Public Health Officer Fears a “Tsunami of Cases” if COVID Protocols Are Not Followed and More in Mendocino County Virtual Press Conference

On Friday, June 19, 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 will highlight in blue any particularly important responses]

Opening remarks from Dr. Noemi Doohan

Noemi Doohan Screenshot from the video.

Public Health Director Dr. Noemi Doohan

• The pandemic continues to rapidly evolve. We are seeing community spread in the Ukiah Valley. We now have 54 cases of COVID-19. 37% (20) are Hispanic, 31% are white (17), 2/54 are Native American. We’ve had a total of 6 hospitalizations, one unrelated to COVID. That patient tested positive for COVID while being hospitalized for other reasons. 10% of Mendocino County’s COVID-19 patients have been hospitalized, which is a much higher hospitalization rate than influenza. Mendocino County has 54 cases, no deaths. Compared to Lake County 34 cases, no deaths. Humboldt 107 cases, 4 deaths. Sonoma County 774 cases, 4 deaths. We have 18 individuals in isolation, 57 individuals in quarantine. Those in isolation had a lot of contacts. Our biggest concerns are that those positive for COVID are not isolating. Early on in the pandemic, that was not happening. People were staying isolated.
• If you are sick, you need to stay home. If you have been in contact with someone that has had COVID, you need to quarantine. 
• Regarding the Bay Area, over 17,000 cases have been identified, 510 deaths, about a 3% death rate which is much higher than influenza. It’s not good to compare COVID-19 with influenza because it is far deadlier and there is no vaccine or immunity in our population.
• The pandemic is far from over and it essential we continue Shelter-in-Place protocols. 
• We have moved into Phase 3 of the Sheltering-In-Place, where we have opened up high-risk businesses. While we’re having these outbreaks, we’re opening up.
• Our economy is part of our health and we cannot keep it shut down at this time. Tourism has been opened up in our county as per directives of the governor. 
• We’ve been engaging in three types of testing: surveillance, outbreak, and testing people when they’re sick. Those that are sick are tested in the clinics or hospitals of Mendocino County. Surveillance testing samples the general population to get a sense of whether we have community spread. We’ve been doing surveillance testing for months now. Optum-Serve has been a resource that has allowed our county to conduct surveillance testing. It is currently at a fixed location and we must have 132 tests/day to keep that resource, we are meeting that goal. We’re looking at the possibility of expanding a testing site to the coast. 
• Outbreak testing has been utilized because of the recent outbreaks that were expected because of the governor’s orders of opening up. 
• The source of those recent outbreaks was graduation parties. One of the parties led to a youth being exposed to friends, then friends spreading it to family. The youth also participated in sports and COVID was spread that way.
• For those that gather into groups, you are threatening our county’s health.
• We do have room to develop “social bubbles”, as per the County’s health order. The social bubble is a stable group of up to 12 people that has the same grouping for four weeks.
• Getting together with a group of 35 people and then playing some sports is dangerous. 
• The governor decided to make a state-wide facial covering order. When outside and 6-feet or closer to other people, you need to wear a facial covering. If you choose to not wear a social covering, what you say is I don’t care about people in my community. I am seeing people not wearing facial covering because they do not think it’s right to. These outbreaks have been a result of not following these protocols
• We have opened up in Mendocino County so we are going to see a spread of the disease. 
• In my orders, I have opened up personal services which includes nail salons, personal services for the face. Facial services are specifically concerning because the client cannot use facial coverings.
• The current SIP order has an end date of July 3. The next SIP order will be simplified. There is a lot of language in the current one that is historical, it built on the old SIP orders. 

Around 20 minutes

KZYX’s Sarah Reith asks: With the emphasis on the role of the state in managing the response, what are your thoughts on the degree of uniformity of implementation of COVID-19 guidelines across school sites? Will schools have similar protocols in place and will someone from public health be consulting with schools and the state to make sure responses are accurate?

• Dr. Doohan says: We are working with state leadership to ask for a meeting of state health officers with the State Superintendent of Schools to get guidance.. I will not be writing the reopening plans for each school because each school site is different and requires guidelines specific to its needs. I want to support our local districts to comply with the state’s school guidelines. Those guidelines have gaps and some of the expectations from the order are difficult for schools to put into place. DOC Manager Becky Emory met with the local schools to understand their concerns and get a sense of how public health can support them. I would like the schools each to come up with a plan so they can be reviewed in collaboration with Public Health. I will provide feedback and recommendations. 

Around 24 minutes

KZYX’s Sarah Reith asks: We know that several teens have come down with this illness. We learned that younger kids can get it. I’m wondering if there are any efforts to come up with a system to keep in touch with people who have recovered from COVID-19?

• Dr. Doohan says: This is the role of the primary care clinicians. They are providing care for people in an on-going manner. We are always encouraging individuals to speak with their primary care providers in the clinics and hospitals. Public Health makes sure that residents in isolation or quarantine are contacted regularly and are always communicating with individuals to be in touch with their primary care providers. I did change the facial covering order for the county, specific to children. I have decided in my health order that children under 12 should wear a facial covering. If they’re playing with peers, that should lower risks of transmission.

