Social Bubble and Work Groups, Another Outbreak, Mendocino Officials Discuss This and More in Virtual Press Conference
Church Outbreak leads to 6 More Cases and Potential Outbreak Stemming from Sonoma County Office in Mendocino Co. Press Conference with Dr. Doohan and CEO Angelo
On Friday May 22, 2020, Mendocino County Public Health Officer Dr. Noemi Doohan and Mendocino County CEO Carmel Angelo held a virtual press conference providing an update on the state of COVID-19 in Mendocino County. Redheaded Blackbelt and other local media asked questions about these and other concerns.
[Note: There is a lot of information in this press conference. We’ll highlight in blue any particularly important responses but there likely will be more of interest to you.]
Opening remarks from Dr. Noemi Doohan & CEO Carmel Angelo
Public Health Director Dr. Noemi Doohan
- I am your full-time health officer. I do not have any other employment at this time which I want to share with you to be clear that the public health officer is a full-time employed individual whose duties are exclusively focused on the work being the health officer and certainly during a pandemic, that is a more than full-time job.
- We have six additional cases in Mendocino County and all six of these are connected to the Assembly of God Church in Redwood Valley. We now have a total of nine individuals, seven from Mendocino County, the six identified today, and the 14th case identified last week and then the two from Lake County. We have a total of nine individuals connected to that outbreak at the Redwood Valley Assembly of God Church.
- When we have an outbreak of such a large magnitude, it’s very concerning. We know that these individuals have had other contacts since contracting the disease. Now, the original three cases that I mentioned, our 14th case and the two from Lake County, these have been in isolation, but the six cases that we identified today which we tested on Tuesday, and our drive-through testing, they now are in isolation. We now have to do the very time-consuming and difficult work of the case investigation contact tracing. We just got this news this morning. We’ve contacted all of these six new cases and we have asked them about their contacts who are quarantined by the blanket orders of the Health Officer.
- We want to offer testing to all of those individuals that are contacts of these six cases. We will be having additional free testing done by our communicable disease team through the case investigation contact tracing so we will be doing that testing tomorrow.
- We have another outbreak that we’re closely monitoring. That is with a fifteenth case who works in a location in Sonoma County and we have reason to believe that there may be an outbreak at that site. We do believe that our fifteenth case did contract the coronavirus from that workplace.
- We are offering for the 55 people that work at that Sonoma County workplace but live in Mendocino County free testing. We are continuing to do the fundamental Public Health work in a pandemic of case investigation contact tracing testing those people that are contacts of cases and offering isolation and q Quarantine housing for those who cannot isolate or quarantine safely at home.
- This week, we achieved attestation with the State of California which allowed me to release new orders which come into play tonight at midnight allowing us to open up our County as fully possible under the governor’s orders for full Stage 2. The final steps of full opening for Stage 2 included allowing restaurants for in-restaurant dining and it allows retails for in-store shopping in order to make sure that business is open in a safe manner.
- I‘m very grateful to the ad hoc committee of our Board of Supervisors, Supervisors Gjerde and Williams, and the West Company for working so hard with us over last weekend so that we would be ready today to have a process for businesses to safely reopen. That process is a self-certification process which has been carefully crafted to be in alignment with the governor and the governor’s requirements for business operations as well as with my sheltering in place orders. Businesses that are reopening that have been closed due to the sheltering in place orders have a self-certification process that is required of them before they can reopen. For those businesses that already were open, my new orders specify that these businesses should complete the self-certification process within the next week and I will share that initial feedback from this online process. It all ties in with readily available resources from the state and from us in Mendocino County regarding how to safely open including hygiene protocols, social distancing protocols, the wearing of facial coverings.
- On one hand we are having outbreaks in our community. On the other hand, we are reopening. This is a time, Mendocino County, where I urge you, I plead with you, to please please support your health officer. P, please support the public health orders. P, please continue to work in collaboration and cooperation with us as we keep our county safe.
- We do want to acknowledge that communication is a critical element in a pandemic response. Public Health has been doing its best to communicate with our public which is what we’re doing now and we want to do better. Today, we will be releasing on our website some posters flyers that you can put up on the wall if you’re a business that show the guidance in very simple to read and clear formats about facial coverings and social distancing.
