Dr. Frankovich Says Recent 100 Person Event Contributed To COVID Spike, Local Surge Site Still Being Prepared, And More

For this type of report, the Emergency Operations Center takes the questions from the media, and staff reads them on camera to officials 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 November 24th Media Availability session with a summary of answers from Humboldt County Public Health Officer Dr. Teresa Frankovich, followed by questions we would have liked to ask in response if appropriate.

EOC:  Good afternoon, and thank you for being with us.  Would you like to start by addressing the community?  

Dr. Teresa frankovich: 

Thank you, yes.  I just want to mention that the state is announcing…that we are- our data has us in the red tier- however, they are moving us to the purple tier. The reason for that is that their data calculations on Monday did not reflect a multitude of additional cases that we are aware of locally.  Our local metrics clearly have us well over seven, which is the cut off for the purple tier.  It is not something we want to see happen in our community, but our numbers certainly support that move.  It is not a punitive measure on the part of the state; it is a measure meant to help us put additional prevention pieces in place to stop this acceleration in cases. 

Ultimately the goal of that is to protect all of us, including our health care system capacity, so I ask everybody to work together again, making sure we’re really following all of the prevention measures that we’ve been talking about for many months now, and most especially not gathering outside household units for this holiday and not traveling for this holiday. 

We need to stay home and celebrate with those in our immediate home.  Thank you.

1 min 20 secs in:

Question by The Times-Standard:  Where is this trend going in your eyes? Are we going to skyrocket before we turn around?

 Answer by Dr. Frankovich: 

Well, that’s a big question. Certainly our trajectory right now is a steep climb in cases. The thing that we have operating is that increasing preventive measures are being put in place. Remember, we were in the yellow tier a very short time ago. Each addition of tier has added additional restrictions that are meant to slow transmission. I think with those things being put in place and local efforts around trying to decrease high-risk behavior.  I think we can stabilize this rate still, and keep ourselves from continuing to escalate, but it’s going to be up to all of us.

2 mins 10 sec in: 

Question by The Times-Standard:  Gov. Newsom last week talked about the curfew’s effect on food service businesses.  What are Dr. Frankovich’s thoughts on business that keep the back door open for takeout, delivery but lock the front door because of the curfew?

Answer by Dr. Frankovich: 

So, my understanding is that in this situation, the restaurants are able to continue to provide takeout and delivery after that 10 p.m.  Food is part of our essential service list, but they cannot be open for in-person dining and so the restaurants, you know, certainly we’ve all noticed that many of them have adapted in this fashion already, and I would expect that to increase.

2 mins 50 sec in:   

Question by The Times-Standard:  Given the recent incident at Costco involving a woman not wanting to wear a mask, what are your thoughts on increasing enforcement of mask use?

Answer by Dr. Frankovich: 

Well, enforcement is always a last resort.  I think by now people have gotten a message about the fact that masks are not controversial.  There really is no scientific controversy about this.  It is not the entire solution to a problem, but it has certainly been well proven to help, and so it’s incredibly important people wear them.  We want to make sure businesses understand it is completely within their rights to require those masks and again obviously law enforcement is meant to be a last resort for these instances where people are not adhering to you know the requirements that our community has put in place.

3 mins 35 sec in:  

Question by The North Coast News:  In your opinion, what are some of the reasons people are not forthright with information when it comes to contact tracing and case investigations?

Answer by Dr. Frankovich:

I think that most people by now have heard our messaging about what is, and is not safe to do, and I think that obviously when someone is exposed to or gets an infection because of some of that activity- it is, it’s embarrassing, you know, and it’s challenging. 

And I think people sometimes want to think that whatever they were doing was not the source of the infection, and maybe there’s, you know a little bit of denial there.  But we really just, again, need people to be very forthright about what they’ve been doing so that we can really, and who they’ve been with, so that we can really make sure that especially people who are potentially exposed who are in high risk work settings, for instance a skilled nursing facility, that we identify those people so that there isn’t a risk to those settings. 

4 mins 35 sec in:   

Question by The North Coast News:  Anticipating that Humboldt will be moving into Purple and places of worship shut for indoor access, what will be the impact on wedding ceremonies that are currently allowed at 25% or 100 in the Red Tier? 

We know wedding ceremonies, funerals and other cultural ceremonies cannot be held indoors in the Purple Tier, and wedding receptions are banned statewide regardless of the tier – but can ceremonies still be held outdoors in some capacity in the widespread tier? 

How do you advise brides in this ever-evolving atmosphere?

Answer by Dr. Frankovich: 

Well, my understanding is that you know, the places of worship and those and ceremonies related to that are able to be outdoors in the purple tier.  Weddings would be included in that, and the question is correct- receptions are not.  So the ceremony itself is able to be held, but not the parties celebrating that ceremony. 

5 mins 45 sec in:  

Question by The Lost Coast Outpost:  Last week you said the county has asked for an expansion of Optum locally. What does that mean? 

More testing resources? Higher capacity? 

Has Optum responded to the request?