27 minutes

Mendocino Voice’s Kate Maxwell asks: Several higher risk businesses are opening. We’ve had a number of outbreaks and established community spread. You’ve said that people have not been complying with the mask order and not self-isolating. Can you elaborate on how residents can be safe during these openings and what the county is doing to track and make sure that people that have tested positive are self-isolating

• Dr. Doohan says: Reporting is mandatory for positive COVID tests. We know who had tested positive. We track that person down. People have been very cooperative, stayed home. That is the work of containing outbreaks. The county is also providing surveillance testing which identifies cases and we also provide isolation and quarantine housing. There is the education component having infographics on our website, posters in businesses. Individuals can choose to wear facial coverings, to stay home when they’re sick, to wash their hands, to cover their coughs, to practice social distancing. You can make the decision: do you want to go to a higher risk business (places where it is difficult to social distance)? If you participate in activities where there is less ability to socially distance, you’re taking a risk. Essential businesses were kept open because there is a certain amount of risk associated with getting food, buying gas. Public health is working with local businesses to make sure they have social distancing and hygiene practices. These local businesses are working with public health for self-certification. Higher risk businesses are required to post their guidelines for following protocols and keeping individuals safe while in their business. Enforcement is a challenge because we are not going to be arresting people for not wearing a facial covering. How do we enforce SIP orders while maintaining a peaceful community? 

32 minutes

Mendocino Voice’s Kate Maxwell asks a follow-up question: You alluded to some folks who are not following recommendations. What do you mean by how people should act?

• Dr. Doohan says: Following the orders is how you should act. For example, I don’t want to wear a facial covering, I don’t want to stand 6 feet apart, I’m going to a party with 35 people, hang out, and then play basketball. And then you find out you have COVID. Now we have to track down every single person that had contact. Once an individual is diagnosed, there are a lot of people that are impacted when they choose not to follow orders. Outbreaks will continue into the summer because people choose to not follow orders. Who is most at-risk of dying? Our grandparents. Our elders. We need to take care of them to make sure we have a safe community for everybody.

34 minutes

Mendocino Voice’s Kate Maxwell asks: Knowing there might be more outbreaks or community spread, is there any consideration of providing more detailed information about where outbreaks originate? 

• Dr. Doohan says: I will reveal the name of a business or a location of an outbreak if I believe there has been a risk to the public. For example, let’s say there is a hypothetical hotel that did not comply with the Health Officer’s orders, I would announce “this hotel is not complying with the orders.” I would shut down the hotel. It is the Health Officer’s authority to reveal the name of a business and/or shut it down if it is a health risk to the public. We currently do not have that so I have not had to do that. 

Around 37 minutes

RHBB’s Matt LaFever asks: I sense within your statement today a sense of urgency. Can you speak to that urgency? Do you see the community’s decisions right now as telling of the trajectory of Mendocino County’s COVID-19 experience? Knowing that our attestation has been approved, now many cases and hospitalizations would need to occur to overwhelm our current medical infrastructure capacity? 

• Dr. Doohan says: I do have a sense of urgency. Our communicable disease team is working day and night in response to these outbreaks. When I say there are 18 individuals in isolation and 57 in quarantine, that’s a lot for a rural county to be handling. There is a heavy burden on our Public Health department as cases increase. Furthermore, tourism is opening up. We have competing pressures. We have the pressures of public health which would keep the state closed for a year but we cannot do that. We have the business community that needs to feed their families and keep their businesses alive. This is very concerning to me. We are inviting 17,000 Bay Area cases in our county. The only way we can protect the county from a tsunami of cases is being careful with our personal practices: wear facial coverings, practice social distancing, stay home when you’re sick. In terms of the number of cases overwhelming our system, it depends on how fast they happen. We’re seeing about a 10% hospitalization. If we had 1000 new cases and 100 hospitalizations, this would be difficult. While you do detect the urgency in my voice, I am very proud of our public health team. Despite the recent outbreaks, all information points to them being contained. That indicates good practices by those affected. 

Around 42 minutes

RHBB’s Matt LaFever asks: Regarding the 64-page document issued to California Schools regarding reopening in the pandemic, and knowing that each district is allowed to implement the guidelines they see most essential, if you had to simplify that document into three essential guidelines what would those be? 

• Dr. Doohan says: For one thing, Public Health Officers are asking to convene a meeting to get that exact guidance from the state superintendent of schools so we can have a unified message. We also need to think about guidelines specific to rural or urban communities. The bottom line, social distancing is effective. It’s hard to do with children. The extent that we can do this in classrooms is important. It is important to have ventilation, open windows, which is hard to do in the winter. It is important to have extra opportunities for hygiene such as handwashing stations, not sharing classroom materials, wiping down surfaces. We also need the ability to stay home when sick. I will say, it’s going to be a hard school year. 

44 minutes

RHBB’s Matt LaFever asks: Are there any recommendations in the CDE’s recommendations that are not worth implementing due to limited financial resources? 

• Dr. Doohan says: Temperature screenings have shown to be not effective because fever is a later presentation of COVID. We have seen that there might be more funding coming from the state to help our schools to implement these changes. Students and teachers must have the ability to stay at home if need be and continue their work from home.

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.