While long-awaited demographic data surrounding Santa Barbara County’s COVID-19 confirmed cases was supposed to take center stage at the county’s Board of Supervisors meeting Tuesday morning, it became a political tug-of-war as the supervisors struggled to identify a way to balance both the public health and economic crises simultaneously.
As is now custom, the Public Health Department’s Health Director Dr. Van Do-Reynoso prepared a lengthy update for the board, showcasing a plethora of numbers and charts.
Not more than two charts into her presentation, the board’s Vice Chair and 4th District Supervisor Peter Adam put a sudden halt to the proceedings.
Mr. Adam questioned the methodology behind simply showing the cumulative number, indicating that it gives a false sense of the current situation.
“I need to make a point on those last two graphs, that total is an accumulation of all the known cases, it isn’t accurately reflective of the current conditions because it never takes off the 45% that we know have recovered,” Mr. Adam said. “It doesn’t have any recognition of any amount of cases that may be out there that people were asymptomatic or even had mild symptoms and just self-medicated and got over it themselves and never got documented. So I’m not a big fan of those graphs.”
Dr. Do-Reynoso answered that the only evidence of asymptomatic cases is anecdotal and therefore not reflected in the charts, as asymptomatic people have not been prioritized by county health officials.
Mr. Adam returned, “We only tested people that were presenting with symptoms. Is that correct?”
Dr. Do-Reynoso confirmed, also indicating that this is being done under the guidance of the California Department of Public Health, the Centers for Disease Control and Prevention, as well as community healthcare professionals.
“It leads you to conclusions that are kind of wacky,” Mr. Adam said.
Board Chair Gregg Hart, who has been hosting the PHD’s nearly daily press conference, chimed in.
“And the reason for that guidance (from the CDC, etc.), and the reasons for less than ideal testing capacity is the shortage of tests, both here in our county, and across the country and the world,” Mr. Hart said. “And so the public health officials have, I think, wisely said that we need to ration the tests to the folks that are most obviously at need for medical evaluation.”
Mr. Adam wasn’t finished, focusing on what he saw as faulty information.
“My point is that the information is at least semi, if not wholly invalid on those graphs. We can’t make any more tests appear, nobody can, so the fact that we aren’t doing any random sampling in favor of just sampling people that present with symptoms is destroying the validity of the test, if you will, or the calculation. You just can’t sample only people that are sick and then come up with a graph like this that shows an ever-increasing number. You are asking an invalid question,” Mr. Adam said.
First District Supervisor Das Williams had sat by quietly to this point, but quickly turned his microphone on.
“I think the department has followed the guidelines on testing and I think we do have data that indicates our testing per capita is comparable for other communities. I don’t think people should be operating under the assumption if they lived in another county they would be getting tested,” said Mr. Williams, who indicated that he did agree with Mr. Adam on the linear approach to the graphs.
“There are some communities, very small ones, that have been able to test the general population, but as far as the information that I’ve gotten, those are communities where somebody with a lot of money has rolled in and paid a ton of money in order to be able to do that. If you looked to the population of Santa Barbara County and did that, I believe it would be $120 million. So, if anyone has $120 million lying around, maybe we could change the situation dramatically.”
Late Tuesday, the PHD announced the county’s fifth death, a person over 70 with no underlying health conditions.
Dr. Do-Reynoso’s data wasn’t the only contentious topic Tuesday, as she eventually handed the mic to Nancy Anderson, the county’s assistant CEO.
Ms. Anderson unveiled an economic reopening plan that is under development, one that she estimated to be a four-to-six week process.
The plan she presented included the following steps:
- Organize a project team to develop a strategic plan for a phased reopening.
- Engage REACH (a nonprofit economic development think tank that is aiding San Luis Obispo County) to assist with the plan and facilitate stakeholder collaboration efforts.
- Identify participants and form countywide stakeholder team related to government, schools and business industries.
- Draft document and engage stakeholder team for comments.
- Finalize road map to phased reopening for Public Health Director.
- Present to the Board of Supervisors.
While working with REACH met applause from 3rd District Supervisor Joan Hartmann, the timeline was much less comfortable for the board.
Mr. Williams has been outspoken about his concern over the worsening local economy, and that didn’t change Tuesday. He took aim at the lack of funding coming from the state capitol, which has received federal aid.
“I’m not advocating to defy (Gov. Gavin Newsom’s) state order. I’m advocating that we ready ourselves for the state order that is modified or lifted. That is two very different things. That is not re-opening things tomorrow, that’s re-opening things when they are appropriate, when we are on the downward part of the curve,” Mr. Williams said.
