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2020-04-20 Regular Meeting NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 505 ASSEMBLY The New Hanover County Board of Commissioners met in Regular Session on Monday, April 20, 2020, at 9:00 a.m. via teleconference in Wilmington, North Carolina. Members present: Chair Julia Olson-Boseman; Vice-Chair Patricia Kusek; Commissioner Jonathan Barfield, Jr.; Commissioner Woody White; and Commissioner Rob Zapple. Staff present: County Manager Chris Coudriet; County Attorney Wanda M. Copley; and Clerk to the Board Kymberleigh G. Crowell. APPROVAL OF CONSENT AGENDA Chair Olson-Boseman requested a motion to approve the Consent Agenda as presented. In response to Board questions regarding the public comment section of the April 6, 2020 minutes, Clerk to the Board Crowell confirmed that the public comments submitted via email were copied into the minutes as submitted. Very minor edits were made in order to preserve the record of how the emails were submitted. The emails will be reviewed again to see if further typographical errors made by the citizens can be corrected without changing the content before the minutes are finalized. Hearing no further discussion, Chair Olson-Boseman asked for direction from the Board on the Consent Agenda as presented. Motion: Commissioner Zapple MOVED, SECONDED by Vice-Chair Kusek, to approve the items on the Consent Agenda as presented. Upon vote by roll call, the MOTION CARRIED: Voting Aye: Chair Olson-Boseman; Vice-Chair Kusek; Commissioner Barfield; Commissioner White; and Commissioner Zapple. CONSENT AGENDA Approval of Minutes – Governing Body The Commissioners approved the minutes of the Regular Meeting of April 6, 2020. Approval of February 2020 Tax Collection Reports – Tax Department The Commissioners accepted the Tax Collection Reports of New Hanover County, New Hanover County Fire District, and New Hanover County Debt Service as of February 2020. Copies of the tax collection reports are hereby incorporated as part of the minutes and are contained in Exhibit Book XLI, Page 8.1. Adoption of Budget Amendments – Budget The Commissioners adopted the following budget amendments which amend the annual budget ordinance for the fiscal year ending June 30, 2020:  Various 20-055  Sheriff’s Office 20-056, 20-057, 20-058, 20-059, 20-060, 20-061  Health/DSS 20-062 Copies of the budget amendments are hereby incorporated as part of the minutes and are contained in Exhibit Book XLI, Page 8.2. REGULAR ITEMS OF BUSINESS COMMITTEE APPOINTMENTS Appointments to the New Hanover County Special Board of Equalization and Review Chair Olson-Boseman reported that seven vacancies exist on the New Hanover County Special Board of Equalization and Review with seven applications available for consideration. Commissioner Zapple nominated Fred Gainey, Hector R. Ingram, Diane M. Karr, Mike Musselwhite, and Christopher G. Stewart as regular members, and Lisa Campbell and Gloria M. Green as alternate members. Commissioner Barfield nominated Gloria M. Green as a regular member. After a brief discussion regarding the applicants, Commissioner Zapple amended his nomination of applicants to appoint Gloria M. Green, Hector R. Ingram, Diane M. Karr, Mike Musselwhite, and Christopher G. Stewart as regular members; Lisa Campbell and Fred Gainey as alternate members; and to appoint Hector R. Ingram as Chair of the Special Board of Equalization and Review for the ensuing year. Hearing no further nominations, Chair Olson-Boseman called for a vote on the nominations on the floor. NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 506 Motion: Commissioner Zapple MOVED, SECONDED by Commissioner Barfield to appoint Gloria M. Green, Hector R. Ingram, Diane M. Karr, Mike Musselwhite, and Christopher G. Stewart as regular members and appoint Lisa Campbell and Fred Gainey as alternate members on the 2020 Special Board of Equalization and Review to serve one-year terms with terms expiring March 31, 2021, and to appoint Hector R. Ingram as Chair of the Special Board of Equalization and Review for the ensuing year. Upon vote by roll call, the MOTION CARRIED: Voting Aye: Chair Olson-Boseman; Vice-Chair Kusek; Commissioner Barfield; Commissioner White; and Commissioner Zapple. PUBLIC COMMENT ON NON-AGENDA ITEMS Chair Olson-Boseman reported that no public comment voicemails were received and three public comment emails were received, and asked that those be read into the record by staff. Deputy Clerk to the Board Dahria Kianpour read aloud the following public comment emails, as submitted, into the record:  Dixie Dobyns, resident of the Wrightsboro community, emailed the following: “Dear Commissioners: One of the things that would be good to know is the location of confirmed COVID cases. Last I heard NHC had 50 or so cases. NHC has declined to give specifics of reported cases due to privacy concerns. I understand this. But why can’t GIS show on a map where confirmed cases have been found? As (if) testing becomes more available, GIS could prove to be another tool to help us determine hot spots. Sheltering in place, Dixie Dobyns Wrightsboro 28429”  Emily Donovan, resident of Winnabow, NC, emailed the following: “There are efforts underway to provide decompression relief to Good Shepherd Center and Salvation Army shelters by offering approx. 