Dr. Frankovich Talks About Pets, Children, Masks, How Personal Interactions Are Worrisome, and More

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 two to three times per week basis. The Emergency Operations Center takes the questions, and staff 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 June 30th Media Availability session with a summary of answers from Dr. Teresa Frankovich, followed by questions we would have liked to ask in response if appropriate.

Samantha Kargas: Before we get started with some immediate questions, can you talk a little bit about California and COVID-19 Virus?

Dr. Frankovich: 

Sure. Well, I’m guessing most people in the county have been watching what’s happening across the country, and certainly in the state of California there are clearly areas of the state that are experiencing really rapid growth, even exponential growth of this virus, which is what we’ve been talking about for quite a long time now.  The idea that COVID could circulate in relatively small numbers but as we bring people out and start to mix them together in that those numbers can increase and dramatically increase across the community.

I think there are huge lessons to be learned here and I think that one of my concerns is that people focus on just things like, for instance, interactions in bars because, of course, the governor in those specific counties has recommended that bars close. 

Bars are certainly a place of risk. There’s no question about that, but what I think is really important for people to recognize is that it is our in fact our day-to-day behavior that is putting us at risk.

It is people gathering between households, it’s those networks of friends and neighbors and after a long time of shelter in place people want to socialize and it starts to feel safe because they look like your neighbors, they’re your friends and it feels safe and I think we just need to accept the fact that it is not safe. The more you mix with other households the more virus is going to circulate and it is going to compromise our ability to move forward. It’s going to compromise our ability to be able to operate many of the things we want to do. So schools are really important for us to be able to have up and running in our community. I don’t want that compromised.  I want us to keep businesses open, but frankly we are going to have to walk things back if it doesn’t change and another big important piece of this is masking. It is absolutely essential going forward it protects other people. It is not meant to protect you specifically, but if everyone is wearing them it will protect you. And so I just again, I can’t emphasize enough that this is our time of personal responsibility. Either we accept that this virus is a problem, and it has the potential to make a lot of us very sick, or we ignore it at our own peril.  

2 Mins and 35 secs:

Media Question: A listener inquired, is COVID-19 transmitting from humans to pets? Do you know what can be done to prevent that kind of virus transmission?

Answer by Dr. Frankovich: 

Well certainly we’ve seen documentation of some animals I’m acquiring COVID. I think that frankly it’s..I don’t think it is a big issue right now and we certainly know that the transmission of COVID virus from pets to people is not an issue, that is not something that’s been documented as a driver in this pandemic.

However it is possible if you are ill with COVID to transmit that and so the CDC has great guidance online about managing your pets if you’re ill and just some of those same things we do with people just, hand washing, not having clothes handling a little bit more distancing than usual, etc., until you’re recovered. 

3 mins 35 sec in:  

Media Question:  What practices do you recommend to empower the immune system and stay healthy?

Answer by Dr. Frankovich: 

Well the sorts that you know Public Health is always talking about, so, you know essentially the things that keep us healthy. A good diet, lots of fruits and vegetables and a good range of foods, good activity. I think it’s a perfect time for us to be outdoors and being active, both as a stress reliever to boost our immune system and just in general for our health and certainly getting rest. And so you know getting some good sleep is important for everyone. 

4 mins 10 secs in:

Media Question: What are the most common medical conditions that warrant an exemption from mask wearing and is DHHS providing any guidance to businesses on how to handle a situation if someone refuses to wear a mask at their establishment.

Answer by Dr. Frankovich: 

So, the types of things that would be medical exemptions would typically need to be people who have really significant respiratory issues, and you know, so, some really restrictive lung disease. Not everyone with COPD or asthma cannot wear a mask, most people can, but there are some people who already have a great deal of difficulty breathing and adding the mask may be really challenging for them in. 

In general, it’s a relatively few number of people that really cannot wear a mask but some people cannot. Some people from a mental health standpoint have an issue as well people who suffer from some claustrophobia and different issues have sometimes also found a mass challenging, and for those individuals sometimes a face shield has been an easier thing to wear. 

In terms of guidance, this is actually something that we can help people with if they contact the J.I.C. We can advise people about that again we do want to emphasize that while employees do need to be masked, if there are individuals who have challenges to being able to do that, that’s something we can advise on and make suggestions, for instance like face shields. Then it also is important to remember that while we want everyone to be masked, the order is for everyone who does not have a contraindication to a mask and is over the age of two, or you know, we want those folks to be masked. If they, basically, if they’re in a public space and refusing to mask we are not requiring businesses for example to enforce that on-site it is completely their prerogative about whether they do so but it frankly keeps everyone safer.

6 mins 5 sec in: 

Media Question:  With direct flights from ACV to LAX resuming July 6th and Los Angeles County just placed on the Governor’s Coronavirus watch list due to a spike in cases, is Public Health concerned at all about people traveling specifically to/from that area? (whether it be residents flying in/out of the county, or outside people coming to Humboldt to get away from other more affected areas.)

Answer by Dr. Frankovich: 

Well, certainly travel has been a concern for us all the way along.  As a relatively isolated community a distance from major metropolitan areas, we’ve had some protection and, but the reality on the ground is that people are traveling. And you know it’s important to recognize that and just try and deal with it from a safety standpoint.  I think focusing on flying, specifically is, is problematic.  I think the vast majority of people traveling in and out of our County are doing so by vehicles, and not by planes. And so just highlighting those individuals arriving by plane really isn’t productive.  

I think we need to be talking about travel in general, and I also do want to mention that our, really, to date the drivers of travel-acquired infections in our community have been our own residents leaving and coming back to the area.  It has not been just tourism for example that may change but that has been our issue today so again the message we’ve been putting out there right from the beginning is, the safest thing is to stay close to home. It really is.

