseling Center.

56:28 In our annual report that will be coming out, I do get a list of how many hours that were served for the number of patients and everything through the year. But it doesn’t break it out, you know, per different group. Well, I would say this was also would be a police report. You know, are they seeing an increase in incidences, an ER report? Are we seeing more people in the ERs? Are we, you know, I just think that this is something that we need to start tracking, that we need to start being mindful of, that we need to start paying more attention to. I know, you know, obviously the concern right now and the our focus and particularly in the first half of this meeting is on COVID, which is also extremely important. But there is a significant impact to our community and our community, you know, is, you know, healthy enough that we are, we have not had a huge COVID impact in our direct community in Marblehead itself. But there’s a huge mental health impact that is happening to our community and particularly the young people in our community. And I believe that this is something we really need to talk more about. Aline? Excuse me, your name, please, because I don’t see you. Alexia Kearney. Alexia. I can’t, I can’t, I tried to un-video, but I cannot do it. Well, thank you for being here, however you are.

58:01 You raise a concern of all of ours, especially me. I’ve been very active at the Marblehead Counseling Center for decades. And every, I think, ad nauseam, I ask Andrew and the board every week about the mental health. And if you listen to us later on, I think several of us, and we have it as one of our goals for next year. It was on our goal list for last year. And oh, there you are. Hi. Yeah, I’m here. Someone allowed me to un-video. Yeah, that was me. So we are very much concerned. Every week Andrew gives all those numbers and places to go as referrals. We are tremendously interested. The school department has a reopening committee meeting and many, many more meetings that I’m not attending. But I do attend the reopening committee and it’s constantly talked about with the superintendent. It’s on everybody’s mind. I have a junior who has chosen full remote and he’s healthy, he’s happy. He’s really worried when he gets on Zooms and he sees these kids on these meetings. He says, literally almost every day he says, mom, we need to do something. We need to reach out to these kids. We’re very worried and I have to speak on behalf of my son that he felt the need to reach out to a couple of his teachers yesterday and, you know, start.

59:38 Well, that’s a good start. That’s a very good start. Don’t let people be alone. That’s the worst thing, is to be alone and miserable. They have to be identified. If you go to the school nurse, each school has their own nurse. Call the superintendent. Call the principal. Call the teacher. So call the parent. Do whatever you can. And thank you for raising the question because it’s very serious. But we will continue. So we do have a really good relationship with our police department. You know, anytime there’s a, you know, a greater issue in town, I’m always available to respond at any time. And they often call on me for different things. You know, we have had a school resource officer in the past, Andy Clark, who’s been extremely well received. And I really hope that continues. But I will reach back out to both of them. We also have a really good relationship with our hospitals. I’m on the Health and Medical Community Coalition for hospitals. They’re not bringing up the mental health issues per se, but we’re generally talking about COVID and stuff like that. So we will also reach out to them to see what the numbers are like and try to track it a little bit better. And obviously, like I said, we do have a really good relationship with our counseling center. Ben Day over there does a really good job running that. Obviously, the number of people that they need to see has really increased over the year. And obviously, telehealth has been a huge piece this year.

1:01:10 So you no longer have to go into the doctor’s office to make a visit. You’re able to do Zoom visits and stuff like that. So there are some easier things that you can do. But we will look into this a little bit more and obviously make sure that this is high on our radar. And I think, Andrew, we really need some sort of a survey in the schools. I mean, these young kids, my son, my junior, is saying some of these kids haven’t, I mean, they’ve gone outside for walks, but that’s the extent. I mean, they’re not. We need to put a survey out to find out how many kids feel hopeless, how many kids feel, you know. I’m very worried. And obviously, that’s something to survey that we can’t just treat ourselves. That has to be a survey that kind of comes from the state. So we can reach out to the state to look for a survey that the school committee would be open to pushing out to their community as well. Well, then maybe we start like a Project Hope or something within Marblehead. But something needs to be done to help these kids. And obviously, like you said, exercise is a big piece. But if you’re really struggling, you know, we need to try to reach you as quickly as possible. We are always there for everybody as much as we can be. But these are tough times. It’s not always easy. And it’s okay to say that you’re struggling. And I think that’s a big piece that people have a hard time with admitting that they’re having a really hard time.

1:02:41 And also, the Counseling Center really is a great resource. They are very much overbooked. But if you call in your Marblehead resident, you say you’re in a crisis, they will do everything in their power to accommodate because they are not going to let anything slide. And that’s where it’s great that, you know, it’s a community-run organization. We support it. The Board of Health supports it. You know, we support a contract with them. So they’re really invested in the community. And that’s why we continue to talk about them. You know, we usually have Ben Day come to our meetings about this time each year. Maybe he should come to the next meeting. Yeah, we’ll definitely ask Ben to come and talk next meeting. That would be great. He’s a wonderful man. And, Alexa, if you ever want to talk to me offline, you know, feel free to call my office. We can talk about anything you want. So please know that we’re always there for everybody. Thank you, Andrew. I appreciate that. I see two more raised hands. I do want to keep this very brief because we have a lot more business ahead of us tonight. Erin, do you have something brief to say? I just had to jump in when Alexia raised that point because it is so important. And I just, only because I heard a lot of mention of the Marblehead Counseling Center as a resource for our town. But the reality of it is, is my understanding is that they are six months out. And while you can call them and they can help you through a crisis screening, there is a absolute, like, lack of mental health therapists to address the actual needs of families and students in particular right now.

