Dr. Ennis Talks Testing at OptumServe and Staying Home Over 4th of July

Humboldt County officials have been answering questions since the stay-at-home orders were instituted on a two question per media outlet. 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 July 2nd Media Availability session with a summary of answers from Humboldt County Public Health Deputy Dr. Josh Ennis, followed by questions we would have liked to ask in response if appropriate.

Media Question: We’ve heard reports of COVID tests at Redwood Acres having a turnaround time of over a week, and a number of people have waited that long only to be told they need to be retested. Some even claim they were told that their tests may have been lost. Can you talk about why/how this is happening for residents? And is it possible that we don’t have an accurate count of positive/negative cases in the county?

Answer by Dr. Ennis: 

Yeah, we have also fielded some complaints about test results being lost, and in the few we’ve been able to follow up upon they consistently have been resolved as the person initially being notified that it’s lost and then a day or two they get the result and it comes back.

Those are for the few tests for which we were able to follow up upon. We followed up with OptumServe in regards to it, and they were unable to give a good explanation for why it is occurring. So we do not have a good answer for why it is occurring. I think it’s part of the bigger picture though across the state is demand has gone up for the OptumServe test site. Their lab that they’re using is having increasing volumes and getting backlogged and there have been some growing pains and so we are continually working with OptumServe trying to improve that process. 

In regards to how that affects the potential count of positives versus negatives in the county, I can say that, in general, for every test that we pick up as positive, there’s likely many-fold more cases in actuality, across the county, and reasons for that are probably multi.. are several fold over. It’s because of distances involved and people aren’t going to seek testing for that reason. There are probably people are very mildly symptomatic or asymptomatic altogether and so they think it’s not required to get tested, and finally, the antibody data we have, based on that, suggests that we’re only picking up maybe one in ten one in twenty cases. That data I want to caution you it is subject to bias, but it suggests that there’s much more widespread circulation than we’re picking up solely with our testing. 

Media Followup questions we’re unable to ask because of the format: Can data about percentage of asymptomatic people versus symptomatic people be added to the county’s COVID-19 dashboard? 

2 mins 35 sec in:

Media Question:  What is the average wait time from booking the test to the actual day you go in? Are you seeing an increase in people scheduling a test lately, or has the demand for testing remained relatively the same over the pandemic?

Answer by Dr. Ennis: 

So I’m gonna make an assumption here and that this question is getting at OptumServe and some of the issues that we know are ongoing regarding an inability to get in quickly. More recently I’ve heard that it’s been upwards of a week or a week and a half and clearly, that’s not going to be very useful if people are having to wait that long, and when it’s coupled with a longer turnaround time it makes it a fairly ineffective strategy for trying to limit spread of disease.

More recently there have been some issues with staffing of the site itself and this has impacted our ability to honor some of the more recent appointments and pushed out the dates that someone could schedule a test for. As a result, we have worked with OptumServe to try and take more responsibility and more ownership over some of the local staffing, and with that we’re going to be much more flexible in the future. And so I expect this to be a more temporary thing that we’ve worked to fix, but it still does not get around the fact that we are seeing cases really pick up across the country, in the state, and demand for testing is going up. And so some of the things that we experienced two months ago, three months ago with supply chains getting tighter and having more issue getting personal protective equipment, staffing for this increased demand, and all of those things are starting to be of concern again as we see cases tick up. 

So I’d say the demand for testing has gone up and we continue to grow testing at an incredible rate, but it also comes with some challenges with growing that fast. 

4 mins 50 sec in: 

Media Question: Are local State Parks implementing safety measures to reduce the density of visitors over the Fourth of July weekend?

Answer by Dr. Ennis:

So State Parks, because they are not a part of our county jurisdiction, are not subject to any plans that we are part of reviewing, and we don’t set those guidelines for them. Given that they are a state entity, I fully anticipate that they’re following the same state guidelines that we at the county level are aligning with. 

5 mins 20 sec in:   

Media Question: Everyone has the responsibility to mitigate the spread of COVID-19, including in the outdoors, but a lot of people are talking about traveling and going to the lake, taking road trips etc. Should people avoid road trips and stay close to home this holiday weekend?

