Good afternoon,

Notes from the October UASI Health and Medical Committee meeting are below. In addition, you all should have received a direct Outlook invitation for the next meeting (specifically to review Goal 7 of the UASI Strategic Plan). If you did not receive this invitation, please contact ian.feldman@houstontx.gov. An Outlook invitation for the December regular meeting will be sent at a later date.

• The committee approved a change request to the City of Houston’s FY2019 Syndromic Surveillance project. Using cost savings in salary and travel/training, additional IT infrastructure will be added to support the increased number of facilities providing data to ESSENCE. The change request now goes to the UASI Executive Committee for final approval.
• Decrecia Limbrick from the Houston Health Department provided an update on the COVID-19 Vaccine project. There are six vaccine candidates under development, though two have paused their clinical trials due to adverse reactions. Five of the six will require two doses given 3 or 4 weeks apart. It is also anticipated at the moment that if someone receives a specific brand of vaccine that they cannot later switch to a different one. The distribution of the vaccine will be done via a phased approach designed around vaccine availability. A public relations campaign is also under development to help explain this process to the public, though it will only be finalized after the local plans are approved and additional details and timing are known.
  • Houston, along with Harris County and other jurisdictions, are what is being considered Phase 0 of the plan to produce and distribute vaccines for COVID-19. This phase entails recruiting sites to serve as vaccine providers when the first vaccine is released (either through formal approval or an EUA). Organizations interested in being providers can apply at https://enrolltexasiz.dshs.texas.gov/emrlogin.asp, however there are certain requirements (including the ability to store vaccines at cold or near-freezing temperatures) which may limit the number of eligible applicants.
  • Phase 1 will begin after the vaccine becomes available, and will involve providing the vaccine to priority candidates (likely healthcare workers, public safety workers, teachers, and workers involved in the food supply/agriculture industry). Final determinations on initial vaccine recipients will be made in consultation with a state panel.
  • Assuming a November start to Phase 1, Phase 2 will likely occur in the start of calendar year 2021, and will involve increasing the number of approved providers and vaccinating additional groups. During Phase 2, DSHS is anticipating using contract support to ensure underserved populations receive the vaccine (local health authorities will work with DSHS to identify these areas).
  • Phase 3 will commence when the vaccine becomes widely available and larger portions of the population become eligible to receive it.
  • Phase 4 will mark the point where need starts to decrease due to high vaccination rates in Phase 3.
• The group reviewed and updated Goal 6 of the UASI Strategic Plan. This is part of an effort that occurs every other year to update this document. Changes were made to account for completed tasks from the previous version as well as account for new concerns using lessons-learned from COVID-19. Language related to the need for CBRNE considerations in regional planning was also modified to more accurately reflect the role of HMC in this process.
• The group will have the opportunity to review and update Goal 7 during a special meeting to be held at noon on Wednesday 18 November 2020.
• During the COVID Updates open discussion, Lori Upton indicated that hospitals are starting to see a slight uptick in hospitalizations, but still staying below levels seen in July and August. SETRAC is still pushing PPE to hospitals and other healthcare facilities and providers. CMS also has new interim rules coming out and SETRAC will work with facilities in the region to ensure that the data they are reporting is properly formatted so as to avoid facilities losing CMS accreditation. Allison Reese with HCIFS also noted an uptick in fatalities recently, and indicated that the region’s plans regarding cold storage capacity will need to be reevaluated (even the planning in the Mass Fatality Plan will not cover the potential need, and lacks certain considerations for regional collaboration for this resource). Dr. Persse with the City of Houston asked about increases in fatalities year-on-year throughout the pandemic, and Allison Reese and others verified that they are seeing a statistically significant increase in fatalities locally, and are hearing of similar increases across the country. The exact reason is not known, but increases are being seen across multiple causes of death, not just natural deaths.
• Tina Rose provided an update on planning efforts from the Clinical Advisory Committee. A POETE table for the region’s surge capacity for burn patients has been created, and the regional burn surge plan is in the editing phase. A tabletop exercise for this plan is anticipated to take place on 28 January 2021.
• In additional training and exercise updates, Lori Upton stated that the SETRAC Symposium is expected to take place in Galveston in 2021, and dates are currently being finalized. SETRAC is also trying to bring a pediatric mass casualty class from TEEX to the region in the spring of 2021.
• Alison Belcher updated the group on new modeling for the THIRA’s pandemic scenario. Johns Hopkins University has begun the process for the main THIRA scenario, which is a COVID-19 pandemic and seasonal influenza with no mitigating factors in place (masks, distancing, etc). At the conclusion of this, the contract will still have additional funding to run other models that are of more direct use to local health authorities and the medical community, and if there are specific requests in that area they should be sent to Alison.
• Alison Belcher also reminded the group that voting members should review the SPR gaps distributed via email and provide changes by the end of October. Alison is also soliciting examples of real-world use of grant-funded equipment, plans, and programs. THIRA/SPR meetings are ongoing, and jurisdictional EMCs will see the NIMS and CPG 101 reporting surveys soon. The kickoff for FY2021 UASI will happen in November and follow a similar schedule to past years (possibly with some earlier jurisdictional internal deadlines to allow the grant managers more time to review projects). New for this grant cycle will be workshops to help jurisdictions and agencies write their applications effectively.
• During the Good of the Order section, Allison Reese asked the City of Houston for an update on its efforts to detect COVID-19 spread via the sewage system. Dr. Persse stated that the program is going well, and there is a correlation with numbers from in-person testing efforts. Samples are being tested by two different labs, and the results from both labs are also consistent. The testing can be done via the zones in the sewage system, and testing can also be done at the building level by sampling at its connection to the sewer system. This building-specific testing has already been done with the Harris County Jail and two homeless shelters, and the City hopes to continue it at specific schools. The issue now is that as this process gains popularity nation-wide, the technology necessary to collect the samples is becoming harder to get.
• During the Good of the Order section, Lori Upton also asked about ways to encourage additional participation during future meetings. For the November meeting for Goal 7 of the UASI Strategic Plan, a traditional Outlook Calendar invite will be used in place of the email distribution from the UASI site in case the current meeting notification method is not effective. Ways to require participation were also discussed. While the only participation requirement that the Executive Committee sets for voting members is participation in THIRA/SPR meetings, they do allow individual committees to add further restrictions on their voting members. To that end, Lori Upton and Dr. Persse will consider the possibility of adding committee participation as a criterion on scoring future grant applications for this committee.

The next meeting will be the review of Goal 7 of the UASI Strategic Plan at noon on Wednesday 18 November 2020. The next regular meeting is scheduled for Wednesday 9 December 2020. THIRA/SPR meetings are currently happening in October and additional THIRA/SPR meetings will take place in November; questions on those meetings and information on scheduling/invitations should be sent to Alison Belcher (alison.belcher@houstontx.gov).