Lincoln County Board of Health
October 12th, 2021 Public Meeting
Summary
By

0:0 - Pledge

0:39 - Roll Call & Review of Agenda & Minutes from the last meeting

3:21 - Board- Requested addition to agenda, what is the plan for COVID? Dr. Rice wanted thoughts about a plan for going forward. Jim’s report from Troy- discussed COVID Vaccination. Prevention options.

6:55 - Motion to accept minutes- unanimous

7:24 - Public Comments- questions process explained. Action items allow comments. Adjustments to how the agenda is Written.

Public- Libby- History has born out absolute power corrupts absolutely- the country is the most divided it's been since the 1800s. Everyone should be encouraged to have comments, especially at the end of the meeting after they’ve heard everything.

10:20 - Board- We’re doing the best they can. We don’t want another 51 people dead, current numbers. We want to hear from the public.

12:12 - Board Discussion of the current COVID plan.

Board - I had COVID pneumonia and nearly died. Description of illness. Referred to the meeting when Dr. Rice brought up what COVID plan. We’ve been doing this for 2 years. I think we should know what the plan was, review where it is now, and adjust accordingly.

13:30 - Board- Lincoln County Pandemic Influenza Response Plan 2019, January. They have 3 plans on the website but could not verbalize what was in them.

Board - We do have access to the Strategic national stockpile at Logan Health. 12 around the country. Unclear if there are anti-virals stockpiled for COVID.

15:57 - Plan 1 was made before the pandemic. It has not been updated.

Board - Requested that the plan be sent to board members and it be added to agenda for next month. Haven’t reviewed that plan yet after 1.5 years

Board - Pharmaceutical and non-pharmaceutical interventions. (Masking, distancing, isolation)defined.

18:28 - Board- Introduced a plan including care kits. We’ve been remiss on educating them about what it is, what people can do to protect themselves

19:07 - Many non-pharmaceutical options. People present in several ways. The group that can’t eat or drink we don’t worry about because they show up in our clinic right away for dehydration. Another group has mild symptoms initially and quickly takes a turn for the worse.

20:00 - What are we testing for? It’s much more deadly than the last strain. COVID weakness makes it difficult to stand. The problem comes on days 5-8 and then pneumonia hits real fast. Deb had no risk factors. Home alone with no idea what to look for.

23:30 - Need to educate the community, the symptoms are changing and varied. One thing we’re working on at the health department is an education pack.

24:49 - Health providers are overrun and not getting information. Need to educate providers. Symptoms include dehydration, horrible thirst, electrolyte imbalances including sodium deficiencies. Discussed kits: send patients home with instructions so electrolytes don’t get misused because they get hydrated and then have trouble taking care of themselves. People aren’t coming to the clinic because the advice doesn’t change. They’re sent home and told to call if something bad happens. They get so sick they can’t go to the store.

27:23 - We need to help our neighbors and friends. People can get into trouble at home and not be able to get help.

28:23 - Discussed volunteers making phone calls to check on people. This is a community issue.

29:32 - Kit also includes an oximeter. Happy Hypoxics. You can be in 70% and not know they’re in trouble. Ivermectin is a moot point for this strain unless taken before you get it or soon after. Other drugs have been working well if taken early.

31:40 - Medications: VIP (send VIP report to board) We can treat COVID. Laying prone opens the lungs. We don’t have to be victims of COVID-we have good treatments, but once it gets bad it’s too late. Create kits with supplies.

32:00 - Educate leaders to organize their own resources. You only talk about treatment. Focus on preventing spread:

33:00 - If you prevent it, you don’t have to treat it. Non-vaccinated people get sicker. Maybe we should try to stop it and not treat it.

34:00 - We’ve talked about educating people on how to boost their immune system with sleep, nutrition, vitamins, etc. We’ve been shot down. Nobody has wanted to hear anything we had to say unless it was vaccination.

35:17 - Sleep is a good personal choice. We're moving on to other business.

36:00 - County representative new board member appointee recommendation discussion. The open position is for the county. 3 Candidates. Interview candidates 1 at a time and other candidates wait in the hall. Once interviews are complete, everyone comes back in the room and discusses any further questions prior to the vote. Dave Harmon, Dr. Rice, Dr. Carvey.

