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1.
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Introductions |
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Chair Andersen called the meeting to order at 1:30 p.m. and announced that Vice Chair Mitchoff would not be in attendance due to another commitment. She then introduced Dr. Chris Farnitano, County Health Director, who would be providing a status update of events that occurred during the prior week and fielding questions. |
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2.
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Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to two minutes). |
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All public comment was taken under Agenda Item #4. |
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3.
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RECEIVE update on most recent COVID-19 developments and on questions recently received from community members.
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Dr. Farnitano reviewed the many changes during the past week. He said we’ve been seeing, since late June-Early July, an acceleration in the positivity rate and hospitalizations. Contact tracing indicates indoor gatherings as the most common link to new cases. He said the positivity rate was 8.2% as of Saturday, indicating increasing community spread. As a result, we have placed additional local restrictions: when dining out or gathering with small social bubble, always wear a mask except when eating or drinking. Also, religious gatherings and protests are limited to outdoor only.
Due to higher numbers across the State, the Governor recently announced that he would be closing certain business sectors/activities across the State, such as indoor dining, cinemas, bowling alleys, zoos, and cardrooms. Contra Costa County hadn’t opened these sectors yet. The State requires counties on the monitoring list to also close bars/breweries, fitness centers, indoor worship and protests, salons and barbershops, and other personal care services. As well, non-essential offices must telecommute or work outside. Key impacts of the new State Order on our county include closure of non-essential offices, hair salons/barbershops and indoor malls, which had previously been permitted to operate. These sectors must close and cannot operate outdoors according to the agencies that regulate those sectors Statewide.
Contra Costa County is on the State monitoring list due to the increase in our number of new cases and in hospitalizations. 7/9 Bay Area counties are now on the monitoring list. The exceptions are San Francisco and San Mateo. Preliminarily, it appears that the messages about the importance of facial coverings, avoiding large gatherings, and inside gatherings, etc., are being heard. In the last week, the county’s numbers appear to be stabilizing but they bear watching. New cases are countywide and not isolated. Hospitalizations were increasing gradually in June but accelerated in July. There are 84 today not counting West County residents who are hospitalized in Alameda County. There are 92 deaths as of today: 64 of which were living/working in congregate care facilities. Outbreaks in these facilities escalated from 9 a few weeks ago to 25 outbreaks currently. Key factors are age and chronic health conditions. There is a high mortality rate in the elderly nationwide. At least 11 of the 25 outbreaks involved 3 or more residents/staff. The County has an Outbreak Response Team to ensure testing, PPE, and adherence to infection control protocols to prevent further spread.
Testing continues to be important but the recent surge in cases has put a strain on testing and lab analysis capacity, so be prepared to wait for a result – average turnaround for all test results is 4 days, but about 10% of tests take 8 days or longer. The State has recognized this as a priority and is working for a solution. County public health is working to identify new lab resources but is in competition with other jurisdictions, so it is a challenging time. Call 1-844-421-0804 or visit cchealth.org/coronavirus to schedule tests online.
He is seeing now a lot of household spread, and from extended family gatherings, airplane travel, workplaces, etc. He has not seen much spread linked to healthcare visits. There have been only three workplaces (outside of congregate living facilities) with more than 3 cases per workplace. The County has a Workplace Response Team to ensure testing, PPE, and adherence to infection control protocols to prevent further spread.
Dr. Farnitano reported that more younger people are being infected: 20-40 year olds, attributable possibly to their being more in the workforce. He is particularly concerned about gatherings involving eating and drinking, when face coverings are not being worn.
Dr. Farnitano responded to questions submitted during the previous week:
He said it is not clear yet whether we’ll be able to open more sectors if we are able to get off the State’s monitoring list. So far, the State just ordered that sectors are closed until further notice but provided no additional clarification.
He reported that more children under 18 are testing positive. They have often been tested not due to symptoms but following identification of a family outbreak.
