City Council Special Called Meeting (Joint Meeting with Travis Commissioners Court) Transcript – 08/24/2021 Title: City of Austin Channel: 6 - COAUS Recorded On: 8/24/2021 6:00:00 AM Original Air Date: 8/24/2021 Transcript Generated by SnapStream ================================== Please note that the following transcript is for reference purposes and does not constitute the official record of actions taken during the meeting. For the official record of actions of the meeting, please refer to the Approved Minutes. [9:08:23 AM] >> Judge Brown: Calling the Travis county commissioners court, today is August 24, 2021 and it is 9:08 A.M., and meeting at 700 lavaca street with commissioners gómez, Travillion, and Howard. And then we've got commissioner Shea remotely. Hand it off right now to mayor Adler to call the meeting of the Austin city council to order. I think that you're on mute, mayor. >> Mayor Adler: Judge brown, thank you. Thank you to the commissioners. Call to order the Austin portion of this joint covid briefing here today on August 24th. The time is 9:08. We have a quorum present. We are ready to go. >> Judge Brown: Thanks. So I'll go ahead and call to order the joint meeting of the Travis county commissioners court and the city council and we'll take up item 1 to receive [9:09:25 AM] briefings on covid-19 and related matters. And any callers? It looks like we don't have any callers but I will confirm. >> Good morning, judge. There are no callers at this time. >> Judge Brown: Okay, thank you. So as per usual we'll get our briefings on covid-related matters, and we've got -- as seems like always a pretty full agenda after this. Some things that we have to get to before lunch because of other things that rely on that happening. So if possible if we could try to limit ourselves to about one question in the order below and we'll go through the commissioners and then the judge and then the city councilmembers and then the mayor. I will turn it over to Dr. Walkes to get started. >> Good morning. Good news is that we have full approval of the pfizer vaccine. So here's hoping that those who were hesitant to be vaccinated will now go forward and get [9:10:27 AM] vaccinated to help with ending this pandemic. Our numbers as of yesterday, we had 708 cases that were reported. Next slide, please. To Austin public health, yesterday, seven-day moving average for hospitalizations at 80. We have 638 patients in hospital. 232 of them are in I.C.U., and 162 are on ventilators. The previous 24 hours we had 64 admissions, and 69 discharges. And our curve is showing a continued increase. We have surpassed our icu numbers from previous spikes. Our ventilator use has also increased. And we need our public to do [9:11:30 AM] what they can to help us with decreasing these numbers so that our icu capacity will not continue to be stretched, continue with masking and social distancing, the limitation of large gatherings. We really do need children to be protected in school as we know that when children go back to school in congregate setting and they're not able to social distance as much as adults can, so all of those things that we've done before in previous surges to get through and decrease the spread of our case numbers is what we're going to need to call upon the public to do at this point. On the left-hand portion of this slide you can see the UT [9:12:31 AM] modeling projections that show opening schools with compliance with mask wearing at a moderate level. It will help keep the numbers down, but we'll still surpass our projected icu capacities, with high compliance with masking we can achieve lower numbers and not stress our icu capacity. So that is what everyone in our community and all of the leaders of our community are striving for at this time. Next slide, please. Next slide, please. With the opening of schools at this point, we are seeing a surge in cases. In the last year at this time, we had school opening -- reopening delayed. And we had masking in place. [9:13:32 AM] But as of the last two weeks, we've had increase of cases up to 414 additional cases in the last two weeks. There was some talk early on in the pandemic that said that there was -- they didn't feel like there was transmission from children to adults, however, recent Canadian study shows that there is indeed transmission from children to siblings and to adults. Those previous reports were thought to possibly be due to the fact that children were not in school as much earlier on in the pandemic. So we are seeing transmission. And let me repeat -- masks stop the spread of covid-19. So it's important that our children rely on us to protect [9:14:32 AM] them by sending them to school with masks at this point in time. If you look on the right-hand side of the slide with the decrease use of masks during the summer, and with the introduction of the delta variant into our community, we are seeing an increase in the number of cases in pediatric age groups, those under the age of 18. We've had 90 so far during the July and August time frame that were admitted to hospital and 26 of those have been admitted to icu. One has been on a ventilator for many weeks. That child has some underlying co-morbidities and medical conditions that have made their case and their disease process [9:15:34 AM] more protracted. Next slide, please. The death rate that we're seeing in our community is slowly increasing since the introduction of the delta variant. We've had 26 additional deaths since August 1st. And this slide was produced late last week. It doesn't record some of those that happened over the weekend. However, overall in comparison to some of our surrounding counties, Williamson and Hayes, we are still showing fewer deaths than those counties that surround us. And we're also showing fewer deaths historically trending in other major metropolitan areas and counties that have those metropolitan areas. You can move to the next slide, please. [9:16:35 AM] Our admissions have increased over time, but you will see that last week over this week we have had fewer admissions, but this does not account for those in hospital whose covid disease has progressed to the prior additional and more intensive care. So we have people over time who have covid who progressed to severe disease, require supplemental oxygen, either in the form of oxygen, ventilation or ventilators, or ecno-therapy, which you will recall is a therapy by where your blood is removed from the body to allow your heart and/or lungs to rest, your oxygen is replenished and carbon dioxide is removed and your blood is put back into your body. So even though we're seeing a slight decrease in the number of [9:17:36 AM] admissions from last week to this, there is a portion of those that are admitted in previous weeks who remain in hospital. And that will continue to accumulate the numbers of people that are requiring icu care. So this slide is looking at admissions. It doesn't look at the full picture, or the full impact on our icus, and it is still important for to us do what we can to mitigate the spread by wearing masks for the short term, social distancing, staying home when sick, staying home if you're unprotected, and by being vaccinated. And it's very important for those who are not vaccinated to be vaccinated. Next slide, please. This takes a look at the breakdown of where people are coming from to be admitted to hospital in austin/travis [9:18:38 AM] county. And we see that 52% of individuals that are admitted are from Travis county, with 23% approximately from Williamson county, and other counties surrounding this as listed. And there's another listing here on the left of the zip codes from which people are coming to our hospitals for admission. And if you look at these numbers, you will see that they are matching up with where we're seeing lower vaccination rates. So it is important that we continue to spread the message to the community that vaccinations are safe. We now have full approval of the pfizer vaccine, so if