1:04:26 You know, I work in juvenile court, and we are constantly having an influx of students with mental health needs trying to find them a bed. You know, trying to find, like, you can make a referral, but it’s only so good as as much as people are there to help you there, you know? So, like, I don’t disagree that they’re a wonderful resource, but they’re just not available. I mean, they’re just, they’re just, they’re over-tapped. And so there’s this unsupported group of people who are flailing. They can’t find a therapist. They can’t, you know, they can’t even, they don’t know where to turn. So I do think that’s a good point. And I just wanted you folks to maybe, you know, be aware, you know, that, that, you know, referring people to the Marblehead Counseling Center is, is, you know, I, that’s, that’s, they’re, they’re just not the therapists there to meet the needs. And I just, I guess to that end, I guess I’m just, you know, I know this is an untownly time in terms of, like, with these new variants and everything, but I mean, part of the decision, part of the decision that our schools remain in this hybrid format is because we’re applying the six-foot distancing in large, you know, in part based upon the recommendation of the board. And I guess I’m just trying to understand, you know, that we are now, you know, in February, we know a lot more about the virus than we did back in August when that recommendation was made.

1:05:58 And I guess I’m trying to understand why we are applying the same six-foot standard to, like, 40-pound kindergartners and elementary kids as we would to a young adult teenager in the high school, for example. And I guess, you know, would we, like, would you be willing to, like, reconsider that and, like, are you still disagreeing with the state recommendation of the three feet at this point, given the fact that we, there is a real health risk to school closure that, you know, we now are very well aware of. There is actual data that kids are suffering. There is risk to it. We cannot live in a COVID-free zero-risk world. Aaron, as far as the six-foot versus three-foot, we, as a board, have been very clear that we believe six feet is much safer than three feet. One of the reasons why there have been so few incidences in school is because there’s been a six-foot distance, which has been proven to be working. The DESI three-foot was just made up arbitrarily, in my opinion, last summer because they wanted to get schools open more. But how is it any more arbitrary than six feet? I mean, ten feet is safer than six feet. Eight feet is safer than seven feet. I mean, we get to this point where at some point, as a health consideration, you are weighing health risks. And, you know, to say to kindergartners and first graders and second graders that they can’t, you know, go to attend school because they’re held to the same standard as, you know, even 17- and eight-year-olds where physically that just doesn’t logically make sense because they’re smaller people.

1:07:48 And that’s where we look at the aerosol rates, I would imagine. Everyone’s masked. We look at states like Connecticut when everybody has been full in with, like, you know, they’ve been full in since September. They’ve made a choice where it’s like remote or all in. I have friends in Rhode Island. Their kids have been all in in public schools since the beginning of the fall. And we know now that kids are not getting COVID in school. They’re just not. People are getting COVID outside of school. That’s where it’s coming from. And that’s partially because kids are keeping farther apart. I think that’s very, very true is that the six feet is safer than three feet. And also with variants, there’s evidence that’s emerging that kids are much more susceptible to dangerous reactions from COVID with these new variants. And while that’s not a known fact at this point, it is leading towards that evidence. So it seems to me that the farther kids are apart from each other, the safer they’ll be. And mental health, of course, is an important issue. But we are in a pandemic and we’ve been very diligent with our rules and our recommendations. But I don’t mean this to sound at all insulting because I absolutely value the work that you do. But my question is, is this coming from a place of like independent analysis that the board and everybody has done?

1:09:19 Or are you all just parroting the CDC guidelines from August? We are not just parroting the CDC. So you are coming to a different conclusion than the state, based on? We are coming to a different conclusion than DESI, which we have been since the beginning. We have not agreed with us. We’re made with the message because public health department, Todd. Sorry, I didn’t hear that. The DESI doesn’t make a recommendation without sign off from the public health of the state. I guess I’m just, I don’t even want you to discuss it. I just want you all to consider it. I just literally just want you all to consider it. Consider the difference between early education students and high school students. Consider taking to a fact that we now know there are known health risks to students for school closure. And maybe we didn’t fully appreciate that then. We now know that this is not spreading in schools. The recommendation that the local boards of health are making is holding, keeping kids out of school. And I don’t want you to discuss it. I just want you to take it and just consider it. Well, I just need to say that this, there’s no, this, the spread is not in the schools because we are at six feet. So I think if you see it’s going closer that you will find. But that doesn’t bear out, Helene, over the national studies that have been done on the schools that are open. That just doesn’t bear out. I mean, that’s just not the case when you look at other states.

