Dr. Josh Ennis Gives Advice About Fire Evacuations And COVID Impact on Community, Updates on Track And Tracing, 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 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 September 10th Media Availability session with a summary of answers from Dr. Josh Ennis, followed by questions we would have liked to ask in response if appropriate.

Question by North Coast News:  Regarding wildfire evacuations and COVID impacts, how do you evacuate if you have COVID?

Answer by Dr. Ennis: 

So we have a few general recommendations without getting into specifics. If you do have COVID obviously you’re going to be on isolation orders and so that can complicate the  evacuation process and what we will attempt to do is have our Public Health nursing staff reach out to isolated individuals and touch base with them in advance of the need for evacuation. And so we would encourage individuals if they know that they are on isolation orders and they have yet to hear from Public Health, reach out to us. We want to connect with you guys and make sure that there is a more solid, robust plan in place before movement needs to occur. If things are rushed, that connection hasn’t occurred, we would think it’d be very important to identify yourself as being in this situation early, up front, to avoid scenarios that can potentially result in you know, potential for transmission. I think the last thing anyone wants to do is malign anyone who’s in this scenario. Clearly if you’ve had to flee your home, you’re in a very stressful situation and so we just want to make sure that movement can be facilitated in the safest way possible and try and just minimize the uncertainty and unknown aspect of a normal evacuation. 

1 mins 55 sec in:  

Question by North Coast News:  Are evacuation centers equipped for social distancing, and do they have budgets for masks, hand sanitizer, thermometers, etc?

Answer by Dr. Ennis: 

So I’m not involved with operations of evacuation centers and so I’ll really have to defer this question to our Fire Emergency Operations Center um there has been a public phone number that’s been set up and it’s 268-2500. I will add though that the personnel and the Fire EOC, many of them have come from the COVID-19 response and so they’re certainly familiar and understand all the precautions that are necessary which include hand sanitization or hand washing frequently for 20 seconds or more, social distancing, masking, as well as trying to limit gatherings of people. So they are  certainly familiar and understand all of those principles.

2 mins 50 sec in:

Question by North Coast News:  Are you worried about a potential spike in cases due to the fire evacuations in Humboldt, and from others who may be evacuating to the coast after being forced to flee from areas impacted by wildfire?

Answer by Dr. Ennis:

So we know and have learned over the past six months that what’s really driving this is  continued gathering of separate households and so in a setting of anything that brings people together from different households, there is some concern about potential for transmission and so certainly if people are having to move around due to evacuations it is reasonable to have some concern about that. But we’ve been putting in mitigation measures for some time and many people are on board and getting used to having to take some of these measures to slow down transmission and it’s those same three things that we’ve been talking about all along, and so if people are going to come together we want to make sure they stay  a certain distance apart, six feet ideally, that you wear a mask if you’re unable to avoid the six feet apart, if you’re coming indoors you wear a mask, it’s the same principles that are in place and so even if a positive case shows up in a scenario such as this, and we have seen not necessarily a case in an evacuation center, but we have seen a positive case in other scenarios where  there are a number of people, and if the appropriate precautions are taken, it really is effective in limiting the spread in that situation. 

4 mins 30 sec in: 

Question by Lost Coast Outpost:  With six months of experience behind us, how useful a tool has mathematical modeling been, either nationally or locally? In what ways has it been useful?

Answer by Dr. Ennis:

So, you know, I think modeling a lot of times I think there’s a public perception that it’s predictive and it tells you what’s going to happen in the future  like it’s a Magic 8-Ball, um and modeling is far from that. You know if  you look at the weather report 10 days out, how often is that wrong? Modeling is about putting certain parameters or saying certain conditions are in place and seeing how it plays out over time. And so when we look at COVID-19 and the modeling that was done early on, both across the state, nationally and even locally,  we are the ones controlling those parameters and so that’s a much more simple scenario or model if you will than what happens in reality. And so what we did early on back in I think  that was in March or April, was we set those parameters and there were some things that we did not know for certain, but we made our best estimates as to  how the disease would behave. And so clearly six, seven months later we’re not in a dire situation. I will note that we do have a current hospital census of four hospitalizations across the county, which is the most we’ve had since Alder Bay occurred.