there's any question about its safety, it's been validated and approved by the fda and now is the time [9:19:39 AM] for people to go and to get vaccinated. And it's very important for people to wear masks and avoid large gatherings, stay home when they're sick. Next slide, please. Last week we had the recommendation publicized that the -- the boosters of modern and pfizer are now recommended. And this slide is depicting what that information is based on. If you look to the right, this is the study that shows that over time there's a decrease in the effectiveness of vaccine. This is not an unusual phenomenon. Everyone is familiar with needing a booster of -- for instance, for the flu vaccine yearly to protect against developing that particular viral [9:20:41 AM] illness. And it's not unexpected that that may happen with covid as well. The dotted line is the projection of effectiveness of protection against mild -- severe disease over time. And it shows that over 250 days that the protection against mild disease is seen to wane, but there's a larger waning or decrease in the protection that's given for more mild disease. And when you look at something like the pfizer vaccine that started out at 95% protection from both mild and severe disease, you see what we are now -- somewhere close to that 250-day mark for those who were initially vaccinated in [9:21:43 AM] december/january time frame. If you look at the graph on the right, I mean, on the left, you will see that we're looking at what are our data is showing for the breakthrough cases that have occurred and have been reported to aph. And this represents 3,642 confirmed breakthrough cases. Our case investigators have been able to reach 896 of these individuals. 42 of them were admitted to hospital. Three of them were long-term care facility residents. So of the over one million doses of vaccine that have been given by -- in Travis county, only 3,642 were confirmed as breakthrough cases. There may be some underreporting of that, but you will see that even with that, the numbers of [9:22:44 AM] breakthrough cases are relatively low. And this also shows that most of the cases have been mild, not requiring hospitalization, so truly the vaccines protect against severe disease, icu admissions and death. And you also will see that in June -- the June time frame is when you start to see our bar graph present itself more, and there is a clear spike that's noted in the july/august time frame. This also correlates with the emergence of the delta variant and the current surge that we're seeing. So this is necessary for those who have been vaccinated. And it's all very, very important for those who are unprotected and unvaccinated to go and to get vaccinated because these vaccines are protecting against severe disease, icu [9:23:46 AM] admissions, hospitalizations and death. So, please, get that message out to your constituencies that vaccines are part of the plan that will help us to end this pandemic. Boosters are now available to immunocompromised individuals. And as of September 20th, others eight months post their first series of vaccines will be eligible to present at any one of the many providers in our county for vaccination. And, finally, our herd immunity has changed slightly since my last presentation. There's been a 1% increase in those partially vaccinated. So we now have 10% of our community partially vaccinated. We have 56% of our community fully vaccinated. And then we have 11% of our [9:24:49 AM] community that's vulnerable. This number continues to decrease. I'm hopeful that with the full approval of the pfizer vaccine that those who are hesitant in the past will get out there, get vaccinated, and get us to the other side of this pandemic. We say that you want to protect our neighbor by wearing a mask, and we want to protect ourselves by protecting a mask, but we also want to protect ourselves by being vaccinated. And truly it is important that all that are not vaccinated opportunity so that our schools can be reopened, our children can be safe, and with masking we can protect those who are unvaccinated in our school systems. And continue to keep our schools open. These first couple of days of school reopening have shown that [9:25:49 AM] there are many, many children who are going to be affected by covid-19 if we don't protect them with masking. And I hope that all of those who are concerned about this issue will continue to stand with myself and others as we try to keep our children protected with masking in schools. That will end my presentation. Thank you. >> Judge Brown: Thank you, Dr. Walkes. >> Thank you, Dr. Walkes. And now I'll give a brief update on the operational side of things. If you are sick, please get tested. If you are exposed to someone who tested positive, please get tested. And when in doubt, please get tested. Austin public health continues to stand up testing operations at dove springs rec. [9:26:50 AM] We have our drive-thru at St. John's. If you need in-home testing because you're home bound or unable to visit a testing site you can call 311 or 512-974-2000, to have someone come out and to provide you a test. If you have insurance or other testing options and providers that are available, please feel free to call your primary care physician. If you need to get a test. We can see over the weeks that the demand for testing increases. Last week we gave almost 4,000 tests -- 3,773 tests were administered by Austin public health. When we look at our vaccine dashboard, you can see the total amount of doses delivered by Austin public health and community care are now at [9:27:50 AM] 453,000 over the past week. And we have delivered 1,370. That is still not where we would like it to be as we're pushing vaccine. We want to see numbers that mirror the earlier part of the year. According to dshs, 77% of the population that is eligible has at least one dose, and 66% of the eligible population in Travis county are fully vaccinated. This data is current as of yesterday evening. We still have 250,000 people who are eligible for vaccines that have not been vaccinated. This increases the potential for hospitalization and even death if they remain unvaccinated. And so, again, we're really asking the community to be proactive, to protect themselves and their loved ones, and get a [9:28:50 AM] vaccination. When we look at the Texas department of safe health services vaccine data broken out by race and ethnicity, um, unfortunately, the story isn't changing for our communities of color. I am happy to announce, or to see that we're over the 50% mark for at least one dose in our hispanic and latinx population. But, still have some way to go for our black and Afghan population, as they're just over 38%. And then when we look at those populations for fully vaccinated, the numbers there are still low -- 42% for hispanic latinx, and 31% for our black and African-American populations. So our efforts will continue to focus on those gaps, making sure that our operations are designed to meet the specific and unique cultural needs for those [9:29:52 AM] populations. For a point of reference, the total number of shots given in Travis county are 1,505,031. When we look at our map here, it's still good because there's a lot of green, but there's still work to do to get those blue areas into the green space. And, again, those are 17425, 5853. And when we look at the second dose map, the areas of focus are these red areas here which are 78617 and so we'll continue to partner with the Travis county vaccine collaborative to make sure that we are having enough boots on the ground information, not only -- or operations, rather -- not only to give out [9:30:53 AM] shots, but to really provide information to the community so they can make good decisions. The science changes daily. And I know that it's a lot to keep up with. And now we're throwing boosters into the mix. And so as we stand up our teams that will very soon include community health workers, we're hoping to provide enough