1:10:52 I don’t know the numbers of the spread in other communities other than our own. There are studies, Andrew knows them. He can find them. There are studies that show that this is not, whether or not kids are in school, masked at different distances is not affecting the community health in terms of COVID. Well, we are, we’re recommending and the school department can make their own decisions. But so even if we do as a board unanimously unanimously still feel that the six feet is is good at this time. And this is for everyone in public. So it’s not just the schools, but the conversation I think should continue now with the school department and the school committee. I really appreciate you saying that. Helene, I see their superintendent is on board, is on our call here. As well as at least I think there was at least one school committee member and I appreciate you acknowledging that. Thank you. All right. I see one more raised hand and I really do want to keep this brief. So if you have a brief comment, Emily, please go for it. I just want to commend the two speakers. Can you hear me? Yes. Yes. Who were on. I can’t be as articulate as they can be, but I will. I have no problem. I’m just saying very open and honestly that my kids are struggling. My family is struggling. My business is struggling. The struggle is real. It is a problem. It is just as much of an epidemic as the virus.

1:12:27 I don’t understand how my son can play basketball at the high school and be in other children’s face and not be able to be in school. I don’t understand how our kids can be out and about freely with masks on, but with their friends going to dance class and other activities that are being held within Marblehead Parks and Rec Department currently. I don’t understand how my son is about to start football season. Let’s just think about the physical contact of football and all of those things violate the six feet distance rule. And yet my kids are suffering in and out of school on a daily basis. It’s not working. I mean, it is not working. So I’m asking if not begging at this point that something real is done to help our families and our children in this town. Thank you. Thank you. Can I just say something? You know, I’m feeling like, you know, we’ve discussed this before. I wasn’t prepared to be having this discussion again right now. I know we’re going to be moving to discussing our budget.

1:14:07 And, you know, like everything, this is, you know, we make our recommendations and we’ve held to the six foot distancing consistently and we don’t make the decisions for the schools. We advise the schools and that is what we do. We don’t make the decisions for the schools. But I am, you know, like all of us, extremely concerned about the mental health impacts. And as always, I think we are, we are open to listening and thinking about how things need to shift. I’m not saying that we should, that we will make any, you know, that I don’t know where we, whether we would shift our thinking around the six foot distancing. But I don’t know. I personally am open to rereading everything that I’ve read before, rethinking everything I’ve thought of before. I’m not saying I would come up with any different analysis than I did, you know, a month ago when we, when we reconsidered this because I am extremely concerned. I’m glad that our kids are in school hybrid versus not at all. But I do hear what you’re saying about the mental health impacts and, you know, maybe next week we’ll be more prepared to think about it.

1:15:50 I wasn’t kind of prepared to be having this conversation right at this time, especially as we move into our budget conversation. But let’s talk about it again next week. I just think with this pandemic, we constantly need to have the same conversations over and over again, even though it feels like we’ve had them before. Everything is, everything needs to be contextualized over and over again because as time marches on, everything is a little bit different every week, every month. I don’t know. I guess that’s my two cents right now. I also think it’s worth noting in response to what Emily was saying about sports is that I don’t think it’s a coincidence that a good half of the superintendent’s emails about COVID cases have to do with sports teams. So we just don’t want to let that detail go forgotten. I do think also Erin, I see your hands raised again. We’ve had a spirited discussion, and I appreciate your points, but I think we need to move on to discuss our budgets. We’ve been at this for a while. I just wanted to quickly commend you all because I do feel like that you all take your role very seriously and are thoughtful and deliberative. I appreciate each of you. I see Michelle responding in time and earnest, and all of you do. I just wanted to commend you for hearing us and having this kind of exchange because the role that you play is so important and that it’s clear that you take it seriously, and I appreciate that.

1:17:22 And I’d just like to say something. We’ve always met every other week or maybe even every third week, and since the pandemic, we’ve been meeting every week. And I venture to say, I think we’re the only board in town that meets every week, and the selectmen meet every other week. The school committee meets second in whatever the weeks are, but they’re every other week. And we have stepped up because we know how serious this is. We’ve given a lot of time, and we want to continue doing this until it’s necessary, as long as it’s necessary. You have, and that is appreciated and noted for sure in the community, and you always accept public comment, and that is really appreciated, and I want to just commend you all on that. Yeah, and thank you for your thoughtful comments. We know that, you know, we share everybody’s grave concerns right now for all aspects of health that are not just the pandemic and concerns about getting COVID. It’s all aspects, so we do appreciate that. Co-board members and Andrew, I am going to have to, unlike every other meeting where, what, you can’t, you’re shaking your head, you can’t sign off. I’m just saying, I’m going to have to switch to get in my car at a certain hour, so I’m just going to have to sign off and get into my car. I’m just telling you that.

