In the seven weeks since the Burleigh-Morton COVID-19 Task Force was created, it has increased access to testing, assisted schools with reopening plans and secured a shelter for homeless COVID-19 patients.
But coronavirus cases in the region continue to spike, and there is more work ahead for the group.
The task force's goal is to lower the region's 14-day rolling average positivity rate to 5% or below, but the rates for the state and Burleigh and Morton counties have been on the rise. The task force operates in an advisory capacity only, which Bismarck-Burleigh Public Health Director Renae Moch said can be a challenge. It does not have the authority to enact mandates.
Task force members attempted to address the continued rise in cases on Sept. 4 by recommending that local governments mandate masks. The commissions for Bismarck and Morton County did not enact mandates. The commissions for Mandan and Burleigh County, which met a week after the previous two, did not discuss mandates because of the other commissions' decisions. Many people in the area believe that mask mandates infringe on personal freedom.
"I feel like there's a little bit of distrust or nonbelief that those measures work, but if they are implemented and people are doing them, they have been proven to work," Moch said. "If we could see more compliance for the mitigation measures we're suggesting, we could make a difference. It's just disheartening to see that our numbers are going in the opposite direction."
Moch believes the community needs to follow the example of schools and colleges, which have required masks.
"There's definitely some work to do," she said. "I think in order to best make a difference in the community, the schools are definitely doing their part, it’s the rest of us that kind of have to get on board to see what we can do to help in that situation."
The task force has made some gains in other areas in its month and a half of work, though.
Task force makeup
The task force consists of a steering committee made up of state and local government and public health officials, including North Dakota Chief Operating Officer Tammy Miller, Bismarck Mayor Steve Bakken and Morton County Commission Chairman Cody Schulz.
Moch heads the task force. Five subcommittees focus on different areas of pandemic response: business community, educational institutions and activities, health care/testing strategy/contact tracing, public education and awareness, and underserved populations.
The task force's initial goal was to get the area's 14-day rolling average positivity rate at or below the state's. Both the region's and the state's average have increased since late July. Burgum on Monday said the task force's new goal is to have the area's rate at or below 5%. It stood at 6.9% for Burleigh-Morton as of Sept. 17.
Miller said the 5% positivity rate goal is better suited to a newly implemented county-by-county risk level system and falls within guidelines from the White House.
Burgum on Sept. 3 moved the state from a statewide green/low risk level to a county-by-county risk level. Eight counties including Burleigh and Morton moved to yellow/moderate risk, eight moved to blue/"new normal" and the other 32 stayed at green. The risk levels are reviewed weekly.
Bakken said the regional COVID-19 hot spot taxed resources, which he looked to the state to bolster. He said the state has provided more testing kits and created an additional testing location. The task force also received an $850,000 budget funded by the federal CARES Act, with much of the money going to support vulnerable populations such as the homeless, according to Miller. Part of the budget was allocated for a local marketing campaign being conducted by Agency MABU.
The business community subcommittee, led by Bismarck Mandan Chamber EDC President Brian Ritter, is addressing confusion among business owners about testing for employees, guidelines for gatherings and changes to business operations.
The subcommittee created a graphic with COVID-19 testing times and locations, distributed it to businesses and posted it on social media. The group also is sharing a series of 20 graphics on social media that answer frequently asked questions about sick leave, traveling and other issues.
The subcommittee is proactive about getting important information out to businesses, Ritter said. When Burgum changed the Burleigh-Morton risk level to yellow, the subcommittee emailed bars, restaurants and personal care businesses such as hair salons to inform them of the change in guidelines from the state.
Ritter said he does not have data on how many businesses are requiring masks or following ND Smart Restart guidelines, but he would like to see that information.
"We're optimistic the business community is heeding this guidance, but it's an ongoing process," he said.
The educational institutions and activities subcommittee was tasked with supporting safe back-to-school plans for K-12 and higher education and making sure children and young adults understand the importance of COVID-19 prevention measures such as wearing a mask, staying socially distant and practicing good hygiene, chairman Anton Sattler said. Sattler works for the environmental health division of Bismarck-Burleigh Public Health and collaborated with local schools on their reopening plans before the formation of the task force.