information to support folks in getting their vaccinations. And to that end, here's a slide that shows all of our vaccinations for this week. The standard three are there -- southeast library, little walnut creek and the Anna lark center. We'll be at manor new high-tech at the catholic church and at the Terry road Baptist church and of course at the del valle opportunity center in partnership with Travis county. We'll be at 20 -- approximately 27 pop-up events this week, including the Mexican consulate, and four ACC campuses. [9:31:55 AM] For a complete listing of our vaccine locations you can visit us at www.austintexas.gov/covid-19. Again, we have our goal in front of us as a team. We know that there are 250,000 folks who are out there that still need vaccine, and we are going to focus on that group and convince and make vaccine available in locations and at times that work for busy schedules. And then, last but not least, it's not only about vaccinations, right. We understand that as a community there are several impacts that covid have that impact our overall health. And so these photos are at a food distribution event that took place at the St. John's recreation center this past weekend. Not only did we pass out fresh food for families, but we also gave out ppe and information [9:32:56 AM] about testing and vaccinations. The staff served over 619 families in the blazing heat, so thank you to the mobile team who were there on the ground, thank you to atd who provided logistical support. As always I am grateful for the staff at Austin public health for the work that they do in serving community, not only with vaccinations, but with testing, with contact tracing, with all of the operations that support our community and getting through this pandemic. Special shout out this week for the health it team in getting our systems ready to accommodate folks for booster shots. We have began giving out booster shots for folks who meet the criteria of being immunocompromised and we will continue to roll out our self-serving platform where folks can make an appointment online if they already have an account for us or they can walk [9:33:57 AM] up from any location and get a booster. And with that I will end my comments. Thank you. >> Judge Brown: Constable morales. >> Good morning, judge and mayor. Commissioners and councilmembers. Chuck Brotherton, county executive for emergency services. This morning, of course, we will hear from constable George morales with precinct four and fire chief Ken Bailey with Travis county fire/rescue. We will turn it over to chief Bailey. >> Good morning. And we will try to share my slide. So the collaborative in the last seven days has delivered about 1,611 shots and 53% of those were first doses, and 47% were [9:34:58 AM] second doses. We are now prepared to start to deliver third doses and over the course of the last week we did five third dose injections. Our total for the collaborative right now is 29,000 shots. We are starting to see -- we saw an uptick of first doses and we're seeing a convergence of our first dose and second doses which traditionally is indicated a waning effort of people to get vaccinated. We have performed or have planned 322 separate events. Mostly in the hard-to-reach areas. And in this slide I also wanted to just kind of give a highlight of what I was speaking to in regards to our first doses versus our second doses are starting to converge once again. John Lawler and constable morales' team has done a really, [9:35:58 AM] really good job of getting out there. And I'll turn it over to constable morales to talk about that outreach effort. >> Good morning, commissioners,. >> Councilmembers and mayor. We continue to focus on our outreach and education doing the work to ensure that our strike teams are successful. This week we have done a total of phone calls outreach of 6,381, with a total contact of 24,321. Our mobile teams gave a combined 1,610 shots this past week. Bailey gave us an extra shot there, with the combined shot for August of 5,165. And hard-to-reach austin/travis county areas. We completed the shot locations this week in pflugerville and wells branch with the help of commissioner Shea and commissioner Travillion. In pflugerville we'll have two static locations. One at foothill farms. And the other is at black hawk [9:37:00 AM] community center. We continue to work with aid, and we will have one static location starting I think in September at Mendes middle school. And then some surrounding elementary schools in the hard-to- reach areas. And also the highly affected covid areas. We will be working -- oh -- we did a shot clinic at campus beronza and I don't want to miss that and we were thankful for the commissioners for their support on that. But I want to give a shout out to Stacey and Julie nitsch, because their work with the homeless community is great and we were able to have a real good clinic there. The last thing that we did is that we did a shot clinic at the Travis county justice center with the project engage -- I'm sorry "Project connect and engage." And folks at Mueller -- we want to thank the constable and his team for helping with that. [9:38:03 AM] And we look at several locations and the second dose clinic at the dove spring recreation center and the lake Travis methodist church, and lender elementary will be a second dose clinic. New grocery store is local grocery store and again, the catholic church for a second dose clinic. And I'll turn that over to chuck. >> Thank you, constable. Folks, as I like to do, I want to show our viewing audience just how easy it is to find vaccination location information. On the Travis county website, on our landing page, one click here takes you to our covid-19 information with vaccine events and a handy calendar. This is Tuesday, August 24th. You can see how many different locations we will be at today. I would like to highlight the [9:39:04 AM] J.D. Markets where we appear on Tuesdays and Thursdays. But click on any link and you can see the time, the address, the type of vaccine. On the austintexas.gov, one click and free locations for a covid-19 vaccination and you will find again information to find locations. And then for private providers, vaccines.gov will help you to find a pharmacy in your neighborhood where you can easily obtain a vaccine. So we continue our operations in cooperation with Austin public health, Travis county, our vaccination collaborative. We are at the Travis county expo center at 7311 decker lane on Saturdays and Sundays, 9:00 A.M. To 5:00 P.M., doing drive-thru vaccinations. Expo is also the regional [9:40:09 AM] infusion center which is by physician referral only, of course, but folks can get a antibody infusion there. And we are setting space aside at expo for an alternate care site to relieve pressure on our regional hospitals should that be needed. But all of that effort at this point is focused at the Travis county expo center. I'll stop there and turn it back to y'all for questions. Thank you. >> Judge Brown: Thanks y'all very much. I'll turn it over to commissioner gómez if you have any questions. >> Gómez: I don't have any questions,. >> But I want to continue to thank very much to the collaborative team for going out and seeing people where they are. And in convincing them to get vaccinated. And so that -- that's the end goal here. And it's true, if we don't get vaccinated, we're going to be hospitalized or we're going to die. And I'm very appreciative of the [9:41:10 AM] psa that pope Francis put out this past week about each person needing to show a little love for yourself, get vaccinated, and show a little love for others so that they don't get infected. And so this is about living, about having life. And we need to -- we need to take that step. Thank you all. >> Judge Brown: Thank you, commissioner. Commissioner Shea. >> Shea: Thanks,. Judge andthanks to all of our stuff. You guys day in and day out are continuing real amazing work to keep our community safe. My question