Dr Frankovich Talks About Hoopa COVID Case Surge, Open-Air Dining Tents and How COVID Will Be In Schools Eventually

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 times a 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 August 6th Media Availability session with a summary of answers from Dr. Frankovich, followed by questions we would have liked to ask in response if appropriate.

Dr. Teresa Frankovich introductory remarks:

I was just going to briefly mention that we, you know, obviously have seen some increasing cases and part of that is due to an emerging cluster of cases in Hoopa that has been reported by Hoopa to the media.

I just wanted to emphasize that local Public Health has a partnership with the medical clinic in Hoopa and the Tribe.  We actually provide contact tracing and work with them quite closely to identify and help to decrease transmission – identify cases and…work to get those individuals who are ill tested, get contacts tested.  And so we actually have a very good system to be able to do that.  That partnership is really important in instances like this and so I’m grateful for that. I have been in frequent communication with Dr. Eva Smith who is the director of the clinic there

and our partnership predates this cluster of cases.

I’ve also reached out to the California Department of Public Health and the California Office of Emergency Services to let them know what’s going on, in anticipation that we may need some additional resources just to help us handle this effectively depending on how this cluster of cases evolves.

1 mins 35 sec in:  

Two Rivers Tribune asks:  There is currently an increase in cases in Hoopa (24 active cases currently). Can you explain how Hoopa’s numbers are reported and how those numbers are integrated into the County’s daily numbers? Are Hoopa’s numbers being contact-traced by the County? Are they community spread cases? 

Answer by Dr. Frankovich:

So the answer to that is Hoopa residents are Humboldt County residents and they are represented in our case counts. That being said, they don’t necessarily appear on the same day because there is a process. If testing is done locally in, in the clinic in Hoopa, then those results have to be sent to us, we have to sort of vet those results, and then we report those out when we have identified those as confirmed cases.  And so there is sometimes a time lag, but the cases do all get reported out um into our county data and get reported to the state through the surveillance system. They are not double counted in any way if they happen to be entered into the state surveillance system on either end, we are able to go in and de-duplicate it so that there’s no double counting.
Oh and I’m sorry an answer, also, to the contact tracing.  Yes, we are, as I had mentioned previously, we are involved in contact tracing with the Tribe and have ongoing conversations about the progress on those contact investigations with the clinic every day.

3 mins 5 sec in:  

North Coast News asks:  A widely cited University of Washington model predicts U.S. deaths from COVID-19 will reach nearly 300,000 by Dec. 1. The forecast of 295,011 deaths is 137,000 more than the roughly 158,000 U.S. deaths reported so far. The Institute for Health Metrics and Evaluation model assumes that many states will impose new stay-at-home orders as deaths climb. Is Humboldt County at risk of another Shelter-in-Place order before year’s end? 

Answer by Dr. Frankovich:

So I do want to point out that when, you know, sometimes people are surprised by this idea that the number of cases could increase that much over a short period of time relatively, and I do want to point out that that’s the thing about this virus, is that we know at some point you can hit a period of really exponential growth where you’re getting a very rapid climb in cases, and so they are sort of anticipating that in this modeling.  

And you know part of the question is whether some of the measures that we put in place will change that prediction.  Are we at risk of another shelter in place order before the year’s end?  As we’ve stated since the beginning of this, it is entirely possible that at any point during this pandemic we may need to step back either at a statewide level, or a local level. And so yes it is possible.  It just gives me one more opportunity to sort of say that that’s why we really are talking about all these prevention measures – the facial use of facial coverings, the distancing, the not gathering, the limiting travel so that we really can impact how many cases we accrue and how quickly that happens. 

4 mins 55 sec in:   

North Coast News asks:  California has stopped removing or adding to a list of counties facing more restrictions on businesses and schools as it tries to resolve a technical problem with the state’s coronavirus testing database, health officials said Wednesday. The state has recorded a highest-in-the-nation 525,000 positive tests. But California health officials say the true number is even higher. They don’t know how much so until they can add backlogged testing data and fix the problem with the California Reportable Disease Information Exchange (CalREDIE). Has the incomplete data hampered public health officials’ ability in Humboldt to follow up with those who test positive and contact people who have been around them to limit the spread? 

Answer by Dr. Frankovich:

So it’s a really good question and as noted, the state is facing a clear problem with the with the movement of data into the Cal-REDIE the state surveillance system.

There is some kind of a glitch there in how the testing report goes from the commercial lab into that Cal-REDIE system and so there are delays and we may end up you know as a state we’re going to see an increase in number of cases when that moves into moves into Cal-REDIE in an accessible way.  In terms of its local impact what I would say is that you know we’re in a little better position than some places in the state. We do a lot of our testing in our internal lab and of course we have access to those results and numbers immediately when we have finished running the test. We also are using as our second largest testing venue our Optum site. And although Optum tests are run at a commercial lab they both report in the commercial lab

reports into the state system which is where there’s a reporting glitch but the lab also reports directly back to Optum and Optum provides us that data when they receive it. So we actually access that in another way besides Cal-REDIE so it hasn’t had as big an impact on us. That being said the problem with Optum for us is just that the lab itself is so um has such demand that their turnaround time is slow and that’s impacted us. The other piece of this is that when we have local providers who submit specimens to large commercial labs directly those will be reported by the lab into Cal-REDIE and would be impacted – but the providers are notified directly and they contact us. So overall I think the impact on us by this computer glitch will likely be not huge. I’m hoping they’re relatively few, but I can see instances where people perhaps tested residents of our county who are tested elsewhere in the state, we may not get notified until we see it in Cal-REDIE. So we’ll see what happens when it comes into our system. 

