Health department could rollback reopening plan as hospitalization rates increase

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ST JOSEPH COUNTY, Ind. --- As health officials with the St. Joseph County Health Department weigh the possibility of adjusting the current reopening stage, growing hospitalization rates across the Hoosier state is a contributing factor to the decision.

Health officials are navigating how to take steps back to keep the public safe, while also keeping the economy up and running in an effort to curb the spread of the virus.

According to this dashboard created by the Regenstrief Institute to track COVID-19 across Indiana, data shows an upwards trend nearly across the board when it comes to hospitalizations. That trend is consistent with positive tests, emergency visits, hospital and ICU admits; the only trend decreasing is the number of deaths.

As for St. Joseph County, positive tests over a seven-day average are up, ranging from around 40 to 46 patients. That number is up from the average of nine daily positive tests from early September.

The positivity rate, however, remained relatively consistent at 9%. 

From March 1-October 6, data showed 541 hospitalizations from COVID-19 in the county. In addition, there have been 898 emergency visits, four patients admitted to the ICU and 76 total hospital deaths.

A current average of 8% of patients who do test positive wind up in the hospital.

As for what demographics fall under the 8%, the highest rate of hospitalizations are in males ages 70-79 and in females ages 60-69.

Results show young people are not immune to COVID-19, as children ages five to nineteen years old are spending by far the most amount of time in the hospital at an average of nearly 19 days—that is five days past the CDC recommended 14-day quarantine period. 

With so many children heading back to the classroom and the growing risk of both children and the general public in danger of being hospitalized, the health department is weighing the options about how to move forward.

The Hoosier state is currently in stage 5 of Governor Holcomb’s ‘Back on Track’ plan, which brings into question how the St. Joseph County Health Department can overstep that progress, while officials weigh the decision to dial back on reopening stages.

There are several Indiana state statutes that discuss the power of local health officers to step in to help out with epidemic control, including ordering schools closed.

Here are three Indiana statutes that lay out the possibility of adjusting the reopening stages:

IC 16-20-1-24Epidemic control; powers

     Sec. 24. (a) Local health officers may order schools and churches closed and forbid public gatherings when considered necessary to prevent and stop epidemics.

IC 16-20-1-25Unlawful conditions; abatement order; enforcement; providing false information

     Sec. 25. (a) A person shall not institute, permit, or maintain any conditions that may transmit, generate, or promote disease.

     (b) A health officer, upon receiving a complaint asserting the existence of unlawful conditions described in subsection (a) within the officer's jurisdiction, shall document the complaint as provided in subsection (d). Upon verifying the information contained in the complaint, the health officer shall order the abatement of those conditions.

     (c) If a person refuses or neglects to obey an order issued under this section, the attorney representing the county of the health jurisdiction where the offense occurs shall, upon receiving the information from the health officer, institute proceedings in the courts for enforcement. An order may be enforced by injunction. If the action concerning public health is a criminal offense, a law enforcement authority with jurisdiction over the place where the offense occurred shall be notified.

IC 16-20-1-26

"A local department of health or local health officer may enforce the department's or officer's orders by an action in the circuit or superior court. In the action, the court may enforce the order by injunction. The county attorney in which a local department of health or local health officer has jurisdiction shall represent the local health department and local health officer in the action unless the county executive employs other legal counsel or the matter has been referred through law enforcement authorities to the prosecuting attorney."

Thus, upon receiving a complain regarding a possible health hazard, it is the duty of the local health officer to investigate and to order its abatement if such is warranted. If such condition is thereafter permitted to exist, the local health officer shall refer enforcement to the county attorney.

While health officials are still in limbo about the next steps, the decision will ultimately be up to the health department, according to County Commissioner Andy Kostielney.

“Ultimately it’s the health departments decision I mean by state statute our understanding is by state statute they have the authority to make some changes to what our current stage is," Kostielney said. "I know governor Holcomb has on numerous times said he’s going to make some global changes or some global things for the state, but then if any individual county wanted to do something stricter then it would be up to them. Our understanding is the health department is who has that authority.”

The statutes may seem straight forward, but when it comes to enforcing the statutes within the local health departments, officials must still comply with state laws.

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