And I’m hoping that other people in the state seeing what’s going on are recognizing that as well and staying close to home during this time, and if people are traveling they really need to think about what they’re doing while they’re traveling, so if they are not masking, that puts their group more at risk when they’re out. If they’re in groups of people in that area who are not masking, that’s a problem. Things like social distancing that you may tend to forget on a vacation are really important to remember, along with hand-washing and all of that, so we really can take those tools with us wherever we go, we need to do it. 

8 mins 10 sec in:  

Media Question: With bars in Humboldt County being able to now submit their reopening plans and the recent announcement from the Governor about bars being ordered to close in a number of other counties, is Public Health thinking about the possibility of having to put those reopenings on hold? Are you working more closely with bars to ensure their reopening safely?

Answer by Dr. Frankovich: 

So again, as we just spoke about a little bit earlier, I think bars are an important feature because by nature they’re a social setting, and so I do have reservations about them being open. And I think it’s particularly important in a lot of these settings that everyone is really adhering to guidelines. So, whether you’re a retail business that’s selling merchandise or you’re a restaurant that has a bar, or you’re a bar, we all need to be following the guidelines, that essentially, people need to be following the plan that they put in place for safety.

And if they are not, then they need to be held accountable for not following that plan because frankly it places our entire community at risk. And so we’ll certainly be watching this closely in our community.

9 mins 15 sec in:

Media Question:  Can you explain how information on COVID tests is determined okay to be released? By what criteria is COVID-related information determined to be ‘needed’ to be disclosed as public information versus being deemed unnecessary for the public and hence considered ‘wanted’ information?

Answer by Dr. Frankovich:  

It’s a good question, and I would say, really things fall into kind of three baskets when we’re talking about trying to put information out there. One is the information that you know, we really feel is central, you know, that we and… when we look to put things out for the public we want to identify those things that we do think are important, and that we can produce with a relatively small staff on a daily basis, so that the numbers are reliable and get out in a timely way. There are some things that I would love to report, but it’s really difficult to do with the systems that we have to work with and our personnel, and so it just is more problematic to be able to produce it and put it out. I’m really appreciative of the Joint Information Center working hard on this dashboard to be able to put information out, so that we can start to have things more visible to the community. And we’ll be expanding that over time, but for a lot of it is our use of resources, and being able to allocate them.  We’re spending most of our resources on responding to this, and so we’re trying to balance those things, in terms of getting people everything they might like to know.  Then there’s another piece of, sort of the data, that is just people wanting information that actually does relate to patient privacy and that we just can’t compromise on- and particularly in small communities -where people are there, it’s you know, you have one person hospitalized in Los Angeles it doesn’t really hurt to report that. You have a person hospitalized because that’s not identifiable, when you start to talk about smaller communities and whether someone’s in the hospital or the ICU or on a ventilator, it starts to become more identifiable about what their diagnosis might be, and and so we really walk that edge all the time in public health. People need to feel confident that their information will be protected. 

11 mins 40 sec in:   

Media Question:  In an earlier response you noted the “disproportionate amount of cases in our Latino community.” Do you believe that a lack of available information and direct outreach to undocumented community members has impacted the local spread of COVID?  Have you seen any cases where community members have been reluctant to seek out health services while suffering from COVID, due to immigration-related concerns or fears?

Answer by Dr. Frankovich: 

So yes, we have seen a disproportionate number of cases in our Latino community, and that’s the same that’s been seen across the state of California, and it is a big concern.  I think the questioner (RHBB) points out certainly an important feature here, which is in a community where English may not be the first language, it’s really challenging to make sure people have the information they need to make good decisions and to understand how to access for instance testing and services that they need. 

It’s certainly been a target for our Joint Information Center in terms of trying to reach out in all kinds of avenues to get people that information in the language that’s appropriate, and I’m hoping we’re making headway in that respect.  I think also, as we deal with cases in our community, I think you know as we do so, we have the chance to earn some credibility with all of our population in terms of how we handle cases and how we handle information. And I think that’s valuable, and helps to create a relationship between public health and communities.

 

In terms of our local cases and immigration, I’m not aware of anyone who has not sought care because of their immigration status.

 

13 mins 5 sec in:

Media Question:  There have been conflicting national media reports over the past week about the degree to which children may be susceptible to contracting and spreading COVID-19. What is your understanding of the latest science about how the disease does and does not impact children?

Answer by Dr. Frankovich: 

Well I think it’s been challenging to understand about how many children actually get COVID, because we know that children typically have mild symptoms.  Children may be asymptomatic, just as other age groups, and are not as likely to be tested. And so I think it makes it really difficult to understand how much COVID is actually circulating in our childhood population  And fortunately, we’re not seeing the rates of severe disease in young children, although that does not mean that there are no deaths or severe disease in that age group.  But fortunately again, it’s rarer and these cases tend to come less to attention. As we expand testing and are able really to do better and better surveillance testing, hopefully we’ll be able to collect more on children and get a better idea of that.

14 mins 20 secs:

Media Question: According to the county dashboard, 12 percent of local cases have been confirmed in people age 19 or younger, which accounts for a far higher percentage of cases than has been reported nationally by the CDC. Do you have any theories as to why Humboldt County is seeing a higher rate of cases in this age demographic?

Answer by Dr. Frankovich:

Well, in our case, and certainly thinking back through any cases in that age group that we’ve had, the vast majority of these cases- in fact perhaps all of them -have been contacts of known cases. So, they’ve come to testing and identification because we are making a really concerted effort to test even those without symptoms in households of people who are identified as cases, and so again, it points to the previous question which is- since children do better and are often asymptomatic, we would not normally pick them up- but in this instance we do, and I think that really in our population describes why we’re seeing that higher number in that age group.