COVID-19: The big picture

Leading SB County physicians discuss the past, present and future

This is the first of a two-part series on COVID-19 in Santa Barbara County.

First, the good news.

A lot has been learned about COVID-19, and progress is being made in curbing its spread, according to two leading Santa Barbara County health officials.

Locally, cases have started to decline, even in hot spots such as Santa Maria.

The bad news is there’s no quick end ahead for the pandemic and a vaccine likely won’t be ready until sometime next year, the physicians told the News-Press during extensive interviews last week.

And in a world where COVID-19 remains a mystery, the doctors presented a mix of similar and different views on the pandemic’s past, present and future.

The two physicians conceded they can’t predict when life will get back to normal, but noted signs of hope. 

One of them — Dr. Henning Ansorg, the county health officer —  started the interview with words of optimism.

“I think Santa Barbara County is definitely on the right path, trending downward,” the Public Health Department official said. “We’re not where we want to be, but we’re going in the right direction.”

In fact, he noted, it wouldn’t take much for cases to decrease to the point that indoor movie theaters and restaurants’ indoor dining could reopen with a cap of 25% capacity. He added that decrease also would mean reopening public schools for in-person learning.

For the changes to take effect, Santa Barbara County, which is among the 38 counties in the purple or worst tier for widespread cases, would have to move into the red tier for “substantial” cases. The county will find out Tuesday if it qualifies.

Dr. Ansorg explained that to move into the red tier, the county must see its current daily average of nine cases per every 100,000 people fall to seven per every 100,000.

“We’re not that far (from the red tier),” he said. “I urge everyone to stay the course, postpone get-togethers and parties and do (socializing) online.”

Dr. Ansorg  praised the tier system, which the state announced in August, as a scientific, gradual and safe way to reopen businesses and schools and a better alternative to the mass reopenings earlier this summer. Afterward, there was an increase in the number of cases.

“It would have been better to have done it in a more thoughtful, gradual way — to have opened some things and not others and wait two weeks and see what happens,” he said. “Unfortunately, the state allowed everything to reopen at once.”

He expressed more confidence in the tier system.

And Dr. Ansorg noted a hopeful sign: Santa Maria, the agricultural city that continues to lead the county in the number of cases, recently showed significant improvement.

Dr. Ansorg explained the initial problem. “The reason we have seen more cases in the Santa Maria area is the density of housing. A high percentage of the population lives in really tight quarters, which plays a big role in the transmission.”

Dr. Ansorg credited the recent decline in Santa Maria cases to testing and educating workers and providing masks. He noted hotel rooms have been provided to separate those who have tested positively from others.

Dr. Ansorg praised the collaborations among the county Public Health Department, growers, infectious disease physicians, agricultural workers and Marian Regional Medical Center in Santa Maria.

The county health officer works with hospitals throughout the county, including the Cottage Health sites in Santa Barbara, Goleta and Solvang. Cottage Health’s hospitalization rates have declined during recent weeks, said Dr. David Fisk, the nonprofit’s medical director of infectious prevention and control.

“However, just overnight last night, we had an uptick in hospital admissions and an uptick in positive test rates from the day before,” Dr. Fisk told the News-Press Monday.

“Is a one-day increase a concern? We don’t know,” said Dr. Fisk, who’s also an infectious disease physician at Sansum Clinic. “But certainly, we are lower than we were a month ago.”

Dr. Fisk cautioned that future reopenings could mean another increase in cases, but conceded that the issue is complicated.

“The need to live our lives: How do we balance that with the need to keep others safe?” he said. “Those are tough issues, and one community’s answer might be different than another’s, and one individual’s answer might be different than another’s.”

But he praised past measures for flattening the curve and noted that numbers would have been worse if restrictions and social distancing hadn’t happened.

The big question is when a vaccine will become available. Dr. Ansorg said he would like to see one by this spring, and Dr. Fisk said he’s hopeful there will be one by August of next year, noting the creation of vaccines often takes longer than expected.

Dr. Fisk cautioned that rushing a vaccine could hinder its effectiveness and safety. “The last thing we want is a vaccine that hurts people.”

Dr. Ansorg noted he favors the FDA’s rigorous testing protocols.

Without a vaccine, the weapons against COVID-19 are social distancing, wearing masks and thoroughly washing hands. 

Dr. Fisk said the county has done well in all three to the extent “that we’re not seeing a giant tidal wave of disease come crashing down onto our community and leading to hospitals running out of beds and people not being able to get care. That’s one way to look at it.

“The other way is there are a lot of people who do not wear masks effectively or appropriately and may not wear them or may not cover their noses,” he said.

To be effective, masks should cover the nose and mouth, according to the Centers for Disease Control and Prevention. 

“However, we’ve also learned that most of this disease is not transmitted outdoors,” Dr. Fisk said. “The virus dissipates quickly into the air outdoors.

“And so the benefit of wearing a mask, when you’re walking down the street, in my opinion, is zero,” he said.

Drs. Fisk and Ansorg agreed that a mask isn’t needed when you’re on a hike or walk and there’s no one around. 

But Dr. Ansorg noted people should wear a mask outside if they’re walking past others in confined places such as outdoor stairs or are standing in a line. 

He said people should wear a mask if they’re next to someone for more than a minute.

“It’s perfectly fine to take a walk and have someone at arm’s length,” Dr. Ansorg said. “We just have to remember the virus is spread from person to person by our respiratory droplets.”

And he said that’s why outdoor gatherings such as backyard barbecues are risky.

Dr. Ansorg explained that the very act of talking loudly, laughing and even singing leads to the widespread transmission of droplets with COVID-19. 

Dr. Fisk noted the importance of people staying six feet apart, whether they’re outside or inside. “Groups of 10 or 15 people at the beach can space themselves apart, and it’s not going to be a problem. It’s hard to make a blanket statement because one activity differs from another.”

As part of the county’s efforts for caution, beaches are closed to people lying around or sitting on the beaches during this Labor Day weekend. Under the order, if you’re at the beach today, you have to be doing an activity such as walking or running.

That takes care of this weekend, but the question on everyone’s mind is when the pandemic will end.

Dr. Fisk said he doesn’t know. “My hope is we’ll see this wane by next summer, but that’s purely a hope. I have no idea.”

And Dr. Ansorg said he frequently asks himself the question of when life will get back to normal.

“The honest answer is I don’t know. But I really had a pleasant surprise when the numbers were trending downward,” the health officer said.

“If we see less transmission of the virus, then definitely more things can open.”

email: dmason@newspress.com

PART 2 LATER THIS WEEK

See Wednesday’s News-Press for more from the interviews with Drs. Fisk and Ansorg. Topics will include treatments, testing and the work at Cottage Health.