38:18 - Dave Harmon Interview: What community connections do you have? 30yr w/ Red Cross, 2 terms with the school board, 12 years public defender, Blood Donor. Town attorney for Troy, Eureka, Libby. 9 years with ambulance service.

40:00 - What related education do you have? Stale degree in microbiology, ambulance experience, and personal inquiry, I’ve kept up with some of that. I have a book called Vaccine. Half the book is about the history of vaccines. The other half is about people who don’t want to be vaccinated. As Abe Lincoln said, you won’t win your side till you know what the other side is thinking.

42:00 - What skill is lacking in the Board of Health and how do your skills help fill that need? I’ve worked with boards. I know employees. I’m not familiar with the board. I’m impressed with the planning people. It’s interesting that starting with legislation, you have police power, and then there’s the health and wellness part. Although with the DUI court addressing alcoholism, we wonder if we’ll see a blend. Health and wellness site is more than COVID. Animal control, sanitation, all those boards cover all those areas. I can maintain a broad perspective. I have no agenda, but I came up with great ideas for presentations.

44:50 - How do you research health-related issues? I love medical research. I look it up. Google, google news…

Do you look in professional journals? Sometimes, but I go to Google science and google citations to get deeper. I don’t have a medical degree. I don’t hold myself out to be an expert. I bring a broad-based perspective to the board.

46:32 - Why do you want to be a part of the board of health? I find it kind of interesting with my service with the ambulance. I had EMT. I have time as I wind down my practice. My religious belief is that I’ve got to act. Tribute to Jake and Sarah. I worked with Jake.

48:30 - When you research, how do you decide what is credible? If you dig into it, does it make sense or is it off the deep end? Looking for MD or Ph.D. or MDPHD. Journalism. It doesn’t take rocket science to see what side people are on and whether that’s off the deep end and is consistent with good science.

49:20 - Don’t you find it difficult when you have two people with letter after letter after their name and yet they are diametrically opposed? There are some basics that have been proven over time regarding COVID in particular. I have an idea I want to press. I don’t have expectations of what would happen if my ideas don’t get adopted. There’s a lot of collective wisdom here and those ideas may spark even better ideas.

52:06 - Dr. Carvey Interview

52:40 - Join by Zoom- technical issues

53:23 - What community connections do you have? Tech issues

54:47 - I'm not on boards in the county. I volunteer in Flathead. I have 4 children and 3 stepchildren, so I don’t have a lot of time to be on other boards.

55:20 - What related education do you have? Attended medical school 2006, joint residency ST. Louis Univ and Scott Air Force 2009, then Chief Resident.

56:00 - What skill is lacking in the Board of Health and how do your skills help fill that need? In the age of information, I’m frustrated that we’re getting more hostile information than helpful information. I’m interested in helping my patients and speaking to other doctors and what they’ve tried and what’s succeeded. And share that information I’ve learned to help this

community.

57:20 - How do you research health-related issues? I use research articles, speak with other physicians, and learn from others. I get the most experience from other doctors working with the same kinds of patients. Trying to keep up on the newest research.

58:04 - Why do you want to be a part of the board of health? This community is special to me. I’m an implant of 8 years. I moved a lot to get my training and had a lot of jobs, and none of them have meant to me as much as Eureka. Contributing what I can.

59:04 - You do manage the nursing home and have during 3 outbreaks. Can you tell us more about how you managed and learned from that experience? I took over medical directorship at the beginning of the pandemic. It’s been interesting to see how it evolved. We’ve had to change our response to it to deal with how it evolved. And a multi-(garbled) approach to it is only way to make headway. Sticking to one protocol, it’s going to continue to trick us. Do whatever works and stay ahead of it. Then share that information without ferocious resistance. Let others apply it to help other people.

1:02:04 - Dr. Rice Interview. What community connections do you have? Physician in Libby, (garbled) Retired Feb 1st, Part of team Habitat for Humanity for 12 homes. Raised $30k per year. Intensive involvement with preventative medicine. Being on Board would be a fun task.

1:04:57 - What related education do you have? Washington, a degree in biology, St. Louis 4 years, residency 3 years in Seattle. A free clinic in Seattle. Women’s health care. Instrumental in the community health center in Eureka and Troy, recruiting physicians. I'm board-certified and I taught medical students 30 years.

1:07:44 - What skill is lacking in the Board of Health and how do your skills help fill that need? Makes sense to have someone with a strong medical background. Especially now, with science background, objective information and differentiate between different beliefs and how

knowledge is developed.

