Lincoln County Board of Health
June 8th, 2021 Public Meeting
Summary
By Sally Durham

:08 Pledge

:31 Roll Call

:48 Public Comment on Agenda Item

1:44 No comments. And public comments on non-agenda items?

2:04 Public- April 13 meeting- Reading of the minutes from that meeting, a board member said that a letter they received made false allegations. The person who wrote the letter wasn't present to defend herself. There was nothing to indicate what letter they were talking about or to whom it is addressed. I feel you owe her an apology for defamatory comments.

3:12 Board- We'll consider it. Asked questions about which meeting and whether the letter was attached to the agenda or minutes. Propose you contact Kathy for access. The letter was pulled up for the board.

6:35 Board- Have you read the letter? I won't apologize for criticizing a letter you haven't read.

Public- You names the letter writer and said she made false allegations without referencing which letter. No one can verify. Made public defamatory allegations without presenting proof.

6:58 Public- we will be challenging the appointment of someone to the board. I want an apology.

7:39 Board- I'm going to cut you off there. We established Procedure 2. We don't have personal comments. You can address the whole board, not one person. The layout of who was appointed by whom. You might want to talk to the city of Troy.

8:20 Public- He was very condescending. And he wears a mask alone in his car. That's not the mindset of a person I want in control of public policy. Treats me like I'm stupid.

10:13 Board- we will discuss your comments, but do not make personal remarks.

10:28 Public- The letter previously discussed, there was a lot of audio distortion.

11:00 Board- Counsel for Board directed her to the approved minutes and to the letter.

12:38 Approval of 4/13 and 5/12 Minutes. Two corrections have been made on surnames and typos. Motion-approved

14:24 New Business- PCR cycle threshold- Motion that when PCR test is being used in epidemiology study to justify any public health decision, the cycle threshold on positive cases must also be included and made public record.

Board discussion-

Board- threshold number is relevant to the case and situation

Board- It doesn't change if it is positive or negative. That's what matters to the people around them. I don't want to be around them, I don't care what the threshold was.

Board- Test should be yes or no, quarantined or not. If a patient wants to know, they can get it. I don't see the use of it.

Board- To justify decisions, we aren't doing epidemiology studies here locally. As a provider, it doesn't matter. We're not doing asymptomatic testing.

19:00 Board- People aren't understanding Faucci's statement. If you have a threshold of 30+, the chances of it being replication-competent are minuscule. There is very little chance that they'll be contagious or sick. At 37+, impossible to culture. If it tests positive they're just nucleotides.

Board- We discussed this at the work mtg. Jim Murphy, state epidemiologist, we'll defer to him.

Jim Murphy- State lab uses 3 tests. Each has a different cutoff value. Explains tests. prohibited from giving those numbers. Qualitative, not quantitative test. CDC guidelines.

Board- You just sent out an email saying we could get those letters, from Jim Seford.

Board- Jim Seford will retract that.

Murphy- got info from the FDA site. Low CT value important for the variant tests. It has a higher viral load or is a fresher specimen. Patient samples taken the same day can have different CT numbers. Highly variable. Regulatory violation. Positive should be treated as infectious.

Board- Why is the CDC currently investigating breakthrough cases of COVID for post-vaccinated patients. Hospitalized or death. Specimens should have a PCR threshold of 28. Why is it important for breakthrough and irrelevant for those who haven't been vaccinated?

Murphy- collecting data on breakthroughs to see if there are variants that are escaping the vaccine. We're not after every case now, just the serious ones. Variant testing on every serious case and we need a larger sample to get the gene sequencing. The higher threshold may not have enough virus to sequence.

Board- More important to be precise when looking for variant than to determine if someone is contagious and need to be quarantined and miss work?

Murphy- We need a higher quality sample for testing

28:35 Board- Any physician can request the cycle threshold and it will be pertinent along with clinical observations to make decisions on what they're dealing with.

Murphy- that's not what the experts say. Some tests don't even give that number. Not clinically significant. Tests can come up with radically different numbers.