50 hotel rooms. Last week, it was reported FEMA will pay 75% of funds needed for Governor Cooper to establish hotel/motel/dorm rooms for populations needing quarantine space. Included in the reporting was the following statement: “People needing social distancing as a precautionary measure, as determined by public health officials, particularly for high-risk groups such as people over 65 or with certain underlying health conditions such as respiratory illness, compromised immune systems or chronic disease. This may include those whose living situation makes them unable to adhere to social distancing guidance.” https://www.newsobserver.com/news/coronavirus/article241852641.html Based on this News & Observer article it appears additional funds are now available to expand the motel sheltering efforts the City of Wilmington, New Hanover County, and generous community groups organized last week. Encampments of unsheltered residents clearly encompass the statement “those whose living situation makes them unable to adhere to social distancing guidance.” Many living in these unsheltered encampments do not have access to basic hygiene opportunities, share food and drink items which can increase communicable viral infections, and often need to travel regularly in group transport situations to find basic needs. What plans are being put in place to address the growing number of unsheltered people residing in encampments served by Vigilant Hope, First Fruits, and Walking Tall Wilmington ministries? Is the county proactively working with these community leaders to track the needs and increase hotel/motel/dorm capacity to include encampment residents? How is the county working to supply food and basic necessities to the community groups supporting and ministering to these vulnerable population? I appreciate your leadership and thank you for your time and attention to this important topic. Emily Donovan 130 Emberwood Dr. Winnabow, NC 28479”  Dr. Robert Parr, resident of Wilmington, emailed the following: “Public Comment Non-Agenda Item County Commission Meeting Monday April 20, 2020 Thank you Commissioners, staff, employees, and volunteers of New Hanover County for the vital work you are doing at this time. COVID-19 is not the first emergency that you have guided us through - and probably not the last. It is reassuring that you folks are there to make the hard calls and get us through to better days. Without distracting you from your duties, I would like to respectfully request your consideration on a matter of public policy. While the Planning Board and County Commission have paused development meetings, citizen input in the planning process through the Citizen Information Meeting has been substantially diminished. Rather than pausing the Citizen Information Meeting, NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 507 the meeting has transformed into a series of random, disconnected phone calls. The Citizen Information Meeting is the main avenue for allowing early, effective citizen input in the planning process. The Citizen Information Meeting establishes the framework for shared information, shared discussion and when necessary shared negotiations. The value of the meeting often begins as the session concludes and citizens, development staff and attorneys exchange contact numbers and are advised to “call me and we will discuss this further before the Planning Board Meeting." These discussions streamline the Planning Board and County Commission Meetings that follow. In emergency situations it is appropriate and necessary to keep the system up and running at all costs - but as time permits it is reasonable to consider taking another look to perhaps find more effective solutions. For your consideration: 1. Include the Citizens Information Meeting in the same temporary pause being used for the Planning Board and County Commission development meetings. 2. Consider having our Information Technology Department assist developers to arrange teleconferencing for their Citizen Information Meetings. Zoom or other widely used platforms are available to preserve the vital meeting format in these times. Thank you, Dr. Robert Parr” ADDITIONAL AGENDA ITEMS OF BUSINESS Commissioner Zapple asked County Manager Coudriet to comment on what the County was doing to address the need for widespread COVID-19 testing and if there was a plan for more swab and re-agent sample kits and personal protection equipment (PPE). County Manager Coudriet stated that sample testing and lab results have proven to be the single biggest challenge in this event primarily because of the access to raw materials to build the sample kits. He has seen some information suggesting private labs are operating at 30% capacity. It is not necessarily an inability for labs to test, maybe time is an issue. County staff is putting a plan together that is a two-pronged approach. First, continuing the work staff has been doing since the onset of the event of acquiring materials to build our own sample kits. However, it would be difficult to achieve this on our own on a significant scale. To date, through the Public Health deployment teams, 22 samples have been done using kits that have been built exclusively by staff. There is capacity today to do an additional 50 samples and more is being built every day. Staff is also working with community leaders to secure swab and re-agent sample kits to perform testing on a scale of approximately 10,000 to 12,000 tests. The minimum standard of testing considered to be a decent read on the pervasiveness of the infection in the community is 158 people per 100,000. At a minimum, 375 tests need