57th Coffee With The Commissioner Event this Wednesday Morning!

 

We will have our 57th Coffee with the Commissioner this Wednesday Morning live on Facebook.

The live stream will take place from 6:30 - 7:30 a.m.   Escambia County Administrator Janice Gilley, Emergency Manager Eric Gilmore, Baptist Health Care President and CEO Mark Faulkner,  Ascension Sacred Heart Hospital Pensacola President Dawn Rudolph and West Florida Hospital CEO Gay Nord will discuss the latest COVID-19 numbers and the impact on the local community. Discussion will include information about the status of the vaccination rollout in Escambia County, testing, and the overall pandemic's impacts on our area and our area's hospitals.

To join the meeting, go to the following Facebook page at 6:30 a.m. on Wednesday, Jan. 20 and watch the live stream: www.facebook.com/CommissionerBergosh/.

Residents are encouraged to send virtual questions and comments they would like to discuss with District 1 Commissioner during the event through Facebook.

 For more information, contact District 1 Aide Debbie Kenney at 850-595-4910 or district1@myescambia.com. For District 1 updates, follow @MyDistrict1 on Twitter.

Escambia's Alcohol Sales Ordinance to be Discussed Next Week

We will be discussing our alcohol sales ordinance next Thursday during our board meeting.  Our current ordinance treats businesses differently according to where these businesses are located in the county geographically.  Some believe this is an unfair double standard and I do not disagree with that assessment.....

Next week I will be bringing our Alcohol Sales ordinance to our regular meeting for discussion among my peers.

I have been asked by constituents why there are currently no sales of alcoholic beverages permitted on Sunday until 1:00 PM on the mainland in stores---but on our two barrier islands (Perdido Key and Pensacola Beach) ----Sunday sales can commence at 7:00AM as our policy is currently written?

Why the differing standards is a fair question?

Looking at the ordinances of our nearby neighbor counties (below)--I prefer and will bring a suggested replacement ordinance for Escambia County that is similar to what Santa Rosa has--that treats all areas the same in terms of the time/date when alcoholic beverages can be sold.

No store will be obligated to start selling early if they choose not to do so--but they will be allowed to do so if they so choose.  

And no--I'm not "advocating" for people to go out and get drunk on Sunday mornings---I'm simply making our ordinance fair for all businesses in the county; as it is currently written, there is a glaring double standard.  

When or whether or not someone chooses to consume alcoholic beverages is a personal choice/decision---and we do live in a free country after all....

So we will see if there is any appetite for changing this ordinance locally--I have no idea where my counterparts stand on this issue.  We will find out next week though.

FASCINATING COVID-19 Data Points----Really Telling and Really Interesting

 

25% of nearly 3500 Asymptomatic patients tested for COVID-19 since Christmas are testing positive for the virus.  This is a very telling number.  What does that mean for the entire population though--could we use that percentage to extrapolate for our entire county's 320,000 residents?

Anyone and everyone can regurgitate FDOH statistics and data numbers.  Lots of people track the positivity numbers and the negative test results etc..  And that's all great.  I follow these numbers daily myself, as I have since this all started last year at this time.

But some interesting stats have been hard to get.

It took me 6 months of pressing to FINALLY get the "Recovered" number added to the County's COVID-19 dashboard.  I have subsequently taken heat because I pressed for that.  Some people don't like the term "recovered" because some COVID-19 patients don't die---yet they suffer significant ongoing medical issues.  That is a fair question and reasonable criticism--but I do not believe it means we shouldn't track the percentages and numbers that "Survive" a COVID-19 Diagnosis.  Perhaps we should change that term from "recovered" to "survived"--I don't know.  

Meanwhile--I recently heard from our Hospital administrators and testing partners that of 100% of nearly 5000 citizens locally in the 2-County Area (Santa Rosa and Escambia) being tested since Christmas----70% are asymptomatic and 30% present with flu-like symptoms.

So, naturally, I asked for the important data from those percentages:  What percentage of the 70% asymptomatic test subjects came back with a positive result for COVID-19?

"We are not tracking that" was the initial response.   "Why NOT?!?" was my reply.

So I asked for this number and I received some FASCINATING information back from the hospital staff with whom I spoke, with percentages, in my email box.  Full disclosure--the verbal disclaimer from these folks was that this was a rough order of magnitude, "Back of the envelope" number.  But still, it is interesting and it is a lot higher number than many would have suspected... From the email:

"Good morning, I wanted to give you the stats since Christmas that we discussed on the phone yesterday. Since Christmas, we still have about 70% of patients being COVID tested in Escambia County who do not have symptoms and 30% who do have symptoms. Of the people with symptoms - they are running at a 41% positive rate in Escambia county since Christmas. Of the people without symptoms - they are running at a 25% positive rate since Christmas." 