1:18:56 You mean your 12-year-old doesn’t have his license? No, he doesn’t. So I just don’t know how I’m going to do that. I’m going to have to figure out how to call in at some point, so. And just before we move on, just want to say there’s no easy answers, and that’s, I mean, we all know that. We all work hard, and we appreciate the public comment, public feedback, but there isn’t a black and white simple answer, and that’s the hardest thing about this, so. And possibly stick around and hear our goals, because they’re there for the year, and some of them are addressing these issues. So, Andrew, how should we structure this budget discussion? Do you want to just, Halaen submitted some goals, I submitted some goals. They’re pretty much in sync with each other. So we have two different styles, like I’ll kind of try to make this as quickly as possible. So we’ve had some, you know, a different request this year where we need to try to align some of our goals, looking for the budget. So we have a waste budget, a health budget, and kind of what we do overall. So, you know, obviously overall, we’re the health department. We also operate the waste department. Waste falls underneath Board of Health very often, so that’s why we do that. We have a mission statement the Board of Health promotes that protects the health, wellness, and safety of the citizens of Marblehead, while ensuring a clean and healthy environment.

1:20:27 In 2015, we went through a process to take a look at goals for our department, for our members, and tried to incorporate this in our daily work, as well as our overall budgeting for the year, and anything else. So obviously, you know, we have a department description, and we cover a huge range of masterable laws, everything from, you know, waste to septic to food inspection, so a huge array of different things. We have a breakdown of obviously the health and waste department, and the board sits above that, above me, and, you know, deciding kind of where the money flows and stuff like that. Obviously, we’ve kind of been level funded for every year since I’ve been here, technically, but we’ve always had increases in the waste department. We’ve always had, you know, some salary increases, but our health budget has been really level funded for, you know, 10 years, 9 years now since I’ve been here. So it’s really time that we start to look at changes and what we really want to do. So I guess I’ll start with, you guys want to start with health or waste? Let’s just immediately. Because we’ve got, this is where people are interested, and we’ve got a group of people that would like to hear. So health, you know, I looked at Todd’s and Helene’s goals, and so obviously, you know, our number one department goal right now in the health department is COVID-19.

1:21:58 Andrew, did you see my edits that I added? No. They came in too late. Wait, wait, you have them on now? Can they still be included even though, do we have to vote on them tonight? Yeah, you guys have to vote on this right now and figure this out now. Can I read my edits out loud? Oh yeah, go right ahead. Are they on the email or text? Where did you send them? I emailed them. I’ll just, I added them to yours, Helene, and I’ll use them out loud because I added them to Helene’s document. There they are. Okay, I see them. It’s in a Google Doc, so I might flummox you, Helene. Oh, okay. What time is it? Right before our meeting. Oh, good. I’ll just, I’ll just add, I’ll just read them. When we get to reading yours, I’ll just read them. Oh, I got it. It’s here. I got it. Okay. And yours is below it? There are edits to… Okay, and how many goals are you looking for for each department, Andrew? So, I have five goals for the Health Department. So, let me read my goals quickly so you guys, this is how I put them in.

1:23:32 So, Department Goal Number 1, COVID-19 Prevention and Safety. Department Goal Number 2, Addressing Mental Health Issues. That’s very high in all our priorities. Department Health Goal 3, Promoting the Clean and Healthy Environment Around the Home. Department Goal Number 4, Complete All Inspections Per Mass General Law. And Department Goal Number 5, Continuing to Dress Tobacco and Baby. Can we add some? No, you can’t. You get five goals and five goals only. Can we tell? So, you have to look at the budget sheets and what you’re requested to, required to fill out. But if we can talk like a healthy atmosphere, can’t we put in about healthy eating and exercise, add to the tagline? There’s no tagline. So, these are like, how are you going to… So, your goal, how you plan to achieve your goal, measure a focus, plan a start. So, there’s a lot that goes into this. Oh, my gosh. I’m sorry. I need to say for the record again. For the record? We do not… This is just… We have so much on our plate right now. This is a great exercise and it would be amazing if we could like, spend a little like less… Having a week to do this is… Next year’s would be better. We’ll have… If we could do this later and do it thoughtfully, there was just no way I could give any thought to this. And I know Andrew felt that it was impossible to give any time and effort to this. That’s the last thing I’m going to say.