to be done primarily focused on people who are symptomatic to get an indication of how wide-spread it is or not. Currently, the County could not do the minimum standard of 375 on its own. Staff believes 10,000 to 12,000 tests is a better read on the amount of needed materials. A plan has been put in place that would allow for between 500 and 800 tests a day. Testing would run from 10 to 12 days if 10,000 to 12,000 sample kits are received. The second part of the issue are the actual lab results themselves. The team is going to continue to use the state lab. Efforts will also be made to continue trying to procure contracts with private labs, not only in the state but around the country, that can do a timely return on any number of tests that are drawn. Ideally, it would be a turnaround time of 48 hours or less and that will depend on how far out the tests are sent and to get the results back. There are only 13 labs in this state authorized to do this kind of sampling. Public Health deployments are continuing when people are identified as needed. Commissioner Zapple expressed appreciation for the information and the work being done by everyone. He then asked if the County has the financial ability to pay for the needed materials and lab testing. County Manager Coudriet stated those aspects are being worked through and again, staff is working with community partners to secure as much of the material for sample testing at little to no cost. The County will handle the cost of the test results, which is why the team is working with a range of labs. The County will continue to send samples to the state lab and he is not aware of any cost for those lab results, but that site would not have the ability to do anything specific to us on this scale. He is not aware of any community in the state that is trying to lean as far forward as the Board has staff doing on this event. The County is effectively working independent of the state at this point and the state is facing similar challenges. There are 5.5 million test kits the federal government is sending out and the states will have to determine how to allocate the kits within their communities upon receipt. Again, staff is working to build the County’s own capacity. As far as PPE, he is not speaking to what New Hanover Regional Medical Center has as the information is considered confidential, but from the County’s stock specifically, the County is supplying first responders, long-term care facilities, etc., and has approximately 25,000 N-95 masks and 152,000 surgical masks on hand. It is felt the County is in good shape on this front. The surgical masks are for less robust protection, but are still viable and have been made available to every County employee not working remotely. Although some are working from home, the majority are not. 1,200 to 1,400 reusable cloth masks have been disbursed to County employees on the front line or working in group settings and this preserves the 152,000 surgical masks for a long period of time. The County also has approximately 1,256 surgical gowns on hand as of the end of last week. As to whether the budget amendment passed at the prior meeting to cover the costs related to COVID-19 is enough at this time or if there is a need for more funds, County Manager Coudriet stated he would like for the Board to hold off on considering the approval of additional funds until staff gets more clarification on what the costs to the County will be. It is fair to say when the County moves forward with its own aggressive testing as described earlier there is not enough funding in the current budget arrangement. The Board has led the County to have a good fund balance position and staff can cash flow anything until the Board convenes for another meeting. Chief Financial NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 508 Officer Lisa Wurtzbacher stated roughly $350,000 to $400,000 of the referenced budget amendment has been spent for invoices for goods that have been received. She does agree with County Manager Coudriet that it is unknown fully what the cost of expanded PPE and testing will be. There are a number of outstanding purchase orders for other items that were ordered. If those items do not come through, the purchase orders can be liquidated to allow for flexibility in what is available right now. Commissioner Barfield stated he wanted to recognize Dr. Damian Brezinski who made available a software program to make N-95 masks via 3-D printers. The New Hanover County School Superintendent was contacted about the ability to use the 3-D printers in the school district to make the masks. The school district agreed for the printers to be used and the school district is able to print approximately 30 N-95 masks a day. The masks are being deployed by the hospital and other providers in the community. He also recognized Parks and Gardens Director Tara Duckworth for installing signs at the parks encouraging social distancing and that citizens walk in one direction. He is amazed to see people ignore the signs and still do whatever they want regardless of other people’s personal health. He shares with people why they need to go in one direction. With stores starting to open up, it is important for those to be monitored by Public Health to be sure social distancing is being practiced. County Manager Coudriet reiterated the County is working to get testing on the scale described earlier and while there is no guarantee of the County’s ability to pull it