He explained that local health orders regarding pools reference the State guidance, which says that face coverings must be worn when out of the water whenever 6-foot social distancing cannot be maintained, unless there is some other face covering exemption that applies. Lifeguards are not exempted from wearing masks; however, if they are up on a perch, presumably more than 6 feet away, then they are not required to don a mask.
He reported that 30% of those hospitalized with COVID are in the ICU, which is a lot lower than it was in the beginning of the pandemic in Mar/Apr, when it was running at about 50%. He suspects the reasons for the decrease in the ICU rate is that we are seeing more younger patients who don’t get as sick, and we have learned how to treat COVID better, so fewer people are requiring intensive care.
He stated that Contra Costa County has 900 licensed and staffed non-ICU beds and 200 ICU beds totaling 1,100 beds. He said that 9-10% of these beds are currently occupied by COVID patients. He is most concerned about ICU bed capacity, which has the potential to become exhausted first. Some neighboring counties have gotten close to reaching capacity, so if our hospitals fill up, we may not be able to rely on neighboring counties for overflow capacity.
He said the Bay Area health officers had a highly coordinated response at the beginning of the pandemic, but the opening of sectors has been taken in phases based on data specific to each county, so the responses of the counties have diverged somewhat. In recognition that this approach is not really working, the State has stepped forward with a more unified approach. So basically, all Bay Area counties, except for San Mateo County, are either subject to or are voluntarily following the same rules as applicable to monitored counties. The Health Officers meet almost daily to exchange ideas and information.
He advised that the State Board of Barbering and Cosmetology has currently prohibited even outdoor services.
He discussed the UCSF study of the connection between viral load (the amount of virus to which one is exposed) and severity of symptoms/illness. The study points to the benefit of masks and their effectiveness in reducing viral load if not completely filtering out the virus, so he finds the study very encouraging and important research. It also supports the concept of isolating at home so that, if someone in the home is infected, then everyone in the home should wear masks to minimize the viral load.
At the suggestion that a process should be established to certify businesses as safe to operate during the pandemic, he stated that the County is expanding enforcement efforts – working with local law enforcement, the DA, code enforcement, and health inspectors – but the County simply does not have the resources amongst these agencies to conduct such inspections and issue such certifications for so many businesses prior to their reopening. Therefore, enforcement will be reliant on consumer complaints as well as observations during normal surveillance activities of these regulatory agencies.
He said the County Health Department has a policy group that regularly reviews new technology to keep abreast. There have been privacy concerns around COVID tracking applications. There has not been widespread adoption of these applications in the United States. Ultraviolet light technology for ventilators is not there yet. |
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Attachments: |
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Questions Received for the July 16 Meeting
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Press Release_ CA COVID Closures_7-13-2020
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Openings at a Glance 7-15-2020
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Press Release_ >8% Positivity Test Rate_7-11-2020
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County Health Order Update_7-11-2020
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CA County Variance Info
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Guide to Safer Social Interactions
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4.
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DISCUSS the June 16 Health Order and any subsequent updates to the timeline for future resumption of business and community activities.
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Chair Andersen invited public comment.
Mike McDermott requested clarification of a discrepancy in bed capacity: 1,700 beds according to some articles vs. 1,100 beds, to which Dr. Farnitano clarified that 1,700 beds are licensed but only 1,100 beds countywide are licensed and staffed/funded. He explained that we look at both numbers with respect to surge plans. Mike requested more lead time in policy changes, e.g., effective on Mondays for church services, to which Dr. Farnitano responded that we are trying to balance the need for quick action with the need for predictability.