Answer by Dr. Ennis:  

I know this is such a difficult thing for people right now. We are so tired of this. I am so tired of this and would really love to see it go away. I think there’s a big continuum here of what we know is safer and what we know is riskier. On one side of that you sit in home, you don’t leave for much of anything and you know you’re gonna really drastically cut down on any risk of exposure, and that’s what shelter in place was, right? At the high other end of the spectrum is you’re going to large events that are indoors, potentially with lots of aerosol generating procedures such as loud singing, screaming, think of a large concert. We know that’s an extremely risky scenario and so, as we’re going into this 4th of July weekend, we know that people really want to get outside, they want to be together and it is so difficult, but this now more than ever with increased disease circulation throughout the state is the time we need exercise 

more caution. This is really one of the most important times, and so when we talk about staying home versus going out on a road trip, the safest thing to do is try to develop your own little celebration that stays at home. That is the safest thing to do. The more you bring people together, the more opportunity you introduce for..having disease circulate around. And so we know that some people are going to leave and if they’re going to do it, you really got to take focus on the activities that place at higher risk and keep practicing the things that reduce that risk that’s hand washing, it’s wearing a mask and keeping your distance from people who are not a part of your normal household.

7 mins 40 sec in:  

Media Question:  What patterns have you noticed about the virus’ spread locally in cases to date? Are there places — like home or work, for example — where people are most likely to contract it?

Answer by Dr. Ennis: 

Yeah, our experience locally is very much in line what people are saying across the world really. This disease travels in clusters.  Something like 80 percent of all cases are in the household.  It’s people who are in close contact, who share indoor spaces for prolonged periods of time, and that’s where the vast majority of transmission occurs within household contacts.  Now, all it takes is for one of those people in that household to have contact with someone in a different household and all sudden it’s made a jump from an entire household to another entire household and you can see how that can quickly stack upon itself if one of those people is being less responsible and bringing a lot of people together and doing it in a less safe way. 

We have seen some examples of people who work in what’s considered an essential job and we have concluded it may have been up to community transmission.  We have no way of proving that in any way, but I’d say that is a small minority of all cases that we’ve seen locally.

 

9 mins 25 sec in:

Media Question: Of cases connected to a contact with a known case, approximately what percentage was the contact in the same household and what percentage traced back to a social contact with someone outside the household?

Answer by Dr. Ennis: 

I think I’ve already spoken to this in the last question. This virus really travels in clusters within households. It’s the vast majority of cases, but all it takes is one person within that household to bring it to the next household and if there’s the delay in identifying that or in people coming forward we find that we’re finding out about these cases almost when it’s too late and then we don’t exercise the ability to change that. So I think it’s important to encourage people to come forward, and so we can act upon the information quickly, and we can potentially reduce the transmission of the disease.

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4 comments

  • Coastal Dweller

    Why is Dr. Ennis wearing a vented mask? Vented masks allow the free flow of exhaled air, and infectious particles, to contaminate other people. As a health professional, he should set an example for everyone by not wearing a vented mask.

    See Humboldt County Face Covering Order, which provides in relevant part as follows:

    10. Facial coverings mean any fabric or cloth that covers the mouth and nose without holes.
    The facial covering can be made using household items (including scarves, bandanas, tshirts, sweatshirts, towels, turtlenecks, or other fabric), can be sewn by hand, or factorymade. Note that any mask that incorporates a one-way valve (typically a raised plastic cylinder about the size of a quarter on the front or side of the mask) that is designed to facilitate easy exhaling is not a Face Covering under this Order and is not to be used to comply with this Order’s requirements. Valves of that type permit droplet release from the
    mask, putting others at risk. Further guidance on facial coverings could be found here:
    https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face­coverings.html

    https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Face-Coverings-Guidance.aspx

    https://humboldtgov.org/DocumentCenter/View/85482/Wear-Facial-Coverings-April-24—April-28?bidId=

  • I have symptoms and my wife wants me to get tested. But if it takes 7-11 days just to get in to have the test performed, then another week or more for results, I dont see any value in the test. By the time I have results I will have either recovered or developed clear symptoms and get a test with no wait time and faster results.

    Sure there may be value in terms of data collection but I’m a busy person.

    The current testing is so slow as to be of no value to me.

    • Call your doctor. If you have symptoms, there are different protocols than if you don’t. The public health lab is turning around tests much more quickly than some of the other testing sites.

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