off, he thinks it is highly probable that the County will be able to pull off the standard of 158 tests per 100,000 people. Again, that is the minimum threshold reported as being a predictor to some degree of rates/incidences of infection across the community. He believes the specific number of cloth masks deployed to County citizens and partners, because the County is working with the municipalities as well, is approximately 1,524. There are several hundred left because after a number of uses the masks will fail, even after proper maintenance, and the County will have to replenish them. The County has been fortunate to find contract providers and people in the volunteer community to build the inventory for reusable cloth masks. As to the plan for a phased reopening of non-essential businesses in the County and its current status, County Manager Coudriet stated he could provide a high-level overview. As it relates to a reopening framework, there are four large community conditions that the team is looking for in order to make recommendations to elected officials. The first is that there is a high confidence that the rate of infection in the community is low. As of this morning, the County only has 68 validated cases. The problem is that staff does not have insight into clinically diagnosed cases. While the appearance on the surface is that the rate of infection is low, and is a key consideration the team would ask elected officials to think about, the surveillance system at large is not penetrating as far as it should. There is no good proxy to identify every diagnosed case and what is the predictable, statistically valid number of other cases that are asymptomatic. It is also unknown if a person is symptomatic but not diagnosed in anyway. The second condition being worked on by the health team is to get a read on the clinically diagnosed cases in our community. While it is not a reportable number yet to the state, the health team is working with healthcare providers to have a system in place where physicians report to the County that they have clinically diagnosed a patient with COVID-19. This means no testing was done, but a patient seen by a physician has all of the appearances and symptoms of COVID-19. The first set of data was due back on Friday, he thinks, and the information should be relayed in the next day or so and provide a sense of how far clinical diagnosis has gone. These are the two conditions, out of the four, that are probably less firm that staff would ask the Board to think about. County Manager Coudriet stated that on the other two parts, he feels the County is in really good shape. One is a public health system that can react well to increased incidents of diagnosis, most specifically the ability to do contact tracing. Whether a person is diagnosed via a lab test or clinical diagnosis, it is important that the health team does its level best to determine what proximity the person had to others so those people can be reached for testing or other evaluations. The final part is having a hospital system that can react to a scaled set of incidents with COVID-19 patients. The hospital is in excellent shape on that front. The system can certainly accommodate the influx of more people who have the disease severe enough to need hospitalization. He knows on Friday for only the second time, staff reported the rate of COVID-19 hospitalization being at eight. There is no assignment of where the persons are from as staff does not know. That number was down from 12 or 13 earlier in the week that Chair Olson-Boseman spoke to during her public comments. It has been shared with the hospital that on occasion information will be shared with the community on the number of COVID-19 positive cases and how many are hospitalized, so our community has a sense of how well prepared the hospital system is right now. These are the four pieces that the Board’s team thinks are necessary to be able to make recommendations to elected officials. As to a plan for phased lifting of restrictions at the local or state level, County Manager Coudriet stated the way the reopening framework is built, noting that elected officials can examine it at any point in time, it is predicated to follow along with the Governor’s order and local orders that currently sunset on April 29, 2020. If decisions are made earlier than that as local orders are rolled back, there has to be overall compliance with the state order. If the Governor were to extend any form of the order into May and the local orders were repealed, there would still need to be compliance with the Governor’s order. The priorities as identified, keeping in concert with what the Governor has in place, the elected officials would be encouraged to re-examine the carry-out food services and marina stores. As the Board knows, restaurants and bars are closed but are open for takeout and the local order went further than the state order with takeout being possible, but it is curbside pickup. That would be something that could be looked at to rollback, but still in keeping with the state order that restaurants are closed for dine-in eating. Marina stores, while closed, could be rolled back as well. Another priority to rollback would be outdoor team sports facilities and our public gardens. The local order went further to restrict the collection of sports that are considered team sports, so the fields have been closed. If the Board rolled that back, there would still need to be compliance with the