Media Asks Dr. Frankovich About: Alder Bay, Casinos Reopening, Precise Numbers and Contradictions

Humboldt County’s Public Health Officer Dr. Teresa Frankovich has been answering questions since the stay-at-home orders were instituted on a two question per media outlet roughly three times a week basis. The Department of Health and Human Services or office takes the questions, frequently re-words them, and reads them on camera for their response. The resulting video, called a Media Availability, is then provided to news outlets at the end of the day.

Here are some of the main points covered in the May 20th Media Availability session with a summary of answers form Dr. Teresa Frankovich, followed by questions we would have liked to ask in response if appropriate.

Media Question: The FDA has approved emergency use authorization for several dozen molecular COVID-19 tests to date, which one is Humboldt County’s public health lab using?
Answer by Dr. Frankovich:

Well what we’re actually using it’s an RTPCR test, It’s probably the most highly sensitive test, or among the most that are available. It’s the same test that was basically distributed by the CDC in this outbreak when other testing was not yet available, those other options. But it really is one of the gold standards.

45 sec in:
Media Question: Is it possible to get a breakdown of the percentages of people with confirmed cases, who presented with the most common symptoms, for instance what percentage of people had a dry cough, fever?
Answer by Dr. Frankovich:

Well it’s a good question, and it really goes to point of the fact that we know that the symptom range is much broader than we originally thought with COVID, and you know, includes things like a headache and muscle aches and sometimes diarrhea, sometimes just some other more vague symptoms like a sore throat, and so we do collect that information. So I will talk with our epidemiologist and see if there’s a way at least on an intermittent basis we can update people on what that’s looking like.

1 min 20 sec in:
Media Question: Of those with confirmed active positive tests so far, how many are asymptomatic, how many have symptoms, how many are currently in the hospital, and how many are currently occupying beds in the ICU?
Answer by Dr. Frankovich:

Sure, so you know basically when we look at these individuals one thing that the community can look at is the active, positive cases that are recovered, or active versus recovered is the label that we put on, that will tell you the people who have been removed from isolation, so they have met those criteria, At this point of having had no fever for three days without medicine, they have improved symptoms and it’s been at least 10 days since their onset of their symptoms. And so that’s one easy way to tell how people are doing.

Basically, when they come out of that isolation period. We don’t comment on people‘s specific- who’s in the hospital and who is not- but you can certainly look at the total number of individuals of our positives, who’ve required hospitalization just by looking at the hospitalization number.

Media Followup questions we’re unable to ask because of the format:

• Is there a reason a number of hospitalizations can’t be specifically spoken about, for instance to specifically consider how many ICU beds are occupied, even considering that you are not being asked for any identifying information regarding individuals?
• What do you say to the criticism that you are avoiding questions about local hospitalizations and hiding behind an exaggerated interpretation of the HIPAA regulations protecting personal information and patient confidentiality?

2 mins 25 sec in:
Media Question: Where do the Covid positive, asymptomatic people from Alder Bay or homeless for that matter go to quarantine?
Answer by Dr. Frankovich:

So, in a facility where there’s a congregate living facility such as Alder Bay or assisted-living or skilled nursing facility, those individuals are isolated in their quarters. And so, in some places that’s much more of like a little apartment or room for them. And, you know basically, the model is to use full PPE going in and out of those rooms, trying to use the same staff as much as possible so that there is just limited interactions there, minimizing people going in and out of the room. So there are ways we try and work to keep that individual rather contained in terms of exposure to others.
It’s a different matter when we were talking about homeless individuals. So, with homeless individuals, it’s important for them to have somewhere to be while they are in isolation because they are a positive, and so they would go into lodging that we have set up through the county, and they are in that. We help to support them in that environment until they come out of isolation or quarantine.

3 mins 40 secs in:
Media Question: Is the Department of Health and Human Services concerned about the coronavirus outbreak at the Alder Bay facility, and if so what measures are health officials taking to monitor the situation?
Answer by Dr. Frankovich:

So, we obviously have an outbreak at the Alder Bay facility, and again as we talked about, in particular, these assisted-living facilities are challenging for these outbreaks. We have been in contact with the California Department of Public health since the beginning of these cases in the facility, and we actually have had them on ground here for a few days now, also sort of assisting with the facility and assisting local efforts with it so that it’s been of great help. Certainly they are familiar with this process as we have been seeing this in facilities across the state.