Tina Sherwin asked what the purpose of the State variance is since we did not open any business sectors, to which Dr. Farnitano responded that the original purpose of the variance changed over time to become a basis for verification of surge plans and outbreak management. The State has now shifted its focus to monitoring vs. non-monitoring counties. Tina also asked who determines policies for Higher Education, to which Dr. Farnitano responded that the State hasn’t issued guidance for higher education yet. She asked why are we pushing asymptomatic people to be tested when testing resources are impacted? Are we prioritizing testing? To which Dr. Farnitano said the County is prioritizing which tests get sent to which labs, depending on the urgency. Tina referenced a CDC finding that masks work based on two COVID-positive hair stylists wearing masks not infecting over 100 clients to which Dr. Farnitano responded he was likewise encouraged by those results.
Shawna Garvin noted that community spread wasn’t said to be happening at sports camps and by children, so why are more limitations being placed on these children’s camps? To which Dr. Farnitano said a few cases had been linked to both settings but a lot of the evidence is showing that younger children are less likely to be symptomatic.
Kimba Joy Theurich expressed gratitude for the forum and work of the health officer and committee in such an untenable situation.
Barbara Csider observed that County residents are suffering financially due to our very restrictive policies as compared to neighboring counties. Yet despite our more restrictive policies, our numbers continue to worsen. Dr. Farnitano responded that our 8.2/100,000 rate was an average over 7 days. Barbara said the proposed administrative penalties for COVID rule violations and for a ½ cent sales tax add insult to injury of small struggling businesses.
Wisti Quenneville asked how an individual having multiple positive tests counts towards the positivity rate. Dr. Farnitano said we are reporting the number of positive tests and negative tests. Since we do not recommend retesting people who test positive, he does not believe the numbers to be skewed significantly. Wisti asked how many County beds are being used by other counties, and is our County being penalized by the State for assisting other counties. Dr. Farnitano said, on net, more County residents are being cared for outside of our county. Wisti asked if the cases/100,000 reported by city are cumulative or regularly adjusted downward to reflect people who have since recovered from the virus. Dr. Farnitano said the State monitoring list measures only the number of new cases in the last 14 days.
Jacqueline Halm, an educator, complained that community college students are having to educate themselves and their children at home in difficult living environments. Some of her students are ESL (English as a Second Language). She said the online education system is failing them, and this is not being addressed. She said she has only limited ability to assist students online.
Toni R asked, if we are following science/data, then are aren’t we applying for a variance to open playgrounds? Why are we not allowed to attend funerals, but other jurisdictions can hold funerals 3,000 strong? Dr. Farnitano explained that funerals were previously allowed but are now categorized with other church services and may only be held outdoors. Toni suggested that the Health Officer was trying to justify the prohibition of indoor church services by marrying them with “indoor protests”; stating protests are nearly always outdoors. Dr. Farnitano responded that there is no size limit to outdoor church gatherings or protests, but masking and social distancing still apply. Toni asked about testing sites and HCQ as a treatment. Dr. Farnitano said the large studies on this drug have been stopped because no benefit has been shown. Toni asked why the County wasn’t pushing back on the early release of prisoners but is planning to penalize struggling law-abiding citizens who are simply trying to make a living. Toni noted that the County’s compliance with the health order is crucial in continuing to receive federal CARES stimulus funds and that realignment funding relies on the County accepting State prisoners into County jail. Dr. Farnitano said no San Quentin inmates had been hospitalized in our County.
Daryn Nabeta asked since the Trump Administration is instructing hospitals to bypass the CDC and report their COVID-19 data directly to the government, will this have any impact on the County’s dashboard or public information? Dr F. said he expected it would make no difference in the integrity of the data. It will be the same data but reported in a slightly different format.
Nicole Kannier asked if County numbers continue to increase, will we roll back further, or will we maintain the status quo and move only forward. Dr. Farnitano said it is not clear at this time. If Statewide numbers worsen, he expects the Governor might place additional restrictions on monitored counties.
