Community Disease Spread Presentation to the Board of Trustees - - PowerPoint PPT Presentation

COVID-19 Response: Review of Metrics Adopted to Monitor Community Disease Spread

Presentation to the Board of Trustees August 25, 2020 Presented by the Leadership Team

1 Attachment A - Updated

Reopening Schools

• Guiding Principles
• All decisions based on a foundation of “Do No Harm”
• Ensure student, family, and staff basic needs are being met
• Ensure equitable access for all students
• Maintain high academic expectations for all students
• Follow as practical all federal, state and local health related guidelines

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Presentation Objectives

• Building from the August 11th Board of Trustees action regarding metrics, a

description of proposed metrics and how they can be used in combination to monitor the spread of the COVID-19 virus, and how that can impact learning model choices.

• Provide possible actions to the Board of Trustees for their consideration and

possible adoption.

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A Step Back—Review of Practices

• Public Health Surveillance for COVID-19 (August 7, 2020). The World Health Organization.
• Surveillance and Data Analytics: The Latest in COVID-19 Data and Surveillance (June 29, 2020).

Center for Disease Control and Prevention

• CDC Data Dashboard (https://www.cdc.gov/covid-data-tracker/index.html#trends)
• Key Metrics for COVID Suppression (2020). Harvard Global Health Institute
• Key Metrics for COVID Suppression: A Framework for Policymakers (July 1, 2020). Harvard

Global Health Institute.

• UC Davis Interactive Dashboard (https://www.ucdavis.edu; https://covid19.calsurv.org)
• John Hopkins University Data Dashboard (https://Systems.JHU.edu; https://www.arcgis.com)
• Truckee Meadows Threat Meter Draft website: (http://tmrpa.org/covid-wc/)
• Nevada Department of Health and Human Services (https://nvhealthresponse.nv.gov/)
• Washoe County Health Division (https://gis.washoecounty.us/COVID19)
• Department of Homeland Security (Various Reports)

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The World Health Organization (WHO)

• As it pertains to disease surveillance, the WHO recommends monitoring using multiple

indicators.

• These include but are not limited to:
• New cases on a daily basis
• Deaths on a daily basis
• Cumulative cases and deaths
• Testing rates (*the WHO does recommend that test positivity be at or below 5%)
• In order to properly surveil disease spread, the WHO emphasizes clear and consistent variable

definitions (e.g. confirmed and probable cases, contacts).

• It further emphasizes the need to report quickly based on newest available information, and

by location.

• The WHO points to the critical need of contact tracing as an element of surveillance, as well as

a factor to mitigate disease spread.

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Centers for Disease Control & Prevention (CDC)

• The Center for Disease Control and Prevention (CDC) provides very similar guidance to that

provided by the WHO.

• In terms of surveillance, the CDC does distinguish between disease incidence, prevalence,

hospitalizations, and mortality.

• Toward this end, the CDC recommends and uses the same metrics being used by the WHO

and adds metrics (e.g. 7 day rolling average of new cases).

• The CDC does report state level data through its COVID Data Tracker

(https://www.cdc.gov/covid-data-tracker/index.html#trends)

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CDC (Total Cases & Test Positivity)

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CDC (Trend in Cases)

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CDC (Trend in Deaths)

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Centers for Disease Control & Prevention (CDC)

The Importance of Reopening America’s Schools this Fall (July, 23, 2020). Centers for Disease Control & Prevention Aside from a child’s home, no other setting has more influence on a child’s health and well-being than their school. The in-person school environment does the following:

• provides educational instruction;
• supports the development of social and emotional skills;
• creates a safe environment for learning;
• addresses nutritional needs; and
• facilitates physical activity.

Consideration for Schools (May 19, 2020). Centers for Disease Control & Prevention Implementation should be guided by what is feasible, practical, acceptable and tailored to the needs of each community. Measures to reduce spread: self screening, hygiene, face coverings, visual cues, cleaning, ventilation, spacing/seating, sharing of materials, outbreak response, etc…

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Harvard—Global Health Institute

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Metric 1: New confirmed case trend: New daily cases per 100k pop (seven day rolling average); + trend direction & rate Metric 2: Case trend as an estimate from new deaths trend: New daily deaths per 100k pop * 100 (assuming 1% IFR) (seven day rolling average); + trend direction & rate Metric 3: New daily hospitalizations per 100k pop (seven day rolling average); + trend direction & rate