Board- asking the board to answer, each person, knowing everything on the letter. Is everyone ok with using 40 cycles as recommended by CDC, ok with using that to quarantine people, shut down businesses, enforce mask mandates, etc.?

30:38 Board- Public comment first, then we'll vote.

30:54 Public- Deb asked a valid question and I don't know why you brushed it off. A lot of people have a concern. If 40 has a high rate of false positives, and you're using that to enact policies that destroy people's lives, then you need to understand the public wants transparency. You're talking about now after injecting people with the genetically modified gene-altering vaccine, it's been dropped. I want to know how many of the cases received the shot. There is a correlation between people who get the shot and people who get COVID. I want you to answer Deb's Question. I'm suspicious of everything. No more subterfuge.

32:38 Board- If you don't trust Fauci, why are you quoting him?

Board- Thank you for your comments

32:50 Murphy- We're concerned about false positives. and doctors are encouraged to judge results along with the symptoms and repeat testing to verify if it doesn't make sense. PCR test is the best test we have. Not perfect. Cut-off values are coming from the manufacturer. Shouldn't be the sole basis for decisions.

34:41 Board- people living together can get positive and negative results. There's no explanation why. The cycle would probably have different numbers. It would be nice to have those numbers.

Murphy- specimen quality might be a reason. CT might not be helpful. Not authorized for use in the US or worldwide.

36:36 Board- Any more comments before we move on?

Board- I think the public had a good point. There's been a lot of mistrust. Transparency would go a long way.

Board- Murphy- the numbers won't be accurate? How does a local board have access?

Murphy- not all tests have the numbers. Not recommended for determining if you're infectious.

39:40 Deb- Breakthrough cases request test with CT.

Dr. Black- Discourage the board from making CT values available. Still the best test we have. Until we have a threshold that tells us what's contagious, can't use it in the wrong way. Test results vary. It's not good judgment to use it other than a yes/no answer

42:42 How do you decide which of the 3 tests you use?

Murphy- Quick result doesn't give CT value. There are 2 machines. It's the luck of the draw which machine is available.

43:52 Of those 3 tests, do they have the same rate of error?

Murphy- they're in the 98-99% range. No test is perfect, but it's the best we have. There are false positives. We encourage providers to retest if they have doubts based on symptoms. We're trying to be transparent.

46:00 Board- I respect the desire to better understand the infectiousness and if quarantine is necessary. But we're a local health board, not experts. I think there are other things we can devote our time to. Once we know more, we might have more reliability.

47:22 Motion read once more, vote- Failed, 3-no & 2-yes.

48:00 Board- If someone is almost over covid and they get a positive test, you're quarantining them and making it to where they can't work. We might be quarantining them for 2 weeks when they only needed 3 days.

49:00 Board- We're looking at a lot of factors. We don't want to over-quarantine, but we have to protect the public.

50:15 Murphy- we no longer require 14. It can be as low as 7 days if they have a negative test but were in contact with an infected person. We hope we get better tests in the future. Love to be more surgical in the approach.

51:35 Board- This is a serious disease 634 out of 110,000 people in Montana have died. When we quarantine people, it's a deadly disease. We're

52:00 Public- I have a good friend who is dying from the shot. He was perfectly healthy when he got the shot

52:20 Board cut off the public comment, moving on to the next topic. BOard opening. Scott Bernard resigned. The opening has to be readvertised. Letter of interest due July 2nd @ 5 pm. Decision made 21st. It will be in the paper.

53:30- Questions about the appointment, and scheduling a morning appointment.

55:04- New Legislation. County Attorney- Host of bills. I sent you HB 257 & HB121- read if you like. The reach of the language causing unrelated consequences. Attorneys are having a meeting to take the 3 bills to come up with guidance to employ in every county in every health board. There isn't a consensus, yet. There's an attempt to reconcile on page 13. What that means is ambiguous. We'll come back with recommendations. It allows options. It is still a public forum. The only change is the potential review from a local governing body. We'll reach out to the commissioner once we have more info.

1:01:28 Board- We have four local bodies

Attorney- the spirit of the bill was to be responsive. There are unintended consequences and no consensus.