- We’ve created an infographic that will explain social bubbles. The social bubbles are meant to be a way that we can have social activities that are safe. For example, one of the social bubbles is called the “household support unit” which is a stable group of up to 12 people that has the same grouping for four weeks. It could consist of three different households that decide that they all come together and be able to be closely together and not have to social distance or wear facial coverings together. This social bubble could recreate together, they could share meals together, they could carpool together, and generally have an expansion of how we’ve been quarantined in single household homes. These household support units are meant to allow us to come together during this time where we know that we are having limited reopening and we know that we have a long haul in front of us. The other two social bubbles are child care bubbles and extracurricular activity bubbles; these are for children and the adults that supervise them, again with stable groups of 12. The idea is that we want our children to be able to get out and play and be with one another and within these bubbles you do not have to social distance, and you do not have to wear facial coverings. In regard to work units, these are stable groups of 12 where we want the stable groupings to be stable for four weeks at a time minimum and within these work groups we should wear facial coverings and social distance to the extent possible. But, for example, you can imagine a construction crew. The stable work group might not be able to do that because of the nature of their work.
Around 19 minutes
CEO Carmel Angelo
- We’re opening the county up for a full Phase 2 which doesn’t mean that the virus is gone and the pandemic is over. What we know is that we have to reopen and consider the people in this community. We have to consider the economy and we have to consider a quality of life for all of us. Our goal, as yours, is to have an improved quality of life. We need to do that but we need to do that safely. This is not the time to let your guard down, this is the time to continue social distancing, wearing facial coverings and following the orders as best you can.
- We have the good fortune now to increase our testing numbers and that has been with the help of Senator McGuire and Assemblyman Wood and the OptumServe testing site is something that will help us get to our metrics and help us stay open in a safe manner.
- Testing is free. This testing is starting tomorrow for the public and it is at the Redwood Empire Fairgrounds here in Ukiah on State Street. In order to call and schedule a test, make an appointment by calling 888-634-1123. You can also make an appointment at www.lhi.care.
- We also have a non crisis support line that is open for anyone who has some special needs. We’re calling this a warm line and that number is (707)472-2311. This is not a 911number this is not a crisis line, this is a warm line if you want someone to talk if you’re having anxiety or any other feelings you’re certainly welcome to call the warm line and that is 8:00 to 5:00 Monday through Friday.
- The OptumServe testing site will be open Tuesday through Saturday, 7 a.m. to 7:00 p.m. 7:00 a.m. to 12:00 p.m. is for first responders. medical personnel, health care personnel, and workers in our skilled nursing facilities. From 12:30 to 7:00 p.m., Tuesday through Saturday is for the general public so you could go online. In the very brief time that we’ve had this line open with OptumServe for appointments, we are booked out over the next few days so you can go ahead and attempt to get an appointment for later this week. Demand outweighs the capacity right now.
Around 26 minutes
RHBB’s Matt LaFever asks: What could you tell the Mendocino County public in a general sense (not specific to individual cases to avoid obvious HIPPA concerns) about therapies and treatments for local patients of COVID-19, maybe if ventilators have been used etc.?
- Dr. Doohan says: We have not needed to use a ventilator at this time for a COVID-19 case, which is very good news. There is one medication that the FDA approved for use for people with COVID-19 and that is Remdesivir and that is in crisis levels of shortage. You require six vials to treat one person and this allocation of vials has been from the federal government to the state and then to counties. Mendocino County was not given any vials but Sonoma County was given 24 vials so that’s enough to treat four people. What we like to do with Remdesivir at this point is offer it to any patient who is hospitalized with COVID-19 early because it’s a medicine that works best if it’s used early. It tends to shorten the duration of an illness and make the severity less. In the best case scenario anybody hospitalized with COVID-19 would be able to have access to Remdesivir, but at this time it’s in crisis shortage level. When we did have our first hospitalization, through mutual aid request, we got a course of Remdesivir brought to Mendocino County which we are grateful for. We would like to be able to offer that medicine of Remdesivir but at this time it’s in such short supply that we are not certainly would it be able to offer that. We do not have any shortages of ventilators anyone who at this time would need a ventilator would certainly get one.In addition to ventilators and Remdesivir, there is the simple treatment of oxygen which is very effective in treating people with COVID-19 and anybody who would be hospitalized with COVID-19 would presumably be having oxygen.There is supportive care which is the basic things we provide for people in the hospital like IV fluids. When people are at home and they’re recovering at home the treatments that they have need to be simple like tylenol, ibuprofen.
Around 30 minutes
RHBB’s Matt LaFever asks: From a health officer’s perspective, being that Mendocino can be expecting its annual influx of marijuana laborers in the coming months leading up to harvest, what relationship could you see between potential surges and the annual migration?
