Medical experts say daycares should close

April 1, 2020

The first meeting of the Covid-19 Emergency Advisory Board was held Tuesday during which medical experts warned that a failure to close daycare facilities in Bartlesville could result in more spread of Covid-19, the coronavirus that the White House Task Force recently said will kill 100,000 to 240,000 people in the U.S.

The Board, created by the City Council on March 23, is tasked with reviewing the City’s current Covid-19 mitigation measures and advising the council of additional measures that might be needed as well as monitoring the state of the pandemic in Washington County.

During Tuesday’s meeting, the Board discussed the daycare issue as well as other potential mitigation measures, in addition to those included in Municipal Ordinance No. 3525 which was passed by the City Council on March 23, as well as an executive order issued by Oklahoma Gov. Kevin Stitt late last month. Measures discussed include additional business closures and strategies designed to limit crowd size and increase social distancing in the city’s larger retail stores.

Daycare

Two medical experts on the Board, Dr. Kyle Craig and Dr. Gopal Chandrasekharan, implored other Board members to seek immediate closure of local daycare facilities, citing at least one person associated with a daycare who has tested positive for the virus.

“Speaking as a pediatrician in the community, I’ve been a bit frustrated that the daycares have not been asked to shut down,” Chandrasekharan said.

He warned that children, in particular, could be “silent infectors” of the virus, showing no symptoms themselves but still capable of infecting those around them — including older and otherwise at-risk family members.

“I know that at least one daycare has shut down — late,” he said. “I’m not releasing any names of these daycares, but … as soon as that daycare tested one positive case, we started getting phone calls from parents who were worried.

“I humbly plead and request the City, the esteemed members of the City Council to make this a No. 1 priority, to shut down all daycares. I’m afraid it’s already too late, but I think we need to do whatever we can to mitigate further spread and transmission of the virus.”

Craig echoed Chandrasekharan’s concerns and expressed frustration that an Executive Order issued by Oklahoma Gov. Kevin Stitt earlier this month lists child care facilities as “critical infrastructure,” allowing them to remain open during the pandemic.

“I’m confused and frustrated by the idea that this is an essential function,” Craig said. “I understand the argument that there are essential workers who are using and depending on daycares — I get that. What I don’t get is understanding the fact that those essential workers are even more at risk of catching this because their kids are in daycare. And those who are essential workers on the front line who have their kids in daycare are more than likely going to be exposed to the virus, with or without symptoms —especially without symptoms — are going to be that much more at risk of being a vector who transmits it to the people they are serving.”

Craig said he had personally been in contact with the leadership of “a particular” daycare to express his concerns. That daycare remains open today, he said, pointing out that mitigation efforts are needed.

“We’re doing the best we can, but we all need other accountability to do the right thing at all times,” he said.

Business

The Board also discussed several reports of large crowds inside some of the city’s larger retail stores last weekend and agreed that reducing the number of people allowed into these stores at one time could potentially help reduce risk of exposure.

“Around town I see a lot of gathering in parking lots,” Craig told the Board. “But big stores here in town that are not specifically grocery stores, I see packed parking lots still. And that’s disappointing. It makes you think, seeing so many cars parked at these places, how much further do we need to go to have that accountability so that nobody has a choice and we have to stay away.”

Board members discussed several ways citizens could voluntarily reduce exposure, such as shopping less often and selecting one person in the family to do the required shopping.

“We’ve all seen people shopping with five or six kids … and it’s disheartening,” said Chandrasekharan. “It’s disheartening because we know what’s coming if this continues.”

He added that everyone should be washing their hands and face when arriving home from shopping or anyplace else, and leaving footwear outside.

“These are important things that you want to make sure that you’re doing so that the people you love in your life are still there come Christmas,” he said. “That’s a stark thing to say … but the reason we’re saying these hardcore things is we don’t want to be put in a position, two months from now, where we’re having to make decisions that are against our oath.”

Vice Mayor/Board member Alan Gentges presented several mitigation measures for businesses that some other communities are using, including:

  • Implement mandatory signage, warnings and instructions for social distancing throughout businesses
  • Requiring certain employees to be provided with barriers to separate them from customers
  • Limits on number of people in buildings
  • Testing/temperature checks before entering business for work
  • Limited hours
  • Reporting for employees who exhibit or report symptoms or illness

Some Board members also expressed concern that the City-owned Adams Golf Course has not been closed, even though golf courses are listed as critical infrastructure in Stitt’s executive order. Mayor Dale Copeland explained that Adams Golf Course has taken several measures to help ensure safety including mandatory social distancing, disinfecting golf carts after every use, requiring that golfers use their own clubs, closing the dining area for on-premise consumption, and cleaning/disinfecting all facilities every three hours. Golf Pro Jerry Benedict announced today that the Club House is now closed as well.