Sattler said local universities have encouraged testing. The University of Mary encouraged its students to get tested for coronavirus before coming to campus, which prevented some students who tested positive from arriving and potentially spreading the virus.
The subcommittee also discussed strategies to motivate testing in students. Bismarck State College created a student liaison position to promote mask wearing and hand sanitizing to peers.
The schools and colleges have excellent plans, Sattler said, but challenges come when students are off campus.
"One of our biggest concerns is students outside of schools and colleges getting infected through community spread," Sattler said.
The subcommittee is pausing its work now that schools and universities are back in session and will meet as needed.
One of the main focuses of the health care/testing strategy/contact tracing subcommittee was increasing testing availability in the region. There are now testing events five days a week, involving several entities.
From Aug. 1 to Sept. 1, the 14-day rolling average daily total tests increased from 918 to 1,076, which is a 17.2% increase, Moch said at the task force's Sept. 11 meeting.
The subcommittee also increased messaging about testing protocols for close contacts, which streamlined the amount of questions public health officials were receiving. Close contacts should now be tested for the coronavirus seven to 10 days after being exposed to the virus.
Going forward, Moch said, the subcommittee will focus on the recent spike of COVID-19 cases in long-term care facilities in the region. State and local officials said that rise in cases is being discussed, though no plans to address it have been announced.
On Friday, there were 196 active cases in long-term care facilities in Burleigh-Morton -- nearly two-thirds of the active cases in long-term care facilities statewide.
Bakken said the task force is investigating how the virus is entering those facilities. Custer Health Administrator Erin Ourada, who leads the subcommittee, was not available for comment.
The public education subcommittee is working with Agency MABU on an information campaign called "COVID Stops Here." The hope is that the subcommittee is putting out information people can trust and support, according to Kalen Ost, emergency preparedness information specialist at Bismarck-Burleigh Public Health and subcommittee chair.
The first phase of the campaign launched online Monday with both paid social media content and posts shared on official pages.
The campaign is aimed at three groups: those who feel "invincible," particularly in the 20-29 age range where the number of active cases is highest in the region; people "fatigued" from taking measures to prevent COVID-19; and those "resistant" to being urged to wear masks or practice social distancing. The campaign encourages residents to take personal responsibility to prevent the disease. Burgum and local officials have been emphasizing personal responsibility and individual choice rather than mandating mask wearing in public.
"For as passionate as the COVID debate is, I'm sure that there are some people who by default will love it and some people by default that will hate it," Ost said. "There's no getting around that. My hope would be that there's people in the middle that look at it and are able to find something in it that resonates with them."
Bakken said, "With the speed that Agency MABU turned around the campaign and messaging, they knocked it out of the park."
Helping the homeless
The underserved populations subcommittee's main focus is securing a location and resources to create a local shelter for homeless people who have tested positive for COVID-19 or need to isolate because of exposure.
The Bismarck Motor Motel has been selected as the shelter, and contracts with shelter management and security providers are being finalized, Moch said. Myriad services had to be secured for the shelter, such as transportation, mental and physical health care, and meal distribution. Moch said plans for the shelter were being discussed before the creation of the task force, but the underserved populations subcommittee provided more organization in the process when it took over.
The shelter will have six rooms, and the subcommittee is looking into how to scale up the available resources in case of an influx of people in need come winter.
Dr. John Hagan, the medical director for the Department of Corrections, heads the subcommittee. He did not respond to requests for comment.
The task force next meets on Sept. 25. It recently switched to meeting every other week, although subcommittees will continue to meet weekly or as needed, to allow more information to be shared at the larger task force meetings.
Ost said that one of the difficulties of responding to the pandemic is that it evolves over time.
"The pandemic is this gigantic, ever-changing monster. Every day it brings up challenges that are brand new, challenges that we thought we had figured out answers for and challenges we never dreamed could have existed," Ost said. "There's no one perfect answer for it."
Reach Sam Nelson at 701-250-8264 or firstname.lastname@example.org.