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AD HOC COMMITTEE ON COVID-19 ECONOMIC IMPACT AND RECOVERY

THE RECORD OF ACTION FOR
JANUARY 21, 2021

Supervisor Candace Andersen, Chair
Supervisor Karen Mitchoff, Vice Chair

Present:	Chair Candace Andersen
	Vice Chair Karen Mitchoff
Staff Present:	Thomas Warne, M.D., Deputy County Health Officer
	Julie DiMaggio Enea, Senior Deputy County Administrator
Attendees:	Lynn Mackey, County Superintendent of Schools

Introductions

Chair Andersen called the meeting to order at 1:30 p.m., introduced the Committee, Deputy County Health Officer Dr. Thomas Warne, and County Superintendent of Schools Lynn Mackey. She explained the format of the meeting.
See attached list of attendees.

Attachments:

Meeting Attendees 1-21-21

Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to two minutes).

All public comment was taken under Agenda Item #3.

RECEIVE status report on the County's COVID-19 status, the County's vaccination plan, and school re-openings. (Thomas Warne, M.D., Deputy County Health Officer)

Dr. Warne spoke to recent coronavirus trends, stating that we are in the midst of a surge that is just beginning to flatten. The big story is the rollout of the vaccine. In the last month, we have scaled up the delivery system and are just getting in the first stage of vaccinating our older adults.

The dashboard statistics indicate that this is a dangerous time: case rate: 57.3 down slightly from a peak of 62 and three times higher than our July peak; positivity rate: 10.6%, highest so far. To reach the Red Tier would need to be under 7 and 8% or less. Overall cases in County are 53,000 and 7-day average is 630. Hot spots are San Pablo, Bay Point, Pittsburg, Byron, El Sobrante, Antioch, Oakley and Richmond. Highest impacted areas are almost 10 times higher than lowest impacted areas. Testing capacity is high at 7,500-10,000 tests per day with quick turnaround times.

Deaths in the County have been rising; 460 to date, correlating with case numbers. ICU beds available (percent of staffed beds) in our county is 1.7% and Bay Area ICU bed availability is 3.4%. Our hospitals are strained but not overwhelmed.

65,151 vaccine doses have been administered: 54,355 first doses and 10,796 second doses. The vaccine delivery system is scaled up and robust, leveraging local hospitals and pharmacy partners. All that is limiting the process is the availability of vaccines. Vaccines are now being offered to those aged 65 and up, with priority given to those 75 and older.

He reviewed the vaccine distribution phases. We are currently in Phase 1B: People aged 65 and over, frontline essential workers, and congregate settings with outbreak risk. There are about 100,000 people in that category, so it will take time to obtain enough vaccine to serve that population. We are currently receiving about 15,000 doses of vaccine per week. There is an online registration system and a toll-free vaccination phone line 833-VAX-COCO. He reviewed the online vaccine registration form as well as the current phase criteria.

Nursing homes: partnered with John Muir and Kaiser to deliver vaccines to the 77 care facilities with 30 or more residents. Vaccinations at the 600 smaller facilities will follow.

Regarding reports of allergic reactions to the Moderna vaccine, Dr. Warne said the FDA concluded that the current lot of vaccines is safe.

He responded to several questions that were received in advance of the meeting:

Is it normal to be asked to provide one’s Social Security Number and Birthdate when registering for vaccination? Dr. Warne explained that this is standard and needed for insurance purposes.While insurance is not required, insurance may be charged to recoup costs.This information is also needed to link the vaccination to one’s health record.
When will youth sports activities be allowed? Dr. Warne answered that the County follows the State’s orders, both the Stay at Home orders and the State’s Blueprint.Conditioning, practice, skills building may be done outdoors with social distancing but not group activities.He described what activities would be allowed when the County eventually reaches the red tier.
What is the State’s model to project 15% ICU capacity? Dr. Warne does not have access to the model, but they use a system based on the number of staffed ICU beds less neonatal and other specialized beds.The 15% ICU threshold is deemed to signify a two-week lead time before ICUs may become overwhelmed.
Comment about SF Gate Article alleging that shutting outdoor dining contributing to the COVID surge? Dr. Warne said it is reasonable to consider that hypothesis, but it is not supported by data.