Governor’s order of not more than 10 people congregating. Again, the local order closed public gardens and of note, NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 509 tennis was rolled back a week ago today. The third priority would be beach openings in a phased approach. The Town of Wrightsville Beach has moved forward with phase one of the reopening by opening beaches for non- congregate use. The second phase of that would be opening for full use access. The fourth priority to rollback, which is currently further than what the Governor has done, would concern hotels, motels, and short-term rentals. Those are currently closed except for those providing service in response to COVID-19 or other essential businesses and nonprofits. Those are the four things that the team thinks the elected officials could rollback at any time, but the best evidence would suggest doing so after this two-week period expires on April 29th. Vice-Chair Kusek stated that the number is 68 validated cases as of this morning. As a percentage of the County’s entire population, that is .000289. Even if that is multiplied by six, it comes to .001736. She asked County Manager Coudriet what does the threshold number need to be under in order to have our additional restrictions sunset April 29th for this County. Commissioner White stated that his understanding of implementing the extra measures was to address the capacity at our local health facilities, not to prevent the spread of something that is unpreventable. If there has been no curve that has manifested itself, and Vice-Chair Kusek statistically pointed out there has been no curve, then by definition it is already flat. He asked that County Manager Coudriet respond to Vice-Chair Kusek’s question in this context. County Manager Coudriet stated in his opinion, Commissioner White is framing it accurately in that the measures locally and statewide were done primarily to prevent a run on healthcare systems and hospitalizations. The data suggests we do not have that, which is good. As to Vice-Chair Kusek’s specific question, he does not know that there is a specific number or percent. He does not know that anyone on the team would say at a specific threshold whether it is wise or not. He thinks from the calls staff have been part of there is some belief that the numbers continue to rise in the aggregate across the state. Whether or not we have reached the peak, he thinks is a matter of debate with the epidemiologists in the hospitals. In looking at the data being presented, the elected officials can rollback any or all of the restrictions and have discussions at any time. He thinks as the team gets a read on the clinically diagnosed the number will increase, but does not know to what percent is it okay to do. All he can speak to are the areas around us, in and out of the state, that are comparable in size that have, in his opinion, significantly more cases than us. The data he has, except for New Hanover County, is from last Friday. As compared to here, Cabarrus County with a population of 211,000 has 191 cases and Union County, which is almost equal in size to us, has 112 cases. Commissioner White asked if it was correct if both of the referenced counties are near hot spots and if County Manager Coudriet saw that as a relevant fact. County Manager Coudriet responded that he does see that as relevant, but he also knows this County has density issues that are very different than some of the other places. New Hanover County has 235,000 people living within 199 square land miles. He personally, and therefore professionally, believes the mitigation that has been done above and beyond the state order perhaps is having some effect. In looking at Horry County where the orders were issued later than here and is similar in population, there are 185 cases and we have 68. However, the measures themselves have not solved the problem. Commissioner White asked County Manager Coudriet how does he know what their percentage of testing is compared to ours, which is the relevant dominator if he has that opinion. County Manager Coudriet stated that he does not know. Commissioner White stated he should then not have that opinion and asked how he could have the opinion that the measures have mattered if he is using Horry County as a comparison and not know the number of tests done there versus us. County Manager Coudriet responded that he is looking at the raw case number. This County looks very different as compared to its peer counties except for Buncombe and Onslow. Their cases are significantly less than ours, and he does not know the rate of testing there, nor at Pitt, Gaston, Union, Orange, or Cabarrus, which as of last week are at a higher rate, but it is an opinion that the measures are having some effect. Commissioner White stated his understanding is that the extra measures were taken at the insistence of local health officials, our Public Health department being a part of that effort, to flatten the curve to address capacity at the hospital. It was not to prevent the spread of a disease that even the best doctors in the world have no real understanding of its rate of spread because of the lack of knowledge on its origin, how fast it spreads, and in what communities it spreads. Those are things unknowable. When the Board was told by Public Health staff and people at the hospital that these extra measures were necessary, it was done because of fear of hospital capacity and the inability of the hospital