Message From: Shah. Nirav OF ADMINISTRATIVE GROUP Sent: 2/17/2018 8:10:11]r PM To: Ray/man; Erik Kauerauf; Donald Subject: Re: Quincy/Legionella situation Attachments: Erik and Don} Ijve spent time thinking about the path forward- in the Quincy situation. The CDC appears to be stumped. They can?t explain how a facility with negative water testing results could still be having cases. if these are ?true? cases} and not those being picked up because of the rise in flu; then I believe we are at the point where relocation or outright closure is the best path. For years; we have been working through the playbook. But now; it appears? we are out of plays. Despite our hopes to be able to reduce cases to near zero, there is something that our scientific understanding does not yet account for going on at l?i/HQ. This is evident in the fact that the CDC wants to start a study a the facility. I applaud that effort, but we have to think about the safety of the residents now. Nirav Nirav Shahg an. Director Department of Public Health as W. Washington Street. Suite Edith bhioago, ii. {312) arrears W. Jefferson Street Springfield, it. ears: or 37 Uh". From: "Rayman. Erik? Date: Thursday, February 15, 2018 at 7:24 PM To: Nirav Shah Don Kauerauf Subject: Re: Quincy/Legionelia situation just read the Riverbender article re: the latest Durbin/Duckworth letter along with some other coverage. if we were frustrated before then i am at a loss of words of our status now. We?ve lost our ability to communicate as everyone lacks a basic understanding of role, how outbreak management works. and what fails outside of our authority when discussing the WA and its use of a private contractor. Our story lacks a first?person narrator. so it?s never been fully told to put everything into perspective and in an open manner. Further cases at IVAQ only complicate matters of openness given we have yet to turn over any documents to the joint legislative committee or respond fully to requests. We need to figure out a way to force a decision by the 60. They are the hurdle holding up our responses. Delays are only making things worse. They should have made these decisions back in December when we asked GO Comms or when we identified the same issues to Trey in early January. We?d be in a situation where legislators, the media, and the public would have a better understanding of what did in a real?time setting. Instead, we are left with their \II?I?nn?l 4124/1 never?ending conference calls with the same result: their indecision. The only time we get timely responses from the 60 is when Patty yells at us for creating timelines that she?d otherwise force us to redact without any legal basis. We need to develop an internal strategy to get our story out. Erik C. Rayman, Chief of Staff Illinois Department of Public Health 69 W. Washington Street, 35th Floor, Suite 3500 Chicago, IL 60602 Of?ce: 312-793?1444 Email: Erih?aymantti)illineisgm; From: Shah, Nirav Sent: Thursday, February 15, 2018 5:48 PM To: Rayman, Erik; Kauerauf, Donald Subject: Quincy/Legioneiia situation Erik and Don, Iwanted to share some strategic updates and thoughts regarding the Legionella situation(s) in Quincy and Chester. 1. We had a number of calls with the CDC today. Bottom line: they are scratching their heads. They cant explain how the water tests show virtually no Leg and yet people are getting SiCliZ. They are going to explore doing a study to shed light on that question, but that will take time. 2. Our teams are deployed at Quincy and Chester. should start getting reports in the coming day. 3. W'e3re still waiting for the Governorjs Of?ce to make decisions on key issues here. These include: 1. Our approach to document productionm My view at this point is that we need to produce documents ASAP. Except for redacting patient data we need to start getting documents out the door to show how quickly and decisively we acted. 2. I don?t believe that the response to Sen. letter from several weeks ago has gone out yet. I do not know for sure, and have not received a final PDF. 3. No response to Rep. Costello?s letter has gone out yet. 4. I don?t believe the letter we drafted on Monday night to the has gone out at all. 4.. \Ve still need the GO to come up with a cohesive communications strategy around all of this. Right now, it?s piecemeal and not giving the public what they need. Nirav hilrav it. hhah, With, tutti. Director tliinois Department of Public Health as W. Washington htreet, Suite 3506 (TS-hieago. it. eases (3th} swears 535 W. 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