COVID Risk Level Case Incidence Red > 25 Daily Cases Per 100,000 People Orange 10 < 25 Daily Cases Per 100,000 People Yellow 1 < 10 Daily Cases Per 100,000 People Green < 1 Daily Cases Per 100,000 People

UC Davis & John Hopkins University

• UC Davis has built an interactive website that displays both state level and county level data

(county level maps not currently available). They are displaying:

• Confirmed Cases & Deaths
• Cumulative total
• Cases/deaths per 100,000
• Daily new cases/deaths
• Total tests and daily test administered
• Total hospitalizations and new daily hospitalizations
• John Hopkins University is reporting at a state and national level including:
• Total cases, and daily new cases
• Total deaths and daily new deaths
• Recoveries

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Truckee Meadows COVID Threat Meter

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Please review our draft Truckee Meadows Threat Meter website

Draft website: http://tmrpa.org/covid-wc/

Please review our draft threat-level guidelines on the next pages

• Please provide comments

and/or edits about the website or any information in this PowerPoint to Jeremy jsmith@tmrpa.org

Truckee Meadows COVID Threat Meter

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Green: Minimal to no COVID-19 activity in the community. Gathering is allowed at pre-pandemic levels according to government recommendations. Follow any state mask recommendations. Yellow: There is consistent disease in the community, yet it is under control. Risk for community spread is increasing, but moderate. Avoid large gatherings. Consistently wear masks in public and with at-risk people. Strongly consider not going to gatherings unless for an important or essential purpose. Orange: COVID-19 risk in the community is becoming dangerous Risk is becoming critical. Case numbers and impact on hospitals are increasing. Only leave your home for essential functions such as work, obtaining food, etc. Consistently wear masks in public. Stay away from at risk people. Socially isolate as much as possible. Red: Lockdown mode At this stage our community is in crisis mode. Our case numbers are critically high and our hospitals are at or near

• capacity. Shelter in place. Don’t leave your house unless you absolutely have to. Strict mask compliance outside

the home.

Truckee Meadows COVID Threat Meter

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• The 4-level risk meter rating is determined through the use of 5 metrics each with a score range

from 0-3, resulting in a range of 0-15. The metrics include:

• Risk Assessments → Measures the slope in completed risk assessments over the previous

14 days.

• Test Positivity→ 7-day average of test positivity.
• New Daily Cases per 100,000→ 7-day average of new daily cases, normalized by population.
• Medical Interventions Due to COVID→ % change in 7-day average compared to previous 14-

day average (hospitalizations and ICU).

• Hospital Capacity→ 7-day average in hospital bed use and ICU bed use.

Governor Sisolak’s Plan

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Governor Sisolak’s Plan

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• 1. Average Number of Tests Per Day (per 100,000) < 150
• Average # of tests daily during previous week, converted to rate per 100,000.
• Reported over a 14-day period with a 7-day lag.
• 2. Case Rate (per 100,000) > 200
• Total # of cases over a 30-day period, converted to rate per 100,000.
• 3. Case Rate (per 100,000) > 50 and Testing Positivity > 7%
• Case rate calculated as above.
• Positivity is the number of positive molecular tests divided by the total

number of molecular tests administered.

• This is reported over a 14-day period with a 7-day lag.

Governor Sisolak’s Plan

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• Counties are evaluated based on these criteria
• 0 of 3 = Low Risk
• 1 of 3 = Growing Risk
• 2 of 3 = Moderate Risk
• 3 of 3 = High Risk
• Based on risk level, the Governor recommends various mitigation

strategies.

• It is noted in the document that for school separate criteria and mitigation

strategies apply.

• Governor Sisolak’s Directive 028, and associated Nevada Department of

Education guidance, requires school districts to monitor state and local data and to work with their local health divisions when considering changes to learning models.

Federal Incident Report & Governor’s Report

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• White House Governor’s Report had listed Nevada as in the Red Zone, but Washoe County in the Yellow Zone
• Red Zone = Greater than 100 cases per 100,000 & a Test Positivity rate at or above 10% using 7-day rolling average.
• Washoe County was Yellow because its Test Positivity rate was below the 10% threshold

Washoe County Dashboard

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August 11 Preliminarily Approved Metrics

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• Test Positivity
• Cases per 100,000 residents
• Increase in cases per 100,000 residents

Metric 1 – Test Positivity Rate

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• Test Positivity Rate → The 14-day rate of positive molecular tests.
• The number of positive molecular tests divided by the total number of

molecular tests administrated.