How do you research health-related issues? Univ. of Washington alumni access to medical journals. Get daily updates. If I see something interesting, I look up the works cited, who the authors are and who financed the study, and if it is peer-reviewed

1:10:58 - Why do you want to be a part of the board of health? I’d like to help Lincoln County. I want to use my knowledge and skills, just not 50-60 hours a week.

You asked what our plan would be going forward on the epidemic. I’d like to hear your plan.

I stated my plan in the paper clearly. We’re at 20+ months. Eastern Australia hasn’t had 1 death. No masks or staying home. In an interview, the lockdowns, restrictions, they don’t like it, but their system works, and the US system doesn’t.

What would you like to see happen in Lincoln County?

Tech difficulties

1:14:11 - Encourage people to abide by CDC recommendations. There’s a scale. Currently, Libby is still at an extreme level. Masks indoors, keep your distance, get tested, isolate, inform people if you’ve had contact with the disease. Their recommendations are extensive and proven. Encourage

vaccinations. I don’t believe in forcing them but encouraging community responsibility. Educate people, listen to people.

1:17:55 - Bring all candidates in and the board will ask any additional questions. A nomination will be made, and then public comments before the vote.

1:20:22 - Board Discussion- Commendable that 3 people tried out. Dr. Carvey my doctor, I like the fact that she’s in the trenches now. My mother was in the nursing home here and Dr. Carvey saved her life. Like that they’re doing Pubmed.

Board- I worked with Dr. Carvey. She worked till 2:30 am, made house calls, managing to keep abreast of all changes. She communicates with other doctors, gets new ideas, trying new things. I like her track record. Only 1 death and that patient was very old and very tired, and the family stopped treatment so she could die in peace. Other than that, she’s gone through this whole pandemic without losing any of her high-risk patients to COVID. I think there is room for a lot of different ideas, and we need to be open-minded.

1:25:14 - Dave taught me something. I like the degree in microbiology and that you keep abreast of recent research. Dr. Carvey, I think you’d be a fine member, but with a full-time practice and seven kids, I don’t know how you do it. Credentials are great, research with other doctors is good. Dr. Rice is retired, has more time, strong med background. Amazed that we have this amount of talent that wants to be on the board. We have 3 reps from Eureka. We have 2 from Troy. 1 from Libby. I would like another rep from Libby. Like Dr. Rice goes by CDC recommendations

1:27:16 - I appreciate all 3 who applied. Mr. Harmon your experience, EMT, Dr. Carvey great experience and open-minded, Dr. Rice has been in the community a long time, very dedicated. We want to keep the board balanced. As Libby is the largest community, I’d like to see another rep from Libby.

1:28:38 - Appreciate all those who signed up. Thank you. All have something to bring to the board. As far as representation, I represent all of Lincoln County. It’s not that we’re heavy-handed in the North. All 3 town councils have a rep. Rexford does too, but I don’t see a rep. I think the commissioner takes into consideration everything we talked about.

1:31:28 - Dave, I didn’t know you had a degree in Microbiology. I appreciate your loyalty to Jake and Sarah. The position was advertised for south Lincoln County. Dr. Carvey has excellent qualifications and works closely with the patients at Primary Care and Nursing Home, but my reservation is the south Lincoln County preference. Dr. Rice I’ve known and worked with. I

appreciate his connections here in town. Even retired, I’m sure he keeps his fingers in a lot of pots.

1:33:00 - Who decided it was a south Lincoln County preference? Answered.

1:34:00 - Nomination- Dr. Carvey, Dr. Rice, Dave Harmon

1:34:57 - Public Comment

Public- Amberli- What percentage of your patients responded and recovered from COVID in the last 10 months? Which patients responded to your interventions?

Dr. Carvey- Every person treated improved to some degree. Nursing home, no one. The clinic has seen hundreds. The first wave treatment was very effective. The last wave is less effective if we don’t get to them right away. It’s changed so much. Symptoms start out mild and everyone is so tired of COVID and they all hope it’s a cold or allergies. They treat themselves and at 1 week they turn south if they’re going to, and there’s not a whole lot that can be done at that point. Interventions have changed and are still successful if we can treat them early.

