Executive Order Increased Restrictions

Mayor Expands Emergency Order at Request of Statesboro Doctors

In a called Statesboro City Council Meeting to expand the emergency order, Mayor Jonathan McCollar and the City Council listed to a request from a large contingency of Statesboro and Bulloch County Doctors asking for more restriction to be put in place.  The doctors are very concerned with EGRMC and the local medical communities ability to handle the large number of cases they are seeing in other Georgia communities like Albany.   Dr. Mark McCraken who is the the lead hospitalist at EGRMC said on the phone during the meeting that they are certain we have cases already in Statesboro.  However, testing is tremendously slow to verify the cases.

In the statement from the doctors they expanded that point by saying that it is not a matter of if the virus with strike our community but when.  They explained that as in many communities and hospitals across the country, we are woefully under-prepared in Statesboro for the number of people who will need treatment when it comes to availability of ICU beds, ventilators, personal protective equipment.   There are only 24 critical care beds total at EGRMC.  You can only imagine how quickly these will fill up if our community becomes sick all at once. With this knowledge, our communities only choice at this point is take difficult actions now and make important choices which may slow the spread of the virus.  Their hope is that by doing this they will not completely overwhelm our healthcare infrastructure to the point where rationing lifesaving measures becomes a reality.  This is what they mean when you here the importance of  “flatten the curve.”

Dr. McCraken referenced on the phone the crisis in Albany, Georgia now where their hospital Phoebe Putney is experiencing a surge in cases, many of which are critical, that has completely overwhelmed the health care system there.  The doctors asked for a complete shelter in place order to be mandated effective immediately.

According to the Georgia Department of health there at now 600 confirmed cases of COVID-19 and 23 deaths which is almost a 4% death rate.

City of Statesboro Responds to Doctor Request

With this request from the Doctors, Mayor Jonathan McCollar signed an executive order which did not grant the full request of making shelter in place mandatory, they did increase mandatory restrictions for many businesses and organizations for 15 days ending on April 6, 2020.  The order includes:

NO gatherings of more than 10 persons including churches, funerals, visitations, wedding, etc.

Bars must close

Hair salons, barbers, nail salons, spas, tattoo parlors, and indoor recreational facilities, including gyms, physical fitness centers, and dance studios MUST CLOSE

Restaurants can only operate as carry out, drive through or delivery.  

Restaurants shall be authorized to sell and deliver sealed containers of beer and wine for off premises consumption.

Grocery stores, retail establishment, pharmacies CAN CONTINUE TO OPERATE BUT MUST COMPLY WITH CDC SOCIAL DISTANCING OF SIX FEET

Albany is in crisis

According to the DPH daily report there are 48 confirmed cases of COVID-19 in Albany.  Phoebe Putney Memorial Hospital has 26 of those patients, with another 63 patients in the hospital awaiting test results for COVID-19.  They are reporting 600 more have been tested and are awaiting test results.

“We have two ICUs and two and a half floors that are nothing but COVID patients,’’ said Ben Roberts, a Phoebe spokesman. “We’ve got a lot of sick people in the hospital.’’  According to Georgia Health News,  Area leaders have linked the spread of the disease in the southwest Georgia city to two recent funerals held there. Those funerals were “heavily attended’’ by people belonging to Gethsemane Worship Center and New Direction Christian Church, said Chris Cohilas, county commission chairman.

For several days now, Phoebe Putney’s medical staff has been working long hours amid tough conditions.   The hospital still faces challenges in obtaining personal protective equipment — masks, gowns, gloves, face shields, goggles and shoe covers – a need echoed by many hospitals in the state.  CEO Scott Steiner said Tuesday that Phoebe finally received some supplies, including from a national stockpile, but that more is needed.

