Category Archives: Local Regulation

Open Letter to Benicia City Council: Dr. Richard Fleming on mask mandate

Professional perspective and corrections: vaccine, hospitalizations, role of government, Bay Area comparisons

Email, by Richard Fleming, M.D., November 17, 2021, with permission

Hi Benicia City Council members,

Richard Fleming, M.D.

Thank you for taking the time to discuss and consider the safest way forward for our city during the pandemic. I hope you can take a few minutes to consider the following points:

  1. Vaccination rate.  According to publicly available data from the California Department of Public Health, the fully-vaccinated rate for the city of Benicia is 67.7%.  We have never been above 70% and certainly never been above 80%, numbers which have been mentioned in past city council meetings. (If we include those who got only one shot, the percentage is 76.7%, but the more important number is those who are fully vaccinated.) I strongly urge you to use the CDPH-reported fully-vaccinated rate for Benicia in future city council meetings. Also keep in mind that many fully-vaccinated people have not yet gotten boosters, and are beginning to lose some degree of immunity. Thus, the proportion of our city which has good immunity against covid-19 is actually less that 67.7%.
    You can see the state-provided numbers here:
    https://dig.abclocal.go.com/kabc/ca-vaccine-tracker/CA_vax_zip_map.html
  2. Vaccine availability is not a good measure of our city’s immunity to covid-19.  It is not a good metric to use in making public health safety decisions. Vaccines are equally available throughout the Bay Area, yet our city’s vaccination rate is below the average vaccination rate for the other 8 Bay Area counties. It is clear that availability of the vaccine does not equate to uptake of the vaccine. It is better to make public health decisions based on the actual level of immunity, rather than the potential level of immunity.
  3. Are cases or hospitalizations a better metric to follow? As Councilmember Largaespada noted at last night’s meeting, covid cases can vary depending on how much testing is being done. He correctly pointed out that the hospitalization rate is a better gauge of the virus’ impact on our city. I am unaware of Benicia-specific hospitalization data, so Solano County’s data is a fair proxy. The August City Council decision used cases as the metric to follow. I strongly urge you to change this metric to hospitalizations, since this measure more accurately captures how the pandemic is affecting our residents. Also, it is important to not view ICU capacity as equivalent to hospitalization rates. Councilmember Largaespada interchangeably referred to ICU capacity and hospitalization rates, but those are two very distinct and different measures. Since treatment options for covid-19 have improved dramatically, many covid-19 patients who are quite sick are now being safely managed on standard medical units or step-down units. The only ones needing ICU beds these days are the sickest of the sick. If ICU capacity in our county is going to be used as a metric, we could have stopped all public health precautions several months ago.
  4. Should covid public health policies let those who choose not to be vaccinated live with the consequences of their decision? At your meeting last night, it was said we at some point need to just move on, and accept the fact the virus will be with us for a long time. Since vaccines are now widely available, it is up to individuals to decide whether to get them or not. I have two responses:
    (a) Yes, covid-19 will likely become endemic at some point, like influenza. But we are not there yet. In fact, we are far from that point. In very bad influenza years, the country loses an average of 142 people per day. Covid-19 is still killing over 1,000 people per day. Covid-19 is surging in many areas of the country and the world, and the coming winter months, along with holiday parties, will very likely increase the risk of viral spread. Most public health experts do anticipate covid-19 will become endemic and something we need to manage in our lives. But we are not there yet.
    (b) Government has always had a role and responsibility to help protect people from themselves. That is why, for example, we have seat belt laws. The availability of seat belts does not necessarily mean they will be used, so we have laws which force people to use them. Even more importantly, government has a role to insure people not make individual decision which harm others. That is why why have drunk driving laws. A person may feel they can hold their liquor and drive safely, but the government has decided to not leave that judgment up to each individual. With covid, those who opt to not be vaccinated are both putting themselves at risk and putting others at risk. It is fully appropriate for government to adopt policies to protect both the individual and the community from those who are putting themselves and others at risk.
  5. What other Bay Area counties are doing. At last night’s meeting, I said that the other eight Bay Area counties are all retaining mask mandates. As was correctly pointed out, Marin has lifted their mask mandate, but it is only lifted for fully-vaccinated people. Partially vaccinated and unvaccinated people are still under a mask mandate. Marin has the highest vaccination rate, the lowest hospitalization rate, and the lowest death rate in the Bay Area. Contra Costa has not yet made a decision to lift their mask mandate. They along with several other counties are lifting mask mandates for selected businesses, but only when 100% of employees and customers are fully vaccinated. The other Bay Area counties have fared better during the pandemic than Solano County, and are approaching easing up on precautions very cautiously. I strongly encourage you to follow a similar approach.