1:25:15 Which is why we’re going to do what we can tonight and we’re going to be fine with what we come up with. And if we do more, nobody’s going to arrest us. No, and I think, you know, obviously those, you know, we’re kind of taken between our goals that we looked at in October 6th, 2015, what Helene put in and what Todd put in. But really, when it comes down to it, let’s talk about the budget, you know. We can talk about goals for days and days and days and how we want to move our stuff. But it comes down to money and how we’re going to be able to operate our department. Well, that’s why I wrote one of the goals is to study the department and its staffing. So at this point, we need to increase our staffing in the department. So, you know, we have myself… Can’t that be a goal? It can be a goal, but, you know, so we are part of that goal is that I’m looking to fund two positions fully this year. So I want to fully fund the public health nurse and I want to fully fund the inspector and fully fund for us. They’re technically getting 40 hour weeks, but we only need them for 37 and a half hours a week per what our office is open. That will be a huge difference. You know, currently, if I have an employee out on vacation, I might be answering the phone. I might be running up to the transfer station. You know, we don’t have a superintendent that goes and fills in for a teacher when she’s when they’re out. Why should I be doing the exact same thing? We don’t have a town administrator that comes in and fills in for a department head when they’re not.

1:26:48 But I do all those things. So we need to fully fund our department. So as far as health, the salaries go. We’re looking for a twenty nine thousand one hundred and fourteen thousand one hundred and fourteen dollar increase, which is a sixteen point five two percent increase. But that’s what it costs to get our department up and running when we compare the health department to other communities. You know, so Todd sent me and over Concord and one other one other and one of we’re underfunded compared to those departments. So we need to advocate that our health department needs more money so we can reach our goals and stuff like that. So health care, health department expenses. We need to operate wherever I am. I have to be able to log on to computers and I can’t always do that through a phone. So we currently use hotspots and stuff like that to access back into our computers. So we need to fund that. So that’s it. And that needs to be for myself and Tracy. Our jobs don’t end when we leave the office at five o’clock. We run at this point. We’re running twenty four hours a day. My phone runs all the time and I’m expected to answer it and I have to respond. And sometimes I need documents and I need these devices to reach those. So the increase in that is nine hundred and sixty five dollars and fifty two cents. The total increase for total is thirty thousand seventy nine and fifty two cents. It’s not a lot. Andrew, can you let me into the meeting? Yeah. I see you.

1:28:20 That is the first page of the health department. You know, that’s the overall cost of the health department.

1:28:35 Oh, you mean the bottom line. Thirty thirty. So when you look at the health offers expense, there’s health salaries, health expense, health local travel, mental health contractual services, which is on the first page. Well, can we tell the audience that that’s for the counseling center? Yeah, that’s yeah. Yeah, of course. You can say that. All right. That’s what I’d like the audience to know that we support the counseling center by sixty thousand dollars and we give the four thousand to Hark. And that’s a share that every North Shore community gives to Hark. They choose to give. I don’t know how many give, but we do. And without that sixty thousand, they wouldn’t be able to run. No, they need it. They need more. We’ve cut them from not recently, but I think they were one hundred thousand dollars many years ago. Yeah, many years ago, there are one hundred thousand dollars. Yeah. Many years ago, every department contributed to them. Yeah. School department, too. Okay, I’m sorry to interrupt. So, Andrew, what do we need to do besides designating that this is the budget that we want? Is there any particular advocacy or anything that we can do to make this happen? Yeah. So obviously, you know. You have to go through the process that we do every year. Next step would be meeting with our FinCon liaisons. Then, obviously, we’ll have a budget hearing with the Finance Committee

1:30:09 where they vote to approve our budget to town meeting. At town meeting, if questions come up, we have to advocate what we’re doing. Obviously, we need a fully functioning health department with full-time staff there at 37 and a half hours a week, plus myself, who’s over and above whatever. First of all, I would encourage you to make the budget the way you feel you can run the office. I also would say that I think that we would have the support of the community based on the hard work that you’re doing and the rest of the staff is doing. I think that we would get the support. Where we get the money is another story. The town’s going to have to figure that out. That’s going to be a town meeting and the Finance Committee. Obviously, people have to understand that there’s many communities out there that, besides COVID, have fully functioning health departments. We take this stuff seriously. We have a lot of master normal laws that we oversee, food inspections, housing inspections, complaints. We are the utility of the town. When there’s different issues, we get called out hoarding issues, mental health services, mental health issues, tobacco control, underage drugs, all of that. Anything that falls under the health, we have to respond to that. Then

1:31:39 there’s other areas that people forget about. Water quality, pools. There’s a huge list of items that we’re responsible for. Public water supplies. Yes, we have town sewer, but if there’s any Title V systems in town, we have to oversee all of that stuff. It’s really important, not just because of COVID, but for us moving forward. Yes, I’m working 50, 60 hours a week and I only get paid for 40. Yes, not good. Maybe it’s time to go for that other step that we tried to… There’s no other step. They just need to start to… They need to give the admin those increases. I think that we can talk about that. Yeah. I mean, they have done a salary study and they need to move forward with the salary study. This is not the night to vote on the budget estimates pages, is it? Yeah, you have to… It’s not technically we’re going before FinCom is when we usually do it, Todd. Yeah, that’s what we do. We’ll go and have our meeting with our liaisons, talk with our liaisons and then come back and discuss what was discussed and then vote on it before we go to the finance committee meeting. To step back on one thing, when you gave the five goals, you said you have to separate