to address that capacity. We now know the fear is no longer valid with eight people in the hospital. If that was the purpose we were serving, it has been served. Reasonable people can disagree on what is the cause of that happening, which is fine, but it is a fact. Commissioner White asked County Manager Coudriet what would be the justification for extending the orders past today or any time. County Manager Coudriet responded that he cannot speak to extending the orders th past April 29. There have been no discussions at this point with any of the elected officials about doing that or not. The Chair, Vice-Chair, and Mayors committed that on a weekly basis, they'll examine their current order. He is not suggesting or saying that what is in play has to continue or should continue past April 29th, rather he is presenting the evidence that is before him based on the questions from Commissioner Zapple. He is not offering an opinion as th to whether or not the County and the municipalities should today decide to continue past April 29 or decide to eliminate. He is only trying to articulate the conditions in the community that are best suited to begin to roll some of these back. Again, it is absolutely the decision of the elected officials on what to do. He hopes no one is hearing him advocate that we continue down this path unfiltered without serious debate. Again, he is just trying to present the information as it is known today. NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 510 Commissioner Zapple stated that Commissioner White makes good points, but it seems to him there is a large, separate group of clinically diagnosed people that we do not have a number on within our community and aggressive work is being done to obtain that information. As to whether the number of cases will change considerably when that information is received, County Manager Coudriet stated he does not know how or to what scale it might change the number. It is accurate to say that the team is working with healthcare providers to determine how many people they have clinically diagnosed, and where the team can get specific data about the person to do their best to do contact tracing. To the team’s knowledge, this is the most aggressive effort in the state to obtain the number of clinically diagnosed patients. While it's a communicable disease, there is the expectation it is to be reported to the state by providers and the best evidence suggests that is not happening because people are working hard on the front line. Commissioner White asked Commissioner Zapple why is that a relevant data point. If the purpose is to flatten the curve and maintain hospital capacity for sick people, and with a local fatality rate of one person deceased, why is the non-clinical data source important in policymaking decisions? Commissioner Zapple responded that for him, he does not believe there is a full grasp of how much COVID-19 has affected our current population. Commissioner White responded that while he agrees with that, there are eight people in the hospital. He asked why does that matter in terms of policymaking, in terms of rolling back or putting more restrictions and why is that relevant; and what if it was found that we had 350 confirmed cases tomorrow with the non-lab, or more, what would that do? Commissioner Zapple responded it could be that or it could be less as well. He thinks it is important to have the data points because it is unknown what percentage of those could turn into hospital visits or worse. We have no idea how much COVID-19 is throughout our community, plus the secondary issue of spread. He also thinks the testing or getting a handle on this clinically diagnosed cohort will begin to provide a picture of where our own hot spots are within the County’s 199 square land miles. Areas may be identified with more specific data through the process of contacting those people and also performing the contact tracing to find out who is healthy or has already had COVID- 19 for the process to start of getting people back to work. While he believes he is on the same page as Commissioner White, he is only asking for more data because he wants to be sure if we begin to reopen, we go forward on the path of reopening and not reverse ourselves when there is a second wave. Commissioner White stated that he does not disagree. He thinks more testing is better than less and thinks there is unanimity on that. However, this County is not unique and every state, county, and municipality in the country is struggling with the rates of testing, how soon or late the testing started, etc. Meanwhile, cases are moving on, people are sick and recover, and we'll never know that information. The strongest data points we were told by public officials 30 to 60 days ago, because we do not really know all of those things, were hospitalizations, ICU admissions, and access to ventilators if needed. Now that we have the data which is moving in a positive direction, while testing is important and he supports more testing to identify hot spots quicker, he does not see the nexus between that and rolling back restrictions on commerce, etc. because if these people are sick, they are presenting themselves and if they meet the criteria they are being admitted to the hospital. We are seeing that trend line, he is not sure it ever got above 15, but it has certainly been cut in half over the last 12 days. It can be argued later about why that is, but those are the facts. We are