really is with regard to the booster -- do we have a -- do we have kind of a central location where people can get basic information about it, even if we're not ready yet to start rolling things out, can we at least direct people to one [9:42:11 AM] site, one location, where they can get information? Because we're starting to get questions about it. >> Yes. The aph has information on their website, and their social media feeds. I'll let Adrienne add in as well. >> No, you took the words right out of my mouth. On that page that Mr. Brotherton landed on about vaccinations, there's also information about boosters. Folks can call in to -- as I said, to schedule an appointment and to ask for information and we're offering them at any of our locations that we're giving out vaccines. You can come and ask for a booster shot. Just make sure that it's a location that offers the shot that you received initially and we are staging operations so that we'll have both vaccines [9:43:12 AM] available so folks won't have to make that choice. >> Shea: And do people need approval from their doctors? >> For boosters? Right now, it's self-attestation. Our website lists the information that helps people to identify whether or not they are immunocompromised. If you're still speaking, ma'am, you're muted and I couldn't hear you. I saw your -- >> Shea: I'm not muted on my end, but, thank you. >> Judge Brown: Thank you. Commissioner Travillion. >> Travillion: You know, once again I want to sincerely thank the team for reaching into the communities and putting up the types of strike teams that are necessary to go into places that are not easy to access. I think that the team that's been putting those resources [9:44:13 AM] together has been exceptional and has made a real difference, and we are hearing about them when we go to football practices and talk to booster clubs and whatnot, they are aware of you. And we wanted to make sure that we continue -- continue on along the lines that you are going. I am still interested in how we continue to build that trusted community member, those trusted community institutions. And along those lines, I'm wondering whether we have worked out more of the details for the pipeline that will allow us to train medical personnel. I know that we have talked about it, there are a number of groups out there in the local workforce board. I know that have that idea. But there are a number of groups that work more closely with [9:45:14 AM] communities. And I'm wondering how far along have we gotten to making sure that there's a pipeline so that people who are interested in working in the medical field and would be trusted members to a lot of the community folks have the opportunity to be trained and work in this area. That might be a chuck question. >> Commissioner Travillion, I hear your call to our healthcare systems to make sure that they are accessing that pipeline for talent. I know that the contract that the county has executed with ascension to build the team that is staffing our strike teams that are in the communities day after day, those folks are hiring from across the region any available qualified person. [9:46:17 AM] So it just continues to be something that we have to stay in touch with our colleges and universities to make sure that those programs are -- continue operating and that we continue reaching into them to pull talent into the work that we're doing. >> Travillion: And I appreciate it that ascension and the work that they are doing. But I think that there are a number of groups that are closer to ethnic communities and are closer to neighborhoods and fulfill that trusted organization space. And I just want to make sure that those groups are connected with ascension Seton or capital idea or ACC or whomever, because ascension Seton is a wonderful group but they need help from trusted organizations and I'd be happy to sit down with you or sit down with anybody on your team and help identify some of [9:47:17 AM] those groups and where they are already working, the results that they're already getting, because I -- I think that there's only so far the large organizations that can go into communities. I think that one of the reasons that -- that the strike team is so effective is, you know, you've got a constable who grew up here and is part of a neighborhood, who is consistent there. I think that there are other community resources that we have to call on in order to move -- in order to penetrate the communities in a way that we haven't done so far. So I don't want to sound like a broken record, but there are some resources that we're leaving on the table, and given what's going on with the variant today, we don't need to leave anything on the table. [9:48:18 AM] >> Judge Brown: Thank you. Commissioner Howard? >> Howard: I had a quick question maybe for Adrienne. Can you point on the website where I can direct people to who need a replacement vaccine card? I've had to call on some special favors, and I'd like to be able to do it myself. But I don't know where to go. >> And so I'm not certain if there's a spot on the website, but if folks have contacted aph through 311 and they have, in fact, received vaccinations through us, we can assist with that. It becomes more problematic if they got their vaccines from someplace else, so for now I would continue to have folks to call 311, and I will get with the team to make sure that we have a spot on our website that >> Howard: Thank you. >> Judge Brown: Thanks. Hey, constable morales, do you [9:49:19 AM] -- first of all, y'all are doing amazing work, you and chief Bailey and the whole team over there. 1,600 doses in a week are great. And, again, it's the communities that we're trying to increase the percentages in so I wanted to give you a shout out for that. Can you discuss anything -- kind of picking up where commissioner Travillion mentioned, are we looking to doing canvassing or going to people's homes or anything along those lines, would you mind? >> So, judge we do block walkings and I explained to some staff members that we try to hit it early in the morning when it's cooler. But we have been in the areas that have been affected highly. And the goal there right now is to push people to the shot locations that are nearest to them. And then we also leave a phone number for those that are -- do not have the resource to get to those clinics and we provide a home shot for them. And that number is strictly [9:50:20 AM] listed on the flyers that we put out there, 512-854-shot. As we continue to go out into the areas, we also started mailing out this week 1,200 mailers that just went out this week. And to the areas where pop- ups are going to be showing. An example is the dove springs rec center, and the St. John's catholic church and the blackhawk community centers. You know, that's -- you know, some areas we can't get to, like apartment complexes that are gated so we'll be mailing into those. Mobile home parks that sometimes are just fearful when people are just walking around the area, and they want to be a little bit more private, we'll be mailing into those areas. >> Judge Brown: Sounds great. Thank you so much. Mayor, I will pass it over to you. >> Mayor Adler: Judge thank you and, we will start with the mayor pro tem and work our way into district 10. So mayor pro tem is with us? [9:51:28 AM] You're muted. >> Harper-madison: My apologies, chair. Did you recognize me? We'll having some trouble with the first day of virtual sixth grade. My apologies, everybody. And that is actually really a delightful segue into the most troubling part of all of this for me, so I'll reiterate my colleagues' appreciation for all involved and doing this incredibly difficult work. And I just want to be clear about expressing my biggest concern right now, both from a personal perspective as I have a second grader who is at a school up to their fifth case this week. And we're rolling into the second week. Very concerned that we will find ourselves in a position where our scholars