1:33:10 the health from the transfer station. Are you from the waste? Did you do that in the goals too or they were all meshed together? No, I do that with the goals too. With the transfer station, so we can move over to waste. Sure. Okay. Obviously, goal number one, finish transfer station. We need to figure out what we’re going to do there. We’ve had some discussion about that. The committee needs to decide how they want to move forward with that at some point officially. Department goal number two, we’re always trying to reduce waste and recycle more. Obviously, recycling has become a different industry. There’s not as much payback as there used to be, but there still is a cost savings. The last thing I need to talk about is we are looking to our waste disposal contract. We’re about to go into our last year. Waste management would like to renegotiate with us. We’re looking at we have options for a three year, five year, 10 year, and a seven year. Some different options, but that’s part of trying to achieve some of these reducing waste and recycling more. One of our biggest pushes that we’ve done to reduce waste in the last couple years is food composting. We’ve made a pretty good stride with that. We now have approximately

1:34:43 550 residents in town that have curbside collection of composting at their homes, as well as we have a total of six 65 gallon totors at the transfer station that gets picked up once a week to service quite a few community members besides the curbside portion. Could you add that to that reduced waste and recycling? Yes. I have it under education because education is really the piece. You should be getting into composting. You should be recycling as much as possible as long as it falls with what you’re allowed to recycle. That’s a big piece too, is the education. Recycle smart. You need to be recycling the correct materials or is considered contamination. If there’s so much contamination, that whole load is considered trash. Now everything in that recycling bin, the whole truck is going to the landfill or to the incinerator. That’s one of the goals I put down to continue to encourage and educate the public on composting proper recycling and solid waste reduction. I look forward to get that. Yes. We have that as department head goal, part of number two, Todd. I also wrote about the food waste pickup and continuing monitoring paper bag bin. We’re interested in the same thing. Yes. Okay. Department head goal number three, obviously we continue to run the transfer station in

1:36:16 a cost effective manner. We have two sides to the transfer station that makes it cost effective. Obviously we have the residential side where we sell six to seven thousand stickers a year. Then we have a commercial side. The commercial side is really important because that’s a huge offset of costs. We are paying, I believe it’s $93 a ton for disposal. We’re charging $185 a ton for commercial waste when people want to use the transfer station to get rid of waste. There is some money to cover costs. That’s how we need to be efficient. Obviously we’re always looking at our fees. We’re always looking across the state and other communities and how they’re operating the transfer station. One of our big steps that we need to take with that is working with the town for payment, making it easy for payment. That would be taking credit cards at the transfer station. That’s something we really want to talk to the town about. We have begun the conversation with our last town accountant, but unfortunately she’s no longer here. We have to wait for the next one to get here and discuss that with them. That would be a big change for us. At this point we don’t take credit cards? We do not take credit cards. No, checks only, cash. Yeah, cash and checks only. No matter what, we do a tremendous amount

1:37:52 of business up there on a weekly basis. We have quite a few accounts. Obviously Andrea has to process that. All that paperwork on a daily and a weekly basis. Yeah, we’re really busy with COVID, but she’s supposed to be split 50-50. It’s almost 80-20. She spends probably 80% of her time really dealing with the finances of the transfer station. She does a really good job with that, but it’s labor intensive. There’s a lot of accounts. You just have to be on top of everything. Obviously we have daily deposits and all that that you have to track in checks and cash. Why would there be pushback about credit cards? Is it the credit card fees? Yeah, generally the credit card fees and how you push that is on to the customer. Yeah, it seems like it would be a real asset to have that convenience. I didn’t even realize you didn’t have it. That’s the interesting thing. The transfer station Venmo account about that. I know. I was thinking not to. Let’s get the credit cards going first. I didn’t have goals four and five because a lot of them kind of tied in together. Like I said, we’re so busy with everything else. We don’t have a lot of time to look at other goals that we want to do. It would be good to have the climate adaptation and mitigation goal. I’m okay. Helene had carbon emission reduction and carbon

1:39:40 emission reduction. I added something on carbon, adding mitigation there. I added something just to make it more global mentioning climate. It would be good to put something in there. To me, that’s more of a health goal than a waste goal. True. Sorry, that’s right. I’m back to health already and you already had five goals there. But obviously, yes, we are concerned about that. We have been working with Sustainable Marblehead to look at the carbon footprint of the town. Yes, looking at solar, looking at all these different uses. Yes, that is on our radar. I’m just not sure how it fits in with all our goals currently. You don’t think it can fit in at all because if you wanted to find space for it, your first two goals about COVID-19, you might be able to combine and then have a space for five. COVID-19 is my first goal. My second goal is addressing mental health issues. Oh, okay. I’m sorry. I would be in favor of … Well, I love the issues in the home. I don’t know. I think the climate one is one to … I would be in favor of putting a climate goal in there. I guess, Michelle, you could try to wrap it into that one. I don’t see an issue with that, promoting a clean and healthy environment around the home, which includes carbon neutral issues. Yeah. Well, let’s do that. An overarching, yeah, like just promoting healthy environments and … I