never going to prevent it from moving around 100%. It has moved around despite the greatest measures in government that have been taken. If we know we have flattened the curve and have 335-plus empty beds at our local hospital, then why are we waiting to rollback restrictions and are we waiting for more tests or more hospitalizations? Commissioner Barfield stated he does not have an answer to Commissioner White’s questions, but there is great diversity between the five Commissioners and staff in terms of thought processes and everyone’s opinions are based on where we come from and what we see. He sees a community of people where some are engaged and care, and to some extent he also sees people that do not care about other people's health. They only care about what is important to them. As for him and his house, he is trying to do social distancing and follow the protocols so he does not get himself sick. From the time his daughter returned from being in school in Italy to four weeks later, approximately 10,000 people died in Italy. He thinks the preventative measures that have been put in place here have been done so that we do not have numbers like New York City and were done in an effort to be proactive as opposed to being reactive. He understands the need for businesses to open and that a lot of people in our community are struggling financially. His heart goes out to the people trying to figure out how to feed their families. Unemployment is through the roof and he is hearing from people that they cannot get online to get an unemployment check and are trying to figure out how to take care of their family. We have a tough decision on how to reopen and move forward, recognizing folks cannot go on forever without income coming in. Commissioner Zapple stated that he would like add to one of Commissioner White’s questions. Again, the healthcare experts have said that the virus has a 10 to 14-day incubation period. We have seen repeatedly that th anything done should have a two-week timeframe involved and again, there is nothing magical about April 29. To him, that will allow time to gather more data to see if any of the clinically diagnosed cases get worse, and if there is an uptick. A number of models have told us the County is either at the peak now, or projected to be in the peak soon, or saying the peak was last week. Clearly the healthcare professionals are all over the map about the peak. Time is on our side as far as waiting and pausing so we do not have to go backwards if a major uptick is seen in hospital admissions or if there are deaths involved. Commissioner Zapple asked County Manager Coudriet if there was a monitoring model in place for assisted living and skilled nursing homes. County Manager Coudriet stated that the County is not doing anything different or unique around its own operational monitoring. Unless something has changed over the last couple of days, there NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 REGULAR MEETING, APRIL 20, 2020 PAGE 511 has not been an outbreak in any facility as in other counties. The best effort in regard to what the County is doing about mass testing, is how potentially the County could have the most effect by taking samples from people from a diversity of places and demographics in our community. There is no a specific plan that mobilizes health teams to go into these facilities for testing above and beyond what is currently happening. Commissioner Zapple stated one issue that has arisen frequently in other areas due to shortages and lack of policy by individual assisted living and nursing homes, is the staff not wearing PPE and that can become a conduit for different patients stuck in that universe. He asked if Public Health could reach out to check on PPE availability for staff in facilities in this County, as well as to check to make sure it is part of their protocol to wear PPE throughout the day. County Manager Coudriet responded that Public Health is in communication with our long-term facilities. As it relates to our N-95 masks, the County is the supplier for, if not all of, the majority for the long-term care facilities. There is a relationship there with information sharing and providing counsel and advice, but there is no specific testing, monitoring, antibody tests, etc. for those facilities. He is not sure the County has a regulatory authority to monitor and inspect and hold the facilities accountable to using PPE, etc. There are specific state orders in place governing access, etc. He takes Commissioner Zapple’s point to mean that there may be a gap on that front and the team will redouble its efforts above and beyond what is currently being done. ADJOURNMENT Hearing no further discussion, Chair Olson-Boseman thanked the County staff for their tireless work in responding to COVID-19 and working diligently to protect the health of our residents. She looks forward to expanding our knowledge of COVID-19 through more testing in our area and working with our community to reopen. We are all in this together, we are resilient, and we'll get through it together. There being no further business, Chair Olson- Boseman adjourned the meeting at 10:07 a.m. Respectfully submitted, Kymberleigh G. Crowell Clerk to the Board Please note that the above minutes are not a verbatim record of the New Hanover County Board of Commissioners meeting. The entire proceedings are available for review and checkout at all New Hanover County Libraries and online at www.nhcgov.com.