are encouraged to resume virtual learning and I don't know if that's Austin public health/aisd question? [9:52:29 AM] But if I can ask the part that you are able to answer -- whether or not that is something as a parent that I should be expecting? Or that other parents should anticipate as a possibility? And then I also had a question about -- I was told that our ventilator use this time around is up some incredibly high percentage. And I wanted to know if that is, in fact, a case and what the plan is moving forward for having appropriate equipment for treating patients who need ventilation? >> For the first part of your question, or first question -- yes, the school numbers are very troubling. And the decisions about changing the processes at school will be made by the independent school districts. So we're just waiting and [9:53:32 AM] watching to see what changes will be made. That's going to be done on a case-by-case basis because we're unable to have the impact and the input that we had in the past -- the past year when schools started and so we're just waiting and in constant communication with the ISDs as the numbers start to become clear. With regards to the ventilator use, there has been an increase in ventilator use, but we have been able to keep up with that. We have a lot of ventilators available to us in strategic national reserve. So at this point we're doing okay with ventilator use, and they have been able to issue to [9:54:32 AM] the hospital systems that have been requesting them. The situation is very surreal because what is happening in our hospitals is very, very concerning. And what's happening outside the walls of the hospitals is very much in many instances looking like business as usual. And it's really important for all of us here assembled for this meeting to translate the reality to our people. We need to be masking and we need to be getting vaccinated and we really need to stay home if we're sick, get tested, and avail ourselves of the opportunity for treatment with the antibodies early on when we discover that we have covid-19 so that we're not progressing to illness that requires [9:55:34 AM] hospitalization. >> Harper-madison: Thank you, I really appreciate that and I do so hope that we can do a better job this time around than we did the last time, watching our constituents struggle to figure out childcare and meals that they anticipate their children receiving through our school systems. I mean, just all of the logistics that go into having a working parent and children, they didn't have enough time to prepare. And I think that the lurch that we left everybody in just by not -- I mean, I'd rather we with an abundance of caution react too abrupt, too -- overreact, I think is the word that I'm looking for -- I'd rather that we overreact rather than underreact because watching our families struggle to recover is really heartbreaking. And I hope that we don't have to watch that happen again. Thank you very much, I appreciate your time. [9:56:36 AM] >> Mayor Adler: Thank you, councilmember Fuentes. >> Fuentes: Thank you. Colleagues, we know that president Biden, the Biden administration, has announced that they will be releasing booster shots beginning the week of September 20th. And so certainly it's great to hear from director Sturrup on the work that we're already doing here with the city and with Austin public health around the administration of booster shots. And I'm happy to hear that aph is in conversation with our I.T. Department to ensure that we're up and ready to meet the moment when we have a surge of individuals who will be ready to take their third vaccine shot. And so I will be bringing forward the policy direction on Thursday at our council meeting that sets forth a booster vaccine strategy that is rooted in equity, but ensures that we are having space to talk about lessons learned with our initial vaccine rollout, and also ensures that we have a robust [9:57:37 AM] public health education campaign. And with the investment of the city recently made with community health workers who are going to be our front of the line agents to help us to address some of that hesitancy that we're seeing in our communities, I think that will go a long way. So the question that I have, director Sturrup, is when you mentioned that we still have about 200,000 austinites that have not yet received a vaccine, can you talk us through with the recent announcement of the pfizer vaccine, receiving full F.D.A. Approval, how are we really leveraging this moment to educate our community when we already know that the vaccine is safe and effective and that you should get it as soon as possible -- what's the plan there to really promote that it has full F.D.A. Approval to address some of those hesitant individuals that make up that 200,000? >> Thank you for that. I [9:58:39 AM] for that. It will be more of the same of what we are doing. At our media availability on Friday, we will take that opportunity to spread that message even further. Our joint information system is working on a campaign to begin to push that out again through social media. So it's a three-point tack. We want to make sure that people know about the mononuclear antibody infusions, boosters, and what it means about the fda approval and the safety and the efficacy of those vaccines. And so we will be using the strategies that we've had in place before. So it'll be the social media push. We'll be on the radio. We'll connect with our community partners that have been boots on the ground and supply them with information. And of course our street teams will have that information as well. >> Fuentes: Thank you. That's really great to hear, because I know in my [9:59:39 AM] conversations that I've had with community members, one of the most common feedback that I receive is that the vaccines are rushed and they came out too fast. And I don't know, it was too quick. And so I think really having a plan in place to promote what's been fully approved, it's safe, go get it, take the shot. That's going to go a long way. Thank you so much for your work. >> Mayor Adler: Thank you. Councilmember Renteria. >> Renteria: I just want to also say thanks to the people out there, you know, distributing the vaccine and trying to get people to go and get vaccinated. I can imagine how frustrating it is to constantly be going out there and begging folks to get their vaccine -- get vaccinated. It really just disappoints me. And I have parents that say, when are you going to open the [10:00:39 AM] gym, I want to go back to boxing or playing basketball. And here we are in stage five again. And we can't open up our gym so our kids can go out and play and participate in sports. So, you know, this is very disappointing. And I share the frustration, because I have family that are suffering, also. And I didn't force them to take that shot. Pick them up and take them to the location. They still say no. So it's just frustrating. And I hope y'all come to the realization before your kids end up getting sick, you yourself get sick, or somebody that you love gets sick and up in the hospital. So all I can say is quit being so stubborn and go and get [10:01:41 AM] vaccinated. >> Mayor Adler: Thank you. Councilmember Casar. >> Casar: Thank you. I want to second what folks have said about taking this moment to convince folks to change their mind. And I've had recent conversations with constituents who have changed their minds. And I think it's important to tell those stories to say, look, there are some people just like you who didn't want to get vaccinated, but now with this news have changed their minds, why don't you do so, too, so we open up the door for people to do that. My question, Dr. Walkes is, I think I followed the four charts on the declining efficacy over time, but because they weren't really clearly labeled I've already gotten questions from people saying what does each of those four charts mean. Can you walk us through one more time what the assumptions are for those