Answer by Dr. Frankovich: 

So Optum previously sent their specimens collected to a commercial lab.  Those specimens are now going to the new state lab in Valencia. There is an expectation that turnaround times will be better, and so we are encouraged by that.  

Yes, we have our current Optum setup that is five days a week we have asked for expansion of that and that has been approved. So we’re finalizing the details, but we expect to add both increased testing at our Redwood Acres site, as well as some mobile testing. And so we believe we will significantly expand our local capacity. We do expect that the expanded optum services will be available in early December.

6 mins 30 sec in: 

Question by The Lost Coast Outpost:  Last month you said that between the county’s in-house public health lab and the new regional testing partnership, you should soon be able to run up to 700 tests per day. Can you give us an update on the status of the regional lab asset? 

When do you expect it to come online? 

Are you still optimistic about the turnaround time for test results?

Answer by Dr. Frankovich: 

We are still working on the regional testing partnership, and I don’t have a start date yet on that because we do want to make sure that we can run the entire testing process- from registering online to being tested to resulting seamlessly for everyone who’s using the system.  

We do expect the turnaround time would be as announced earlier. It would be somewhere in the range of 24 to 72 hours, which was similar to our own internal lab. We’ll update you as soon as we have the launch date.

7 mins 25 sec in:  

Question by The Redheaded Blackbelt:  Can you give us a general update on how testing among our local homeless community has been going now that winter is here and specifically if you can give us an idea of the rate of infection you are seeing in that demographic, and if the case rate has increased recently along with the general spike in cases?      

Answer by Dr. Frankovich: 

I would say that getting really robust testing in the homeless community is an ongoing challenge for us, but one that we are certainly working on at this time.  We have not detected any outbreaks among the homeless population in our community, and we have not seen a dramatic case rate increase in that population, that you know, that that we have seen in the overall population at this time.  

So, it’s a situation where we need ongoing monitoring of course, and also it’s just interesting that…it’s not quite clear why we are not seeing as much activity right there, and perhaps there is some protective factor for individuals who are essentially living outdoors where we know there’s a little less risk of transmission, but we’ll continue to monitor.

8 mins 35 sec in:  

Question by The Redheaded Blackbelt:  As a Public Health officer, looking ahead into December and January, do you project a steep curve continuing to trend the way it is currently, or for whatever reason, do you anticipate that the curve will naturally fall flat after we pass the holiday season? 

Answer by Dr. Frankovich: 

Well, epidemiologically, what you would expect to see with this rate increase right now is that you know, we’re going to see it continue for a bit until we’re able to have all these preventive measures start to have an impact. So, we know that oftentimes the there’s a few week lag time between when we initiate something and we are able to see a response- in the same way when we have a high risk event that occurs, such as a large gathering at Halloween, it takes two to three weeks sometimes to really see that play out in our case count. 

So, right now my expectation is we will see some continued increase in cases. I’m hoping that will slow and then stabilize for us, but right after Thanksgiving is not as much the period I’m worried about, as the period two to three weeks post Thanksgiving.

9 mins 45 sec in:  

Question by The Redheaded Blackbelt:  In regard to the Governor’s Project Roomkey, which Humboldt was able to take part in, can you tell us if trailers were utilized- they were available for purchase- and if so, about how many if you know that figure, and then please tell us more about how the program assisted in addressing community transmission in Humboldt?

Answer by Dr. Frankovich: 

Well, that actually would be a great question for DHHS Media.

10 mins 40 sec in:  

Question by The Redheaded Blackbelt:  Follow-up RE Project Roomkey:  Are you able to share with us which local partners have been involved with supplying isolation hotel rooms via Project Roomkey- such as Motel 6 which CA contracted with for the program- locally? 

Perhaps local housing advocates or homeless services programs like the Eureka Rescue Mission, Betty Kwan Chinn Center, or Affordable Homeless Housing Alternatives have been involved?

Answer by Dr. Frankovich:

Well, I would have to say again, I think the most updated information would come from DHHS Media. 

10 mins 50 sec in:   

Question by The Redwood News:  We saw 56 new cases reported since Friday and it’s safe to say locally we are seeing a surge in cases already. With this in mind, are you expecting a surge following the Thanksgiving holiday?

If so, what is your message to the community about what they can do to prevent that…and also on the flip side, what people can expect following the holiday?

Answer by Dr. Frankovich: 

Well, we talked about this a little bit already but I would also point out that you know, the Thanksgiving holiday, if people are gathering there is the potential to spread to other individuals, expose other individuals at that gathering.  Those cases will emerge over the following couple of weeks, but also the mixing that people do after the holiday will help to continue that spread.  So we really want people to continue those precautions about not gathering at the holiday, and after the holiday, so that we can limit transmission that occurs.

11 mins 45 sec in:   

Question by The Redwood News:  With the colder Winter weather and also the potential move to the purple tier forcing restaurants to only operate outdoors, can you speak more about the safety of restaurants using tents for outdoor dining. Specifically, what kinds of tents are allowed or safe?