Thank you for your work helping safeguard our community.

Richard Fleming, MD


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For details on Council’s discussion and outcome, see: “Benicia City Council debates changing mask mandate, decides to keep in place, will review again on Dec. 7

Benicia City Council debates changing mask mandate, decides to keep in place, will review again on Dec. 7

The Council’s August 24 Mask Mandate remains in place for now

By Roger Straw, November 18, 2021
Benicia Mayor Steve Young

Benicia Mayor Young reported on last night’s City Council meeting that “Council decided not to change the mask requirements but to continue with the same metrics.”

The mandate, he continued, “will be reviewed again at the Dec 7 meeting.  If our 7-day case rates stay below high or substantial for another two weeks, the mandate will be dropped.”

The Mayor agreed with the Benicia Independent and many throughout the community that the City should be wary of dropping the mandate before the holidays and onset of winter.  “I was urging to wait through the holidays,” he wrote.

Dr. Richard Fleming agreed: “While the council agreed to continue the current mask mandate until their December 7 meeting, there appeared to be a desire by some to lift the mandate soon if the current case counts stay where they are for two more weeks.

“I feel strongly,” he continued, “that such a step would be premature and would risk opening the door to more viral spread.  I wrote the Council this morning (see text here), to explain why I think they should reassess the basis on which they decide whether to retain or remove the mask mandate, based on scientific evidence.”

Dr. Fleming added that “Many city residents called in to offer their opinions, and the vast majority were in favor of retaining the mandate until the pandemic has subsided significantly.  A number of callers spoke of the likelihood of a winter surge in cases due to colder weather and holiday gatherings.”

Council rejected a motion by Councilmember Lionel Largaespada to ease the metrics governing the mandate, which would have basically done away with the citywide mask mandate at this time.  Largaespada’s motion died for lack of a second.

Mayor Young was prepared to bring a motion to allow local businesses to voluntarily permit customers to enter maskless if 100% of employees and customers show proof of vaccination.  Young wrote, “The idea generated over 100 form letters of virulent opposition, and were evidently persuasive to council who did not support it.”  Sensing no support, Young chose not to offer the motion, and joined the majority in support of the City’s previously agreed upon mandate metrics – requiring 30 consecutive days below the CDC’s SUBSTANTIAL transmission level (7-day case rate).

For Benicia’s current and recent 7-day case rates, see http://beniciaindependent.com/coronavirus/#beniciacases.

No final vote was required on maintaining the status quo.  As Mayor Young wrote, “Since we weren’t changing existing policy it didn’t require a motion.”


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Richard Fleming, M.D.


>> For an important analysis of Council’s discussion, see “Open Letter to Benicia City Council: Dr. Richard Fleming on mask mandate“.

10 Reasons to Extend Benicia’s Face Mask Mandate

By Benicia author Stephen Golub, November 16, 2021
Open letter to Benicia City Council, considering amendments to the mandate TONIGHT, Tues. Nov. 16.  (See Council Agenda: Instructions for Public Comments are on p. 6.  Items 20.E. and 21.A. are on p. 9.)

Dear Mayor Young, Vice Mayor Campbell, and Council Members Strawbridge, Largaespada and Macenski:

Benicia Author Stephen Golub, A Promised Land: America as a Developing Country

I am a Benicia resident writing to urge that, at tonight’s meeting, the City Council extend indefinitely (and probably until at least March 2022) Resolution No. 21-88, which requires that “face coverings be worn in all indoor public settings in the City.”

I am not a public health expert. But it is clear that the evidence demonstrating that masks limit the spread of Covid is overwhelming. It includes a 350,000-person randomized controlled trial, summarized below, that was completed in August. But before diving a bit into such data, the following list of reasons for extending the mandate starts with one very basic consideration:

  1. Common Sense. Winter is coming, and with it the very strong likelihood of a significant rise in Covid cases and resulting deaths due to more people being indoors and holiday gatherings. We’ve seen this movie before – last winter, to be exact. And we’ve seen other Covid waves caused or exacerbated by relaxing precautions prematurely, even after vaccines were made available. Let’s not repeat such mistakes by weakening or eliminating our mask mandate.
  2. Europe’s Record-high Cases a Harbinger for California. As recently reported in the San Francisco Chronicle, Europe, including highly vaccinated Western European nations, are seeing skyrocketing cases: According to the director general of the World Health Organization, two million cases last week, which was the highest figure at any point in the pandemic, along with a 10 percent mortality increase.
    As Dr. John Swartzberg, a UC Berkeley infectious disease and public health expert warns us, “Throughout the pandemic, Europe has been a harbinger of things to come to the US, including California and the Bay Area,” he wrote in an email to the Chronicle. “If this pattern holds true (and I suspect it will), we should be very worried. The colder weather (more people inside) and the holidays already make the upcoming winter a precarious time.”
  3. Look Toward the Future, Not the Past. If, in the final days leading up to the October 24 storm that pummeled the Bay Area, someone had suggested that it would be a good day for a picnic since the past week had been pleasant, we’d look at them askance (to put it mildly). Yet that is somewhat akin to the policy the Council adopted with the best of intentions in August, relying on the past 30 days of transmission rates to determine whether to drop or modify the mask mandate.
    I am not suggesting that such a criterion be dropped. It is in fact useful and relevant. However, I urge that it be supplemented by consideration of likely trends and other data. As I’ve noted, such trends point toward a very possible storm of Covid cases, which in turn points toward leaving the mandate in place. Even if this means the Council makes a somewhat subjective assessment of whether or when to modify the mandate, that is what you’ve been elected to do: take account of recent data, yes, but also exercise your good judgment regarding what the future holds. This probably means holding off on revising the mandate until at least March, when winter is behind us, and only if the data and trends suggest doing so.
  4. Evidence from Across America. As pointed out by Dr. Richard Fleming, who called in to your August meeting, a comparative study in Kansas found that masks help limit Covid’s spread. More specifically, “counties that chose to enforce [a statewide mask] mandate saw their cases decrease. Counties that chose to opt out saw their cases continue to rise…. the findings were consistent with declines in coronavirus cases observed in 15 states and the District of Columbia where masks were mandated, compared with states that didn’t require the face coverings.”
  5. “Gold Standard” Evidence from Abroad. For the 18 months ending in August 2021, a Stanford/Yale-led team conducted in Bangladesh the largest and most rigorous study of whether masks make a difference in people catching Covid. Involving roughly 350,000 people in 600 villages, it featured research comparing results between carefully selected, demographically similar populations. Some, in the “intervention villages” were encouraged to wear masks and were supplied with them; others – the “control villages” – were not.
    The upshot? Despite the fact that fewer than 50 percent of intervention villagers wore masks in public places, Covid infections were 11 percent lower in the intervention areas for the population as a whole and 35 percent lower for those over 60. “We now have evidence from a randomized, controlled trial that mask promotion increases the use of face coverings and prevents the spread of COVID-19,” said Stephen Luby, MD, professor of medicine at Stanford. “This is the gold standard for evaluating public health interventions.”
  6. Yet More Evidence for Mask Efficacy. I am only scratching the surface of the research indicating that masks prevent Covid. Two of the numerous compilations of relevant data can be found here and here.
  7. Heed Benicia’s and America’s Health Authorities. As pointed out by the aforementioned Dr. Richard Fleming in a letter to the Times-Herald, Solano County Health Officer and Deputy Director Dr. Bela Matyas has been wrong on face masks in key respects, including his claim that “Our data clearly shows that indoor public spaces are not where the disease spreads.” As Dr. Fleming notes, “[Dr. Matyas] said spread results from private gatherings, so a mask mandate would not help. Yet he has published no data to support that statement.”
    Indeed, regarding the mask mandate and other Covid-related matters, Dr. Matyas has been at odds with other Bay Area counties, the State, the CDC, the Napa-Solano Medical Society, numerous other public health authorities and the roughly half-dozen Benicia-based medical and public health personnel who called in to your August meeting in support of the mandate. Going forward, the Council should heed that broad consensus of data-based opinion rather than Dr. Matyas.
  8. Protect Benicia’s Businesses and Workers. The face mask mandate benefits Benicians by making workplaces and workers safer. In the process, it makes good business sense. One reason the country saw a record 4.4 million Americans quit their jobs in September is because of Covid safety concerns, according to this Washington Post piece: “There are likely some delta-induced quits here,” said Daniel Zhao, an economist at Glassdoor, in reference to the coronavirus variant. “Workers are fed up with working conditions and feel unsafe…Quits are high in leisure and hospitality, health services and education,” Zhao noted. “Those are all industries where an increase in covid can make work less safe.”
    While masks are by no means the sole solution, the absence of a mandate can be part of the problem.
  9. Freedom. It’s unfortunate that this bears repeating nearly two years into the pandemic, but I’ll repeat it anyway: Face masks protect not just or mainly the persons wearing them, but the persons with whom they come into contact. In voting to maintain the mandate, the Council will be doing what it can to advance freedom from disease and death. That’s a freedom far more important than from having to wear a simple facial covering.
  10. In sum, I ask that the Council extend the mandate because common sense, a plethora of data and Benicia’s and the nation’s public health authorities have concluded this:
    • Face masks help prevent Covid’s spread.
    • Face masks help prevent illness.
    • Face masks save lives.

