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JUNE 18, 2020
Supervisor Candace Andersen, Chair
Supervisor Karen Mitchoff, Vice Chair
Present: Chair Candace Andersen  
  Vice Chair Karen Mitchoff  
Staff Present: Chris Farnitano, M.D., County Health Officer
Julie DiMaggio Enea, Senior Deputy County Administrator
1. Introductions
  Chair Andersen called the meeting to order at 1:30 p.m.  See attached list of participants.
  Meeting Attendees 6-18-2020
2. Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to two minutes).
  Chair Andersen announced that all public comment would be taken during Item 4 following the Health Officer's update report (Item 3).
3. RECEIVE update from County Health Officer on most recent COVID-19 developments and on questions recently received from community members.  (Chris Farnitano, M.D., County Health Officer)
  Dr. Farnitano reviewed the status of the pandemic, highlighting the concerning trends:  increased number of cases reflecting spread of the virus, 36 new cases today, a current average of 39 cases/day and compared to 12/day only one month ago.  He noted more testing resulted in more positive cases, from 2-3% positive, now to 3-5% positive.

Gradual increase in hospitalizations, from 12-13 to 24, not including West County residents in Alameda County hospitals.

He reported that we are beginning to get transfers from SoCal, particularly from Imperial Co.  He stated that we are not an island.  Even though our numbers are comparatively good, we can be impacted by other areas. 

He reported an increase in fatalities:  5 deaths today, 11 over the last three days, the most the County has had since April.  Most are elders in facilities, but majority of hospital cases represent the general community.  The virus hasn’t changed but our behavior has changed, so precautions are important to help control the spread and prevent escalation.

He said the June 16 Health Order opened barber shops and hair salons, and loosened swimming pools restrictions, including the number who can be in the water at the same time while still following social distancing.  With the updated timeline, new activities can open July 1 and 15 assuming no bad surge in the meantime.  He said that data will drive decisions.  He said a health team is reviewing state guidance as a basis for County guidance.  State guidance can be an early guide in the absence of specific County guidance.

He noted that the State provides no guidance on prohibited activities such as youth sports, concerts, festivals, and professional sports with audiences. County guidance on religious gatherings has been updated to be more consistent with State guidance.  Even though considered high risk, the State has made some allowances: up to 100 people or up to 25% of space.  Dr. Farnitano still recommends virtual or outdoor gatherings, which are lower risk.

Social bubbles of 12 allowed but, generally, smaller groups are lower risk.  The large the group, the more difficult to socially distance and the more people who might be potentially exposed.

Regarding offices:  facial coverings should be worn in enclosed rooms if with other people.

Regarding schools, CA Depts of Public Health and Education issue statewide guidance to resume schools.  Current County order does not prohibit school.  The County is engaged and advising on how to resume schools safely.  It will be different than before.

He explained that dentists/medical offices were permitted to resume sooner than aesthetic services because they are deemed more critical to people’s health, e.g., essential vs. elective services.
4. DISCUSS the provisions of the June 5 Health Order reducing Shelter in Place restrictions and also the timeline for future resumption of business and community activities.
  Chair Andersen invited public comment and questions.  The following individuals commented: 
  • Monica Hahn, who owns a massage studio in Walnut Creek said the State has issued guidelines on massage, which can reopen 6/19.  She asked if the County will issue guidance, to which Chair Andersen replied that massage can open July 1 as long as it doesn’t involve touching the face.  Dr. Farnitano added that Health Services is studying the State guidelines and will determine if they are sufficient for the County or if the County needs to be more restrictive.    
  • Alex, regarding sport teams.  He said data-driven guidelines are needed.  He suggested to resume modified low/no contact sports, permit more than one team, and permit organizations to set practical group size limit based on activity/size.  The camp model doesn’t work for a large outdoor sports venue.  Guidelines need to distinguish between high and low contact and not lump them together.  He requested clarification on the social bubble: may and child or adult participate in only one or more than one? Appendix C-2.
  • Alison Snow, who is a healthcare consultant, commented on the low death rate, and suggested a display showing data from Feb-April vs. the current trend, to better illustrate the positive impact of preventative measures.  She recommended having a public health nurse visit and educate people living in high risk areas, and in communities of disparity.
  • Tina Sherwin, who is a clinical lab scientist, expressed concerned that testing data isn’t clear.  She asked if the testing data described a discrete number of people tested or same people having multiple tests.  She asked if the data could be stratified among symptomatic, pre-symptomatic and asymptomatic people and if the County is  county tracking.  Hospitalizations by age?  Care at nursing homes?
  • Barbara Csider:  Are deaths COVID caused or simply positive for COVID.  Reflect on dashboard the age of death daily.  Concerned that masks hinder effective communication.
  • Jared Thomsen:  14 pages of guidelines for religious gatherings is cumbersome.  Children under 2 are not required to wear mask, but elsewhere it says 12 and under.  Needs clarity on actual age requirement and if there are differences in requirements for outdoor vs. indoor.
  • Tony R:  Frustrated that dialogue is not permitted because mics are muted.  My 66% of new cases where people who were SIP.  Why are playgrounds/parks closed if virus doesn’t survive on surfaces.  Why restrict children’s activities when they account for no deaths?  No info on co-morbidity.  Are permits required for protests.  New sales tax, cuts in services, restricted activities.
  • Ellen Mossman:  Massage therapist and teacher.  Concerns about providing safe environment for massage.  If numbers are on upswing, then why are we opening high-risk professions?  If people choose not to work to protect public health, she is concerned that they will not have access to unemployment insurance.
  • Renee’s iPhone:  no comment
Dr. Farnitano responded to the comments and questions.  He said to realize there is a risk of spread as we open up more business sectors, so precautions are more important than ever. On July 1, tentatively, absent a new surge, the County is planning on opening personal services that don’t involve touching the face, opening up indoor dining, gyms/fitness centers, personal training, indoor leisure, and hotels.   Effective July 15, higher risk personal services that involved the face, movie theaters,and card rooms may resume.  See website.