Lori Moraca asked how often should workers in childcare centers be tested? She would like to have a regular testing schedule. Dr. Farnitano said the County doesn’t have resources to do onsite testing at facilities unless there has been an outbreak. But test sites are open throughout the county to anyone, except that we are currently having challenges with turnaround time. Higher risk persons are encouraged to get tested monthly. Lori asked if subsidies are available for private childcare programs, of which many are operating at a deficit? Fewer children, more staff, and more restrictions but less operating revenue, so deficit.
Lydia asked if the County gets compensated per COVID test. The County is bound by State guidelines but is the Health Officer advocating for the community using the variance process rather than hiding behind the State rules because it is easier? She thinks the restrictions on children’s parks are outrageous. She asked about HCQ treatment. Dr. Farnitano said it costs the County to run the tests and the County bills insurance providers, but otherwise receives no compensation thus far to do tests for people without insurance. The County hopes to get federal and/or State aid under an emergency declaration but such reimbursement could take years to be received. The County is certainly not profiting from providing testing if that is what is being asked. He reiterated that HCQ as a COVID treatment is no longer being pursued by the medical community.
Landi spoke about people who provide salon services to special needs clients. She cited what she sees as contradictions in County restrictions. She asked if landlords will be expected to go into foreclosure due to extended rent protections. Dr. Farnitano explained that the death rate from COVID continues to be much worse than a bad non-COVID flu year. Although hospitals are relatively safe in terms of COVID, hospitals are taking the precaution to do more via video appointments. He discussed the risks involved in crowded protests.
Chair Andersen invited attendees to submit questions to her or Supervisor Karen Mitchoff for response at
She addressed comments made by speakers about enforcement efforts and proposed administrative penalties, clarifying that the objective is education and compliance, citing issues of fairness and health risk. The proposed penalties are another tool, she said, in lieu of criminal proceedings, for law enforcement to use if education doesn’t work.
She confirmed that the Board extended the rent moratorium, which also applies to small businesses. She clarified that it is not rent forgiveness but rather a forbearance. People will eventually have to pay their back rent. In order to obtain this forbearance, renters must prove that they cannot pay rent due specifically to COVID-19. They must also reach agreement with their landlord on repayment. She said we are doing this to avoid creating more homelessness, which would only exacerbate the pandemic. The economic impact of the pandemic from the beginning has been extremely serious and we are unable to resolve every situation, but we are trying to address these issues. She said she does not support the BOS-approved sales tax measure at this time, but the voters will have to decide, assuming the contingent legislative actions are accomplished.
Chair Andersen shared information about the Workforce Development Board supplied by Patience Odofu. |
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Attachments: |
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Updated Health Order on Facial Coverings_7-5-2020
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Press Release_ Updated Facial Covering Guidance_7-7-2020
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Updated Health Order_Mass Quarantine_7-5-2020
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COVID Community Outreach Activities_7-7-2020
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Updates to Health Order 6-16-2020
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Contra Costa Receives State Variance for More Local Control
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Public Comment_John Luis_7-9-2020
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Public Comment_Tina Sherwin_7-9-2020
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Public Comment_Bob Welsh_7-16-2020
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Public Comment_Geri Engberg_1_7-16-2020
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Public Comment_Geri Engberg_2_7-16-2020
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Public Comment_Anonymous County Resident_7-16-2020
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5.
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RECEIVE and APPROVE the Record of Action for the July 9, 2020 meeting.
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Chair Andersen approved the Record of Action for the July 9, 2020 meeting as presented. |
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AYE:
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Chair Candace Andersen
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Passed
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Attachments: |
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Meeting Attendees 7-9-2020
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DRAFT Record of Action for the July 9, 2020 Meeting
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6.
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The next meeting is currently scheduled for July 23, 2020. |
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Chair Andersen confirmed the next meeting date of July 23 but announced that the start time would be moved up to 1:00 p.m. to accommodate another standing meeting commitment of the two Supervisors. |
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7.
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Adjourn |
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Chair Andersen invited attendees to email their questions to either her or Supervisor Mitchoff for response at the next meeting, and adjourned the meeting at 3:11 p.m. |