That  the community has pitched in to sew masks, which can be placed over an N95 respirator. That would allow longer use of the respirators. DPH Report

Executive Order in Entirety

During the course of the State of Emergency for the City of Statesboro declared on March 19, 2020, pursuant to Sec 30-4(b)(8), the following, deemed necessary to promote and secure the safety and protection of the civilian population, shall be applicable:

A) Public or private gatherings of more than ten (10) persons are prohibited anywhere in City of Statesboro for the duration of this Executive Order. For the purposes of this Order, a ” gathering” is any indoor or outdoor event or convening, subject to the exceptions and clarifications below, which brings together or is likely to bring together, ten (10) or more persons at the same time in a single room or other single confined or enclosed space, such as an auditorium, stadium (indoor or outdoor), tent, arena, event center, music venue, meeting hall, conference center, restaurants, cafeteria, church, or any other confined indoor or confined outdoor space, to include birthday parties, family reunions, baby showers, and weddings. Funeral services shall only be held outdoors/ graveside and shall adhere to CDC distancing recommendations as current or amended. For purposes of this Executive Order, a “gathering” shall not include the following:

i) Office space, government facilities, public or private schools, child-care facilities, residential buildings, or any type of temporary shelter or housing;

ii) Hospitals and medical facilities;

iii) Grocery stores, shopping centers or malls, other retail establishments; and

iv) Restaurants operating in compliance with Section B of this Order.

B) Restaurants shall only offer curbside, take out, delivery, and drive through service options. Restaurants remaining open for business shall operate in a manner that allows for a minimum of six feet of separation between all customers and employees. Any bar not serving food shall close for business. Restaurants shall be authorized to sell and deliver sealed containers of beer and wine for off premises consumption.

C) Hair salons, barbers, nail salons, spas, tattoo parlors, and indoor recreational facilities, including gyms, physical fitness centers, and dance studios, shall be closed for the term of this Executive Order.

D) Any violation of this Executive Order shall be a misdemeanor, punishment pursuant to Section 30-11 of the Code of Ordinances of the City of Statesboro. Statesboro Police Department shall be authorized to enforce this Order.

E) This Order shall be effective at 12:00 A.M. March 23, 2020 and remain in force until noon on April 7, 2020 or a subsequent Executive or Council Order is issued

F) SO ORDERED this 22nd day of March, 2020

 

____________________________

Mayor Jonathan McCollar

Letter from Doctors

Dear local and state officials:

We are physicians who serve Statesboro and the surrounding communities. Collectively we are acting to respond to the COVID-19 pandemic as it enters our community.  This letter and our signatures represent our individual professional opinions regarding swift and bold action that must occur to curb the potentially-devastating impact on our hospitals, our patients, the city of Statesboro, and the state of Georgia.

It is inevitable that the virus enters our community, as neighboring cities and counties are beginning to report positive results of the COVID-19 test. It is not a question of IF, but WHEN. As are many communities and hospitals across the country, we are woefully underprepared for the number of people who will need treatment when it comes to availability of ICU beds, ventilators, personal protective equipment. Our only action then is to make choices which may slow the spread of the virus, so that we have a chance to not completely overwhelm our healthcare infrastructure to the point where rationing lifesaving measures becomes a reality.

As such we implore you to put a shelter in place order effective immediately, or as soon as is feasibly possible.

We understand that there will be unintended consequences of these drastic measures, but the alternative is worse.  If we cannot slow down the rate of infection immediately, our health care system will be overwhelmed. This is what we mean when we say to “flatten the curve.”

We applaud your sophisticated understanding of this disease and its spread.  As you and your public health advisors likely already know, COVID-19 is contracted through respiratory droplets (sneezes, cough, just breathing, on hands/surfaces) and should be considered highly contagious.  While the majority of patients (>80%) will recover without the need to be in the hospital, up to 10% will be so ill they need to be admitted to the intensive care unit (ICU). The death rate is much higher than with seasonal influenza, particularly for people with certain medical problems.  The death rate is also significantly higher for patients over age 60 and possibly over 20% for those over the age of 80.

The recommended measures of personal hand hygiene, avoiding touching your face, and aggressive social distancing are burdensome but are the best measures to reduce the number of people getting sick.  Just as important, these measures will reduce the speed with which the virus spreads. If we can reduce the number of cases but also double or triple the time over which those cases happen, the healthcare system will be less likely to be overwhelmed by the demand; this is “flattening the curve.”

East Georgia Regional Medical Center (EGRMC) has a total of 24 critical care beds. You can imagine how quickly these will fill if our community becomes sick all at once.  Slowing the spread or “flattening the curve” will undoubtedly save lives.

The timing and scope of these additional measures are difficult considerations.  It is possible that any measures at this time could be deemed either overly aggressive or too late.  With that in mind, we advocate for steps that may be deemed overly aggressive, as this is preferred in matters of community safety.   We commend you and city leaders for the aggressive actions you have taken to date, such as closing our public schools and also canceling any large official gatherings to lower the likelihood of community spread.