“The state has received federal aid, we have not received any of that aid. Our ability to sustain this is very much dependent on the state aid, not only to us, but to the many people that are slipping into poverty. If anybody doubts that poverty has severe healthcare effects … a WHO study on exactly that, that we will be having deepening poverty effects in the state and that will have deepening health effects. So we have to take steps, either through state aid or thinking through the restart of the economy on how to avoid lingering and severe health effects, on primarily children, who are the ones impacted by the increased mortality associated with poverty.”
Mr. Adam questioned Dr. Do-Reynoso on whether Gov. Newsom’s plan to re-open the economy was solely focused on positive COVID-19 tests and not potential antibody tests that could soon hit the market.
Dr. Do-Reynoso confirmed his assumption, although she did indicate that serology testing should be available in the county in the near future.
Pointing to the shortage of tests and Governor’s methodology, Mr. Adam was clear about what he would like the board to do — even though he knew that it wouldn’t gain traction.
“We are in the process of self-inducing a depression, we are talking about having negative effects on children, I can’t imagine a more negative effect and lasting effect then having a permanent reduction of the standard of living for our children,” Mr. Adam said. “There was a Chamber of Commerce statement the other day that one in 10 businesses can last a month, and one in four can last two months like this. And we are into a month right now, we are over a month, and I would recommend, and I know we won’t get any traction on this board for this, just for public purposes, I would recommend at least interpreting the Governor’s order as liberally as possible and open our economy as soon as possible — fully.
“If not simply defy it, and make him come and enforce it. I think it’s void for vagueness, among other things, and I think that we have a responsibility to future generations to reopen this thing. Yes, some people are going to get sick, and that’s unfortunate, but people are going to get sick in any case. And we can’t stop that, and we are just inducing a depression. And I find that just appalling.”
Fifth District Supervisor Steve Lavagnino asked Dr. Do-Reynoso what it would take for her to loosen the reins on essential businesses, pointing to San Luis Obispo and Ventura counties as ones that are already making plans to do so.
“When we see not only the cases, but also the hospitalizations going down consistently for a 14-day period,” Dr. Do-Reynoso said. “That is the benchmark, if you will, other jurisdictions have used in order to consider elective procedures, in order to clarify some of the recreational activities that can take place.
“As a region, we definitely want to be consistent in our policies in what is allowable.”
Demographic data on county’s COVID-19 cases revealed
While the back-and-forth over case reporting and the economy found many opinions, Dr. Do-Reynoso’s presentation of the now 429 confirmed cases met appreciation.
The PHD was able to interview 307 of the patients, including 221 of the general population and 86 that are incarcerated.
Here are the findings:
- Ethnicity breakdown: Hispanic: 61% (48% of population count); White: 31% (43%); Asian: 1% (5%); American Indian: 0.5% (0%); Black: 2% (2%); Pacific Islander: 0.5% (0%); Multiracial: 2% (2%); Refused: 2%
- Primary language: English: 77%; Spanish: 19%; Others: 4%
- Health insurance: Private: 62%; Public: 28%; VA: .5%; None: 8%
- Can see a healthcare provider? Yes: 84%; No: 15%; Refused: 1%
- Household members: 2 or less: 31%; 3-5: 53%; 6 or more: 14%; Missing: 1%
- Household income: Less than $10,000: 1%; $10,000-$14,999: 4%; $15,000-$19,999: 3%; $20,000-$24,999: 4%; $25,000-$34,999: 6%; $35,000-$49,999: 6%; $50,000-$74,999: 19%; $75,000-$99,999: 10%; $100,000-$124,999: 7%; $125,000-$149,999: 3%; $150,000-$174,999: 4%; $175,000-$199,999: 1%; $200,000 or more: 1%
- Knowledge of coronavirus: Not at all: 8%; Slightly: 10%; Somewhat: 26%; Moderately: 29%; Extremely: 25%
- Knowledge of social distancing: Did not know anything: 16%; Heard about, didn’t understand importance: 8%; Understood, but unable to practice: 24%; Understood, able to practice: 48%
- Social distancing at home before getting sick: Yes: 58%; No: 38%; No answer: 4%
The PHD recommended more outreach into the Spanish-speaking community, something echoed by Mr. Hart.
Lompoc federal prison update
Brian Olmstead, a lieutenant with the Santa Barbara County Sheriff’s Department, provided the board with an update on the outbreak at the Lompoc federal prison, which houses 2,700 inmates.
According to Lt. Olmstead, the prison saw its first case on March 18, with a second one occurring on March 25.
On April 11, due to the increasing numbers, a conference call was had with multiple agencies, including the Board of Prisons, in order to start plans on utilizing a spot on the prison campus for a mobile hospital.