He discussed the three types of social bubbles:  household support, childcare, children’s extracurricular.  A child can be in one of each but not in more than one of each type of group. 

He acknowledged the disproportionate impact of the virus on low income communities, citing that the infection rate can be as much as four times as high due to denser housing and more high-contact jobs.  Health Services is trying to get more testing in these communities and have opened new testing sites in Richmond and Monument Corridor in Concord. He noted that the casino in West County can open because it is under tribal authority.  HSD is advising them of safe operations.

He clarified that the test data reports the number of tests completed not the number of people tested, but the number of people who have been tested multiple times is small and also the number of repeat positive tests is small.  People in high contact jobs should test at least monthly.

He advised that he does not have an age breakdown of hospitalizations but national data indicates there is a mix, mostly adults but also some children and young adults.  Also, the virus has lingering complications. Even ones who survive may be left with serious symptoms that take a long time to resolve.

He reported that the growing consensus is that facial coverings slow the spread of the virus. The State’s new masking order will prevail since it is more restrictive than the County’s.  New order requires masks for anyone >2 years old.  It is the most important thing we can do aside from hand washing and socially distancing.  Exceptions for people with medical conditions, but small percentage.  People with conditions like asthma and similar conditions are at higher risk and should continue to SIP.
Summary, we are opening new business sectors cautiously and at greater risk.  Still recommends the five key precautions:  facial coverings, hand hygiene, social distancing, stay home if feeling ill, get tested.  Testing is now easier.

Business meetings in a conference room, sales calls.  In person sales calls are permitted as long as they follow all of the other protocols.

The Committee agreed to take some additional public comment.
  • Bernadette: had questions about how facial coverings will be enforced and why hospitals remain closed.  Dermatologist wanted to do video appointment rather than in person., to which Vice Chair Mitchoff explained that the hospitals set their own policies.
  • Erika Coday:  why can skate parks, dog parks, operate without social distancing monitors but pools must have monitors?  To which Dr. Farnitano clarified that swim monitors are required by the State Order.  No rationale has been provided but he sees swimming as a higher risk.  Follow all other protocols on the pool deck.
  • Jared Thomsen: asked if restrictions will be loosened for outdoor worship environments and are facial coverings outdoors only required if not socially distancing.  Dr Farnitano replied that the County is now aligned with State Order, and there are no additional requirements in local order.  New State masking order just came out, so more clarification is to come. 
  • Toni R asked for the rationale behind not entering family homes but recommending families to stay outside in stifling heat.  Why can’t playgrounds be open since the virus can’t survive in the heat?  Dr. Farnitano replied that the science is evolving, but playgrounds are still not allowed by State.  Surfaces are not totally risk free.  Playgrounds have many high-touch surfaces.  Most parks are open and park agencies determine their protocols.
  • Dave Mason:  Still six feet distancing in pools?  Pool decks.  Dr. Farnitono replied that we still need to distance in pool since we would not be wearing masks. 
Dr. Farnitano also recommending planning outdoor summertime activities in early morning or evening to avoid stifling heat.

He noted that the Health Officers don't get advance notice on the publication of State guidelines.
Chair Andersen invited people to email questions to her and/or Vice Chair Mitchoff in preparation for the next meeting on June 25.

  Updates to Health Order 6-16-2020
  Media Release 6-16-2020
  Updated Road to Recovery 6-18-2020
  Contra Costa County's Road Ahead Diagram
  Contra Costa Receives State Variance for More Local Control
  Contra Costa Reopenings to Date
  Health Order 6-5-2020
  Public Comment_Nicky Lecher_6-12-2020
  Public Comment_Nicky Lecher_6-16-2020
5. RECEIVE and APPROVE the Record of Action for the June 4, 2020 meeting.
  The Committee took no action on the June 4, 2020 Record of Action.
  DRAFT Record of Action for the June 4, 2020 Meeting
6. The next meeting is currently scheduled for June 25, 2020.
  The Committee decided to schedule the June 25, 2020 meeting to begin at 1:00 p.m. instead of 1:30 p.m.
AYE: Chair Candace Andersen, Vice Chair Karen Mitchoff
7. Adjourn
  Chair Andersen adjourned the meeting at 2:45 p.m.

For Additional Information Contact:

Julie DiMaggio Enea, Committee Staff
Phone (925) 335-1077, Fax (925) 646-1353

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