Health board moving forward on possible restrictions

The Hill County Health Board approved Wednesday taking steps to slow the spread of coronavirus in the county if the residents do not slow the spread themselves.

"Our rate of cases is climbing at a pace where we can't keep up,"Hill County Public Health Director and Heath Officer Kim Larson said. "Our health care system and our public health system are not keeping up and we need to do something."

The health board Wednesday approved the health department's plan to possibly implement more restrictions on the county in response to the recent surge in COVID-19, and reviewing a proposal by Hill County Sanitarian Clay Vincent to address businesses that refuse to comply with current regulations set forth by the state.

Larson said the restrictions will be implemented if the county's number of new cases is at or above an average of 50 per day per 100,000 residents - .05 percent of the population - which calculates to about 58 cases per week, during the week of Oct. 26, next week.

Hill County is currently seeing an average of much more than 100 cases per day per 100,000 residents, more than double the goal.

Larson said recent clusters of cases have been associated with schools and large events where people did not take public health guidelines seriously, as well as people going to work when sick.

She said the county has a 31 percent positivity rate, meaning 31 percent of tests come back positive for COVID-19.

She said anything over 5 percent is troubling and 10 percent is the danger zone.

Despite the situation, which she has described as dire, she said she's not in favor of shutting down businesses across the county.

"I don't want to do a full shutdown, I don't see that as a sustainable approach," Larson said. "COVID-19 is not going away any time soon."

While Hill County Commissioner Mark Peterson has also expressed opposition to closing down businesses in the wake of the surge, he said whether these restrictions get implemented will be up to the people of Hill County and whether they can get the county's numbers down.

"The public has a choice; they can either help us get the numbers down... if they don't, they're going to have to take what we give them," Peterson said.

The restrictions approved if the rate doesn't drop include social gatherings being limited to no more than 25 people, regardless of the ability to socially distance, as well as limiting restaurants, bars, distilleries, breweries and casinos to 50 percent capacity.

The restrictions would be in place for one month, after which the new cases average will be assessed, and the continuation of restrictions will be determined based on whether the average is below 50 per day per 100,000.

The need for further restrictions may be necessary if the county does not see a decrease in cases, Larson said.

Vincent said many people in Hill County, the majority, are doing a good job of sticking with the guidelines, but this is an unprecedented situation and many people are no doing enough, or are outright refusing to abide by public health.

He said his office has received several complaints about businesses and individuals in them who are absolutely refusing to wear masks, and no matter what the department does they will not comply.

"We've tried education, we've tried talking to them, we've tried begging them, we've tried everything in the world but there is no response and they are absolutely not going to do it," he said.

Vincent said people are dying because of this virus and he can guarantee that many cases have come from businesses not complying with public health, which he said has the power to enforce these guidelines if needs be.

Vincent proposed the creation of signs to be put on non-compliant businesses doors to make it known to the public that they are a risk to their customers' safety.

"This is what the health board is for in this community," he said. "... These aren't ideas or suggestions, these are rules that are enforceable under a court of law and they are there for a reason. We really haven't had to use these because we've never had a situation like this before, but if we don't use them then there's no real reason to even have a health board."

The signs would read "Attention. This business is refusing to comply with the state of Montana's mandate for wearing face masks and social distancing. The Hill County Health Board has the authority under 50-2-116 MCA to protect the public health. Complaints have been made to the Hill County Health Department. Because this business refused to comply with the state mandate and help protect employees and customers from COVID-19, this notice must stay posted on the front door of the business."

Vincent said if the sign is removed by the owner, they must attend the next meeting of the health board and explain why they are exempt from the mandate to protect public health.

If they then decide to begin complying the health department, Vincent said the department will be happy to take the sign down again and work with them to get things in order.

He said he didn't want to just take business owners to court and described this measure as a middle ground between that an no enforcement at all.

Hill County Attorney Karen Alley said she wasn't able to comment on Vincent's proposal until she had a chance to examine it in more detail, but she said Larson's plan was legal and in keeping with her role as health officer.

"This is well within her rights in order to contain the spread of infectious disease," Alley said.

She said she will review Vincent's proposal.

The health board voted to move forward with restrictions if the number of cases does not drop and to review Vincent's proposals.

Hill County Commissioner Diane McLean being the only one to vote against the proposal.

McLean faced technical difficulties during the meeting and wrote in the chat: "This may in fact spark even greater polarization of public, less compliance with current directive ... It seems unenforceable."

During the meeting the board also discussed ideas for greater community engagement with public health.

Board Member Kristi Kline said enforcement of the mask mandate was the big one, but that is only part of the issue, and that they need a community effort to make things work.

She suggested that the health department coordinate with groups like the Havre Area Chamber of Commerce, the Hi-Line Tavern Owners Association to facilitate that.

Local nurse Kris Martens said she wants to see the health department engage in a sort of marketing and communication effort to encourage people to do the right thing for their community, something she said she's seen work in other states.

She suggested the department take advantage of talented graphic design and marketing students at Montana State University-Northern for this effort.

Martens also suggested that the department simplify the data it puts out into the public so people can understand it more.

"I know public health said it's dire, but what can I compare that too? What is my risk?" she said.

She also suggested that the department loosen requirements for contact tracers to further bolster their workforce and start reporting which individuals in the community have been infected and the location of hotspots.

"I think we've got to lose this attitude of not disclosing information about infections," she said " ... I think it's basically a disservice to our community to not be open about who has got the disease and where it's at."

Larson said that, due to state and federal laws and regulations, the health department generally cannot release personal information about who is infected.

Larson said the marketing suggestions were helpful but the way the department reports data is standard throughout the country and the department cannot legally release personal information about those that are infected due to the Government Health Care Information Act.

During the meeting, the board also elected new officers. Peterson was elected chair and board member Erica McKeon-Hanson as vice-chair.

Both appointments were unanimously approved and will begin Jan. 1, 2021.

The next quarterly meeting for the board of health will be Jan. 20 and the board's next COVID-19 update will be Friday at 1 p.m.