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Supervisor Candace Andersen, Chair
Supervisor Karen Mitchoff, Vice Chair |
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1. | Introductions | ||||||||||
Chair Andersen called the meeting to order at 1:32 p.m. and introduced the Committee, Deputy County Heath Officer Dr. Thomas Warne, and County Superintendent of Schools Lynn Mackey. She welcomed all of the guests and explained the format of the meeting. See attached Record of Attendance. |
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2. | 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. | |||||||||||
3. | RECEIVE status report on the County's COVID-19 status, including the December 10 Updated Quarantine Order, County vaccination plan, holiday planning, and school re-openings. (Thomas Warne, M.D., Deputy County Health Officer) | ||||||||||
Dr. Warne introduced himself and described his background as a primary care physician at the West County Health Center in San Pablo and TB/Communicable Disease clinician in public health. He acknowledged the difficult circumstances presented by the unprecedented surge in the COVID 19 virus that has gripped the whole nation over the last few months. The County’s infection and hospitalization rates are now at much higher levels than they were at even the highest points during the summer. He reviewed the current numbers, which place the County well into the in purple tier. The number of new cases per day per 100,000 in population is 37.9, and the test positivity rate is 8% generally and 13% in vulnerable areas. Total cases in the County over time is 33,000. In the past two weeks, there have been 6,000 new cases, so nearly 20% of all the County cases this year have occurred in the last two weeks. The County has had 290 deaths so far, 30 of which occurred this month. Hospitalizations have risen gradually with the case numbers. Currently, 196 persons are admitted in county hospitals with coronavirus. Two weeks ago, there were only 110. He said we are not yet overwhelmed yet but we are concerned. Of the ICU beds, 141 are occupied and 25 are still available. 13% availability is less than what we want to see. There are enough ventilators. Most affected areas are San Pablo, El Sobrante, Richmond, Byron, Pittsburg, Oakley, Bay Point, Discovery Bay, and Antioch. He discussed the reissued stay at home order and how five counties including Contra Costa instituted it earlier than the State required based on concerning local trends. Due to the dwindling supply of hospital beds, we are now subject to the State’s orders for at least the next three weeks and possibly longer. He reviewed the Stay at Home Order. He announced the arrival of vaccines, considered to be safe and effective, and said they are the light at the end of the tunnel and the ray of hope. He said we are fortunate to have two vaccines available – Pfizer and Moderna. He said the Pfizer vaccine received FDA approval for emergency use. The Moderna vaccine is still undergoing FDA approval process. He said the County has been planning in terms of logistics, supply chain and security, so as to be ready to administer the vaccines. Shipments from Michigan began on Sunday. We received our first doses on Tuesday morning. He expects that the County will receive rolling shipments over the next few weeks. 9,750 doses comprising the first shipment of the vaccine have been distributed by CCHS to local hospitals. Supply will be short initially and health care workers and nursing home residents will receive priority according to federal and State guidelines, which prioritize based on occupational risk, age and health, and situational factors such as being in a congregate care facility. The vaccines are expected to be available to the general public by early to mid-2021. ACIP makes recommendations about priorities and the additional phases of vaccine distribution. A three-phase system of distribution has been established: 1A health care workers and skilled nursing facilities, 1B other essential workers, first responders, food workers, grocery stores; 1C older adults and adults with chronic medical conditions. A pharmacy partnership (e.g. Walgreens and CVS) will deliver vaccines to long term care facilities. Most first responders are part of Phase 1B of the rollout; some will be in phase 1A. ACIP is still determining protocol. Medical jail personnel are categorized with healthcare workers. Jail inmates’ priority has not yet been determined. Restaurants can be open for take out and delivery, but dining is closed. All the recommendations are science-based. Case investigations have revealed much but are limited. COVID is everywhere in the community and people with the virus have reported multiple contacts that could have been the source of exposure. Dr. Warne said the County reaches 78-80% of cases through contact tracing and only about 40% of case investigations reveal their contacts, so data is limited. The most common sources of exposure have become the nucleus of policies. We know a lot about how the virus is transmitted, so policies focus on activities that pose the highest risk for how the virus is transmitted, which is airborne. What may have been safe two months ago may not be safe now due to the uptick of cases in the community. Dr. Warne recognized the economic impact of the health orders, and so he emphasized following the orders closely so that we can get our metrics out of the purple tier as soon as possible. In reference to the recent letter from local doctors challenging current policies and claiming that the County data was inaccurate, Dr. Warne said there is a wide range of medical expertise in the medical community, and this results in differing opinions. He doesn’t share the opinions expressed in the letter. He said the coronavirus diagnostics test are very accurate and the current wave of infections in the hospital is not typical of the seasonal flu. He said it is more logical to base policy decisions on our coronavirus case data than on historical seasonal flu data. He thought it was irresponsible to spread misinformation about the accuracy of the diagnostic tests when they have demonstrated a high level of accuracy. Chair Andersen invited public comment:
In response to the two previous comments, Dr. Warne said that it is the recommendation that the vaccine should not be withheld from people who may have already been infected with COVID 19 because the immune response varies between people. It is believed that people who have been infected with COVID 19 may be immune for a few months, but it is not known if they will be immune beyond that, so we need to vaccinate them. Anyone currently with the virus will need to wait 14 days until the virus has passed before being vaccinated. Dr. Warne explained that there is a difference between licensed ICU capacity and staffed ICU capacity. ICU beds may be flexed back and forth depending on staffing. The County doesn’t control the staffed ICU capacity numbers used in the State reporting. The State receives ICU capacity data directly from the hospitals throughout the county. ICU bed utilization changes from day to day and even shift to shift. Overall, the availability has decreased. We need to preserve beds not only for COVID patients but also for others.