1:03:02 Board- I tried reading it and I was lost

Attorney- Frankly, it's not clear, it's ambiguous and there are inconsistencies. It's our hope to come up with a unified approach across all counties.

1:04:44 Program Reports

In addition to normal activities, we've added staff and protocols for Covid. Discussed licensing. Inspected 92% of establishments. More flu shots than previous years. 49 mobile flue 14 other clinics. People didn't have to mingle.

1:08:15

Preventing rabies. We evaluated all bites and it's an extensive process. 12 recommendation, doubled from last year.

Landfill- 63k visits, 11% increase. Landfill extension. Recycling numbers. 11% under budget, primarily before Covid money. Lots of information on programs.

1:11:36 Board- can you explain the rabies thing?

If someone is exposed to a bite, we do an assessment. Can we get the animal? quarantine at the shelter. Unknown cases, we recommend they treat. We monitor domestic animals. Rabies is urgent, not emergent. Severe bites get immediate treatment, especially a bite to the face, too close to the brain to wait.

1:13:56- 3 active cases of Covid. Vaccines have slowed as well.

Board- what was our highest number of cases?

Board- Have to look it up. November was the peak.

1:15:20- Board- is the county vaccinating children?

Board- 12 and up.

Board- What's the rationale

Board- Protecting the people around them

Board- What's the risk for that?

Board- There may not be any for the child, but covid is scary and harmful. They could die. As a parent, that's not a risk I would take. Beyond that, they can give it to other people that might not have a strong immune system. It is approved.

Board- It is still an experimental drug, I'd like to point that out. Do you have an update on the CDC investigation on myocarditis in youth after vaccination? VERS report- over 500 deaths after vaccines. Have those been validated?

Board- We report any death within 2 weeks after vaccination. CDC hasn't found any direct correlations.

Board- Have we had any severe reactions.

Board- 2 needed epi, and both had severe reactions in the past. No blood clots reported.

1:18:14 Board- I've been looking at VERS. People who have died 24 hrs. It's too convenient the CDC can disregard and say it has nothing to do with it. It leads to distrust and I am appalled you're pushing this at kids. What about Ivermectin and hydroxychloroquine. Safe and proven.

Board Chair- I disagree with that. Let's go on to environmental health.

Board- Excuse me. You are so dismissive. I'm sorry, but we're talking about life and death.

Chair- yes it is

Board- taking the vaccines is voluntary. They're making a choice.

Board- You didn't roll out informed consent till 3 months after it had already been in play. That's negligent.

Board- excuse me, that's a requirement of every vaccine. March 30 was a copy for the board.

Board- when did the training take place?

Board- No training provided. Consent available the whole time.

Board- Wasn't provided to VFW

1:21:00 Board chair changed topic- Solid Waste & Recycling. Wanted to notify the board that the panoramic view was chip-sealed last week. Looks great. We're continuing to work with the lot owners.

1:22:30 How long will that remedy last?

Chip-seal is a long-term fix.

Solid waste & Recycling- It would be easier to review the bill if you see the landfill. Welcome board members but can't go in a group or form a quorum. It would be great to take a couple of you at a time.

1:24:55 Report showing optimal use, human health, and environment. It's half as long as the first draft. Updated to include comments from ARP. It's hard to come up with every scenario. Any questions?

Board- wait for the tour.

1:27:09- Board- percent of the budget goes to them, it's good to know how it's being used.

1:28:09- Asbestos Resource Program- Brief overview Apr & May- 60 hotline calls with breakdown. 224 utility locate tickets with breakdown. 69 Site visits and breakdown. 4 Abatements- 2 completed. Mine tailings found when ziply fiber went in. Planned soil removal in Troy with a new property owner. Ongoing work. Potential sampling in Troy, property for sale.

1:32:49 Focus Area Liaison- Asbestos and groundwater. We don't have a liaison right now. Tabling for now.

Board- would it be possible for George to do that? (missed something, speaking off-camera) George is already invested.