Sincerely,

Stephen Golub

My blog: A Promised Land: America as a Developing Country

Important policies that cities can adopt NOW to help fight climate change

[Editor: Here’s a challenge for cities large and small.  Check out the climate change policies proposed by Seattle Mayor Jenny Durkan.  Especially interesting: the link to How Building Performance Standards Are Addressing Climate Change.  – R.S.] 
Traffic during rush hour along I-5 in Seattle. CREDIT: KUOW PHOTO/MEGAN FARMER

Seattle mayor proposes new climate measures to tackle pollution from traffic and buildings

KUOW Puget Sound Public Radio, By John Ryan, November 2, 2021

At the global climate talks in Glasgow, Scotland, Seattle Mayor Jenny Durkan announced policies she says will take a big bite out of Seattle’s climate-harming emissions from buildings and cars.

“We are really working toward urgent action on climate change,” Durkan said.

She proposes requiring large buildings to clean up their carbon acts, starting in five years.

Her executive order seeks to make existing commercial and multifamily buildings convert to clean electric power and eliminate the use of fossil fuels no later than 2050. Initial emission reductions would begin by 2026.

Seattle has mandated climate-friendliness in new construction but to date has done much less to tackle the bigger problem: the impacts of existing buildings.

The proposed policy would cut building-based emissions in the city 39% by 2030 and eliminate them by 2050, according to Durkan.

caption: Seattle Mayor Jenny Durkan speaks from the global climate talks in Glasgow, Scotland, Nov. 1, 2021.
Seattle Mayor Jenny Durkan speaks from the global climate talks in Glasgow, Scotland, Nov. 1, 2021. CREDIT: SCREENSHOT FROM NOV. 1 CITY OF SEATTLE PRESS CONFERENCE

Monday’s executive order directs city staff to engage with community groups and draft legislation for performance standards for large buildings by next July, six months after Durkan’s term has ended. Then the Seattle City Council would have its say.

Of course, public process is often where proposals go to die in Seattle, like one Durkan touted in 2018 for downtown tolling, which she dropped in 2020.

Other proposals announced by Durkan Monday include:

  • Creation of an urban pedestrian-only zone by summer 2022.
  • A $1 million pilot to replace diesel trucks with electric ones in the heavily polluted Duwamish Valley. City officials say the $1 million pilot is expected to subsidize the purchase of 15-20 electric trucks.
  • A ban on fossil fuel use in city-owned buildings by 2035.
  • A new design of the Burke-Gilman Trail’s 1.4-mile “missing link,” which has been stalled by opposition from some Ballard businesses for decades.
  • Free transit for Seattle middle schoolers. High schoolers got free transit in 2020. “We know that kids, when they ride transit, become transit users for the rest of their life,” Durkan said.

“This provides safe, reliable, and affordable trips for families,” Alex Hudson with the Transportation Choice Coalition said at the mayor’s press conference. “Transportation is the single largest contributor to greenhouse gas emissions as well as the air pollutants that affect public health and increased rates of asthma and other public health emergencies.”

“The city of Seattle is leading America in all of our efforts,” Durkan said, echoing a claim Seattle mayors have made for nearly 20 years.

Following similar bans in Oakland, San Francisco, San Jose, and other California cities in 2019 and 2020, Seattle banned most natural gas use in new construction of large buildings in February 2021.

State law prohibits Washington cities from banning fossil fuel use or imposing tighter energy codes on residential buildings less than four stories tall.

“Three cities (Washington D.C., New York, and St. Louis) and Washington state have already passed legislation creating building performance standards,” trade publication FacilitiesNet.com reports.

Seattle’s Green New Deal law requires the city to aim for zero climate pollution by 2030, not 2050, as Durkan’s policies do.

“I thank [the Seattle City] Council for what they passed in terms of some of the targets they want to meet, but targets mean nothing unless we have a cohesive plan,” Durkan said.

“Zero emissions by 2030 is the proper goal, and what the City committed to in 2019,” climate activist Jess Wallach with 350 Seattle said in an email.

“Actually leading the nation would look like doing more than taking four years to make an underwhelming promise with no real targets or accountability,” Wallach said.

Durkan’s proposed 2022 city budget devotes much less money to curbing fossil fuels than activists have called for. It includes $1.7 million to convert 125 low-income households from oil heat to electric heat pumps. The “solidarity budget” pushed by progressive activist groups calls for $85 million annually over three years, enough to convert all oil-heated low-income homes in the city to clean energy.

Both candidates for Seattle mayor, Lorena González and Bruce Harrell, one of whom will replace Durkan in January, have signed a climate pledge to reduce the city’s greenhouse gas emissions 58% by 2030 and eliminate them by 2050.