1:38:18 - Dr Rice- I agree with Dr. Carvey. This light spring-early summer is more contagious. Much of the country thought the summer would be better so restrictions lessened. People waited to be tested and there was a huge lack of education. Intravenous antibodies were effective if given early. A pill is coming out that can be used in the first few days and prevent hospital stays. It’s critical to come in with the first symptoms. People are being treated later than they should be. We had good results in the first wave. Called patients daily. Contact is really important. Hydration and nutrition done properly, and oxygen saturations. The second wave is just difficult. Luckily the numbers are going in the right direction. I think the death rate will change in 3-4 weeks.

1:43:00 - Board- Inexperienced patients aren’t believing inexpensive oximeters. One patient was reading in the 70% range and he thought it was malfunctioning because his finger was cold. He had no idea how sick he really was. We need education and quality oximeters

1:44:14 - Vote- In the event of a tie, the vote goes to the commissioner. Tie vote between Dr. Carvey and Dr. Rice. 3 votes each. Scheduled for 9:45 am. The meeting is open to the public; candidates may attend if they want.

1:46:40 - Program Reports

Public Health- very busy since July, everything we get back from the test is Delta. Results in triple digits, all Delta. But things are slowing down. A few people have gotten 3rd dose shots. We’re overwhelmed and waiting for other vendors. Only using Pfizer boosters and Moderna 3rd doses.

1:49:17 - Board- questions on the report. I’m not seeing the flu represented in the numbers. This report is last year's. Flu and COVID shots are available in the clinic.

1:50:50 - Board- One of the preschools called. They thought they were told the Libby nurse was coming up to give shots? Trista does all scheduling.

1:51:49 - Board- Regarding the quarantine, it is not mandatory for close contacts, just a recommendation, right? [Didn’t hear a response but she nodded.]

1:52:02 - Environmental Health- Offered planner sanitarian position, candidate accepted the position.

1:53:00 - Parents are receiving conflicting information from multiple sources. A CDC letter went out and infers it’s a mandate on the quarantine. Close contact people should be quarantined so they don’t spread in the contagious but asymptomatic first 48 hours. Some parents’ bank accounts get low because of the quarantine. Some people are homeschooling, some people just send their kids and say screw it.

1:56:12 - It’s a double edge sword. We’re doing the best we can with what we’ve got. In the beginning, parents got financial help for COVID-related issues, but help has dried up, and then they must take time off work.

1:57:00 - Solid waste & recycling- ARPA grant application submitted. This project protects groundwater. Received $2million. The cost is $5.9 million. We have over $1million squirreled away for this project because we saw it coming, but not as fast as it came. The 2 million is great.

1:58:13 - Asbestos resource program- Number of utilities locates from calls. 1 abatement is 1/3 complete. Results this weekend. 1 planned abatement in Troy. Previous owners didn’t complete the investigation and now we need to do a removal. 3 sampling events. Operation and Maintenance.

2:05:15 - Focus Area Liaison- we don’t have one.

2:05:39 - Libby City Rep- Nothing to report

Troy City Rep - Went to a school board meeting about masks. Most were against the masks. A story about a breast cancer patient and people walking 10 miles to help. Kid with Leukemia, they put on a spaghetti feed. Some of these people are the same helpers. Why are people so against the mandate? The board meeting was respectful, and we left as friends. It still seems odd to me that people aren’t helping people as they should be.

Eureka Rep. – The community is organizing. Churches. It’s bringing people together. They’re making their own kits for their people. It’s been a good thing for us.

2:09:13 - Health Officer Report. - Dr. Black- [Signal spotty] We covered COVID, variant, and the difference between first and second waves. Still a lot of people with waning immunity. This will continue to surface. We’re headed into cold weather and have a low vaccination rate; I’m concerned about what happens if we aren’t careful, and we’ve already lost too many people.

2:13:35 - Do we have a budget to improve the internet connection? Hard to hear people. Discussing internet issues. Zoom didn’t work, switched to the direct line, miss a lot of conversation.

2:14:59 - Work Meeting in Troy scheduled. Discussing ground rules. Agenda posted, taking minutes, but no decisions will be made till the public meeting. The agenda will be sent out. Minutes will be to you in the next few days.

2:16:00 Suggestions about the death toll tables and how they’re broken down. Categories are kept vague because people can be identified.

Adjourn

“Faith is taking the first step even when you can’t see the whole staircase.” - Martin Luther King Jr.