How enclosed can they be? (i.e., must have a certain number of the sides open, etc.) What is the overall guidance for restaurants when it comes to this?

Answer by Dr. Frankovich: 

So, the guidance for tent use in this circumstance is that it does need to be open on three sides. So it’s really meant to provide an overhead protection against sun and rain and such, but it’s really not meant to just simply be …indoor dining in a tent.  So it really does need to be an open facility.  Obviously the idea of that is to make sure that there is a lot of ventilation occurring.

12 mins 40 sec in:   

Question by KMUD News:  If placed in the purple tier, what will the restrictions look like in Humboldt County?

Answer by Dr. Frankovich:

Well, we’ll be putting a list of this out in our media release today, so that information will be available online. But again, in this tier bars, brewery’s, distilleries are all closed.  

Wineries are open outdoors only.  Family entertainment outdoors only.  Retail is a 25 capacity, which is a change.  Places of worship are outdoors only.  Only outdoors: movie, gyms, and fitness outdoors. There are some additional restrictions about the spa and pool, and those facilities within hotels, and lodging, and again of course restaurants open only outdoors.  

Basically in this tier system, the move is to decrease capacity and then for some entities to move operations outdoors.

13 mins 30 sec in:  

Question by KMUD News:  Can you describe the current difficulties with contact tracing? 

Answer by Dr. Frankovich: 

Well, yes.  A good example is if you have, as we have had for instance, a party of 100 people.  If we have an initial- you can imagine that as we look at that event, we look at the positive individual, their close contacts at that event, the numbers of people who are potentially very close contacts and are in quarantine expands from there. 

If a certain number of those people actually develop the infection, then they, that potentially exposes household members, other individuals. So basically, the branches again spread when we have a very large number of contacts, it’s very hard to make sure that we are basically identifying everyone, following up on them in a timely way as well as taking in all of the new cases that are occurring every day.  

So we really do have to streamline our process and create some efficiencies.  It’s not as robust an investigation as we’d like to do, but we have to focus on high-risk settings, high-risk individuals, investigate those fully and the others we are going to depend again, on the community assisting us in letting the people that they have been in contact with know that they’ve been exposed, so those individuals can monitor themselves for symptoms, and they can quarantine according to the instructions that we have available online. 

So again, that’s one large event.  If you take multiple small gatherings, we have the same thing that we’re dealing with, and they’re multiple different case lines so it also is a tremendous- takes a tremendous amount of time to investigate.  So, bottom line is we have to slow the number of cases that are emerging, so that we have the time to do the robust investigations we really need to do.  So again, it goes to all those prevention measures that help us have a head start.

Media Followup questions we’re unable to ask because of the format: 

Can you please share where the nature of the celebration was, and what part of the county the event was held?  

15 mins 45 sec in:   

Question by The North Coast Journal:  Is the pattern of small case clusters driving our spiking counts continuing, or have there been any large exposure events/gatherings that are partly responsible for the spike of the last two weeks?

Answer by Dr. Frankovich:

Well, as I just mentioned we certainly had a 100 person gathering.  We have multiple smaller gatherings that occurred I think, and so over this time frame, and you know those are the things we know about- we don’t necessarily obviously know about all the gatherings. So again, it’s important for people to just think about the math here, as we’re starting to see more COVID in our community.  The risk that at any gathering you go to, someone may have the infection -and not even know it yet, or never know it- rises and so everything becomes a greater risk than when we were seeing very little COVID in the environment.

16 mins 30 sec in:   

Question by The North Coast Journal:  You and Dr Ennis have repeatedly said that the local health care workforce could be a limiting factor in the county’s ability to meet a surge that threatens to overwhelm local health care.  Can you please provide an update on efforts to build health care workforce capacity, and what if anything is being done to make sure they are ready to mobilize when needed?

Answer by Dr. Frankovich: 

It’s a really good question, and you know, I’m sure references what we’re seeing nationally with entities having actually sometimes equipment care for patients but not enough staff to operate the equipment so you know it’s absolutely correct we not only our hospitals have been working hard to increase their internal capacity to care for patients within their own walls we’ve been working on finalizing all our…alternate care site so that we can take some of the overflow as people are ready to leave the hospital mostly but not quite and take the pressure off that system, but we are in ongoing discussions with our healthcare partners about staffing for this.

We are designing the alternate care site to be a low acuity setting so that we do not need a lot of highly certified personnel.  For instance, you know, we are able to work with a smaller number of nurses and a lot of people, working assistance and aids and such, working with those nurses. If you increase the severity of illness in that facility, obviously you need higher intensity staffing. So we are deliberately looking at trying to keep a model that will allow us to staff it at the same time we are able to staff the hospitals for their increased activity as well. So it’s a partnership with really, the entire health care community.

18 mins 5 sec in:   

Question by The North Coast Journal:  Are you giving any thought to imposing local restrictions beyond those the state has handed down at this time? 

Answer by Dr. Frankovich: 

Not at this time. 

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