thanks to all of our members, including state... · 8 covid-19 diagnostic testing as of 08.05.2020...

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Thanks to all of our members, including:

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COVID-19 HEALTH & SAFETY

CONSIDERATIONS

PRESENTED TO

FOOD AND BEVERAGE WISCONSIN

AUGUST 6, 2020

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John R. Raymond, Sr., MDPresident and CEO

Medical College of Wisconsin

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COVID-19 DIAGNOSTIC TESTING AS OF 08.05.2020• Cumulative tests administered as of 08.05.2020: WI = 1,001,924; MKE = 196,791

- Negative WI 944,984

- Negative MKE 176,767

- Positive WI 56,940 (5.7% stable)

- Positive MKE 20,024 (10.2% stable)

- # of tests reported yesterday in Wisconsin= 16,139; Highest single daily total was 17,410 on 08.04.2020

• Testing capacity: Stable at 24,156 in Wisconsin. New concerns about supply chain!

- 83 laboratories currently testing. 24 planning to test

• Positive tests (# positive has been at or above 900 eight times in last two weeks)

- Wisconsin = 884 (5.2%); MKE = 172 (6.8% seven-day average)

- Numbers of positive tests and positivity rate are early indicators

- Previous highest daily positive tests: WI: 1,157 on 07.21.2020; MKE: 477 on 05.29.2020

Learn more at covid19.mcw.edu

08.06.2020

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COVID-19 HOSPITAL METRICS AS OF 08.05.2020

• Number of cumulative hospitalizations: 4,826 (8.5% of positive tests)

• Wisconsin hospitalizations on 08.05.2020

- 330 inpatients - stable (high was 446 on 04.09.2020; low 235 on 07.04.2020)

- 112 in ICU – stable (high was 196 on 04.09.2020; low was 65 on 07.05.2020)

- Hospitalizations and ICU use are lagging indicators

• ICU capacity: available ICU beds – 302

• Ventilator capacity – 340 ventilated patients; 1,655 available

• PPE trends: Stable (most critical needs = gowns, goggles and paper masks)


08.06.2020

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VARIOUS COVID-19 INDICATORS AS OF 08.05.2020• Death is a highly lagging indicator

• Deaths as a percentage of COVID-19 cases = 1.7%

• Cumulative deaths WI = 970 (rate is flat) MKE = 388 (rate is flat)

- Male: WI = 522 (53.8%) MKE = 207 (53.4%)

- Female: WI = 436 (46.2%) MKE = 181 (46.6%)

- Black/African American: WI = 209 (21.5%) MKE = 149 (38.4%)

- White: WI = 670 (69.1%) MKE = 168 (43.3%)

- Hispanic/Latinx: WI = 117 (12.0%) MKE = 56 (14.4%)

• Doubling time: WI = 35.4 days MKE = 43.1 days

• 7-day mean growth rate: WI = 1.6% MKE = 1.0%

• Reproductive number: WI = 0.97 MKE = 0.85 (early indicator)


08.06.2020

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08.06.2020

TRACKING COVID-19 PANDEMIC TRAJECTORYMilwaukee Mask Mandate

07.17.2020

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HOW DOES COVID-19 SPREAD

Three main routes of spread:• Most common is large respiratory droplet inhalation- Reduced by face coverings and distancing

• Probably spread by respiratory aerosols (indoors)- Can spread farther than 6 feet and can persist in air for hours

- Face coverings are less effective than for large respiratory droplets

- HVAC interventions: upward flow, maximize air exchanges, filter air

• Also spread by touch (secondary to respiratory droplets)- Reduced by handwashing and sanitization and keeping hands away from face


08.06.2020

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DISTANCING WORKS FOR DROPLETS

Source: Chu et al. The Lancet, June 2, 2020

DOI: https://doi.org/10.1016/S0140-6736(20)31142


Distancing is probably less effective for aerosols

Infectious aerosols

08.06.2020

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HOW DOES TESTING MITIGATE SPREAD OF COVID-19?

• It is estimated that half of COVID-19 transmissions are from individuals

with no symptoms or mild symptoms

• Testing results in earlier detection (pre-symptomatic or asymptomatic),

which allows earlier quarantine and isolation

• Early detection by testing means better treatment and triage

• Testing allows for contact tracing, earlier interventions and tighter testing

cycles for those exposed to an infected individual

• Testing allows earlier detection of outbreaks in neighborhoods,

workplaces, and congregate living situations


08.06.2020

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OPTIONS FOR TESTING AND SCREENING

• RT-PCR COVID-19 RNA test

- Results are only good for the day employee was tested. Could perform pooled testing.

• Temperature checks

- Low sensitivity for asymptomatic patients. May be cumbersome. May expose the

individual performing the screening. Could demonstrate commitment to safety.

• Daily symptom self-screening before reporting to work

- Requires app or web-site.

• Serological tests for antibodies

- Limited value for return to work.