Dr. Warne explained that certain activities pose greater risks. He said the CA death rate is high but not as high as other areas in the nation. To stem the curb, we need to reduce our levels of activity that contribute to transmission. Restaurants are considered essential and can still be open but only for takeout and delivery. Dining inside or outside of a restaurant is not considered an essential activity because the food can be consumed elsewhere where there is less mixing of people. Regarding big box retailers, Dr. Warne said they serve many needs that can be considered essential.
Dr. Warne disagrees that getting a flu shot will increase the risk of getting COVID.
Supervisor Andersen explained that CA Health & Safety Code section 101040 gives County health officer the ability to take preventative measures to protect the public during a local emergency. We’ve been under a declared state of emergency since March. She also said that Health & Safety Code seciton 120175 states that each state health officer shall take measures as may be necessary to prevent the spread of a communicable disease. These are broad powers. She said that we don’t want politicians making these decisions. We want to rely on the knowledge and expertise of the medical community. Survivability of COVID 19 depends greatly on the ability to receive proven treatments in a hospital setting. We on a very serious trajectory and our board wants to make sure that people can receive the treatment they may need. She wished we could have a normal Christmas. She wished that all businesses could be open and thriving. But the reality is that we are in the middle of a global pandemic. It’s not something that somebody made up. The decision to shelter in place in advance of the State requirement was to preserve our shrinking ICU capacity. For as many people on the call today who said these measures were draconian, she also gets calls and emails asking the Board to take stricter measures and not open schools. It’s a divided issue and a divided country. Supervisor Mitchoff clarified that she is not doing other things while people are speaking. She is working from both a desktop PC and a laptop so that she can readily see the speakers and the meeting packet. She occasionally needs to leave her desk to assist her mother, for whom she is the primary caregiver, but she is monitoring the meeting when she does so. She said the Court injunction mentioned by a previous speaker was a temporary injunction pending further data and our own court turned it away. She suggested that people direct their anger at the issues and not at the people trying to address the issues. Dr. Warne said he’s got a desk full of meeting papers and notes, two machines he is looking at, and was consulting with colleagues during the meeting regarding questions raised before and during the meeting that needed context. He said he smiled out of frustration over not knowing all the answers but not out of disrespect for the meeting attendees. Lynn Mackey explained that she appears to be looking down at her desk at times because she is taking meeting notes. She said that County Health has been a valuable advisor on how to open schools. She gets about 50/50 split of requests to either open schools or not to open schools. Opening or not is to be decided at the discretion of each school district. If distance learning is an issue, she recommends reaching out to the school district directly. Right now, school districts can submit their opening plans for a future time when opening may be possible. Supervisor Andersen will invite Superintendent Mackey to be a presenter at the next Committee meeting. |
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4. | RECEIVE and APPROVE the Record of Action for the November 19, 2020 meeting. | ||||||||||
The Committee approved the Record of Action for the November 19, 2020 meeting as presented. | |||||||||||
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5. | The next meeting is currently scheduled for January 21, 2021. | ||||||||||
Chair Andersen confirmed the next meeting date for January 21, 2021 unless a special meeting sooner than that should become necessary. | |||||||||||
6. | Adjourn | ||||||||||
Chair Andersen adjourned the meeting at 3:12 p.m. | |||||||||||
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