So we’re clearly not in any dire surge situation but we are continuing a kind of a march towards more and more disease burden  which will result in more and more  people ending up in the hospital, getting sick and ultimately potential for fatal cases.  The difference I think is between the model back then and what we’re experiencing now is that things change day-to-day. We have developed much more of an ability to contain disease with our case investigation and our tracing. And so in a way we’re almost able to extinguish little hot spots here and there. The modeling kind of bookended the two extreme scenarios and in some ways I think  maybe our mitigation measures may be even better than we initially estimated. We put that mitigation around 40 percent but no one’s been in the scenario before and so that was our best estimate as to those few basic things that we’ve been saying all along as to how well they could work to slow the spread of disease. They did not take into account those models, the ability to actually contain disease with measures such as case investigation, tracing, and so I think maybe we underestimated our ability to grow that portion of the response early on. And so it, you know, in in a lot of ways people may look back to those models, and use it to criticize a very concerted, robust, strong response up front, but you know in my mind had we not done those things, had been much more likely that those models would have come closer to the truth. 

We’ve looked at using models more recently to try and actually forecast or predict what’s happening but unfortunately when we’re dealing with a much smaller population like Humboldt County and we’re very early in it still, so our antibody data suggests that 1.8 percent of the population does have antibodies at this point, which is a clear minority, the models simply break down for any kind of predictive ability when the numbers are that small. So unfortunately they still have limited utility for predictions. However they’re very useful for playing out different scenarios for planning purposes in terms of looking at critical resources like hospital beds, ICU beds and ventilators. 

9 mins 5 sec in: 

Question by Lost Coast Outpost:  Did the Joint Information Center receive any tip-offs in advance of the southern Humboldt gathering that resulted in at least 22 positive COVID-19 cases?

Answer by Dr. Ennis: 

Yeah to the best of our knowledge the JIC did not receive any reports in advance of this gathering that was recently reported out. 

9 mins 30 sec in:   

Question by Redheaded Blackbelt:   Can you give us an update on the track and trace team? Were additional people hired to assist in the tracing process, and if they are able to keep up at this time with the recent caseload?

Answer by Dr. Ennis: 

Yeah the case investigation and tracing has really been the foundation in conjunction with widespread testing of our entire response. And early on we were able to pull a lot of county employees in as disaster service workers and were able to rapidly expand that team to deal with the increased volume of positive cases. As operations throughout the county have come back online, many of these people have been pulled back to the normal duties of their county position, and so we have had to bring new people in and so we have most definitely hired new people dedicated for this purpose into the response. And building in a way that ultimately is more sustainable in the long-run. At this time the recent case load is manageable. Certainly when we have a big influx over a matter of a few days that can be a little slower and it can be challenging to manage that volume, but if you look over time at our our daily cases, we have a team that is capable of managing the current caseload and is likely capable of responding a bit further beyond what we’re seeing right now. 

11 mins in:   

Question by Redheaded Blackbelt:   If community members are taking in evacuees from fires, what are the recommended precautions for having more people in a single-family house, for instance having to share space with several additional new people from outside their regular pod? 

Answer by Dr. Ennis: 

So I’d encourage people to think of this as maybe just a modification of how we’ve been doing things all along. We’ve been asking households to avoid mixing as much as possible and so when a household physically has to come in close proximity with a new setting, a new household, if you can recreate two households as much as possible that is best, that is ideal. So what does that look like? Well if there’s a mother-in-law unit on the property, if there’s an RV, if there’s some other type of housing situation that can physically keep separation between the two households, that is ideal. And so that includes separate facilities such as a bathroom, separate kitchen for preparing food, separate dining. Naturally that’s not going to be possible in some or many of these scenarios. And so if you cannot avoid mixing the households, there are some of the measures that can be put in place that we’ve been saying all along. If you have to come inside, masking. If you’re going to share meals, the more you can do it outdoors and maintain that distance, the less risk that is involved, frequent hand washing, if someone’s preparing communal food that person needs to be in good health and exercise good hand hygiene before preparing food. If it’s possible to have separate facilities,even though there may be sharing some of the spaces, if they can have a separate bathroom that can go a long way as well, and so there are a lot of measures that can be put in place to mitigate the spread of disease even though these households are forced to maybe share some things that they wouldn’t otherwise. 

13 mins 10 sec in:  

Question by The Times-Standard:  What precautions are being taken at evacuation centers to limit the potential spread of COVID-19?

Answer by Dr. Ennis:  

I think I’ve addressed this to some degree. I’d again refer to the Fire EOC for specific questions that if any are directed towards a particular evacuation center, but again the EOC staff have served with the COVID 19 response and they are very familiar with the precautions that need to be in place to mitigate risk of transmission of COVID-19. 

13 mins 45 sec in:  

Question by The Times-Standard:  Do PSPS events raise concerns of larger gatherings among people without power in their homes?

Answer by Dr. Ennis: 

And so I think I’ve also addressed this question. Anytime more people come together who normally would not, it will introduce the potential for more risk but if people continue to practice the things we’ve been saying along, which include the masking, social distancing, frequent hand washing and limiting time together spent in those situations where there’s mixing, it can go a long way to mitigating the transmission of illness in that setting.

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