It was decided to utilize an old factory on the grounds for this purpose, with construction in progress, with an expected finish time within the next week.
The Aspen Medical Group will take on healthcare services, currently securing the right equipment and also personnel to aid the prison.
As of Tuesday, there were 99 inmate cases at the prison, while 29 staff members had tested positive.
Mr. Lavagnino pointed to the outbreak in Lompoc as a reason to question the process, as he also touted the single inmate that has tested positive at the Santa Barbara County Jail.
Lt. Olmstead provided some insight.
“The prison has a disease control unit and they are identifying and trying to trace that back to the initial infection. They have put the whole facility on lockdown, they’ve really restricted the movement of the inmates. And the staff, they are doing temperature checks for the employees as they come in,” Lt. Olmstead said.
“With the Sheriff’s Office, we started a very strict process of trying to control and prevent the COVID-19 from coming into the facility, and so far we have been very successful with it. Our inmates, as soon as they are booked into the facility, they are in a quarantine location for at least two weeks, where they are monitored and then after that two weeks, they are checked again and then they are moved into a different part of the facility.
“We’ve had a very robust system of trying to keep COVID out of the jail.”
Rep. Salud Carbajal and Sens. Kamala Harris and Dianne Feinstein on Tuesday sent a second letter to BOP Director Michael Carvajal re-emphasizing the need to take action to provide medical equipment and care facilities at the federal prison, while requesting an update from the bureau on what is being done. The legislators previously sent a letter for Mr. Carvajal on April 15.
City of Santa Barbara speaks to pair of re-openings
During the Santa Barbara City Council meeting, City Administrator Paul Casey indicated that they were working on two distinct re-openings: the boat launch ramp at the Santa Barbara Harbor and some local golf courses.
“We will put social distancing measures in place down at the launch ramp to make sure we don’t have any crowding going on,” Mr. Casey said.
While exact details weren’t available on the golf courses, Mr. Casey did indicate it would also come with new rules.
“There are conversations going on right now between our staff and county public health officials and county recreational folks to consider about reopening golf courses in the county, again with restrictions in place. That is happening as we speak so please stay tuned for an announcement on that. We haven’t had any final confirmation, but as some of the speakers have said it looks like the other counties are starting to open up so we are engaging in that conversation with our county here as well. Perhaps we will be opening up the golf courses relatively soon,” Mr. Casey said.
Cottage Health, by the numbers
A look at the current status of Cottage Health through Tuesday:
- Cottage Health is caring for a total of 201 patients across all campuses.
- 149 are acute care patients; 224 acute care beds remain available.
- Of the 149 patients, 8 patients are on ventilators; 60 ventilators remain available (adult, pediatric and neonatal ventilators)
- Of the 149 patients, 18 are in isolation with COVID-19 symptoms; 13 are confirmed COVID-19 positive.
- Of 18 patients in isolation, 9 patients are in critical care.
- Cottage has collected 2,336 cumulative test samples: 180 resulted in positive, 2,078 resulted in negative, and 78 are pending. In most of these tests, patients did not require hospital admission.
In addition, the supply donation drop-off at Goleta Valley Cottage Hospital has new hours, with the parking lot tent open from 10 a.m. to 5 p.m. on Tuesdays and Thursdays.
COVID-19, by the numbers
A look at nationwide and worldwide numbers:
- In the United States, there are now 819,164 confirmed cases with 45,340 deaths and 82,973 that have fully recovered.
- Across the world, there are 2,564,190 confirmed cases with 177,424 deaths and 681,842 that have fully recovered.
First COVID-19 deaths happened in Bay Area; L.A. sits on alarming numbers
According to the Santa Clara County medical examiner, two COVID-19-infected patients died in early February due to the virus, weeks earlier than experts previously thought.
Initially, officials believed the first death was Feb. 29 in Kirkland, Wash., with the first Bay Area death on March 9.
The medical examiner debunked that Tuesday, with three patients dying Feb. 6, Feb. 17 and March 6.
Santa Clara County released the following statement:
“These three individuals died at home during a time when very limited testing was available only through the [U.S. Centers for Disease Control and Prevention]. Testing criteria set by the CDC at the time restricted testing to only individuals with a known travel history and who sought medical care for specific symptoms. As the Medical Examiner-Coroner continues to carefully investigate deaths throughout the county, we anticipate additional deaths from COVID-19 will be identified.”
Meanwhile, in Los Angeles County, health officials are saying that with the addition of antibody tests, they are finding the rate of infection to be 40 times the already state-leading 15,000 confirmed COVID-19 cases.
According to a study done by USC and the L.A. County Public Health Department, the tests showed roughly 320,000 people infected, or roughly 4% of the city’s population.