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LaCrosse Public Health Director lays out epidemiological metrics
Jen Rombalski
JENNIFER ROMBALSKI has been LaCrosse County’s Director of Public Health for the last four years. Her latest challenge is the COVID-19 pandemic, but Independent-Scout’s readers will also be famil-iar with her work to get to the bottom of the problem of nitrate contamination of wells in Holmen and Onalaska.

LACROSSE - According to Jen Rombalski, LaCrosse County Public Health Officer, the county will not issue a county-wide public health emergency order at this time. Rombalski made this announcement at a media briefing on Thursday, May 14.

“There are a number of options available to LaCrosse County, including issuing a county order to replace Safer at Home, or doing what Dane County has done,” Rombalski said. “There is not full support for either of these options in our county, so we are going to see how our citizens and businesses do without the order – this does not rule out future actions in the future.”

Rombalski said her department is currently reviewing the language of the Supreme Court decision which canceled Department of Health Services Secretary-Designee Andrea Palms ‘Safer at Home’ order extension until May 26. She says she is also in communication with health departments in neighboring counties.

“We are trying to understand how broad the powers in Statute 252.02 to public health officers are,” Rombalski said. “All along it has been a question of lives versus livelihoods.”

Rombalski says that if her department does decide to issue an order, it will not be a blanket order like the statewide ‘Safer at Home’ order.

Call for action

Rombalski emphasized that “this is a fight against a virus and not a fight against each other.” She characterized the fight to control the spread of the virus as a war.

“This is a time for unity, and the overturning of the ‘Safer at Home’ order does not mean it is time to return to normal behavior,” Rombalski said. “More than 70 percent of the state’s citizens support the ‘Safer at Home’ order, and the virus is not a political issue.”

Rombalski urges citizens and businesses to:

• stay at home if you are sick

• minimize close physical contact with those outside your household

• minimize travel, especially to areas that are virus hotspots

• wear a face mask when out in public

• maintain distancing of six feet between yourself and others

• minimize congregating in groups

• wash your hands with soap and hot water frequently

• avoid touching your face.

Data-driven decisions

Rombalski discussed the metrics LaCrosse County uses to evaluate danger to the community from COVID-19.

She described three categories of data that her department considers relevant in decision-making:

• epidemiology – the study of what the virus is doing in the community

• Public Health Capacity – this mainly revolves around her department’s ability to conduct the contact tracing necessary to identify individuals who may have been exposed to the virus and prevent them from spreading it further

• Healthcare System Capacity – this relates to the availability of ICU hospital beds, health care workers, ventilators, and personal protective equipment

Rombalski went into detail on the topic of epidemiology. She said there are four key metrics her department monitors:

• An observed decrease in new cases of lower than 10 percent of tests coming back positive. LaCrosse County had gone for 13 days with no new cases, but in the last week has seen seven new cases, an increase of 260 percent.

• A rate of doubling of cases of six days or more. She said that the county has met this metric, but that there are too many unknowns at this time to feel comfortable resuming business as usual, especially if the current outbreak has not peaked, and if there will be additional outbreaks. She said the county’s current doubling time is 40 days. Things she cited as unknowns include whether individuals previously infected have gained immunity; if the next outbreak will overlap with the flu season; and whether cases will decrease over the summer months like the flu.

• Less than 10 percent of tests positive. She said the county has met this metric, consistenly, coming in at between one and two percent, as compared to the statewide average of 8-10 percent. She attributes this low rate to the early and aggressive timing of the original ‘Safer at Home’ order.

• Daily testing is at 75 percent of the level needed for surveillance. She said this metric has not been met despite Mayo Health System and Gundersen Health having  increased their testing capacity by 40 percent in the last week. To meet the 75 percent standard, the county would need to conduct 247 tests per day, and are currently conducting 177. 

National Guard testing

Rombalski announced that the county’s application to the state for a National Guard testing event had been approved. The event will take place on Thursday, May 21, from 11 a.m. to 7 p.m., at the Omni Center in LaCrosse.

“The National Guard will be able to administer 400 tests at that testing event,” Rombalski said. “Since we don’t believe that even this will result in enough tests, we are considering applying for another testing date.”

Rombalski said that there is no requirement that individuals tested be LaCrosse County residents.

“It is likely that we will see more positive cases as a result of this testing event,” Rombalski said. “One of the hallmarks of this virus is that some people have either minor symptoms or no symptoms at all, but are still capable of spreading the virus.”

Rombalski said that her department is currently at maximum capacity for contact tracing, and is evaluating how to increase capacity. She said contact tracing will be crucial, especially as things begin to open back up.

“If people have been isolating, then they only have a few contacts for us to trace,” Rombalski explained. “If they start going out and congregating, then it is going to become much more complicated.”

Rombalski shared that, like everyone else, she has very mixed feelings about things opening back up.

“This is a time of great change, and I have very mixed feelings about the Supreme Court’s decision,” Rombalski said. “Despite the fact that the ‘Safer at Home’ order has been overturned, we all still know what it is that we need to do – this decision should not change our behavior.”