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Boulder County Health Update PresentationAgenda •Introductions – Indira •COVID policy update - Trina •Youth Suicide Michael & Jax •Data, trends - Michael •Highlighted programmatic community interventions – Jax •Fentanyl - Indira •Data, trends - Indira •Highlighted programmatic community interventions - Georgia •Drug Task Force update – Nicholas Goldberger COVID Policy update National and Local Shifts States are releasing universal mask orders, often followed by school mask orders Locally: Denver School Mask Order:expires Feb. 25 Pitkin Mask Orders: expire Feb. 22 Other states: Most states have either let orders expired or have announced orders expiration date -Approx.5 states have universal indoor mask orders still in place -Approx. 13 states have school mask orders still in place Nationally: Expecting updatedCDC guidance Case metrics as a predictor of severe illness (hospitalizations) Contributions to difference in hospitalizations •Omicron disease severity •Reduced viral load transmission due to vaccinations, masking •Availability of therapeutics Boulder County Public Health Orders Expired February 18, 2022 5 PM •Both school order and universal indoor mask orders expire •Some state and federal requirements remain in certain settings •Public Health advisory issued February 18, 2022 •92% of total population have at least 1 dose in BoCo (97% of 5+) Colorado Requirements Masks required for unvaccinated individuals 11+ in: - Jails, prisons, community corrections - Homeless shelters - Emergency medical and other healthcare services - Public Transportation Long Term Care Facilities: - Detailed requirements regulated by state Federal Requirements Transportation Security Administration: March 18, 2022 Masks required on airplanes and at airports for 2+ Masks still required in HeadstartPrograms age 2+ Masks still required on school buses age 2+ Masks for 2+ still required on public conveyances - Ride shares - Public Buses Boulder County Public Health Advisory Businesses and other entities may choose to implement their own mask policies When not required, individuals may choose to mask based on their own risk tolerance. Please remember that individuals may choose to mask for a number ofreasons which may not be obvious from their appearance. Please be courteous to others Boulder County Public Health Advisory - Outdoors is less risky than indoors - Increase air flow indoors - Hand washing - Stay home if sick - Testing: Recommend getting a test if intend to be in close proximity to individuals at high risk for severe disease, hospitalization, or death Boulder County Public Health Advisory 1. Individuals Who are Up to Date on Vaccination AND not High Risk: -Recommend a face covering* while in close proximity to an individual who is high risk -Recommend a face covering* while in settings primarily serving individuals who arenot up to date or at high risk 2. Individuals who are not up to date: -Recommend a face covering* around others during substantial and high transmission 3. Individuals Who are High Risk for Severe Disease, Hospitalization, Death -Recommend a face covering* while around others *snugly fit, medical grade face covering (N95, KN95, KF94, etc.) Boulder County Public Health Advisory Full Advisory available here: https://www.bouldercounty.org/families/disease/covid-19- information/mask-recommendations/ Update on Fentanyl and Youth Suicide in Boulder County Feb 22, 2022 City of Boulder Council Meeting Suicidal Ideation among Boulder County Residents Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Suicidal Ideation among 10 to 17 year olds Suicide ideation comparison, weeks 1-51/ 2019-2021 among age groups in Boulder County Age (years)ED visits for SI 2019 ED visits for SI 2020 ED visits for SI 2021 % increase in 2021 compared to 2019 % increase in 2021 compared to 2020 10 to 17 234 233 329 41% 41% 18 to 24 263 206 238 -11% 16% 25 to 29 127 123 154 21% 25% 30 to 39 194 199 204 5% 3% 40 to 49 129 122 132 2% 8% 50 to 59 74 92 100 35% 9% 60 to 69 62 74 83 34% 12% 70 + 23 21 34 48% 62% Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Suicide Attempt Suicide Attempt among Boulder County residents Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Suicide Attempt among 10 to 17 year olds Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Source: Vital Statistics Program, Colorado Department of Public Health and Environment. Source: Vital Statistics Program, Colorado Department of Public Health and Environment. Please note that 4th Quarter 2021 data is not yet complete. * Source: Vital Statistics Program, Colorado Department of Public Health and Environment. *indicates fewer than three events in category. Please note that 4th Quarter 2021 data is not yet complete. * Source: Vital Statistics Program, Colorado Department of Public Health and Environment. Please note that 4th Quarter 2021 data is not yet complete. Community Health Division Programs at Boulder County Public Health Outside Boulder County Public Health Fentanyl Overdose 2019-2021 Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Fentanyl Overdose among Boulder County residents Opioid Overdose 2019-2021 Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Opioid Overdose among Boulder County residents Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) Death data from Vital Statistics, 2018- 2021 https://www.cdc.gov/nchs/nvss/about_nvss.htm Please note that 4th Quarter 2021 data is not yet complete. Source: Vital Statistics Program, Colorado Department of Public Health and Environment. Please note that 4th Quarter 2021 data is not yet complete. Source: Vital Statistics Program, Colorado Department of Public Health and Environment. Please note that 4th Quarter 2020 data is not yet complete. Source: Vital Statistics Program, Colorado Department of Public Health and Environment. Please note that 4th Quarter 2020 data is not yet complete. The Works Program: Harm Reduction Programming at Boulder County Public Health Works Participants reached in 2021 1,658 unique individuals in 6,194 separate encounters Provided 647,751 sterile syringes Distributed 1,402 Naloxone kits in 2021, up from 814 in 2020 HIV and hepatitis C tests were on hold in 2020 and most of 2021 (Aug- Dec 55 HIV and 51 HCV tests conducted) but in 2019 provided 337 HIV tests and 277 hepatitis C tests Works Participants Program Strategies Secure ongoing (non-grant reliant) funding (opioid litigation funds provide an opportunity) Sustainable funding for partners engaged in syringe access programming (Boulder County AIDS Project and Mental Health Partners) Increase County funding for supplies ($55,000 every year since 2015 but population has increased 60 - 70%) Latinx peer community educator Native American community connect and explore Peer Advocates and Peer Litter clean up Drug testing to prevent deaths from overdose beyond fentanyl Case management Behavioral hub integration Anti-stigma campaign Drug Task Force (DTF): Update on Fentanyl •Current landscape of Fentanyl in Boulder County •DTF cases •Hospital emergency room visits: BCPH data •Law Enforcement "saves": Spread amongst individual agencies •Fentanyl/Drugs avenues into Boulder County •Traditional Major City hubs •Door to door via mail services •Dark web •International deliveries •Communication and coordination amongst all Law Enforcement Entities (Local, State and Federal) •Working on fentanyl Overdose (OD) deaths and poisonings •Communication and pushing out information amongst all stakeholders and Law Enforcement (School Districts, CU, the public, …)