- Dr. Doohan says: We did have concerns about this with our Covelo outbreak and I have the very good news that we have not had any additional cases in Covelo other than the initial six. The Covelo outbreak has been contained. From the beginning, we have two arms to our pandemic response; one is containment and one is one is mitigation. In the containment arm, that’s when we do what we’re doing now, for example in Redwood Valley. We do case investigation, contact tracing, we isolate the cases and their contacts, we quarantine, and then we do testing. We do a lot of testing to make sure we can find any of the cases that might not be aware of. We were able, through the trusting relationships we built in Covelo, conduct widespread testing and we’re very grateful for that. I was concerned that there would be fear to come forward to Public Health. We offered anonymous and free testing and so we wanted to really message to people Public Health is here to protect the public’s health. With planting season coming up and we know for a fact that we have people coming into the county from outside the county including from areas where we have widespread COVID-19 we know that there’s going to be introduction of COVID-19. My response to your question is that we we want Public Health to be seen as protecting privacy, protecting the public’s health and if we are offering free anonymous testing, we really want to encourage people, regardless of the work they do to please trust us and and come forward for testing. What we would do then is we would ask for people to give us their phone number they don’t have to give their name and if they tested positive, we would call them and we would be able to work to contain the outbreak. Any person, regardless of what activities they’re involved in, I hope that they will be practicing the public health principles that we’re sharing which is to stay home if you’re sick, practice social distancing, wear facial coverings, wash their hands to avoid crowding indoors and these types of things. I would hope that in the cannabis industry that would be those social distancing and hygiene protocols would be being practiced.
Around 35 minutes
Mendocino Voice’s Adrian Baumann asks: Regarding the outbreak in Redwood Valley, my understanding is that there were three people present at that service, do you know which one of the people was the one that infected the other two? I’m trying to get a sense of sort of how the virus is flowing: is it flowing from Lake County into Mendocino County? Does this indicate the community spread is happening? Can you describe the information you’re getting out of the contact tracing?
- Dr. Doohan says: We had one known Mendocino case from the church; we got six more today so that’s seven. There’s two from Lake County so that’s nine. We are still trying to understand the dynamics of who was together at what point but I believe there were more than three people together in the church on Mother’s Day.
Around 36 minutes
Mendocino Voice’s Adrian Baumann: Certainly the reopening increases the risk of such outbreaks as does tourist and harvest season. What can you tell us what the thresholds might be for sending us back into some kind of lockdown, more strict shelter in place? Are there formal benchmarks established that if we reach them we automatically go back in or is it something that you would make a call on yourself? If so, can you give us some insight into when you might make those decisions?
- Dr. Doohan says: If we are getting to a point where we have so many new cases that it is straining our healthcare system, supplies of personal protective equipment, and we cannot stay ahead of the increasing number of cases, that’s when we would have to go backwards. I do not believe we’re at that point today, but if we have this weekend… if we have people defying the health officers orders, in other words coming together having parties, if businesses do not comply with the orders, if people ignore the reality of this pandemic, this weekend could be disastrous for us. This weekend could be a turning point. Be very safe and know that tourism is closed in Mendocino County, lodging is closed for tourism or leisure. Whether you’re an in-County person or an out-of-County person, lodging is closed. There’s no camping. I already know that there are tourists coming to our County so be very careful. I’m not giving you a specific answer because I don’t want it. I don’t want to say right now what would cause me to go backward because I want to keep hope that it won’t happen and I want to believe that Mendocino County is going to continue to work so hard as we have all these these many weeks.
Around 46 minutes
KZYX’s Sarah Reith asks: we learned this morning that there would be more conversations this afternoon with the state about the nature of the mutual aid arrangement regarding our public health officer and I’m wondering if you could go into more details about that, like the levels of Dr. Doohan’s involvement after she goes to her new job in June and who would be our local liaison with the state and if there is any consideration about hiring local doctors to take more of a public health role?