four charts that show the declining efficacy over the course of the eight months? >> Sure. So, the charts allow for [10:02:43 AM] whatever the beginning assumption was as far as efficacy is supported. So for the mrna vaccinations, modern and pfizer, they were 94.5 and 95% each as far as their efficacy at the beginning. And with time, the amount of protection against the severe disease or mild disease -- mild disease is the solid line. The dashed line is the severe disease. And that lower right-hand side graph would be the one for the 95% efficacy mrna vaccines that are available here in this country. And that shows that over time, at the 250- day mark, that we're [10:03:43 AM] seeing that level of drop in the efficacy of the product. >> Casar: So -- >> And on the left-hand side, that's kind of illustrating what we're seeing in our community that goes along with that. And the fact that we have so few breakthrough cases after delivering over a million plus doses shows that yes, it is protecting. The fact that only 42 of the 3600 cases were hospitalized shows that this disease that we see represented on this graph is mild. And so it is still protecting against severe disease for the most part. So that's what this -- what these two graphs are representing. >> Casar: Thank you. Just to be really clear, with the focus on the right side with the four smaller graphs -- >> That was done because there's [10:04:45 AM] several different vaccines out in the world. And they don't all have the same efficacy. But the ones that we're talking about, particularly in our country, that are most widely used are the mrnas, 95%. So that bottom right-hand corner applies to our scenario. >> Casar: People should focus on that chart, look closely if they got pfizer or modern, and the dotted lines are severe disease. And the solid lines are more mild infection. But they should focus on the bottom right one. And the difference between red, purple, and blue is? >> Just one sec. I need to pull up my key. >> Casar: It seems to talk about half life of ten years, but I think some folks might really want to know in layman's terms what that means for them. [10:05:46 AM] >> That's not going to be as easy to give you. It's a long paragraph. Can I send you that? >> Casar: For the average person watching, which of those lines, for a person that got pfizer with public health or the collaborative, which line should they be looking at or thinking of? >> The blue. >> Casar: The blue line. >> Yeah. >> Casar: Okay. So for us right now, people generally should be looking at the bottom right chart. And the solid blue line for mild infection, and the dotted blue line for severe disease. >> Exactly. >> Casar: So that folks aren't looking at the top left chart and looking at the solid red line. That wouldn't be a good way for people to be reading this chart for what this means for themselves. >> Exactly. Thank you. >> Casar: Okay. >> I'll send you that. >> Casar: Thank you. [10:06:46 AM] >> Information. I'll send you the article. >> Casar: That's fine. I'm happy to take a look at it. There's such a large difference between those scenarios, so, thank you for that, Dr. Walkes. >> Thank you, sir. Thanks for the question. >> Mayor Adler: Thank you. Councilmember kitchen. >> Kitchen: Thank you. This is all very helpful information. In the interest of time, I'll just ask one followup and then I would just ask also to be -- with regard to nursing facilities I'd like to have an update on what's happening there, but we can take that offline and then perhaps at our next joint briefing we can get some more information on what's happening with people living in nursing facilities. My question today, can you help me understand if there are any targeted efforts occurring at [10:07:46 AM] the moment in 78745? I'm just trying to remember -- or wanting to understand what the current status is. That's one of the zip codes that is somewhat lower with regard to vaccinations. >> And so I am aware of the mobile vaccine program selecting locations in that area for vaccinations. And they're kind of taking advantage of -- I can't ever remember what the marketing term, but when you're in the checkout aisle and they put candy there and you buy one. So we're really trying to create those easy opportunities for folks to get vaccine during the course of their day, and even when they're leaving a schedule site they've reported back that they've stopped at work locations or restaurants and just asked people, hey, do you [10:08:48 AM] want to be vaccinated, especially if they have leftover shots. We are building off of the model that constable morales and his team put forward. And as we're hiring community health workers, they will too use data to figure out locations where that kind of boots on the ground information would be most useful and either set up locations or events for the mobile vaccine teams who come in and give shots, or drive people to locations. >> Kitchen: Okay. >> I can provide more specifics about the activities and the events at the next briefing if you would like. >> Kitchen: Yes. That would be fine. And I'm curious if this isn't one of the areas that the constables have been going door to door. >> Yes, it has, councilmember. We have been into the cooper lane area, stassney, and [10:09:50 AM] manchaca, and we have three locations, qc market, and a pop-up. >> Kitchen: Okay. Thank you very much. >> Mayor Adler: Thank you. Councilmember Kelly. >> Kelly: Thanks. I don't have a question today, but I do have a story I want to share. So as we've all talked about, vaccine hesitancy is a real thing in our community. And recently I was able to convince my 77-year-old family member to get vaccinated. And I just want to thank Austin public health for being able to provide that opportunity to my family member, who's homebound and watching right now. I'm proud of you for getting that vaccine and making that personal choice. With that said, I want it to be known that we can all be advocates for the vaccine and we can all continue to talk about the benefits. And we really should for the safety of our community. Thank you. >> Mayor Adler: Thank you. Councilmember pool. >> Pool: I'd like a little bit [10:10:53 AM] of ex-plication on the percentage of prevention that the vaccines offer. When it came in at 95%, for example, my understanding was that was pretty high and the normal percentage is something lower on vaccines. And so the reason I'm asking that is I wanted to put the lowering percentage numbers into the context of what is expected from a vaccination and rates for prevention. >> So, we usually, with the flu vaccine, many years we don't get more than 50 to 60%, sometimes 70. When they initially started asking for submission of data for the vaccine candidates that [10:11:55 AM] were being worked on, they were looking for something that was at 70, but that's pretty high. There are years when we don't quite get all of the variations of, for instance, the flu virus that's circulating in our community. And sometimes the flu vaccine is not as effective and people will get mild illness for that reason. And so having said that, the hope was to get something along the lines of 70% at least when they were requesting that these vaccines were developed. So that's a good level. And with the decay that we're seeing here, even at the 250-day mark we're in that range of [10:12:56 AM] about 70%. And we're seeing the level of breakthrough that we're seeing here based upon the fact that we not only have -- well, actually, predominantly right now we have the delta variant. So that's why we're seeing the level of breakthrough that we are seeing. But even at that rate, it's not that bad because it's 3400 cases total over that period of time and there have been over a million doses delivered. So we're still getting good coverage and good benefit from having been vaccinated. We're taking that extra step to boost our immunity because as we know, we have over 200,000 individuals in our community alone, and only 2% of