08.06.2020

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Dose of COVID-19 inoculum is based on four contact parameters:

Number, proximity, intensity and duration of exposures

Number Intensity Duration

AVOID SINGING

Proximity

AVOID CROWDS

STAY AT HOME

AVOID SHOUTINGMAINTAIN DISTANCE LIMIT TIME OF EXPOSURE

LIMIT INDOOR ACTIVITIES

WEAR A FACE COVERING

WASH HANDS

WORK FROM HOME

NON-PHARMACOLOGICAL INTERVENTIONS: EMPLOYEE


08.06.2020

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Dose of COVID-19 inoculum is based on four contact parameters:

Number, proximity, intensity and duration of exposures

Number Intensity Duration

SANITIZE SURFACES

Proximity

REDUCE WORKFORCE

DENSITY

FILTER AIR

VIRTUAL MEETINGS INCREASE AIR EXCHANGES

MANDATE FACE COVERINGS

PROVIDE HAND SANITIZER

MODIFY TRAFFIC FLOW

LIMIT CONGREGATING

CONTROL ACCESS POINTS

DAILY SCREENING

STAGGER SHIFTS

NON-PHARMACOLOGICAL INTERVENTIONS: EMPLOYER

KEEP INTERACTIONS BRIEF

LIMIT TRAVELREMOTE WORK


08.06.2020

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THANK YOU VERY MUCH

QUESTIONS?


08.06.2020

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Workforce Protection Through Proactive Testing

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Flattening the curve

*4 Total Test Cycles To Date. Absenteeism and Positive Rates Remain Consistent.

30-Mar 9-Apr 19-Apr 29-Apr 9-May 19-May 29-May 8-Jun

Perc

ent

of

Pop

ula

tio

n In

fect

ed

Actual % positive

Est. % w/o prevention

2% 11% 16% 19% 10% 5% 3% <1%

Test Cycle 15.8% positive


Test Cycle 3*0.2% positive

Paid Sick Leave

100%

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Who Are We?

CoVigilanceSalm Partners

• Smoked sausage supplier for Brands and Retailers

• Sharing the benefits of technology– Coextrusion, Cook-in-Pack

• Do not own a retail brand– We don’t compete with our

customers

• We Coordinate High-Volume COVID-19 Testing Solutions for Businesses and Institutions

• Initially Focused on the Food Industry After Designing the Testing Protocol for Salm

• Primarily in Wisconsin, But Have Executed Testing Protocols Nationwide

• Our Goal is to Find the Best Solutions Available Today for Our Clients

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Salm Partners: Benefits For Our Customers

• Extended shelf life

• Superior food safety

• Clean label

• Waste reduction

• Consumer preferred

• Agility and scale

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Our initial COVID-19 response

Engineering Controls

• IR temp checks

• Physical barriers

• Masks and shields

• Increase buses (x3)

Admin Controls

• Education & communication

• Social distancing

• Wellness screens

• Aggressive contact tracing / sick leave

• Plant layout and flow changes

• Audits

• Pay premiums not tied to attendance

Assess Vectors

• Transportation

• Entrance

• Workstations

• Breaks/Break Areas

• Hallways

• Exits

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Wellness Screens

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What Has Changed?

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Physical Dividers & PPE

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Preventative controls (e.g. masks, partitions, distancing) help reduce spread but there is ongoing spread outside our plant

Source: Dr. Melvin Sanicas

Decision To Test: Asymptomatic Spread

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Round One: Test!

• 1st round of testing on April 24th

• Challenge: How to safely test 500 people and document?

• Nasopharyngeal Swab– aka “The Brain Tickler”

• No one tested was symptomatic

• 5.8% tested positive– Pre-symptomatic, asymptomatic,

post-infection

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Mid-May Testing

• Switched to anterior nasal swabs

• Increased documentation automation

• Inline with CDC guidance, did not test previously positive individuals

• 0.5% positivity rate

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Flattening the curve

*4 Total Test Cycles To Date. Absenteeism and Positive Rates Remain Consistent.

30-Mar 9-Apr 19-Apr 29-Apr 9-May 19-May 29-May 8-Jun

Perc

ent

of

Pop

ula

tio

n In

fect

ed

Actual % positive

Est. % w/o prevention

2% 11% 16% 19% 10% 5% 3% <1%



Test Cycle 3*0.2% positive

Paid Sick Leave

100%

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Salm Partners: Lessons Learned

• Preventative controls seem to work– Masks, social distancing, hygiene

– Wellness screens

• Social distancing is not natural and difficult to maintain

– Audit, audit, audit

• Difference between positive and infectious– An employee may test “positive” for up to three months

• Testing takes a significant investment in process design– Social distancing, low wait times for testing, overhead burden

• Our partners appreciate the effort being made to protect them, their families, and their jobs

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CoVigilance: Lessons Learned

• Speed To Response Is Crucial– If you’re waiting to smell smoke, you should at least be holding the fire extinguisher.

• View Testing As A Cost Of Doing Business– Testing Every 3 Weeks = ~$1/hr Increase In Labor Costs

• Testing Is Challenging, But Achievable– Treat this like a big problem. Do what hasn’t yet been done.

• Top-Level Buy-In Is The Make-Or-Break – A supportive culture and committed resources are necessary to achieve lasting

organizational change.

• Objectively Assess Employee Adherence to Preventative Measures– If you believe you have weak spots in your preventative controls, test...test…test.

• Listen To The Experts, Not The Talking Points

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Q&A

thanks to all of our members, including state... · 8 covid-19 diagnostic testing as of 08.05.2020...

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