1:41:24 don’t know. I can’t think straight anymore. My first phrase is promote a clean and healthy environment, which includes personal property of the home and reducing carbon footprint or something like that. Or overarching strategies for climate adaptation and mitigation. I know it’s not eloquent and it’s just throwing it all in there, but at least it’s in there. So start it off by saying, promote a clean and healthy environment and put both statements after that, including both of them. Including what? Including the private property, so the home and say how you want to save the other. And then, I don’t remember what I said, promoting fostering strategies for climate adaptation and mitigation. That kind of covers everything. And we don’t have to get into the weeds right now. It just, it covers … It appears here. Yeah, because then it covers the stuff that we might want to address around heat issues, protecting people from disease vectors or strategies to

1:42:58 mitigate climate risk like solar and all those other things.

1:43:08 All right. So as far as waste goes though, as far as budget, we are really only looking for some salary increases. Now, the big piece of the salary increase that we need to address is that we have a scale operator and then on the weekends we had two part-time positions. We had a scale operator on Saturday as well as somebody that sold stickers or checked stickers. Now, what happened was that we had retirements, we couldn’t find anybody that was willing to fill in that position. We had somebody that we found. However, it wasn’t enough hours. And then the other thing was that any time my scale operator was either out sick or on vacation, there’s only two people that could fill that position, Andrea or myself. So we have to leave our other jobs and go do that job. So I could be stuck up there for a week doing scale work and taken away from my director’s work. And so that needed to change too. So we made, there was a position called transfer station operator, which is a low grade kind of laborer, but we could use them in a scale house. So in my budget, I have 37 and a half hours for a transfer station operator. It comes at $38,020, but you’re removing also those,

1:44:38 that temporary general labor and that seasonal general labor. So you’re subtracting two other positions. So there is a small delta, but there’s a big argument for having this full-time person. Now, when Kay goes on vacation, he can slide in. Now he’s up there Tuesday through Saturday. He’s checking stickers, he’s selling stickers, and he can fill in any time she’s not there. That’s a big pivot that we need to make. That department brings in quite a few bit of money. If that scale is closed, we’re not bringing in any money. Or if that scale house is closed, we’re not bringing any money. The scale is closed. Nobody can do any commercial trash, and you can’t throw anything away that requires money. So we need to pivot to fill that position. And that’s provision, there’s a provision for that in the budget. Yep. Well, you’re not, you know, we are going to have to ask for an increase at that point. Yes, you are going to, you know, take away the temporary general labor. So there’s a cost savings of $12,938. You’re also getting rid of the seasonal general labor at $5,981. Overtime. I continue to run into overtime issues. Because we’re so busy, we tend to go pass our hours. So yes, the gate’s going to close when the gate’s going to close, but that doesn’t mean

1:46:09 that the guys are finished cleaning up. So we’ve been running into a little bit of an overtime issue. So last fiscal year, I spent $9,442.72 on overtime. I only had a budget of $6,703. This year, I increased it to $6,904, but this fiscal year, but I’m asking to increase that up to $9,500. So that’s an increase of $2,596. Do you think that this new person that you’re hiring will alleviate some of that overtime? They’ll still have to do this. That person couldn’t start cleaning up earlier? This person’s really in the scale house. Yes, some of the overtime is coming from, so the scale closes at $330, the door closes at $330. You have to process all your payments at that point. You never had figured in that you were going to go over that time. So he’s going to contribute to some of that overtime. It’s also cleaning up the yard waste area, the recycling area, and commercial trash. That’s where you’re getting a large amount of OT at those times, too. So also, if you know you’re going to use that overtime, wouldn’t it be cheaper to add hours to the job? I can’t. Everybody’s full-time. Are there all 40 hours? Yep, 37 and a half. 37 and a half is full-time? Yep. Not 40? Not 40.