Libby- no new info

Troy- Call from Mayor putting him on the BOard. Someone objected that Mayor appointed him. It didn't go through regular channels. Council mtg on 19 will decide, till then he's in limbo.

Eureka- no new information

Health Officer- what more can I say. Second-year of pandemic. We're not done with it. I've never seen a vaccine this effective and safe. Need to keep doing the things that stop the spread. This second year is still dangerous. People want it to be done.

1:38:00 Board- Physician prescribed Ivermectin at Long Term Care Facility here. 2 cases, and I was related to one so I know her situation. Not one person passed away. Quarantined. Nurses also on Ivermectin. I'm not a doctor, but we need to look at multiple options.

1:40:30 tech diff

1:41:00 I'm disturbed you talk about it as if Ivermectine isn't an option when it has saved lives. I encourage people to be open-minded. They say only right-wing radicals use it because it's not approved. But the providers aren't right-wing radicals and they are using it for covid. There are lots of drugs used for off-label uses. Let's use what's in our toolbox. No snide comments, be united. Ivermectin has been around a lot longer than the vaccine and it's actually FDA approved. To say we'll use one and not the other is contradicting.

Board- Anti-viral properties in Ivermectine, but recent studies show there is no evidence it works on coronavirus. Till there are more studies, you don't want to push this on people. Ivermectin has side effects. It's not been shown to be efficacious.

Board- We know both Ivermectine and Covid vaccines have side effects, Brad. I would think that as a physician, (Can't make it out for about a sentence) If you don't want to save lives, then fine. But physicians are using it.

1:43:58 Board- After the Ivermectin controversy, the drug board committee researched off-label drugs. Studies from India, Pakistan, & Africa. The conclusion was what Brad Black said. They said they never proved it effective. Hydroxychloroquine wasn't effective. Actually, they said it might be effective, but it was never proven effective. They didn't recommend it. These are the best scientists we have. I look at studies all the time. If you want to take it, fine, but as a health board, we can't recommend it. If you find a dr that will give it to you, more power to you.

1:45:20 I doubt the physicians prescribing it are doing it for popularity. It's not a popular subject. If they didn't think it valid, they wouldn't prescribe it. Clinics are prescribing it. And as a board, maybe we don't recommend it but I think it's a disservice when you make snide comments about it so they don't ask a provider about it. I think it's between the dr and the patient.

Board- absolutely

Board- Your comment to Dr. Black was also a snide comment.

Board- Zip it. I don't talk very often, so let me finish. You do a disservice to your constituents if you discourage them from talking to their provider by making them seem small-minded for asking. People up here ask, but some don't because there's a stigma about them being some kind of right-wing radical or religious zealot or small-minded.

1:47:00 Board- I think we can use respect on both sides. I wanted to be the first in line for the vaccine. I will not take Ivermectin. It's for parasites for horses. I will not take Hydrochloroquin, it's unacceptable and at toxic levels, way too dangerous for me. I will take the vaccine and I want to be respected for my decision also.

Board- I have nothing against you and I've never discouraged anyone from taking the vaccine. But just as your comment said, it's for parasites in horses. That's not entirely true. They make Ivermectine which's human grade. Those are the kinds of comments I'm talking about that cause division.

Board- And telling me to zip it doesn't cause division? Saying Dr. Black doesn't want to save lives? He took an oath. He goes by science and is speaking as a medical professional. If other providers want to offer it, let them offer it.

Board- I never said he didn't want to save lives and I told you to zip it because you interrupted me while I was still talking to you.

Board- your voice cut out and I thought you were finished.

Board- we are having a problem with the zoom. The microphone in Eureka gets louder and softer.

Board, I thought you were interrupting. And I'm just saying that when you cause people to be averse to asking, you really could cause them to lose their life.

1:49:25 And there are two sides to every comment.

Board whispers to chair

Chair- say it louder

Board- Motion to adjourn

Board- second.

Board- any comments?

Board- next meeting July 20. There are applications to review, so normal mtg.

“With men this is impossible; but with God all things are possible.” - Jesus Christ, Matthew 19:26