Dr. Frankovich Talks Local Control Over Reopening, Dining Out, Alder Bay, 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 three times a week basis. The Department of Health and Human Services or office takes the questions, 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 29 Media Availability session with a recap of answers form Dr. Teresa Frankovich, followed by questions we would have liked to ask in response if appropriate.

Dr Frankovich first addressed the current status of reopening in Humboldt County.

I know it’s been a crazy thing lately, the pace of this. And I know it’s been a bit confusing for everybody, and a lot of the information that’s coming to us from the governors office for instants, we have not had much lead time on. So we are sort of hearing and understanding a lot of it at the same time that the community is.

So I think that the best way to sort of frame this is, in response to requests from many bodies across the state, the Governor’s office is gradually turning over more and more pieces of the framework to local control and I think that that is a great approach. Because we will be able to tailor things.

But I just want to emphasize to people that, in spite of that, the governor opening those things to local control does not mean that the governor is endorsing that all of those things to be open all at once. That is not the message. It simply allows for local conditions to help mark the path going forward and it’s very important for us to follow the sort of framework that we’ve been talking about here for a long time- which is that we look at our local data, We open, we allow enough time to be able to keep monitoring the data and see what affect we’re having and then we move forward some more.

It would be lovely for us to flip a switch and just be back to old times. That would be great. But it’s not safe to do, and in this situation not a practical move. So we need to pace ourselves a bit.

We have spent up our pace compared to what we had originally planned at the outset of this pandemic, but we are monitoring very carefully. And so as people know, we begin opening retail a couple weeks ago. It’s been about now two weeks. We are allowing restaurants to open and again, in accordance with the guidance provided for safety, and with approval at the County level so that people going to visit these entities know that they have submitted a thoughtful plan that the county has reviewed. And I think that that is reassuring for both employees and for people in the community. And we will continue that process as we move forward.

2 mins 30 secs in: 

Media Question:  On Thursday, the Sonoma County Sheriff said he and his department will no longer enforce Sonoma County Public Health Orders. How difficult do you think it will be for the health officer there to minimize risk of transmission—if the public knows they will not face consequences for disobeying the orders?

Answer by Dr. Frankovich: 

Well, first off, I found that announcement disappointing. I think in the best of all worlds, this really is a partnership between public health and law-enforcement and multiple other entities within the community.

I think that from the beginning we have framed this as primarily education rather than enforcement, because we believed that most people, given good information about safety and about what is needed going forward, will use that information and do what’s needed to protect other, their family members, their friends, other members of the community as well. And so I think that remains the case. But again, it’s certainly not optimal going forward for Sonoma.

3 mins 45 sec in:

Media Question:  Sonoma County Sheriff Mark Essick yesterday announced that he will no longer enforce his county’s shelter orders. With the increasing partisan divide over government health orders, do you feel that the Humboldt County’s Public Health branch has the full backing of Sheriff Honsal?

Answer by Dr. Frankovich: 

Well, I’ve really appreciated Sheriff Honsal’s support in this. We have met extensively over the last few months and we continue to do so. I appreciate the perspective that he brings to the table when we meet, and sort of make plans going forward. You know, frankly, I count on that continued support.

4 mins 25 sec in: 

Media Question:   As the local number of positive cases continues to grow and with the third local death reported, is there any consideration of pulling back on the reopening of businesses? Or do you continue to believe it is a good idea to move toward Phase 3 of reopening?

Answer by Dr. Frankovich: 

Well, first I wanted to of course mention that we mourn the loss of any resident of our community, and again it highlights the issue that COVID is a particularly problematic infection for people who are older and more fragile, in general.  That being said, you know, looking at mortality in our county due to COVID is only one of the indicators that we look at for deciding on safety of moving forward.  We look at multiple indicators. 

I think that we are in a position to move forward, however again, I want to emphasize that it’s important that we do so gradually, rather than all at once, and that we are constantly monitoring data as we move forward.

6 mins 45 sec in: 

Media Question: Now that local restaurants are being cleared to resume dine-in service, do you personally plan to eat at any of them? Would you advise your own family members that doing so is safe?