- CEO Angelo says: We did have a candidate for our health officer position. Dr. Doohan came on at a time last year to assist us because we did not have a health officer. We had a recruitment out and we needed a health officer and we have the good fortune of Dr. Dooohan stepping up and saying “I can help you for a few months I am relocating and until I’m actually relocated in Southern California I will stay and help you and that was only to be I think until March. “Along came COVID- 19 and Dr. Doohan, being the professional that she is, said “I’m not going to walk away from Mendocino County. I’m not going to leave you at a time when you really need a health officer.” At that point in time we did not have applications from qualified physicians who had experience in public health who were willing to apply for the job and come to Mendocino County on a full-time basis. Dr. Doohan recruited Dr. Flaherty to come in as our Deputy Health Officer. We also had a group of physicians that did sign up to be advisors to Dr. Doohan and Dr. Flaherty. They were retired doctors but none of them wanted to work full-time and those doctors that did have full-time practices that had signed up didn’t have much time as well so we found ourselves you know really without a local candidate who would come on full-time. Full-time for the health officer in a pandemic is not 40 hours but between 60 and 70 hours. We did have some controversy with Ddr. Joseph Iser. The Board of Supervisors did meet on this past Tuesday and decided that Dr. Iser was not an appropriate match for Mendocino County so what the board directed me to go ahead and work with the state and ask for mutual aid. There have been comments about sharing health officers between maybe Mendocino and Sonoma, or Mendocino and Lake, or Mendocino and Humboldt. The time to do that is a time when there’s not a pandemic event and particularly in a rural area. When we know this is a time for rural. Today, we sent up a formal request and I sent it through our medical health area operational coordinator and that goes up to the state for mutual aid and then they will work with the California Department of Public Health. We will work with them to determine what our needs are as we as we wrote and sent up today and see if they can assist us.
- Dr. Doohan says: I am a local person. My family has had a family ranch in Mendocino County for 40 years I was married on that ranch, my children were raised on that ranch, and I consider Mendocino my home which is why I had not stopped working for a day since this pandemic broke out. There’s so many people in the county that are my people. I got an alarmed phone call from the state it was about a week ago saying that somebody from Mendocino County had called the state and asked what happens if Mendocino County doesn’t have a health officer. That set off alarm bells at the state because the answer was Mendocino County has to have a health officer. There’s a Health and Safety Code (101000) which says that each Board of Supervisors shall appoint a health officer who is a county health officer and it continues that the county health officer shall be a graduate of a medical college of good standing and repute and compensation is determined by the Board of Supervisors. The Health Officer works for the board. There is a Mendocino County ordinance fromrom 1954 that that states that a doctor practicing medicine in the community, like having a private practice, cannot be the Health Officer because of conflict of interest There’s a state ruling that also supports this. That’s exactly what we’re experiencing now. If there’s a pandemic and a doctor has a duty to serve at the hospital as well as a duty to serve as the health officer, how are they going to choose? That’s the conflict of interest: do they go to work at the hospital or do they go to work for the Board of Supervisors and public health?
This is the goal of the job posting that’s been posted for months which is to find a doctor to be the health officer for Mendocino County and it would be terrific if it was what we’re calling a local person. Although, I think defining what a local person is challenging because there are certainly people that work in Mendocino County that don’t live here and I would question, do we call them local? I myself have been messaging for months that we need a health officer to apply for this and that’s in fact how Dr. Iser came to us. I am hopeful, because Governor Newsom actually called out Mendocino and Lake County for achieving testing capacity, that he will call us out and our need for a health officer. In the meantime, I’m here I’m full time and I’m your health officer and I will continue to serve thank you well
Around 49 minutes
KZYX’s Sarah Reith asks: My question is about antibody testing and I’m wondering if those are available and if they are how people can go about getting them and if it would be even relevant from an epidemiological standpoint to know if we had a certain number of people who had gotten the virus months ago and recovered without incident?
- Dr. Doohan says: Antibody tests are certainly a very hot topic. It’s called serology testing so it’s a blood test and it’s testing for antibodies against coronavirus. We talk about tests of having sensitivity or specificity and the antibody tests have lower specificity. You can have false positives and that arises because they cross react with other coronavirus antibodies that you might have, for example from the common cold. Antibody testing it’s really for research purposes. At this point, it is not sufficient to allow an individual, for example, to say that they had coronavirus and is now immune. We don’t have the science to back that yet. That is ultimately what we want: we want people to be tested for Coronavirus and know that they are now immune. We do have antibody testing that we can get a sense in a population how much of the population do we believe has been infected and it’s that antibody tested that we’ve used, for example, in the Bay Area. I have heard that Quest is doing antibody testing. I’ve heard that it costs about $200 but that you can go into your clinician’s office and ask for that test.
The last 10 minutes of the press conference was a Spanish question and answer session between Al Punto’s Jackeline Orozco and the county provided translator George Verástegui. The questions and answers were not provided in English so a summation cannot be provided.