the world is vaccinated. So there's still a lot of [10:14:00 AM] fertile ground for this virus to mutate and create another variant. So it's really important for us to not only vaccinate ourselves, but for the world to be vaccinated so that we don't develop any more mutations. >> Pool: Right. So, the takeaway for me there is that a very high rate of efficacy, and even with the decay, it's still at rates that provide a lot more protection even than our annual flu vaccinations. And with the fda approval that happened yesterday, and the fact that these vaccines are so easy to get in our community, I just urge everybody who has not yet gotten their shot to go out and get the jab. And that is your job, is to get the jab. Thanks. And thank you to our staff for continuing at a time when I know they must be emotionally and physically exhausted. Thank you so much. >> Mayor Adler: Thank you. Councilmember Ellis. >> Ellis: Thank you, mayor. [10:15:03 AM] Dr. Walkes, could you go into detail about guidance for outdoor events? Seeing situations where some voluntarily cancelled their events, like blues on the green. And acl announced it's going to be requiring vaccinations or proof of negative tests. So I think there's a lot of folks that are curious over the next couple of months what to expect for outdoor events, what can we encourage as a city, especially on things that are on public land or should there be any changes in expectations in the future that you see people should be aware of right now? >> I think that the reopening of schools is going to have a large impact on our community with regards to the numbers of cases that develop, particularly if we don't mitigate and have mask-wearing. And so as that unfolds we're going to see that we're going to have to revisit our expectations [10:16:04 AM] and what we can do in our city. The way that this virus spreads is through social interaction that's unprotected by masking and vaccinations. And so at this point, we are looking at advising policy-makers and making recommendations that are going to put in place guidance that's based upon the fact that our situation is changing in the wrong direction. And we don't have all of our citizens vaccinated. We have a lot of cases in our hospitals, our icu capacity has been exceeded. And in certain areas in our trauma service area, we're looking at higher mortality rates than we are seeing here in Travis county. We have to put the brakes on [10:17:08 AM] now. And we have to take a serious look at those situations that are going to put more strain on what we're currently experiencing. So that's not a definitive answer to your question because the situation is fluid and it's going to require an assessment of all of those factors that come into play when we have large events. Things like the strain on our emergency systems, the strain on our hospital systems in particular. We've received some staffing, but it's not enough. And we would love to have an alternate care center, but we need staff in our hospitals first. So all of those things factor into the decisions that are made with regards to large events. I'm sorry I can't be more [10:18:08 AM] definitive, but that's all of the -- it's more complicated than I guess -- answer. >> I appreciate that. Folks are paying close attention, both event organizers and people who would like to attend an outdoor event. I know it's really important in our community to keep our eyes on some of these other factors. >> Yes. >> We want to make sure our kids at school are healthy and safe, too. I know that's a really big concern for a lot of folks. I do appreciate your answer. >> Thank you. >> Mayor Adler: Thank you. Councilmember tovo. >> Tovo: Yes, thank you. Thank you for the questions about that chart. Dr. Walkes, I was going to suggest, I think that chart is a little challenging for general members of the public to understand. And so if you would send us all that extra information, I think that would be helpful. But I think it's super to have [10:19:08 AM] that kind of detailed information and I wonder if what might help is just to have a summary comment about what the conclusion is on that page, just so that all of us looking at it kind of get that main takeaway that you said, which I think was, as I understood it, that even at these variable rates, having a vaccine still provides protection, significant protection over the course of the next months. And so again, I think having those kinds of summary comments paired with that detailed information might be a good way to just continue to emphasize to this public that message, to the general public. And thanks for providing that detail. I had two quick questions. One is, if someone could please clarify whether the Travis county and city orders extend to schools beyond k-12. It's my understanding that those [10:20:10 AM] mask mandates extend, appropriately in my opinion, to our community college as well as to our public colleges within the city of Austin and within Travis county. So that would encompass U.T. My second question, could someone on the call, Dr. Walkes probably, clarify to whom monoclonal treatments are available? >> The masking does apply to everyone except U.T. Because that's on state property. And the monoclonal antibodies are available to those who are at risk for developing severe disease. So that includes people with immune compromised conditions such as cancer, those who are taking antirejection medications after organ transplantation, [10:21:12 AM] diabetics, those who are over age 65, those who are in certain racial classes that have been historically disproportionately impacted by covid-19, those who are over the age of -- I'm sorry, over the bmi, body mass index of 25. So it's a very long list. And it is at the discretion of the provider that's evaluating the person that is testing positive. And it requires a referral from a provider. And then they're offered an appointment. And we have appointments available Monday through Sunday. Did I answer all of your questions? >> Tovo: You did. Thank you. I appreciate that. I believe you may have covered this in a previous session, but if an individual believes they may qualify for the treatment or is uncertain but does not have a provider, what should they do next? Should they call 311 and get [10:22:13 AM] connected to a nurse line? >> Yes, they can do that. And then there's some safety net providers in our city that can offer them services as well, as well as telehealth lines that are available for that purpose as well. >> Tovo: Great. Thank you. So if a person believes they may qualify but doesn't necessarily see themselves reflected on that list, they should call just in case, because the treatment is -- >> Yes, and earlier rather than later, because it's not available to those who would require oxygen therapy, or if they do require oxygen, somebody that requires more oxygen than they normally would, or someone that would be more appropriately treated in-hospital. So as soon as you know that you're positive, reaching out to a provider for some guidance is the best thing to do, because [10:23:16 AM] the treatment should be done within ten days of symptom onset. >> Tovo: Thank you very much. >> Thank you for the question. >> Mayor Adler: Councilmember tovo, thank you. Those questions about the monoclonal treatment are real good questions. In a world today where we have such scarcity in our system and we're strained in so many places, the one place where we have capacity that's not being utilized is in this monoclonal treatment. It's the treatment that the president got. It's the treatment that the governor got. And it is available in our community for anyone who's at risk and gets that referral. And if you don't have a primary care physician, as Dr. Walkes said, call 311 so that we can get you someone. But remember, it has to happen early in the course. You can't wait until you're in a tough place, because then at that point you're not eligible [10:24:17 AM] for it anymore. So people who are at