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In Media Availability, Public Health Officer Issues Grave Warning About Gathering During the Holidays, and During the Case Spike – Lost Coast Outpost


Nov 21, 2020

Video of today’s media availability with Dr. Teresa Frankovich, Humboldt County’s health officer, above. Rough transcript below.


Good afternoon, thank you for being with us. Thank you. Would you like to start
by addressing the community?

Yes, I do want to mention a couple of things at the outset here
before we begin answering other questions.

A couple really important issues. One is if people
in the community are concerned about what they’re seeing in terms of rising case counts per day,
I want to make it clear I am also very concerned and the trend that we’re seeing is alarming
and it is very likely to land us in the purple tier in short order. And I think
that when we look at our local case counts we’ve more than tripled those in very recently
and acceleration at this pace is exactly the thing we’ve been trying to avoid throughout.
We’ve been luckier than most for a very long time, but again, I think we’re seeing the drivers
of moving indoors in colder weather and the fact that we are seeing gathering and travel and those
drivers are getting us in trouble. There’s just no doubt about it, and it’s important for people
understand that our contact tracing has been a big part of helping us to contain, and we can
do that robustly when we are getting a scattering of cases.

When we start to see very large numbers
of cases coming in, as many other counties are experiencing, the type of contact tracing you do
has to decrease, you cannot do as deep and expansive an investigation and that means cases
will be unidentified in the community, increasing spread further. So it’s a partnership with the
community and the response team to try and keep the transmission rate down, and I’m asking everyone
to really join on board and stop the gathering. We have to stop the gathering or we are not going to
see this slow, and in addition the travel, and the two of those mixed are particularly challenging.

The second point I want to make is that we know that when we reach out to positive cases sometimes
people have been doing things that they know we have not been advising, and I think there’s some
sometimes some hesitation on people’s part to give the full details of what they’ve been doing.
I just want to emphasize that particularly as our case counts rise we don’t have the time to
wait three or four days or five days to be able to get a full picture of what exposures might be.
It means that there is spread in that interval and we can’t afford that right now.

So I again
would like to ask our community members, if we reach out to you and we’re talking about
with you about your case, please be forthright right at the beginning.
Let us know what really happened and we’ll work with you to try and contain
infection in your friends family and those others who may have been exposed.

The Times-Standard asks, “There
have been reports nationwide of spikes in demand for COVID-19 testing as the holidays approach.
What advice would you give people who think that testing negative on a single
day in advance of a holiday gathering ensures the safety of themselves and their families?”

It’s a good question. What I would say is there really is not a safe way to have a
gathering around a table eating with masks off indoors — there isn’t. There just isn’t.

And so I think people need to take that into consideration when they’re dealing with friends
and family members, because again we are seeing this where a single gathering around a table
leads to multiple infections in that group. You’re just very vulnerable. So I think if people are
going to have even the three households gather, ideally that should be outdoors. I get it that
that’s challenging here right now but it should be outdoors ideally. If you can’t be outdoors,
you should be distanced, if you have to unmask you should clearly be distanced. For eating that means
not all being around one table, it means people who are sick stay home, people who have been
exposed potentially stay home, and again I just, and make the room as well ventilated as possible,
so that we can decrease transmission. But the safest thing is simply not gathering.

In terms of
testing a day before gathering, that’s great, you know you’re negative that day, it means nothing
about what you are the next day. And so it does not ensure safety of those you’re gathering with.

The Times-Standard asks, “What are Humboldt County’s contingency plans to
deal with the possibility of post-holiday COVID-19 surge?”

Well, we are looking at
planning. We’ve been planning essentially around the possibility of a full surge,  meaning where we’re seeing a lot of impact on healthcare capacity and all that we’ve been
planning for that for a long time. In terms of a marked increase in cases afterwards, we will be
again kind of robustly staffing as much as possible through the holiday and after the

We’ll also in our, for contact tracing, will also be trying to maximize
testing availability and we’re asking the community of course to really follow the
guidance that we really cannot be traveling and gathering. It just can’t happen right now. In
the event that we do see an impact in our health care system, that we are getting overburdened with,  you know, filling beds, that type of thing. We have been again planning with our Alternate
Care Site and our partners around that and we would be talking about activating that site
if it becomes necessary in order to serve as sort of a valve on the hospital to protect inside-the-wall capacity at the hospitals for the people who most acutely need it.

So I would say that kind of
is the the thrust of what we do around planning as we go forward in this. The best case scenario
is that we never need the Alternate Care Site. 

The Times-Standard asks, “What are
the most important lessons we’ve learned this year about the spread of the virus in Humboldt County?”

Well, I think there are some really good lessons learned. One is the effectiveness of facial
coverings, something we did not know or have an appreciation for at the beginning of this
pandemic, but we do now. It works. It is not a controversial issue at this point. From a
scientific standpoint, people need to wear them.

Distancing: we know that closer is clearly more
dangerous and one of the biggest things is, the indoor/outdoor distinction. You know there really
has been very little linked to outdoor events in terms of large outbreaks. That’s not all,
but when we look at even our in our cases locally, the things that have occurred outdoors have been
less likely to spark an outbreak in cases than things that happen indoors, so that
importance of being outdoors if you’re going to be with others is critically important. 

The Times-Standard asks, “What long-term health effects of this pandemic will
Humboldt County residents be dealing with in the months and years to come?”

It’s a really good question, again, and we don’t know, we simply don’t know. You know I’ve compared
before, the fact that when you get influenza, if you recover from influenza typically you’re done. You know, we don’t tend to see long-term impact of influenza per se.