Lynn Mackey provided an update on changes in County schools opening status and what could be realistically expected as to the timeline to get children back to school. She highlighted the Governor’s December Safe Schools for All initiative and then on January 4 the state launched its Safe Schools for All online hub to provide one authoritative source on State schools guidance. She said there haven’t been many changes in the guidance, but the new hub will improve consistency. She highlighted changes in social distancing in school and a greater emphasis on ventilation. She said the public remains very split on the desire to reopen schools or not. Schools will be required to post their safety plans. As of Jan 25, all schools will have to report on their opening status to improve transparency. She discussed cohort guidance.

She addressed some questions that had been received prior to the meeting.

Will the new State guidelines make it easier or harder to open schools? She said it would depend on where each school was at in the reopening process.Unless a school is very small, they still will need to operate under several restrictions.
Once a teacher is vaccinated, will they be required to return to the classroom? She said not necessarily, as there are several other guidelines that must be met before a school can reopen.She also said the district must still negotiate with its labor partners and there is no State directive saying that once one gets the vaccine, they become a disaster services worker.
When you open some classrooms can you open the entire school? If a school was in process of reopening, they can continue under the current order.
Sports conditioning is still allowed in high schools.

The following individuals spoke during the Public Comment period:

Mike McDermott requested consideration for adding local pastors to the early vaccination list because they frequently interact with the sick and elderly, and with youth through education.He also commented that the ICU denominator continues to change, and so the ICU availability can be manipulated by changing the denominator. Dr. Warne said the County is not yet at the point where …He said the State has developed specific ways to calculate ICU availability.He said that the denominator can flex up and down for a variety of reasons.
Anouschka asked about a WHO statement about PCR tests and asked if the County will lower the spin cycle at the laboratories. Dr. Warne said there is likely to be scientific debate on PCR tests and false positives, but it is a very sensitive test.She asked where we can find information on the effect of the lack of school and sports on children’s mental health.
Mendy Gonzales asked about scientific data that refutes CDC guidance that says its safer for schools to be open and how a current campus cohort differs from a school cohort in a hybrid school model.She said there is no data to support that schools currently open are safer than schools that could open now.Lynn Mackey agrees with the caller but acknowledges fear held by many people.
Stephanie Singer of Rossmoor was vaccinated at Contra Costa College and expressed gratitude to County Health for a smooth and efficient process and concern about people who are not adept as using online registration system.
415-555-5555 asked if the health officers spent Christmas with extended family in violation of the health order, to which the Committee members responded that they observed the health order during the holidays. The caller said that LA County has lifted the ban on gatherings, but Contra Costa has not.
17 asked if the Supervisors received the vaccine. Supervisor Mitchoff said she received the vaccine through the normal protocols. Supervisor Andersen had not yet received the vaccine as her age doesn’t currently make her eligible.
Laura Magu, a Lafayette restaurant owner, asked at what point County doctors consider the health of all citizens in terms of loss of jobs and livelihoods, effects on children and families.She said no one seems to care about the impact on the larger population.
Tiffany asked for clarification of the 25 per 1,000 goal for schools to reopen. Are we looking at a rolling average or a daily count? Dr. Warne said that for case rates, the county uses a 7-day average, but was not certain about a 25 per 1,000 (likely 100,000) goal for school opening.

Chair Andersen asked if there was a response to the controversy over the letter sent by John Muir doctors about the efficacy of testing. Vice Chair Mitchoff said the letter had been refuted. Chair Andersen said that suicide and suicide attempts are being tracked and being taken very seriously. She said there has been strong advocacy for small business relief and support.

Chair Andersen asked about a vaccine strategy that rolled out first doses for everyone and delay the second dose based on availability. Dr. Warne said he thinks it is an unlikely strategy here, but it remains to be seen. He said there is overlap between doses and phases here. He said they are trying to pace the rollout to provide a certain allotment of second doses. There is not a firm deadline by which the second dose must be given.

Vice Chair Mitchoff commented about recent federal direction that gave her optimism about the future availability of vaccine.

Attachments:

CCHS Press Release_COVID019 Vaccination Efforts_1-11-21

CCHS Press Release_Vaccine Distribution_12-16-2020

CCHS Press Release_Limited ICU Beds_12-16-2020

Updated Quarantine Health Order_12-10-2020

Openings at a Glance 12-9-2020

County COVID-19 Vaccination Plan_12-1-2020

Bay Area Health Officers Joint Press Release_12-4-2020

County Stay at Home Order_12-4-2020

Stay at Home Order ICU Scenario_12-4-2020

Regional Stay at Home Order_12-3-2020

Supplement to Regional Stay at Home Order_12-3-2020