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A Conversation With … Clay Goddard

Director, Springfield-Greene County Health Department

Posted online

Springfield Business Journal: You have started working with the city attorney and City Council to draft a face mask ordinance. What would it take for a mandate to be put in place?
Clay Goddard: I’m working on an ordinance and some provisions. We have to try to take the politics out of this and rely on the science. With our Great Clips experience, we have our own moment that got national attention about the efficacy of this practice. We need to normalize it. I’m utilizing one when I go out in public, and I hope others will adopt this practice. Whether that is by an ordinance requirement or people doing the right thing by protecting those around them, I hope that we get there. If it’s not immediate, is there a trigger and what data sets would we use to do that triggering? (We’re) meeting to look at those types of metrics. You hit a threshold where you almost have to do it as a community, but those conversations are still in the works. Unfortunately, it also emotes strong reactions and it’s become a little bit politicized. I think we have to figure out how to navigate those waters. We want to make this is as less contentious as possible. I always encourage us to follow science as a community. There has also been some research done where states have gone to a universal masking requirement, and it seems to be effective in reducing case numbers. The evidence is there, but as with any debate that is contentious or polarizing, people will gravitate to studies that support their arguments. The whole goal is that if you’re sick and you’re interacting with somebody, that’s going to reduce the droplets that escape your mouth and nose. They’re going to be captured by the mask. It’s one of the tools that we can throw at this disease.

SBJ: You mentioned at City Council June 29 that the Springfield Smokefree Air Act of 2011 would be helpful in drafting the mandate. How does that play into the discussion?
Goddard: The enforcement methodology. There could be tickets written to somebody who was smoking at the protest of a business owner, and you could also do an enforcement provision on a business that was allowing behaviors that were against the law. So it's kind of a bifurcated enforcement strategy. We haven't written any code yet, so that was just a conceptual idea.

SBJ: Without a city or county mandate, does that put too much pressure on businesses to make those decisions regarding masking?
Goddard: We do require a certain segment of businesses to mask. If you go to the hair salon, barber, tattoo parlor, nail salon, massage therapist, we do have that piece in place. You do point to an issue that has been a hot button nationally. That is one of the things that we’ll have to navigate as we have this discussion further. Who owns it? Is the enforcement piece on the city or is it a business requirement? Probably the proper answer is it’s a little bit of both.

SBJ: How effective has the city been on following the science of stopping this disease?
Goddard: I’ve been very proud of our community. We went to stay-at-home orders earlier than I thought we would and that did help buy time for our community to stand up testing and health care capacities. That is in part why we’ve fared so well from a data perspective compared to like-size communities in the Midwest. That said, I’m of the impression that people are tired of this, and they’re ready to move on. I’m tired of it, too. If we try to go back to life pre-March and we’re not paying attention and we’re not using masking and physical distancing and we’re going out when we’re sick, we’re simply helping the virus accomplish its goal, which is ultimately to infect 60%-70% of us.

SBJ: Are these numbers of cases what you were expecting? As of July 1, Missouri had nearly 22,000 confirmed cases. McDonald County has the most infections per capita than any other Missouri county and Joplin is being called a hot spot.
Goddard: I’m not surprised by anything I’m seeing. We expected more cases. The public health approach would have been to lock down until the disease is gone, but economically that’s just not possible. I’m not suggesting I advocate for that. I think we were effective in buying that necessary time for our health care partners to get ready. What you’re seeing in some of the communities in southwest Missouri is a vulnerability. It does seem like those poultry plants and those environments inside of them are really conducive to disease spread. And then what you worry about is that ripple effect in the community. Another vulnerability is that this disease has moved into younger populations. We’re hoping this spike is not a canary in the coal mine for a crunch on our ICU capacities down the road.

SBJ: To what do you attribute the increased cases in our region? Greene County has 316 confirmed cases as of July 2, which is double where we were 45 days ago. Are more people getting sick or is it that more testing is available?
Goddard: It is primarily driven by more people getting sick. Access to testing does play a role. We have started testing anyone who came into contact with a positive case. Before, we would just quarantine those folks for 14 days. About 8% of the testing that comes back through our lab comes back positive, that’s a pretty high result. We’ve also seen the percentage of positives in our mobile test unit more than double. When you reopen … that’s the consequence.

SBJ: How long do you expect to continue announcing the public health exposures? And what do you attribute those exposures to?
Goddard: These exposure notices are not new; they are just more frequent. If we had a tuberculosis or measles exposure where we could not track down all of the exposed people, we’ve always gone public in the past. This disease is beguiling because it presents itself a lot of times mildly, or people will explain away the disease as something else, and then they go out on their own and go into public places and that’s what we worry about. We want people to realize that this disease is circulating in this community and they should model their behaviors to help mitigate against them contracting the illness. There is no reason to believe a business would continue to be a hot spot after the exposure. They are all doing a good job of doing the appropriate environmental pieces.

SBJ: Some businesses are conducting their own contact tracing. Is that a best practice?
Goddard: I went to Mother’s (Brewing Co.) backyard with my wife on (June 26), and they are taking cellphone information and having you sign in and sign out. In those situations, there would be no need to do a public exposure notice because we have a definitive list that would have been there during time frames. I know that there are several that are doing it that way.

SBJ: How close are we to a vaccine?
Goddard: They have had an unprecedented focus on vaccine development with many candidates in different stages of clinical trial. The Oxford vaccine has had some early progress. They vaccinated thousands of people and were able to elicit immune response from most. Let’s just say by some miracle they announce they have a viable candidate later this summer, it will still take time to manufacture it in quantities and get it into arms.

SBJ: I spoke to former Health Department Director Harold Bengsch in March and he said that success in a public health department is when people say, “You blew that out of proportion, that was no big deal.” How do you manage that challenge?
Goddard: If I get criticized for this not being a big deal, I take this as a compliment. After 25 years of doing this, I have been called every name in the book. I’m not going to base my own view of my work on comments that I receive that are negative. The data validates that we’ve done some of the right things here. You just have to look an hour down the road to see what happens when things go off the rail. You are going to get criticized in these positions. You have to make decisions based on your experience and based on what the data is telling you.

Clay Goddard can be reached at cgoddard@springfieldmo.gov.

Comments

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hjones@laserequip.com

The CDC says you should not wear a mask if you are not sick. The masks we wear are proven not to protect you against covid. It even says it on the box! This is ridiculous! I will not wear one. It is worse for your health to wear one if you are not sick. It should be a choice. If you are scared of getting sick, stay home. That is your choice.

Thursday, July 2, 2020
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