As reports about the novel coronavirus continue to pour in from around the world, the Santa Barbara City Council received a presentation on “regional preparedness and efforts” from the Santa Barbara County Public Health Department Tuesday in an attempt to address the many concerns in the community over cruise ships, public gatherings and the county’s emergency strategies.
“We are prepared and we continue to prepare,” said Dr. Henning Ansorg, County Health Officer for the Santa Barbara County Public Health Department.
“This is what we have been trained to do, and all of us in our dedicated department have ample experience with disasters. We have been on the front lines with different communicable diseases in the past from Ebola, Mers, over to H1N1 and all sorts of diseases, and have been successful.”
The primary mode of transmission for coronavirus, officially known as COVID-19, is through respiratory droplets spread through coughing or sneezing, according to Dr. David Fisk, Infectious Disease Specialist for Cottage Hospital.
Droplets have the potential to travel a few feet from the body, but do not stay suspended in the air for a prolonged period of time. It is unknown how long the virus can survive on surfaces, but Dr. Fisk said the primary mode of transmission is through direct contact with respiratory droplets.
“That’s where the close contact becomes a factor. If you’re six feet away from someone, your chance of acquiring this from a droplet that comes out of someone else is much lower than if you were two feet away,” said Dr. Fisk.
Because coronavirus is transmitted through respiratory droplets, large events, public spaces, and Santa Barbara’s frequent visits from cruise ships are a major concern for the community, and many of the council’s questions addressed the county’s authority to regulate these areas.
On Monday, the city of Santa Barbara announced that Princess Cruises, which had a number of reported coronavirus cases on board, had officially cancelled a Grand Princess cruise that was set to dock in Santa Barbara on March 24.
The city and county of Santa Barbara have sent letters to other cruise lines to request the cancellation of upcoming visits to Santa Barbara, asking that they do not disembark until the CDC recommendation to not travel by cruise has been lifted, according to Waterfront Director Mike Wiltshire.
There are still 10 cruise visits planned for Santa Barbara through June 2020.
The legal jurisdiction for halting cruises is complicated by issues like maritime law, international ships and the authority of the CDC and the Coast Guard. Orders issued by the city must be consistent with directives from those agencies, but need not mirror them exactly, said City Attorney Ariel Calonne.
“They are pretty complex legal issues but if push came to shove I would have the authority to block a ship from disembarking,” said Dr. Ansorg.
To do this, the county would have to follow the federal government and California’s lead and declare a public health emergency, initiating a process for rapid deployment of resources to combat the virus.
The three triggers that would prompt Dr. Ansorg to declare a public health emergency are; a confirmed case of COVID-19 in the county, if neighboring counties have widespread community transmission, or if there were multiple cases being tested that are anticipated to be positive for coronavirus.
“All it takes is really five minutes. We have everything prepared and it would be just a formality from our perspective because we are prepared to do it in a matter of minutes,” said Dr. Ansorg.
If a public health emergency is declared, the city and county could then take steps to restrict large social gatherings on a case-by-case basis.
Public facilities could be restricted, such as libraries and city meetings, while the city would have to work with private venues, especially theaters, to cancel events.
Councilmember Oscar Gutierrez voiced a popular sentiment and asked why there must be a confirmed case in the county before a state of emergency is declared.
“Why would we wait for that to happen when we can take steps now to try and prevent it?” said Mr. Gutierrez.
“There’s a lot of our community who are vulnerable and some of them can’t be here physically to speak because they are scared. I feel like we should uphold our oath to keep the people as safe as possible.”
“Anything with very close contact with people should probably be cancelled, but we are not at this stage at this point,” said Dr. Ansorg.
Because there is no evidence of widespread community transmission in Santa Barbara or neighboring counties, the Public Health Department is only recommending self-imposed abstinence from public events, said Dr. Ansorg.
“We don’t have the data that this would be helpful at the moment and it would harm industries. It’s a fine line, and to time that perfectly is really an art,” said Dr. Ansorg. “Without any proof that there is any sustained transmission in the community I feel pretty hard pressed to implement such draconic measures at this point. This could change over night.”
Currently there are zero cases in Santa Barbara County and there are not any individuals that the county is highly suspicious of that are going to be possible cases, according to Paige Batson, Deputy Director for the Community Health Division of Santa Barbara County.
Patients suffering from coronavirus have mild to severe respiratory illness including symptoms of fever, cough and shortness of breath.
Individuals greater than 65 years of age and those with chronic medical conditions such as lung and heart disease are the most at risk of needing hospitalization from the virus.
The vast majority of people who become infected will experience a mild version of the disease and will not require hospitalization, said Dr. Ansorg.
“They will recover well with chicken soup, tender loving care, as I always say, at home and some Tylenol for fever,” said Dr. Ansorg.
While the counties testing capabilities are currently “limited” according to Dr. Angsor, it will soon “ramp up dramatically”.
“As of today Labcorp and Quest (Diagnostics) are running those tests that can be ordered by any provider without any need for approval by public health. That is a big advantage. We are hoping the providers use the testing capabilities judiciously in the beginning until we have a lot of test kits available,” said Dr. Ansorg.
The virus works slowly, and so relatively healthy adults or youth that feel unwell should not immediately race to the doctor to get tested. If you have mild symptoms and come to the Cottage Emergency Room to get tested, you’re not going to get it, said Dr. Fisk.
“It’s important to protect the capacity of the Cottage Emergency Department to care for people with other disorders, and if suddenly there’s a thousand people coming to Cottage ER saying I want a test because I have a sore throat, that’s going to impact the ability to provide care to our community,” said Dr. Fisk.
For more information and updates from the county on the coronavirus, you can now visit publichealthsbc.org or call 805-681-4373.