The hours and days ahead will be critical to mitigating community spread.  While recommendations for hand hygiene and social distancing are spot on, their voluntary implementation in our community are clearly challenging and not optimally effective given the exponential growth in COVID-19 cases in numerous communities across the country despite widely-publicized recommendations for social distancing.

We know these are difficult steps, and we are hesitant to have to recommend them.  We as a state may face short-term economic set-backs as a result, but the long-term economic consequences of not acting now are greater.  The big-picture perspective is necessary.

We also want to acknowledge that this virus tends to be surprisingly mild and well-tolerated in most kids, healthy young adults, and middle-aged adults.  This makes it really tempting to say it isn’t a big deal, most people get this virus. Although they may not be severely affected by the virus, young, healthy people must practice social distancing.  In South Korea, where significantly-more testing has been done, 20-29 year-olds represented 30% of those infected. Individuals in this age group can have relatively mild symptoms but still spread the COVID-19 virus.  If infected, older family members, friends, or other vulnerable community members may be hospitalized or die with this virus, particularly if there are shortages of medical care.

Hindsight will not look kindly on actions that are taken too late here.  Moreover, as health professionals, we know that the weeks to come are already at risk of overwhelming our fragile healthcare system.  Please help us so we can help our community face this crisis.

Thank you for your consideration of our perspective.  We would be happy to discuss further if you have questions or concerns.  Likewise, we would be happy to provide resources and guidance to you.

Best regards,

  • Chelsea Mikell, MD, Obstetrics and Gynecology, Ogeechee OB/GYN
  • Scott Mikell, MD, Family Medicine and Geriatric Medicine, Statesboro Family Practice
  • Ian Munger, MD, Emergency Medicine East Georgia Regional Medical Center
  • Sreelu Dega, MD, Urgent care Physician,  Mednow / Northside Hospitals – Augusta / Atlanta
  • Ruthie Crider, MD, Emergency Medicine, East Georgia Regional Medical Center
  • Hugh James, MD, Anesthesiology, Anesthesia Management Associates
  • Albert Lee, MD, Anesthesiology
  • James Hiller, MD, Obstetrics and Gynecology, Southern OB/GYN
  • Ajay Jain, MD, Cardiology, Cardiovascular Associates of Eastern Georgia
  • Rani Reddy, MD, Internal Medicine, Candler Internal Medicine
  • Brian Moogerfeld, MD, Internal Medicine, Moogerfeld Internal Medicine
  • Maria Moogerfeld, MD, Internal Medicine, Moogerfeld Internal Medicine
  • Angela Davis, MD, Family Medicine, Family Health Care Center
  • Anna Benson, MD, Pediatrics, Mama Doc Pediatrics
  • Al Palmer, MD, Obstetrics and Gynecology,  East Georgia Women’s Center
  • Benjamin Oldham, MD, Obstetrics and Gynecology, Ogeechee OB/GYN
  • Gary Sullivan, MD, Obstetrics and Gynecology, Statesboro OB/GYN Specialists
  • Glen J Dasher, MD, Family Medicine, Southern Family Medicine
  • Luke Krautter, MD, Family Medicine, Southern Family Medicine
  • Matt Phillips, MD,  Family Medicine,  Southern Family Medicine
  • Carla Branch, MD, Family Medicine,  Statesboro Family Practice
  • Mark McCracken, MD, Hospitalist, East Georgia Regional Medical Center
  • Randy Smith, MD, Family Medicine, Statesboro Family Practice
  • Thomas J Miller, MD, Family Medicine, Southern Family Medicine-Claxton
  • Uday K Tata, MD, Internal Medicine, Hospitalist, East Georgia Regional Medical Center
  • Kevin Purvis, MD, Family Medicine, Statesboro Family Practice
  • Wayne R Bryan, MD, Hospitalist, EGRMC
  • Kashyap Patel, MD, Neurologist, EGRMC
  • Justin Rountree, MD,  Anesthesia/Pain Management, East Georgia Regional Medical Center
  • Cristina S. Rountree, MD, Pediatrician
  • Cheryl E Perkins MD, Pediatrician
  • Michael Taormina MD, Neurologist
  • Anthony Chappell MD Cardiologist

 




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