The numbers

Board experts say the number of Covid-19 cases has yet to “peak” in the U.S., including Washington County, and that additional mitigation measures are necessary to reduce spread of the disease. While much is unknown about the novel (new) virus, estimates indicate the peak could occur around April 17, at which point infection rates could begin to fall.

City Manager Mike Bailey presented several graphs showing the current trends and modeling of what could happen in the near term based on current growth rates. Currently, the number of infections is growing at a rate of 33.5 percent every day — with deaths increasing by 33.8 percent each day.

“Assuming we peak sometime around the 17th and this curve continued, we would be at nearly 5,000 cases in Washington County, if we grew at 35 percent as we have,” Bailey said, referencing a chart showing increases in new cases in Oklahoma. “When we start talking about ‘flattening the curve,’ I wanted to project something to show what the differences would be if we were able to improve those outcomes. So assuming we were able to use social distancing and some of the policies that are in place to reduce that down to 25 percent, you see that by April 17 the number of cases are just a little over 1,000.

“Now, I don’t know which of these two scenarios is most accurate, but this was a way to demonstrate what the effect would be based on the growth of the disease and the number of new cases per day if we were able to control that a little.”

Gentges said he had been working on modeling which shows that assuming even a 10 percent increase in infection, “we’re probably looking at 100 to 120 cases here in Bartlesville.”

“If the modeling is right, they’ve got about 20 percent of the reported cases are ending up hospitalized,” he said. “That should give us some idea of what kind of load we would be looking at.”

Social distancing

Bailey said there is some data that indicates social distancing, which includes staying home as much as possible and maintaining six feet of distance between oneself and other at all times, is working, referencing a company, Unacast, that uses cell phone data to measure success.

“Using cell phone data they were able to determine there was improvement in Oklahoma by a change of about 24 percent in average distance traveled,” Bailey said. “From their result, that gave us a ‘C.’ I think this is another tool that we can use to try to determine the success of social distancing measures.”

Bailey said Washington County showed a negative 28 percent change in average distance traveled, receiving a C grade as well.

Board Chair and Mayor Dale Copeland said based on his review of growth rates of infection in the state, the U.S. and globally, Washington County appears to be increasing at a comparable rate, but that mitigation measures could significantly reduce that number.

“A fairly small deviation can result in substantial change,” Copeland said.

Preparedness

“I will tell you this virus is unforgiving and unrelenting, and it makes even the youngest in our community extremely ill,” Bidleman said.

“Currently we are in Phase 1 of (a three level-strategic plan)” Bidleman said. “We are working on redeployment of staff, orientation of critical care nurses, and calling back any and all nurses that have retired but want to come back in and help.”

Bidleman called Covid-19 “unforgiving and unrelenting,” saying a significant percentage of those infected have and will continue to require advanced critical care. She said the hospital currently has plenty of Personal Protective Equipment and ventilators, which are often needed for critically ill patients with Covid-19.

“We’ve had amazing donations (of PPEs) throughout the community,” she said. “We do not, nor have we had, a decrease in our supply, and we are getting shipments on a daily basis so I don’t have concerns about that,” Bidleman said.

“Regarding our ventilator status, we identified that these patients … were requiring critical care at a very high level so we reached out to a company and were able to get our hands on additional ventilators, if needed. So they’re just in the wings, waiting. We currently have ventilators in-house, and we have more than what we currently need.”

Ascension St. John President/CEO and Board member Mike Moore assured the Board the hospital is prepared for a potential influx of patients requiring medical care due to the virus.

“As the numbers grow, (we will) expand to meet the need,” he said. “We are prepared.”

Next step

The Board agreed that City staff would compile recommendations based on Tuesday’s discussion for City Council consideration. The council will hold it regularly scheduled monthly meeting on Monday, April 6, via teleconference. The council is expected to consider whether to keep the current mitigation efforts in place, amend them or cancel them, as well as the Board’s recommendations.

Based on the Board’s discussion, the council could be asked to consider the following recommendations:

  • Extend existing measures and proclamation of emergency
  • Close daycare facilities
  • Close additional businesses or limit occupancy, including barring or limiting the number of minors allowed into retail establishments
  • Acquire services to track success of social distancing
  • Expand age range in “stay at home” order
  • Reduce gathering limits to five
  • Track travel to determine compliance and to adjust restrictions

The Board meeting Tuesday was held via videoconference, per Senate Bill 661. Board meetings may be viewed live by the public at the City’s website, https://www.cityofbartlesville.org/city-government/city-council/webcast/ and are aired live on Channel 56. To view a recording the March 31 meeting, see www.cityofbartlesville.org.