4 mins 25 sec in:
Media Question: Could these two deaths impact Humboldt’s reopening efforts, and if so how?
Answer by Dr. Frankovich:

So, what I would say is that no single piece of data dictates us moving forward. You know, the deaths are obviously difficult for us, and sobering as we move forward. But in terms of our local situation, we need to take in a full context of what’s going on in the community. Do we have hospital capacity, do we have contact investigation capacity, what do our epidemiologic numbers look like? All of those are taken into account when we go forward. So again, as much as we regret these, it doesn’t necessarily change the trajectory of what we are doing going forward.

5 mins 10 sec in:
Media Question: I understand that you stand firm on the concept of sheltering-in-place and that Humboldt County residents are asked to remain home as much as possible, but yet discussions are continuing, to re-open more nonessential businesses, don’t you think this is a contradiction?
Answer by Dr. Frankovich:

Well, I understand the question, but what I want to say is that I think we all agreed as a community that there is no way for us to remain in shelter in place until a vaccine is available, or therapeutics, because we don’t know what that timeframe is. And, staying as we are in this very restricted environment is also a health threat, and a societal and an economic threat to people in our community. And so I think we are in general agreement that we need to move forward, the only question is pace. What I would tell you is that one of the important features about moving forward is that we try and control a number of things all at once. So, while we recognize that we need to get some businesses open, we are asking people to still, not spend the kind of time outside their home- for instance extended shopping, those kinds of things or doing so in groups etc. that they might have enjoyed before- we’ll get there. we’re just not there yet. And so, it’s not a contradiction in the sense that we need both things to happen. we need people to still be limiting their activity, and we need to start opening.

Media Followup questions we’re unable to ask because of the format:

• Has the county produced an updated model projection regarding countywide hospitalizations, considering that the previous models are not being referenced?

6 mins 35 sec in:
Media Question: If the mass population has the OK to shop or frequent nonessential businesses, why not approve people to attend self-help or support groups as a mental health tool, and what would the criteria for approval of that be?
Answer by Dr. Frankovich:

So, I understand that that is a need. It really goes to this issue of the number of people that can gather right? So I know some groups have been meeting through technology, such as Zoom and various things and that has been helpful. I agree that it’s always great to be able to meet in person, so what we are really looking at is, when is that moment. Right now, the state has not put out guidelines about the number of people gathering outside of the household unit. Again, when we speak about those number of changes, people need to understand increasing our group sizes increases exposure. And so, we plan to do it, it will happen hopefully very soon, and we will certainly make sure people are aware of that.

Media Followup questions we’re unable to ask because of the format:

7 mins 30 sec in:
Media Question: On Tuesday, the sheriff was asked about Bear River Casino reopening this weekend, and he said the public health officer has said, ‘we don’t believe this is a good time for them to open up right now and we strongly recommend that they do not.’ Why do you believe that it is not in the public’s best interest for casinos to re-open right now?
Answer by Dr. Frankovich:

So it speaks to some of the things we have alluded to in this conversation… the gatherings of people is a significant risk. As we look across the country at some gatherings that have occurred in a variety of settings, these larger gatherings have a potential to allow a lot of transmission of virus.

 

So my concern in the casino setting is, again, as careful as they might try to be in structuring the work environment, the individuals operating casinos, you cannot get away from the fact that we’re pulling large numbers of people into a common space, indoors, for extended periods of time. And, as we have seen in scenarios in our county, we have had individuals who have had absolutely no symptoms initiate outbreaks. And I think that that is going to happen in our community. I just don’t think it’s the right time to introduce that type of exposure in a large setting.

8 mins 50 sec in:
Media Question: Eureka saw a second death in an Alder Bay resident reported Tuesday. How are residents who contract Covid at Alder Bay being quarantined to minimize risk of spread?
Answer by Dr. Frankovich:

I think we covered that question previously.

Community members with questions, concerns and comments are encouraged to call 441-5000 for information.