Bay Area health officers join KTVU for digital town hall about coronavirus
OAKLAND, Calif. - As California and the Bay Area continue to work carefully towards re-opening, public health officers are on the front line of making crucial decisions for their communities. KTVU recently held a digital forum with three county public health officers, helping to craft policy for their communities during the coronavirus pandemic.
KTVU political reporter Greg Lee spoke with the public health officers for Marin County, Dr. Matt Willis; Contra Costa county, Dr. Chris Farnitano; and Alameda county, Dr. Erica Pan.
The doctors addressed a number of topics, including their thoughts on the new information that there were three COVID-19 deaths in Santa Clara county dated back to February 6, much earlier than experts initially thought the outbreak descended on the Bay Area.
Dr. Willis said the revelation was “not a surprise. We know that there was active transmission in parts of the world especially Wuhan, China, probably through December and there’s a lot of travel interchange with that part of the word, especially in the Bay Area. It’s likely we probably didn’t have a lot of transmission in January in our own region. My sense is we weren’t seeing a lot of transmission, because COVID19 is a clear, clinical entity. We know what the symptoms are, with the kind of clear characteristics, ARDS presentation. When we look back, we weren’t seeing dramatic increases in those kind of illnesses coming into our hospitals.”
Dr. Pan: “It just echoed and even her (Dr. Sara Cody, Santa Clara's public health officer) sentiment, we all agree, really grateful we intervened when we did, because it really had been circulating earlier than we thought. We had some speculations and some discussions about it, but this was our first evidence it was circulating sooner. Very grateful we were able to work together, and intervene quickly and early, we’ve seen some really good outcomes from that.”
Dr. Farnitano: “The tragic thing is we’ve reached that milestone so quickly ,there were very few recorded deaths in January and February, really seeing the surge in deaths just in March, just last month. With about 2,000 deaths per day, that’s really a staggering amount. Even though there’s’ areas of the country, like NYC, that seem to be past their initial surge, the numbers are really at a plateau in those areas. It’s not like they’re coming down as rapidly as they came up. Hospitals are still full, and there’s still a staggering number of deaths. There’s going to be waves across the country and there will likely be multiple waves that are coming. So, unfortunately this kind of level of death rate across the country, we may be seeing consistently or up and down for some time over the next few months.”
TESTING:
Dr. Willis: “As we consider what the next step might look like, one of the prerequisites of any relaxing of the shelter-in-place order, is to make sure we have the testing capacity for early detection and intervention in many cases that might result from having more social interaction that may lead to transmissions. We’re obviously very interested in making sure we have the testing capacity, really as a way to giving us freedom to be able to move about more.” “What is the number of tests we’re going to need as a community based on our population, that should be able to safety move forward, they estimate 2 per 1,000 per day, so in Marin, that’s about 500 test per day, and we’re about 1/5 of that, we’re going to have ramp up our testing capacity.”
Dr. Pan: “We have a lot of lab capacity, sometimes those are the barriers. Within our health system, we have clinicians that are really frustrated they can’t test the people coming in with symptoms and we have community testing sites that aren’t at their capacity. Part of our task force’s goal among many is to bridge those gaps and leverage those resources across the different entities.”
Dr. Farnitano: “The principal of contact tracing is that every person who tests positive for COVID19 is identified. A health professional has a conversation with them and helps to identify who they’ve been in contact with during that time when they were potentially contagious, that may have transmitted the virus to others.” “We’re especially focused on people who work in and around vulnerable populations so that nursing home staff worker that tests positive, that may have exposed some of those vulnerable elderly individuals. The purpose of this is not only to give information to the person who tested positive about how they should be isolating themselves at home and staying away from people, but also identifying all those people that were potentially exposed so they also are quarantining and staying away from the general public during the time they might be incubating the virus and being contagious and spreading it to others.”
FACE COVERINGS:
The entire Serrano family is decked out in face masks.
Dr. Willis: “We think this is an important complement to any potential relaxation of the shelter-in-place. Again, as we start expecting more social interaction that could lead to transmission, and that was partly driven by evidence, trying to be science-based in our all our decision making here. The role of transmission for people who are not having symptoms is higher than we thought. We cannot rely on symptoms as the only proxy for contagiousness.”
Dr. Pan: “We as a collective public health community are trying to think about all the different layers of what we call mitigation and containment. Mitigation being everything from the physical distancing to the having a mask on each individual. Your mask protects me and my mask protects you. We want to lay on as many layers as possible to slow the spread of the virus.” “Not only do we want to preserve that cloth coverings are good for source control and a couple things about the medical masks: not only do we want to preserve those for healthcare settings, the kinds that some people have from the fires and things, the kind that have a valve on the outside, those actually don’t want people to use those in public. Those expel the essential droplets, those need to stay in the healthcare setting”
Dr. Farnitano: “As we slowly open up society, we also have to change how society interacts. It may be the handshake goes away and no longer becomes a cultural norm. Face coverings may become part of our normal behavior. A lot of these social distancing protocols, really may need to be here at least for a couple of years until we have a widespread availability of a vaccine.”
MESSAGE TO THE COMMUNITY:
Dr. Willis: “Thank you… It’s so clear people took this seriously, and we have really flattened the curve. There was an estimate, between 30 and 40,000 lives were saved based on the shelter-in-place order that went in, when it went in and how well it was followed by our communities. That demonstrates for us, when we act together we can affect the trajectory of this virus. We have some control over this. I know people are getting fatigued over this, there’s cabin fever. But that spirit of collective action and working together we’re going to need to lean into even more, over the more challenging aspect of this, which is the re-opening process.”
Dr. Pan: “Thank everyone in our community for participating and their trust in us. This was an extremely difficult decision we made and I’m so grateful we have such great colleagues to make it together with and ask for the community’s patience as well. This is an unprecedented time and we’re working hard to make the best decisions we can with a lot of changing information and estimates and modeling that have a huge spectrum of information.”
Dr. Farnitano: “The support of the community throughout the Bay Area, we really did flatten that curve and have so far avoided that type of surge. Bought ourselves time, time for our hospitals to prepare, figuring out more how this virus works and how we can work to control the spread. But it’s sort of like, now we’re in the eye of the hurricane, we’ve gotten past an emergency place and we’ve got a little bit more time, but it’s not time to take the shutters off the windows. The virus is still out there, it’s in our community.”