With COVID we really don’t know. We certainly know that there are people who are experiencing more long-term and chronic effects
of this, we know there can be cardiac effects of this, so again it’s a reason why even people who
are younger and healthier individuals we want to avoid infection because we don’t know how
many of those individuals may have some sustained effects. 

The North Coast Journal asks,
“While the state has changed its time frames under its reopening blueprint to be more responsive to
immediate conditions, does that change the requirement that a county meet the criteria
for a lower risk tier for three consecutive weeks before being moved into that tier?”

Well, the short answer is we don’t know yet. Again, in recent discussions with the state there isn’t a
significant expectation that anyone’s going to be moving into a less restrictive tier
in the near future. That would be quite surprising.

I think it is very possible
that intervals may be changed because of this going forward, but I don’t know yet. 

The North Coast Journal asks, “Given COVID-19’s incubation period, do
you expect local case numbers to increase, remain consistent or decline over the coming two weeks?”

I expect them to increase, I would be surprised if locally we saw a decrease. I think we are still in a position where we could contain this and help to stabilize,
particularly, again, if people’s activities over the holidays don’t push this forward,
but my expectation is we’re going to see an increase in activity.

The North Coast
Journal asks, “You mentioned during Tuesday’s supervisors meeting that you believe part of
the reason young demographics locally represent a large percentage of new cases is because they
are more likely to be frontline workers. Does the county have any data regarding what percentage of
community transmission cases or known contact cases are employed in front line positions?”

You know, we really don’t track the data that way, so I’m really not able
to give specific percentages on this. What I can tell you is some of the examples of this have
been, for instance, in agricultural settings, where we have a relatively young workforce
and working in close contact often, and we are seeing you know infections in that setting.

You know, it’s more anecdotal from our standpoint as we look at sort of the histories on the cases
that are coming in, and I think nationally data suggests that as well — that not only are younger
people more part of that essential frontline workforce, but a lot of vulnerable communities and
communities of color are part of that frontline essential workforce, and it is part of the reason
that we’re seeing a disproportionate impact in those communities.

The Redwood News
asks, “Earlier this week you were asked about any cases tied to gatherings specifically on
Halloween or voting in person/gatherings for Election Day. With more cases and time to trace
our existing cases are you able to give more of an update on whether any cases are tied to these
two types of gatherings? Why do you think there may be more cases tied to one than the other?”

I think that for the voting — for instance, on Election Day — what we know about significant
contact is it’s usually again unmasked within six feet for 15 minutes or more, so by nature I think
the voting on-site is going to be far less of an exposure than activities such as gathering,
which are typically — we’re seeing at least now — indoors, often unmasked and not distanced. 

The Redwood News asks, “You mentioned that the demand for testing has
increased recently. At this point in the pandemic, can you talk about how limited
accessibility to testing would impact our case count, amount of virus circulating
in the community? Is anything being done to increase testing and make sure those community
members that are wanting to get tested can do so safely and in a timely manner?”

Absolutely right. Testing is an underpinning of response in this and so we’ve been
working for a very long time at trying to continually bolster our capacity locally.
We’re doing that a number of ways. Our internal lab is testing at a higher rate than they have
ever done, and there are days I believe where we’re testing as many as 250, 260 samples.
When you consider that when the pandemic started the lab was doing 30 samples — actually at the very beginning there wasn’t local testing available, we had to send it
out to the CDC — but we started it kind of that 30 specimens a day. So it’s been a dramatic increase
in what we’ve done internally.

We’re also working with Optum. The state has now guaranteed Optum
through the end of April, which is great. Optum is now feeding specimens to the state lab at Valencia
instead of to a commercial lab. They’re just getting ramped up. Their expectation, as they’ve
said publicly, is to get 150,000 or so tests per day run, but they’re not there yet, and there’s
you know obviously some stumbles and issues when you first get a system up and running. But
the expectation is that we’ll be able to have very reasonable turnaround times with that. We’ve also
asked for some additional expansion of Optum locally and so I think we’ll be talking about
that next week, about what that’ll look like and that increased capacity will be hugely helpful.

And then, again, we’re really working on our regional lab asset as well, that we’ve referenced
before, and we’ll talk more about that as well when we have a go live date. So again I agree
completely with the question, it’s incredibly important and we’re building it quickly.
Again it’s helpful if we can sort of calm this acceleration so that we get all these pieces up
and in place so that we can address the increasing need. 

The Lost Coast Outpost asks,
“You mentioned that the state’s CalREDIE system assigns or attributes cases to an infected
person’s legal place of residency regardless of where that person contracted the virus.
What happens when an infected person is from out of state or from out of the country?”

What happens is that when we have, for instance, someone visiting our area who is from another
state, another county, we may test them here, they may become part of a case investigation while
they’re here, but that case is reported in their county of residence. So I can certainly tell you
that we are following cases here that are really not reported out as local cases, so they don’t
count in our tally for Humboldt County cases.

And by the same token if we have our county residents
traveling elsewhere, getting tested and are positive, they get reported back into our system,
it’s just the way the system is set up for consistency. 

The Lost Coast Outpost
asks, “Given that the state assigns cases in this way, is the county obliged for its own purposes
to keep a separate ledger of cases acquired here or cases that the local medical system is handling
in order to have some idea of the spread of the virus and the local population?
Are the discrepancies significant?”

I would say that in this instance it’s probably not a
significant difference. We do keep a log of cases and we either put them in our case count or don’t
put them in, depending on the county of residence. It’s a relatively small proportion, actually a
quite small proportion of our total cases, so it doesn’t have a big impact on our numbers,
but of course this movement between counties or states is a driver of infection.

So we
do have that data, we do follow those cases, but you know, again, we do not count them in our daily
numbers as they’re non-residents.


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