How Much Does it Cost to Provide a COVID-19 Test to an Escambia County Citizen?

What is the actual cost of performing a COVID-19 test on an Escambia County Citizen?

A fascinating discussion occurred late, as the BCC's regular meeting  dragged on past 9:00PM last night.

We were discussing CARES act allocations and we had several contracts to consider---including two that would have provided additional CARES act funding for COVID-19 tests.

We were contemplating approving a contract with Ascension Sacred Heart which would have provided $100 for each uninsured citizen that gets a COVID-19 test at one of Ascension's sites.  According to representatives from Ascension--they "Ate more than $1 Million" in revenue loss from COVID-19 tests administered thus far.  There was no elaboration on exactly what that means, though.  

Was this $1 Million + in losses unrecoverable from any federal source under CARES?  Was it $1 Million in actual costs or wass this $1 Million in retail or list cost?  I'd like to know this, but did not get clarification during the morning session.

When County staff was asked during the subsequent evening meeting "How much does Ascension pay for a COVID-19 test?"  The answer came back from staff that "They (Ascension) do not share this information."

Additional discussion among board members centered on the fact that Community Health Northwest is paid $37 per COVID-19 test in a separate agreement--which apparently covers their costs and allows them to provide these rapid tests to at-risk citizens.  This is quite a bit less than what Ascension was going to be getting.  Naturally, one would assume it must be less expensive for Ascension to administer these tests, given their size, economy of scale, and their organic, in-house testing capability?

So why do they need to get $100 per test? That was the question that went unanswered last night.

  Because nobody from Ascension came to answer--and because board members had questions--the contracts with Ascension for both the mass vaccinations AND the testing were not approved.  Hopefully over the next two weeks we can get some clarification from Ascension....because folks like me want to know---How much does it cost to provided a COVID-19 test to an Escambia County Citizen?

Who Should Administer the COVID-19 Vaccines Locally?

If we have to pay to do it locally--it is in our best interests to hire multiple outlets
to administer the COVID-19 vaccines.  It is not in the citizens' best interests
for the county to do an exclusive, sole-source procurement
with only ONE (1) of several qualified providers locally.  That's why tonight
we are NOT doing a sole-source deal.......

We all heard about Operation Warp Speed.

We heard the military would start mass-vaccinations nationwide.

Then we heard the state would handle the vaccinations.

But then reality hit.  

About two weeks back the Florida Department of Health in Escambia County and Escambia County administration had a tense conversation at which point it was made clear that the local state Health Department did not have the capacity to administer the vaccinations locally.

The rollout thus far has been a massive cluster.

Escambia County at the local level is going to have to step in and pay hospitals and/or other entities to do it---otherwise citizen outrage will continue to roil to a boiling point and there won't be an orderly rollout.

One of the hospitals has now presented us with this contract.  It mirrors contracts this particular Hospital Corporation is using to vaccinate in other markets as well, to include Santa Rosa County.

As I stated in last weeks blog post--why are we paying for this?

But getting past this frustration and the botched state rollout of this vaccination program--why would we ever do what appears to be an exclusive deal with just one of our local hospitals/clinics that can and want to help in the administration of these vaccines?

Answer--we shouldn't do this, we shouldn't do sole-source procurements for these services.

So at tonight's meeting we will bring an updated version of this contract that makes it clear that this $3.5 Million is a total of a currently allocated "pool" of money to be utilized for the express purpose of providing vaccinations to uninsured in the county AND that we are not doing an exclusive deal with ANY one hospital;  this is a NON-EXCLUSIVE agreement and the county can and will add other vendors that choose to participate locally into this program allowing them to vaccinate under the same terms, conditions, stipulations and reimbursement rates from this "pool" of money as in this first contract.

For us as Escambia County to do anything else makes no sense.... I mean--why would we want to limit the number of hospitals, clinics, and/or other licensed and qualified county-approved facilities that we will enlist and pay to provide vaccinations--- if we are truly interested in getting the maximum number of vaccinations out to our citizens as quickly as possible?

We should expand the supply channels not narrow them with exclusive, 1-outlet deals.

This is why we won't do an exclusive deal with one provider, and we will fix this contract tonight before it is approved so that multiple providers, if they so choose, can participate and vaccinate and draw down the $3.5 Million for providing the vaccine to the uninsured citizens.

Anger Mounts over Vaccine Rollout Strategy Cluster....

