Health administrator Durnell discusses easing of restrictions

Wednesday, May 13, 2020

With state and local Covid-19-related guidelines being partially relaxed, several area restaurants wasted little time opening their dining areas back up to customers. Beginning last week Iguana Azul, Los Sauces, and 54 Cafe were among local establishments allowing patrons back in.

When reached by phone on Monday, an associate of Iguana Azul informed the Daily Mail that their main restriction was no parties of more than 10 people. Nevada Health Department administrator Steve Durnell, however, said additional guidelines for restaurants are in place pertaining to capacity seating. Durnell said while indoor dining is now allowed, establishments are supposed to adhere to protocol that tables, booths, and chairs remain six-feet apart. Additionally, communal seating is not allowed, meaning members of different families are not to occupy the same table. Immediate family members, however, are allowed to seat up to 10 at the same table.

Those three locations are the only known in Nevada allowing customers to dine in at this time. Area fast-food establishments McDonald's and Burger King are allowing patrons inside, but only for order pickup.

Durnell said that while the health department had at one point issued a local order, they ultimately deferred to the order issued by Missouri Gov. Mike Parson.

"It was actually hard to try to mesh the two orders together," Durnell noted. "The health board and community decided to try to follow his order, and his order was essentially through the month of May. After that, I'm not sure which direction he's going to go. I think the positive cases, how they will trend, will be the indication of what the next step will be. The order here locally has some enforcement powers, but there's certainly more emphasis, with this order, of community and business support versus any sort of regulatory action. It's more of trying to help the businesses, trying to help people. Help people get where they need to be to understand what the rules are. Rather than what's going to happen to them if they break them."

Retail establishments are allowed to operate under the guise of reduced occupancy limit. based on size, and must adhere to the six-feet apart social distancing guidelines.

"Before we even asked, our local fire department went out and started setting occupancy limits for the retail establishments," Durnell said. "The fire department will be happy to set an occupancy limit for local businesses, they've been great doing that."

Other group with differing guidelines, forced to close their doors at the onset of the outbreak, were categorized as non-essential businesses. These businesses, for example, include beauty salons, barbershops, tattoo parlors, massage therapists, and chiropractors.

"We realize that they're going to have to work on people closer than six-feet away," Durnell began. "But what we ask is that you take extra precautions. Follow the CDC's guidelines, Whether that be masks, whether that be putting partitions up. We just ask that you put as much practice in place as you can to avoid the spread of this stuff. One thing could be to not allow waiting rooms to be open."

The final category in the group of four pertains to events, camps, tournaments, and gatherings.

"If they can maintain that six-feet of social distance between people at their events, then they're allowed to go on with that event," Durnell explained. "That's going to be the hardest area, because some activities are just pretty much impossible to stay that six-feet away at all times. It's all about the public doing everything they can to help stop the spread of Covid-19. We have to have community buy-in with people, and with businesses who want to do the right thing —and then it will work."

Positive cases

There's been some confusion locally whether or not Vernon County has three or four confirmed positive Covid cases. While the health department has reported four official cases, some in the community have complained the number should actually be three. Various theories have circulated about the one case differential, but Durnell put the debate to rest, confirming the actual number of official cases in Vernon County sits at four. The number was actually briefly higher due to a clerical error at the state-level, as well as an individual who lives outside of Missouri having been recorded as a positive case for Vernon County. The oversights have since been corrected.

"Those were simply just errors, and those things happen when you're dealing with the amount of numbers the state of Missouri is dealing with right now," said Durnell, who is also an environmental public health inspector. "Clinical labs and providers notify us of results as well. We make sure the state has been notified before we release information. It's a two-way system of getting positive notifications."

Durnell continued: "We're fortunate that we've only had four confirmed positives that live in our area. It's four too many, but we've been blessed that we haven't had any deaths, and that our numbers have been pretty low. We've done a good job as a community with keeping these numbers low. I pray that they continue to stay low. Of those four cases that we have, there's at least three of them who have recovered, so-to-speak. We had three early on, been a little bit of a wait, now we have our fourth one."

Reporting the number of recovered individuals is no easy task, according to Durnell.

"For communicable illnesses with diseases such as this, that is something they generally do not categorize," he said. "It doesn't make sense to me. I would think it would be good to hear how many people have recovered, because they certainly report how many people died. So I would think it would be positive to know how many people have recovered. But there hasn't been a case definition yet of recovery versus still in quarantine."

Durnell said the health department attempts to stay in contact with infected individuals, but it's generally up to their primary care physician to make the call on releasing them from quarantine. Durnell also said the local health department looks to notify individuals who may have been in contact with the infected person. A person typically would have needed to be in close proximity with the infected individual for an extended period of time in order for the department to initiate the trace contacting phone call.

"For us at the health department to have quarantined anybody, or make somebody self-isolate, is because they were considered a close contact of somebody that was positive," Durnell confirmed. "And the CDC's version of close contact is within six-feet of the infected person, for longer than a 10-minute timeframe. So, they would have had to have met those criteria."

Durnell expressed some genuine trepidation of the gradual easing of restrictions, better known as the Show-Me-Strong phased re-opening of the economy.

"One can only assume that the more we are back in interaction with others, the greater chance our numbers will go up," he said. "If I told you we were in the clear, our numbers are going to stay low no matter what, I'd be lying to you." Durnell also pointed out that a spike in positive cases may relate to an increase in testing, and not automatically point to an easing of restrictions as the primary culprit. For example, major meat-packing plants throughout the state have drastically increased testing in recent weeks, resulting in a spike in positive cases,

Durnell said he has recently deliberated with presiding Vernon County Commissioner Joe Hardin and interim City Manager Mark Mitchell about this very topic.

"At any time, if our numbers balloon, we will certainly look at putting in an order here locally if the number of positives warrant that order," he said of the discussions. "But we've been pretty lucky. And I do suspect the positives will go up a little bit, as we've kind of got out of our bubble so-to-speak. (Gov. Parson) has asked for local authorities and the health department to help him carry out this order.

"We as the health department have been giving a lot of advice and guidance — in trying to advise people on what they can and can't do. What we'd recommend they do to be even safer, for ball tournaments and things like that. It's within our wheelhouse to answer those questions locally. The main goal is that hopefully there is a commitment from businesses in the community to follow these rules. We share that same hope and optimism as the governor that people and businesses will work together and do the right thing. Because, obviously, we can't be at every event."

Durnell said that it seems as though a high percentage of Covid carriers present as asymptomatic.

"There's so many things about this disease that I'm learning every day," he said. "There's a lot of asymptomatic people, it effects some worse than others, the elderly seem to be the ones having more trouble with it — but it's also getting people who have no underlying health conditions. It's just bizarre, we're learning something new every day with it."

Durnell said he's spent a lot of time thinking about area businesses who have been hit hard by the pandemic.

"I've lost sleep over the people I know who were having a hard time making ends meet," he said. "There will be some small businesses that probably never recover from this. I have a big heart, and I care about people. Sometimes you have to tell people that they can't stay open and feed their family. It's not a very easy thing to do."

Durnell also lauded his staff at the local office as they navigated through the new reality that is the Covid pandemic. This includes being inundated with phone calls from the public, and issuing guidance to the best of their ability. The pandemic has also created a new work environment dominated by the virus, where they've had to transition away from their traditional duties.

"I ask my girls to share a lot of the administrative duties and they do a large portion of my administrative duties," Durnell noted. "I couldn't do what I do without them. So I'm blessed to have a good staff."

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