risk, which is what this virus really does seek out, should really take advantage of that. Dr. Walkes, I want to thank you. You have appeared now in multiple court hearings, most recently the temporary injunction hearing yesterday in front of the judge. I appreciate you sharing the factual information that you are with the court and we'll all wait now to see what happens with that. These cases are in the district court level and working their way up through the appellate court level. We appreciate -- I meant to say a second ago, I appreciate the governor for standing up that monoclonal center that we have, because that's something the state has done for us. And we appreciate that. We appreciate the staffing of our hospitals. We just wish there was more, because what we're getting isn't enough. But the courts right now -- it's [10:25:24 AM] at the court of appeals level, district courts doing temporary injunction hearings, various parts of the state, will work their way up. We appreciate that the supreme court hasn't ruled on the merits and is waiting for those cases to be developed. And we're all waiting to see. But I think that the cases that are moving up right now just really clearly identify the issues. It's about our kids, at the highest priority and the question is can local school boards and parents provide the protections that all of the doctors and data say are necessary for our schools. Dr. Walkes, do you anticipate getting here sometime soon your guidance with respect to large [10:26:27 AM] events, the protocols acl are using? I know other venues are reaching out asking for the same kind of advice. And I know some of them individually have gone to you. But do you have a general timeframe for when you're anticipating being able to get out your analysis of how large events impact infections and what's necessary to keep that number down? >> I believe that we are planning on setting up a meeting sometime in the next 24-48 hours to talk to both you and judge brown and city manager cronk. So they should be directly. >> Mayor Adler: Sounds good. Thank you for that. And again I want to thank the constable and the chief, and your office, and director Sturrup's office. Everybody's working really, really hard to -- on this [10:27:28 AM] effort, so, thank you. It looked like people had raised their hands. Councilmember Casar, real fast. I know that judge brown's trying to get back to his meeting. >> Alter: I didn't have a chance to ask a question. I wanted to ask my question. I wanted to first of all congratulate all those folks who had a great start to school and really appreciate all of the students and teachers who chose to protect themselves and others by wearing masks. I know from my son that, you know, folks were complying and at least at his high school. I wanted to congratulate them on doing that and thank them. My question has to do with the fda approval. It's my understanding that the original orders from the governor did not apply if there was fda approval. So I'm not sure who can best answer this, if it's director Sturrup, the city manager, the mayor, or Dr. Walkes. [10:28:30 AM] But how does this change the landscape for requiring vaccines in different kinds of settings, whether it is the city, whether it is, you know, one of our local universities, whether it's the school district, whether it's employers? >> And so we are still getting that complete analysis from city legal. The attorney that I was conferring with yesterday said she needed more time to look into it. And what she said was it does give us some more leeway, but she believed there was something in the order that she wanted to check out before she gave us guidance or advice. So we are working to understand what that means for us as a city. >> Alter: I certainly hope that all of those folks who said we needed to wait on approval will now take the important step of getting vaccinated or allowing us to further encourage [10:29:31 AM] vaccinations more forcefully now that there is approval for one of the vaccines. Thank you. >> Mayor Adler: Before I pass it off to you, judge, one last thing real fast. To demonstrate the efficacy and impact of the vaccine, numbers happening around the world, forgetting numbers around the country and state, just looking at what we're looking at in Austin right now, the chances if you're unvaccinated of ending up in the hospital are not twice as great or four times as great, or eight times as great, or sixteen times as great. You are 17 times more likely to end up in the hospital here in Travis county if you are unvaccinated than if you are. So we are hoping that people take a look at the new information and data. With that, judge, we'll turn it back to you. >> Judge Brown: Thanks, mayor, councilmembers. >> Judge, I just have a quick [10:30:33 AM] request before we end the joint session, and that is for future briefings, if the staff can begin to talk in specific terms about how we will prepare to roll out the booster program, I just don't want to repeat the confusion and the chaos that happened when the first round of vaccines became available. I think we need to be clear with the public about how we intend to do this. So I would ask that that be part of our future briefings. Thank you. >> Judge Brown: Dr. Walkes, do you want to address that? >> Shea: It's a request for future briefings. I don't think we need a whole discussion about it now. But I think the public will want to know that information and will need to know. >> Judge Brown: Yeah, I'm just seeing if they have any updates for us right now. >> And so there is no different process. You can walk up to any site where aph offers a vaccine and request your booster. You can register through Austin [10:31:34 AM] health force in the same way that you might have registered for your first round of vaccinations. Of course there's the screening questions that one will have to do either online or when they show up in person. I will say that your process will go faster if you preregister online. But that does not have to be a barrier. And because there are multiple providers in community and for the boosters, aph is not required to serve as a hub provider, we are not expecting the same type of mad rush for our services as we saw in January. But there is no different process. You can call 311. You can sign in through your account. Click the booster button or the third shot button and schedule your appointment. >> Judge Brown: Thanks. Chuck, I know we've started talking to community care and Jason, ascension, others that worked on these efforts early on along with aph and Dr. Walkes. [10:32:36 AM] And so maybe next week, chuck, we could get an update from them to what commissioner Shea is asking about. It seems like the data for everybody who's gotten the first and second shots is in community care's database already, there would be some less complications. But, you know, it sounds like we still have some work to do to prepare for that. >> We do, judge. We are in conversation with community care and decision to be made about whether we want to begin using an appointment-based system out at our drive-through site at the expo center. But again, that database exists with community care for the first few months of our vaccine rollout. And then we've also got chief Bailey's database as well. But those decisions are still to be made. Fortunately we do have a little bit more time, commissioner Shea, than we had last time around. But we are actively planning and I'll be sure and update you next [10:33:36 AM] week. >> Judge Brown: Awesome. Thanks, everybody. And thanks. So I guess we're going to adjourn now. Why don't we come back at 10:40 at the commissioners court and I'll pass it over to you, mayor. >> Mayor Adler: Judge, thank you. We'll go ahead and adjourn the city's portion of the joint meeting here at 10:33. We'll try to gear back up at 10:45 so people can participate remotely. I'll probably work my way down to the chamber. Quarter 'til. See you guys then. >> Judge Brown: Thanks.