1:47:46 Okay. Sick annual bonus goes up a little bit because you have to account for that additional employee. And then you get into some of the other costs. We have a contract change with JRMs, so it’s a yearly increase. The yearly increase on that contract is $25,140. We also have new internet service up there. The town is no longer providing internet service up there, so we have Verizon internet service up there. That’s now going to run us $2,045. Because we’re doing so much business, we’re running through all our forms. Every scale slip, that’s a printing. So we need to increase our printing up to $10,000. In FY20, we spent $9,139.75 on printing. We only at that time had $4,500 budgeted, so we’ve increased that up to $10,000. Well, instead of using slips, can’t you use that on the computer? Can’t you put that through on the computer? Use what? Instead of using slips every time they come in to, what is it, for the commercial? So how are you going to give them a receipt? On their computer, I can get it when you go to Staples. Right, so that requires printing. Printing. So it’s a special form that we use in our scale slips that’s designed for the scale

1:49:18 printer. That’s how you give them a receipt. Through the printing. It’s not a handwritten thing. No, it’s not a handwritten thing. We are a professional business. Good, well I know, but I didn’t, when you’re saying the slips, it didn’t make sense to me. That’s right. All right, thank you. And then, you know, miscellaneous custodial health supplies, same thing. We’ve been, you know, you got to keep a clean business. You know, we have employees, everything needs to be taken care of. There’s always an increase in costs. So those costs need to go up a little bit. So that’s just going up $200. And that’s really it for the increases, but it’s a total of $32,385 for, you know, equipment and stuff like that. And the new salary position, right? Well, the new salary position, you know, is $23,955.50 increase. So your total FY22 budget request is $1,893,000, is $2,412,239, which is an increase of $56,341.

1:50:50 2.26%. So, I mean, I think all these increases are very logical. I mean, it doesn’t make sense not to ask the case. Correct. I mean, obviously, of contractual issues, we have no choice but to pay them. Right. So if there’s no issues amongst the three of us, then we can take this to our liaison meeting like this. Are we going to vote on this tonight? No. No. We’re not getting any money for recycling or anything? No. So no matter what, that goes back into the general fund. Because where is there any income on this? No, there’s no income on this. It does not show the revolving accounts or any of that stuff. Okay. Well, I guess it makes sense. And you’ve justified it. So, and we certainly agree that it’s one of the lowest priced budgets in the town and every resident has a chance. The waste budget is definitely a higher budget, but there’s a lot

1:52:24 of costs associated with that. curbside collection has a large cost. Trash disposal, there’s a large cost. Yes, there is something that offsets it. That’s the commercial trash. And so yes, we do give back some money at the end of the year. We always carry a delta in our trash disposal line in case of emergencies. You could have a hurricane where there’s a huge amount of trash that’s coming in from the residents that you haven’t accounted for and that needs to be paid for. There could be other issues that go along with that. We’ve always carried a pretty good delta to deal with that. And then obviously, we are obviously going up for disposal costs this year, but we really need to discuss the proposal from waste management at our next meeting about entering into another long-term contract with them, be it three years, five years, seven, 10. And please note that as landfills and waste energy facilities close across the state, costs are going to increase. So many facilities are closing in the next, you know, five, 10 years. The cost of trash disposal is going up anywhere between 3% and 5% on an annual basis. It adds up. Well, thank you for

1:53:56 the work and the presentation. I wish you good luck with the finance committee. You all set with it, Todd? I mean, obviously, like, you know, we don’t have all our goals stuff filled out, but I’m just going to submit it as is, you know. Okay. Yeah, I think we just have to, you know, it has the new, the essence of what we’re doing, and I think that’s fine. Could we say the language before you submit it, like tomorrow morning, whenever you put it in? When I finish it with that, yeah, I can send it to you. There’s not a lot of language, you know, the only thing that you’ve changed is, you know, including private property fostering strategies for climate change mitigation. Okay, but we really didn’t see the other in print either. So you have all the other stuff, Elaine. I sent everything to you. Oh, you did? The new, yeah, the combining of the two. Yep. So at the very beginning of those health and waste budgets, is that goal sheet, the objectives and goal sheet. Yeah. And it’s all in there. Oh, it is. All right. Just that phrase is that it. Okay. And we picked the five we want to do. So, yeah, I printed it off, you know, the swooning. So, right. Okay, that’s great. Okay. So we’ll hear from the thing come soon when they want to meet with us, right, Liazms? Yeah, you know, it’s hard, you know, usually it’s after February vacation, obviously.

1:55:28 So, yeah, as soon as we hear from them, we’ll schedule a meeting and we’ll continue on. Okay. So I’m going to have to hop. How much more do we have to do? Adjourn and next week, same time, same place. Okay. Can I make, all right, same time, next place. Can I make a motion to adjourn? Well, we’re going to try and get Ben there, though. Yeah, we’ll try to get Ben here. And if not, ask him for whatever he can do in the next few weeks. Yep. And not school vacation week. Correct. And we’ll probably take a break school vacation week. Correct. Is that the only week you’re going to be gone that Tuesday? Well, I’d like to be gone a lot more, but I think. We don’t like to be gone. But you know what, have computer, we’ll travel. Oh yeah, that’s the only week I’ll be gone for. All right. So we have a motion to adjourn. I’ll make a motion to adjourn. Second. Miss Gottlieb. In favor. Miss Hazlett. Favor. Dr. Belficher. Gaver. Good night, everybody.