• Metric is reported over a 14-day period with a 7-day lag.
• This is a lagged indicator because of test result turn around times. A positive hit is

based on the date a sample is taken.

• If the positivity rate equals or exceeds 10% for two consecutive weeks,

the criterion has been met.

Data Source: Nevada Department of Health and Human Services (https://nvhealthresponse.nv.gov/)

Metric 1 – Test Positivity Rate

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• Published rates
• August 19 update – Cumulative rate 7.4%
• August 19 update – Average weekly rate is 8.7%

Data Source: Nevada Department of Health and Human Services (https://nvhealthresponse.nv.gov/)

Metric 2 – Case Rate Per 100,000

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• Case Rate Per 100,000 → The 7-day rate of positive cases per 100,000 county

residents.

• The 7-day cumulative number of confirmed cases divided by the total county

population, multiplied by 100,000.

• The metric is updated each Wednesday after Wednesday counts are updated by the

Washoe County Health Division; and

• The metric is updated daily with every other Wednesday constituting the 14-day trend

window.

• If the 7-day rate is at or above 100 for two consecutive weeks, the acceptable case rate

has been surpassed; or

• If the 7-day “rolling” rate is at or above 100 for the majority of days during the

previous 14-day window, the acceptable case rate has been surpassed. Data Source: Washoe County Health Division (https://gis.washoecounty.us/COVID19)

Metric 2 – Case Rate Per 100,000

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89.51 109.59 100.80 109.17 132.38 108.33 95.78 106.87 July 1st July 8th July 15th July 22nd July 29th August 5th August 12th August 19th

7-DAY COVID-19 "NEW CASES" RATE PER 100,000

Metric 2 – Case Rate Per 100,000

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132.4 143.9 129.9 119.0 116.1 114.2 118.2 108.3 96.6 106.2 92.4 89.5 93.1 96.2 95.8 102.5 93.3 91.0 97.5 96.6 103.5 106.9 89.5 102.7 109.0 106.5 108.5 50.0 60.0 70.0 80.0 90.0 100.0 110.0 120.0 130.0 140.0 150.0 29-Jul 30-Jul 31-Jul 1-Aug 2-Aug 3-Aug 4-Aug 5-Aug 6-Aug 7-Aug 8-Aug 9-Aug 10-Aug 11-Aug 12-Aug 13-Aug 14-Aug 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug 21-Aug 22-Aug 23-Aug 24-Aug

7-DAY "ROLLING" COVID-19 "NEW CASES" RATE PER 100,000

7-Day Rate per 100K 100 Case Threshold

Metric 3 – Increased Case Rate Per 100,000

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• Increased Case Rate Per 100,000 → Comparison of weekly 7-day rate of positive cases,

per 100,000 county residents.

• The 7-day cumulative number as calculated for Metric 2.
• The metric is updated daily after counts are updated by the Washoe County Health Division.
• Each week (or day), the 7-day rate is compared to the previous week to calculate the rate of

change as a percent of the previous weeks rate per 100,000.

• Using Wednesday to Wednesday as the 1-week windows, if the 7-day rate change is at or above

+10% for two consecutive weeks, the criterion is met; or

• If there is a 10% or greater increase after one week and the rate does not decrease by the end
• f the next week, the criterion is met.

Data Source: Washoe County Health Division (https://gis.washoecounty.us/COVID19)

Metric 3 – Increased Case Rate Per 100,000

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• 25.0%
• 20.0%
• 15.0%
• 10.0%
• 5.0%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% July 1st July 8th July 15th July 22nd July 29th August 5th August 12th August 19th

7-Day Covid-19 New Cases Rate Change per 100,000

Case Rate percent increase per 100,000 No Change Increase Limit

Metric 3 – Increased Case Rate Per 100,000

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• 40.0%
• 30.0%
• 20.0%
• 10.0%

0.0% 10.0% 20.0% 30.0% 29-Jul 30-Jul 31-Jul 1-Aug 2-Aug 3-Aug 4-Aug 5-Aug 6-Aug 7-Aug 8-Aug 9-Aug 10-Aug 11-Aug 12-Aug 13-Aug 14-Aug 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug 21-Aug 22-Aug 23-Aug 24-Aug