Answer by Dr. Frankovich: 

I certainly miss dining out in Humboldt County restaurants.  As do many people, I know.  Personally, I am 60.  My husband is 70.  We will likely be eating at home for the most part. But, I do suspect there will be occasions that we will go out and eat. 

I would just recommend to people that there is really very good guidance available for restaurants to operate under the time of COVID.  And that again, those restaurants are using that guidance, they are submitting plans, that’s being reviewed and the reason for doing so to really help ensure that people are safer going out and eating or doing other activities in our community. 

So, I think that we can do that but I would still encourage people who are perhaps older or medically have underlying conditions that put them at risk, strongly consider whether they are going out, and if they do, perhaps they want to do something like go at hours that are not as populated.  Go to places that are structured for outdoor dining or that really have, you know, sort of different capacity levels.  All of these entities should be prepared going forward and so I hope people are able to enjoy going out a bit more than they have been able to.

7 mins in: 

Media Question:  On Thursday, another Humboldt COVID death was announced in connection to Alder Bay senior living facility. Have you recommended a plan to Alder Bay for how residents in the facility who develop COVID-19 will be handled (for example., transfer to single room, implement use of Transmission-Based Precautions, prioritize for testing, transfer to COVID-19 unit, if positive)?

Answer by Dr. Frankovich: 

Sure. So we’ve worked extensively with Alder Bay over this time period.  We have, again, worked on many of these issues.  We’ve made sure that they have adequate PPE, we’ve worked to get additional staffing on board, to get additional staff trained, and a variety of things.  We have done ongoing testing for that facility, and continuing to do so.

Interestingly, and in our area and this is common for across many areas of the state, most facilities are not structured to be able to have a separate wing perhaps or area to have a unit, as described in this question, and so it’s really a matter of looking at the landscape of what they have and what can be safest within that.  Also, just of note, we are working intensively with the other assisted-living facilities as well as our skilled nursing facilities, going on site, providing a lot of the same assistance so that people are prepared.

8 mins 30 sec in:   

Media Question:  Is it true there a various strains of the virus?  I’ve heard rumor that there is three strains?  Can you please explain?

Answer by Dr. Frankovich:  

Well, there are multiple strains of this virus. There’s really no evidence I’ve seen to date that any particular strain is more virulent or causes more significant disease than the other strain, but it’s very normal for virus strains to mutate and circulate in all of their varieties through a country or community even.

Luckily, the testing that we have in our lab and in many of the large commercial labs, the RTPC are testing is designed actually to capture the common pieces of genetic material across the strains so that we are able to identify it in testing.

9 mins 25 sec in: 

Media Question:  Can you provide specific graphs showing what modeling looks like with the current amount of the county open?  When is the current influx expected to peak, and what does that mean in terms of expected hospitalizations?

Answer by Dr. Frankovich: 

Well, it’s an interesting question. I don’t have a model for where we are at right now.  Again, I think most people are aware of our previous conversations that it’s very difficult for us to have a modeling that tells us what opening retail does, or opening restaurants would do at this time because there are a whole lot of variables.  What I can say is that over time we will sort of re-create our models and keep looking.  At this time, mostly what we are doing is looking at trend lines that are current epidemiology and looking at all of those trigger features that we have been talking about within our variance, to monitor where we are in terms of safety. In terms of the question about peaks, what were tending to see with COVID right now is this kind of pattern, we get clusters of cases, we see identified contacts, we quarantine and isolate, and then we gradually see a decrease until the next cluster of cases emerges.  And so none of these (gestures with rolling hand motions) are in the sense of surge, it’s not at that level.  But I anticipate that we’re going to see a lot of this potentially going forward and our goal of course is that we sort of have these smaller peaks as we get these clusters without ever having tall peaks that we can’t accommodate.  And again, that’s what we are going to be looking at when we monitor our data is- are we able to keep up with the case investigations, are we able to isolate and quarantine so that we can help contain spread, do we have hospital capacity, do we have ICU bed capacity, are we testing enough, and what is our increase or trend in positive cases?  So all of those things are on the table and we look at those things daily.