7 mins 55 sec in: 

 North Coast News asks:  It was reported yesterday that a Georgia second grader tested positive for COVID-19 just one day after starting school. Are you concerned about the possibility of this happening in Humboldt when some schools reopen for in-person instruction? 

Answer by Dr. Frankovich: 

Well, I – you know, I’m no expert on Georgia schools, but my understanding is, from what I’ve looked at, is that many of the that there really isn’t sort of a comprehensive requirement um or even recommendations around some of the things that we have as sort of part of our routine plan locally.  So for instance if masks or facial coverings are optional that is going to increase risk in the school setting.  If people are not social distancing in school as we have outlined for local schools that’s going to impact spread.  And so I think it’s very difficult to compare what might happen here to a place where they’re operating with a very different plan in place.  And so here in California schools have been provided with both the guidance from the California Department of Public Health as well as guidance that local public health has provided.  The local public health guidance has been informed by the state and by the Academy of Pediatrics and schools have been working very hard to construct plans that incorporate those safety features. 

For instance use of facial coverings in school, the use of distancing in school – those are all important components. That being said we will have cases of COVID in school if children have on-site instruction just as we’re going to have cases of COVID in other parts of our community, and so the important thing is that we have features in place to try and decrease transmission when cases do occur.  And so again it’s just very important that schools that are able to operate with on-site instruction.  Not all will be able to but for those that do, it’s important that they are following those guidelines, and the schools have been as I said working very hard on incorporating that into their plan.

 

10 mins in: 

North Coast News asks:  In the Georgia case, the student’s teacher and 20 other students in the class must quarantine for two weeks and then return to virtual learning, the school district said. Do school reopenings make things more challenging for the health department as far as containing and tracking the virus? 

Answer by Dr. Frankovich: 

Well certainly. You know the- it… you know, basically we know that as just as we knew moving forward and emerging from shelter in place, bringing more people together in our community, opening businesses, and having other things occurring we knew that we would see increased transmission. That’s just what is going to happen around COVID. So we expect that there will be some cases. We expect that we will need to be involved in contact tracing and for schools that do open on-site instruction and so you know we are planning accordingly for that.  And again it just makes all those safety measures more important, so that we are, none of us are either overwhelmed by contact tracing needs or that the schools are having to quarantine and interrupt learning. 

11 mins 15 sec in:  

Redheaded Blackbelt asks: Will the surge in cases this week in Hoopa push the County onto the State’s watchlist?  

Answer by Dr. Frankovich: 

Well I don’t know. We have, you know, obviously we have things that, other cases other than those occurring in Hoopa, and so it really depends on what the whole, what we’re looking at like across our county.  Again, not only do we need a certain level of cases per hundred thousand, but we also need to look at our positivity rate.

So far we’ve been able to keep that at a reasonable number, but as we’ve seen in other counties outbreaks of a significant size can change that dramatically. And so we’ll be watching the data carefully to see. 

12 mins 5 sec in:  

Redheaded Blackbelt asks:  Hoopa has been restricting non resident’s movement on their reservation out of concerns for their elders in particular, but recently there were cannabis eradication operations and fire crews brought in to deal with the Red Salmon Complex.  Has there been any indication of connections from these incidents to this recent surge? 

Answer by Dr. Frankovich: 

Not that I’m aware of. 

Media Followup questions we’re unable to ask because of the format:  Is there any type of oversight from Public Health when these eradication events are staged, and what specifically is being monitored in terms of COVID prevention in these circumstances? 

12 mins 30 sec in:   

Lost Coast Outpost asks:  To what degree are promising drugs or therapies like remdesivir, dexamethasone or convalescent plasma available in Humboldt County?  Are they being used here? 

Answer by Dr. Frankovich:

Those are all therapies that are available to patients here in Humboldt County at this time and so we’re we’re happy about that and, you know, it remains to be seen how effective these will prove to be in the long haul, but it’s really I think an excellent benefit to our residents here to have that available. 

13 mins 10 sec in:   

Lost Coast Outpost asks:  We’ve seen big, white dining tents outside some restaurants. They appear to be mostly enclosed.  Are there Public Health guidelines for such structures?

Answer by Dr. Frankovich: 

There definitely are.  Now that dining has been moved outdoors only, there are really specific guidelines about how that can look outside, and specifically you can not have enclosed tents. And, you can basically have one side available and that is it.  And the purpose of course, is to make this very much like a complete outdoor environment and not an indoor one.  And so, I believe that our Joint Information Center and team in the EOC have been reaching out to places where these are noted, and making sure that they understand those recommendations.  We get that you know a lot of the guidance changed and some of this came along fairly quickly, and so we just want to be sure that everyone’s well informed about what is required. 

Community members with questions or concerns are encouraged to call 441-5000 for additional information.  

For the most recent state and national COVID-19 information, visit cdc.gov or cdph.ca.gov. 

Local information is available at the Humboldt County COVID-19 Data Dashboard: humboldtgov.org/dashboard, on Facebook @HumCoCOVID19, Instagram @HumCoCOVID19, Twitter @HumCoCOVID19, and Humboldt Health Alert humboldtgov.org/HumboldtHealthAlert