Anger is quickly building among constituents who are frustrated over the inability to get clear guidance on how to get a COVID-19 vaccination shot in Escambia County.

The state's rollout of this vaccination program here has been a cluster.  And that is being polite.

It's a goat rope.

Constituents in Escambia County are not happy about it either.  My office is getting irate phone calls and emails of complete and utter frustration over the State's vaccination strategy.

"Nobody answers when I call the published number!"

"I call and then a recording says go online to sign up--but I called because I do not have internet access!"

"Nobody can tell me when or where to go to get my vaccination"

These are common complaints that I am getting because our office answers the phone calls and responds to the emails.

Emails look like this:

“The Vaccination roll-out has been a complete cluster. I would hope that the commissioners will address this during tomorrow's meeting. I can't think of any agenda item that could be more important then the health of Escambia County citizens.

I 'finally' got through to the Escambia Dept of Health today (Wednesday). Obviously they are overrun w/calls. According to staff, they are being kept in the dark, like the rest of us us. There seems to be no 'real' plan in the county or the state of Florida. If this is the plan, it needs to changed, because this is not working. We call or sign up at the link and don't get a reply or anything, except an auto-thank you, so we don't know if we are registered or not. Why not have a Website/Online Tool or something, so we can see register and where we are in line, rather then having to constantly search for updates and hope to get an idea of when the next vaccination clinic is? There were months to prepare, but it appears like there was no plan. It would be great to see a brainstorming discussion at the BOCC Meeting where ideas are tossed around. Not 2 weeks from now, but asap.”

and this:

“Dear Sir:

As a SENIOR CITIZEN in Escambia County, I am dismayed at how I am being treated in regard to Covid Vaccinations.  I am asking you to please tell the SENIOR CITIZENS of Escambia County a truthful, realistic, expeditious way in which we can register for and receive our Covid Vaccinations? It is unconscionable that we have gotten nothing but jibber jabber from the appropriate agencies in our county.  These are the very same agencies that are here to “protect and cater to our SENIOR CITIZENS.”  I THINK NOT...My husband and I have been calling constantly, day and night, to the agencies and phone numbers provided. There is no way to get through; the line rings “busy” every time.  And the website recommended is not even up-and-running.  And yet thousands of vaccinations have been given. How did those people get appointments?   Certainly not using the phone numbers and websites dispersed to the public by health officials and Emergency Management. Not providing us with a viable and fair way to register for and receive the Covid Vaccination is disrespectful of our esteemed ELDERS, detrimental to our health, and actually, quite shameful!  I hope that there is a logical resolution to this problem and that ALL CITIZENS of Escambia County can fairly and straight-forwardly receive our inoculations.”

Yeah, so folks are mad.

I'm now told that even despite all of the state's problems---some way, somehow, The State Department of Health in Escambia County still has managed to compile a "list" of about 10,000 residents that have reached out to them wanting vaccination.  But the state has told our staff they cannot handle the logistics of distributing the vaccines.  So now this is falling on us to fund--as I pointed out last week.

We're jumping in with a solution that will maximize the county's various distribution channels to move the vaccines locally and get as many citizens the shot as possible--that will be approved at tonight's meeting.

A Better COVID-19 Dashboard is Now Here! "Recovered COVID-19 Cases" Number Now Tracked

 

After months of work to make it better--we have succeeded.

Our County's CoVID-19 Dashboard is now reflecting a "Recovered" number along with all of the other important metrics that we track and provide daily.

The "Recovered" metric is an estimate based upon the approximate total cases prior to last month minus deaths.  The staff will be using the Crude Recovery Rate and the Crude Case Fatality Rate applied to the number of cases to provide the estimated recovery rate.  The Crude Case-Fatality Risk (CFR) is calculated by dividing the Total Number of Fatalities in Escambia County (Resident and Non-Resident) by the Total Number of Confirmed Cases in Escambia County (Resident and Non-Resident) and multiplying by 100%. The Crude Case-Recovery Risk (CRR) is calculated by subtracting the CFR from 100%. The CFR and CRR are not adjusted for the time delay from diagnosis to death which is highly variable from one to eight weeks. (CFR discussed in: The Lancet Infectious Diseases, October 19, 2020).

I've been pushing for the inclusion of this metric for the last 6 months-----as I know how vitally important it is to provide as much good data to citizens as quickly as possible.  And to only provide the gross, cumulative "cases" number without the counterbalancing context of recovered cases was not giving a complete picture of the situation in Escambia County.  And this is why many other states and countries also provide a "recovered" figure.

It took a while, but now it is here.  I'm grateful to staff for working to keep this data up to date and easy to read.