How We Have Made Decisions During the COVID-19 Pandemic
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This post was originally published on August 11, 2020. It was updated on September 1, 2020 to reflect orders that happened since August 11.
It’s easy to forget how much has happened in only a few months of the COVID-19 pandemic in Dane County. Our first staff were pulled into a COVID-19 response in late January, and we identified the first case of COVID-19 in Dane County in February (which was also the 12th known case in the U.S.). Now, we have upwards of 100 staff contributing to a long-term pandemic response, and a history of orders and decisions that we made to protect the health and wellbeing of our county.
Throughout the course of the pandemic, we have made decisions based on guidance from state and national public health agencies (CDC, Wisconsin Department of Health Services) and our own local data and epidemiology. The following timeline takes a look back on decisions we made and what data and information led us to making those decisions.
| Date | Action | Context |
|---|---|---|
| 2/5/20 | The first case of COVID-19 in Dane County was identified on February 5, 2020. | |
| 3/13/20 | Madison & Dane County order prohibiting mass gatherings of 250 or more (news release) | In mid-March, we closely monitored the situation across the country and modeled our recommendations based on guidance from the Centers for Disease Control and Prevention and other jurisdictions who were experiencing COVID-19. |
| 3/14/20 | Madison & Dane County order revising March 13 order by including places of worship under the mass gathering limit (news release) | |
| 3/15/20 | Madison & Dane County order prohibiting mass gatherings of 50 or more and closing schools (news release) | As the number of cases started to increase around the country and other local jurisdictions put out orders limiting mass gatherings, we took further action in Dane County so that we could prevent any exponential growth in our communities. |
| 3/16/20 | State Order prohibiting mass gatherings of 50 people or more | Later the same week, the state took action on a statewide level to slow the spread of COVID-19. |
| 3/17/20 | State order prohibiting mass gatherings of 10 people or more | |
| 3/24/20 | State Safer at Home order issued | |
| 3/25/20 | Madison & Dane County order adopting content in the state safer at home order | We adapted our orders to fit with statewide orders. |
| 5/13/20 | State safer at home order overturned by Wisconsin Supreme Court Madison & Dane County issues Emergency Order #1, which included safer at home provisions (news release) | At this point, the criteria we had identified using the Badger Bounce Back scorecard at the county level looked promising. However, given the exponential nature of the virus, it was critical to develop a plan to open gradually and have our decision-making rooted in robust local data. We released an order to continue Safer at Home to keep Dane County residents healthy and keep our healthcare system from becoming overwhelmed. At the same time, we worked hard to develop Forward Dane, a plan for a safer and gradual reopening. |
| 5/18/20 | Forward Dane released and Madison & Dane County issues Emergency Order #2, preparing for phase 1 (news release) | Forward Dane helped us create guidelines for how reopening would look, knowing that orders would also have to be adjusted depending on the local epidemiology. Through this plan, we developed local metrics that continue to guide us through reopening. The metrics include: the percentage of individuals who test positive, the average number of daily cases, average number of daily tests conducted, hospital capacity, testing capacity for healthcare workers, healthcare worker positivity rate, lab reporting timeliness and contact tracing, community spread, and the levels of people presenting to emergency departments with COVID-like symptoms. While case counts during this time were low (generally less than 10 new cases per day), mass testing through the Alliant Energy Center had just begun, so it made sense to pause for a few more days to ensure our case counts wouldn’t increase too much due to more testing. In addition, this phase allowed businesses and organizations to make plans so that they could be in compliance once Phase 1 started. |
| 5/26/20 | Madison & Dane County issues Emergency Order #3, which moved Dane County into Phase 1 of Forward Dane by allowing most businesses to open to 25% capacity (news release) | Many businesses that were previously closed were now able to open to 25% capacity at this time. |
| 6/5/20 | Madison & Dane County issues Emergency Order #4, which modified the last order to allow religious entities to open to 25% capacity (news release) | In response to a 17-page letter from a Washington D.C. based law firm that was retained by the Catholic Diocese of Madison, we adjusted our order to avoid a costly legal battle. We continue to recommend that faith and spiritual organizations continue to provide virtual services as the safest and recommended practice. |
| 6/15/20 | Madison & Dane County issues Emergency Order #5, which moved Dane County to Phase 2 of Forward Dane by allowing most businesses to open to 50% capacity (news release) | In June, we started to see a gradual increase in daily cases as community testing increased. However, the average number of new cases per day remained below 20 cases per day, and other metrics met the criteria for many businesses to open to 50% capacity. The metrics in the ‘green’ category during this time included percent positivity, tests per day, hospital staff testing capacity, hospitals operating outside of crisis care, healthcare worker positivity rate, and COVID-like syndromic monitoring. |
| 6/25/20 | Madison & Dane County issues Emergency Order #6, which added an amendment to Phase 2 by reducing the number of people allowed to gather and stipulated people in bars and restaurants must be seated when not in transit (news release) | From June 20, 2020 through June 24, 2020, 279 individuals tested positive for COVID-19, which was the highest of any five (5) day period before. Half of these cases involved individuals aged 20-29. 45% of the positive cases stated that they had attended a gathering, party or meeting with people from outside their household. Further, contract tracing efforts revealed that many of these individuals frequented bars or restaurants, representing the largest time and location bound clusters of the epidemic so far. This was the first of a few orders issued to slow this rapid spread. |
| 7/2/20 | Madison & Dane County issued Emergency Order #7, which further limited gatherings, eliminated indoor bar service, and reduced restaurant capacity to 25% (news release). | Cases continued to rise dramatically in late June. From June 20, 2020 through June 26, 2020, 482 individuals tested positive for COVID-19, which was the highest of any seven day period at that point. The number of cases increased by 45% in just one week, which was the largest percent increase we had experienced since the end of March. These orders were issued to specifically and quickly reduce spread in the areas that were driving the increase; many cases were connected to clusters at restaurants and bars. From 6/26 to 7/2, we knew that at least 90 cases were associated with bars at that time (and knew there likely would be more as we continued to interview cases). |
| 7/13/20 | Madison & Dane County issued Emergency Order #8, which included the mask requirement (news release) | When the order for face coverings was announced on July 7, we had just again experienced the highest ever number of cases in 7 days: 780 cases from 6/27 to 7/3. Additionally, our lab timeliness and contact tracing metric turned red, and our community spread metric was red. The mask order was intended to reduce risk broadly across the community and target the large number of cases associated with community spread. |
| 8/1/20 | State order requiring masks issued | The state issued an order requiring masks and face coverings, largely matching our local Dane County order. By this point, the average number of cases per day had decreased from 98 from June 27 to July 10 to 50 from July 25 to August 7. |
| 8/21/20 | Madison & Dane County issued Emergency Order #9, which required schools to begin the school year virtually for students in grades 3-12 (news release) | Order #9 allowed in-person student instruction for grades kindergarten through second grade (K-2). In the release that accompanied this order, we defined school metrics to guide decisions for in-person instruction. |
While the average number of cases per day is still elevated compared to May and June, cases have been slowly decreasing since mid July. And while we don’t know causation, at least some of this decrease is likely to be associated with the issuance of Emergency Orders #6, #7, and #8. No decision around loosening or tightening restrictions has been straightforward, and moving forward, we intend to continue making decisions based first on slowing the spread of COVID-19 in our county, while also taking into consideration other health impacts of restrictions.
This content is free for use with credit to Public Health Madison & Dane County .
