Boise-based health district issues ‘strong recommendations’ for major changes to combat COVID-19
Editor’s note: This story was updated to clarify that there is already a mask mandate in place for Ada County in public spaces.
Central District Health on Tuesday night issued a series of “strong recommendations” aimed at significantly reducing residents’ activity without additional mandates in the latest attempt to slow the spread of COVID-19.
Among the recommendations are requests that residents of Ada, Valley, Elmore and Boise counties — those under CDH jurisdiction — wear face coverings anytime they’re within 6 feet of nonhousehold members; suspend youth and adult sports where social distancing can’t be maintained; work from home if possible; avoid close contact with nonhousehold members if they’re in certain risk categories (including 65 and older); and close restaurant dining rooms.
Masks were already mandatory in public spaces in Ada County, per a CDH public health order. Now, CDH recommends masks be worn everywhere when 6 feet distancing is not possible with nonhousehold members.
CDH Director Russ Duke said during the board meeting that it has been made clear to him that people do not want mandates, so instead he wanted to issue a health advisory. The advisory doesn’t address the operation of schools other than in extracurricular activities. Duke told the board schools have done well controlling COVID-19 and he doesn’t think closing them would have a significant impact on community spread. The Boise School District is going to remote learning after Thanksgiving break because of staffing shortages related to COVID-19.
The health advisory is based on situations that Central District Health has seen happen in the community, common sources of transmission and health care advice. There is no penalty for violating the advisory, but there is potential it could later become an order from the health board.
The advisory was approved unanimously by the Board of Health.
The advisory states that if one of the major health systems in the Boise area — St. Luke’s, Saint Alphonsus or the Boise VA Medical Center — reaches crisis standards of care, it could become an order. Crisis care is defined as a situation when health care providers are forced to choose which ill person receives medical care because the system is overwhelmed.
Duke says he hopes that his district does not reach that point, but believes it could if action is not taken. If Idaho starts using crisis care standards, “It would be too late to slow it down. It would take us several weeks,” Duke said.
Ada County has averaged 253.6 new confirmed coronavirus cases per day over the past seven days, according to data tracked by the Idaho Statesman. However, it’s possible the true number is higher because CDH says it has fallen behind on data entry as the case numbers climb.
Kimberly Link, communicable disease control manager for CDH, told the board that she anticipates hospitalizations will continue to increase as cases increase. She said Ada County’s case rate per 100,000 people is likely to hit 73 per day for last week. It must drop below 30 for the recommendations issued Tuesday to be nullified.
“The trajectory that we are on is not sustainable,” Link said.
The advisory states the following recommendations for businesses and public buildings in Ada, Valley, Elmore or Boise counties:
- Businesses should implement delivery and curb-side services when possible.
- Bars, distilleries, restaurants, breweries, tap rooms and wineries should move to carryout and takeout only and close at 10 p.m.
- Gyms and fitness centers should limit capacity to 50%. Fitness class instructors should maintain a 6-foot distance from participants at all times.
- Places of worship should implement virtual services.
- Discontinue youth and adult sports where physical distancing is not an option.
- Discontinue all school extracurricular activities where physical distancing cannot be done, and those that involve excess breathing, such as choir or band.
The advisory states the following recommendations for residents in Ada, Valley, Elmore or Boise counties:
Duke said he knows some of this is a “tough message to deliver” during the holidays, but it must be done.
“We see case after case after case of families spreading the virus from one house to another and then within the household,” Duke said.
Duke said he knew some business owners, especially bars, may not support the move but he sees it as a way for them to stay open.
“We are very near a crisis situation and these are steps that I think are absolutely necessary so that you can stay open, but also help the community contain the disease in environments where we know it will spread,” Duke said.
The advisory will remain in effect until there is a two-week case rate of less than 30 per 100,000 people per day and a two-week decline in cases.
If one of the health systems implements crisis standards of care, the Board of Health will consider making the recommendations part of a order of mandatory actions.
This story was originally published November 18, 2020 at 4:00 AM.