7-Day "Rolling" Covid-19 New Cases Rate Change per 100,000

7-Day Rate Percent Change per 100K No Change Increase Limit

Decision Making Matrix Based on Preliminary Metrics

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Metric Reporting Date (1) August 12, 2020 Reporting Date (2) August 19, 2020 Limit Exceeded Yes or No Test Positivity Rate

• 8.7%

No New Cases per 100,000 95.78 106.87 No New Case Increase per 100,000

• 11.6%

11.6% No If 2 of the 3 metric limits are exceeded, per Board of Trustees direction, all schools with noted exceptions will be shifted to full-distance learning model

Additional Data Elements

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• Strongly consider using hospitalization rates as a 3rd or 4th metric.**
• Case rate (per 100,000) among our student-aged population.
• Monitor case rates (per 100,000) using the same calculations as

are done with the total population.

• We are developing, on a school-by-school basis, an indication of

what staffing levels are required to keep a school safely operating.

• Allows planning for substitute teacher deployment.
• Provides threshold level which if exceeded would result in a

single school being temporarily shifted to full-distance.

WCSD Learning Model Implications

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** Note that under current state directives, In- Person is only an elementary school option at this time.

Full In-Person

(Elementary Model)

Hybrid

(Secondary Model)

Full Distance Safety Protocols

Daily Self-screening; social distancing; Mandatory face masks; Hygiene breaks; visual cues; Outbreak Response Plan. Daily Self-screening; social distancing; Mandatory face masks; Hygiene breaks; visual cues; Outbreak Response Plan. Staff available to support students, families, and staff with information pertaining to virus spread & testing.

Cleaning

Enhanced cleaning conducted nightly; Sanitizer available throughout school; soap and water disinfectant. Enhanced cleaning conducted nightly; Sanitizer available throughout school; soap and water disinfectant. Routine disinfecting conducted daily around staff who may be administering distance learning from inside the schools; Sanitizer available throughout school; soap and water disinfectant.

Academics

5-day a week educational programming. Limited class sizes to adhere to social distancing requirements. A/B cohort model (every other day in-person instruction / off days distance instruction). Vulnerable students attend full week. NorthStar Online School Edgenuity Site-based (On-Line Curriculum Guides)

Activities

District sponsored after school activities and extra-curricular activities are not available and will be reviewed periodically. District sponsored after school activities and extra-curricular activities are not available and will be reviewed periodically. District sponsored after school activities and extra- curricular activities are not available and will be reviewed periodically.

Food

Modified Café Service Classroom Delivery Service (CEP sites) Meals To-Go Service Modified Café Service Mobile Cart Service Classroom Delivery Service (CEP sites) Meals To-Go Service Central location distribution such as a high school.

Transportation

Bus capacity up to 50%. Face masks required. Assigned seating. Board from back, exit from

• front. Maximum ventilation.

Bus capacity up to 50%. Face masks

• required. Assigned seating. Board from back,

exit from front. Maximum ventilation. NA for school transport. Transportation may be used for material and food delivery.

Vulnerable Populations

Priority scheduling. Allowed to attend school daily. Prioritized to receive device/internet support.

Data Monitoring

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• Administrative staff will monitor trends on a daily basis.
• Administrative staff will work with the city task force and Washoe County

Health Division to refine metrics.

• Administrative staff will present trends for discussion weekly at COVID-19 Task

Force meetings and Reopening Task Force meetings.

• Administrative staff will share through Superintendent highlights, data displays

depicting trends with the Board of Trustees.

• In the event of a shift to full-distance, administrative staff will present findings

to the Board of Trustees at the next available meeting.

• Data will be reviewed formally every Wednesday with findings presented to

the Superintendent on Thursday morning. If the data prompts the shift to full- distance, full-distance learning will be implemented the following Monday.

Possible Actions

1) That the Board of Trustees approves threshold metrics, from one

• r more sources, related to COVID-19 monitoring.

2) That the Board of Trustees uses approved metrics to determine if the District must use the Full-Distance learning model or if it can remain using the In-Person/Hybrid learning models. 3) That the Board of Trustees takes action to consider how the metrics impact students in vulnerable populations.

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Thank You Questions?

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