Category Archives: Solano County Health Officer Bela Matyas

Dr. Richard Fleming: Reflecting on Solano County’s huge ‘correction’ in COVID numbers

The importance of accurate COVID-19 numbers in Solano and Benicia

By Richard Fleming, M.D., March 12, 2022
[BACKGROUND: Solano Public Health corrects COVID numbers
AND Solano Public Health Director explains.]
Richard Fleming, M.D., Benicia, CA

Having accurate numbers on COVID-19 cases, hospitalizations, mortality rates, and long-covid rates is very important.

I’m glad Solano County has decided to include positive antigen tests in their case numbers. False positive antigen tests are uncommon, so a positive antigen test almost always means a true infection.

The antigen test is the rapid test done with the at-home kits. Many of these positive antigen test results are not being reported to the county or state, so total covid-19 cases are increasingly being under-counted. Nonetheless, it is appropriate for Solano County to do what other counties have been doing, which is to count positive antigen tests as covid-19 infections.

It is a little surprising the county has decided to start excluding positive serological test results. A positive serological (or antibody) test for COVID-19 is almost always due to a prior COVID-19 infection. I am not sure what the rationale is for deciding to take these cases off the count of covid-19 infections.

One of the biggest data gaps is how many people are facing long-covid problems. In assessing the impact of the virus, this is an important aspect to understand. Sadly, there are currently no county-level, statewide, or even national numbers on how many people are dealing with this condition.

Looking at the big picture, Solano County will, in all likelihood, continue to see better numbers, in parallel with the improvement in the state’s and the country’s numbers.

As we celebrate our progress locally, it is important to look at the fact that neither Benicia nor Solano County is an island, and much of what happens with the pandemic here is impacted by the situation in surrounding areas. There is little doubt that we in Benicia and Solano County have benefitted, and continue to benefit, from the actions of other Bay Area counties, which have much better numbers than we do. These better numbers are no doubt due to the fact these other counties have much higher vaccination rates and have had more stringent public health safeguards in place than has been the case in Solano County and in Benicia.

And, because we are not an island, there is also little doubt that Solano County has made things slightly worse for the other Bay Area counties.

The question which will be hard to answer is whether we (Benicia and Solano County) could have seen fewer hospitalizations, fewer deaths, and fewer cases of long covid had we followed the same public health measures as the rest of the Bay Area, including more masking requirements, more vaccine mandates, and more vaccinations. Actually, the question is not whether we would have had fewer, but how many fewer, in each category.

This is not just an historical question. It is a question which should concern all of us today. How many of the 80 Benicians who acquired covid-19 this past week may have avoided this infection if our city had waited a couple of weeks longer to lift its mask mandate? How about those who will become infected next week? It would be nice if there was some way to quantify that, but it may never be known.

Richard Fleming, M.D.
Benicia, CA

Solano Public Health Director explains this week’s huge increase in COVID cases

By Roger Straw, Friday, March 11, 2022

Dr. Bela Matyas, Public Health Director with the Solano Public Health Department (Chris Riley/Times-Herald)

In the March 6 Fairfield Daily Republic, reporter Todd Hansen wrote about his phone interview with Solano Public Health Director Bela Matyas: “Solano County expects to receive a significant report of previously unreported cases that were identified through a different testing procedure.”

Sure enough, in the County’s March 7 COVID Dashboard update, Public Health reported a whopping 4,115 previously unreported cases in Solano County, and 71 previously unreported cases in Benicia, unprecedented increases and huge numbers by any measure.

I wrote to Public Health Director Dr. Bela Matyas asking for clarification:

Dr. Matyas –

Please explain the meaning of reporter Hansen’s “different testing procedure.”  What accounts for these dramatic increases?

I agree that the numbers show cases declining. But what these revelations clearly do show is that previous updates were vastly under-reported. Are you going back and updating the dates where these new cases were discovered, showing a higher curve?

How is the public to understand in detail what WAS our experience with COVID over the period when these cases were not being uncovered and reported?

Dr. Matyas gave me permission to share his email explanation:

Hi Roger,

The State’s COVID-19 database, CalREDIE, collects several types of laboratory data for COVID-19, including pcr results, rapid antigen test results and serology results.

According to the State, only the pcr results are counted as confirmed cases, and the State’s total of cases for each county represents these confirmed (i.e. pcr-posititve) cases.

For most of the duration of the pandemic, we have noted that the State’s reported case count for Solano is different from our own count.

In continuing to investigate the reason(s) for this, we recently learned that

      • the State’s count of confirmed cases for Solano included several hundred persons whose only laboratory evidence of disease was a serology for COVID-19 (serology is not approved by the FDA for diagnosis, except for Multisystem Inflammatory Syndrome of Children [MIS-C]),
      • and it included several hundred persons whose laboratory result was a positive rapid antigen test.

Among those with serology results only were 33 residents who had been hospitalized in out-of-county hospitals (e.g. John Muir), and the diagnoses based only on serology were nearly all from mid-2020 through 2021.

As for the cases with positive rapid antigen tests only, it is difficult to discern a pattern to identify which of these were counted as confirmed cases and which were counted as probable cases (and not, therefore, included in the case count for the county). It is noteworthy, however, that over the last several months, use of rapid antigen tests to diagnose COVID-19 cases rather than use of pcr tests has become increasingly prevalent; in fact, in a growing number of circumstances, the rapid antigen test has become the preferred test for diagnosis and is the test recommended by the State.

Based on this, we decided to remove from our county case count those persons whose diagnosis was based on a serology test only, and this included 33 hospitalized individuals.

By contrast, we decided to include in our county case count those residents whose diagnosis was based on a rapid antigen test only.

The resulting math was to:

      1.  Delete 409 serology-only cases (including 33 hospitalized);
      2.  Add 4410 rapid antigen-only cases; and
      3.  Add 114 cases diagnosed over the prior three days (including 3 hospitalized).

The net result, therefore, was an increase of 4115 cases and a decrease of 30 hospitalizations.

With respect to your specific questions below, yes, the previous updates were significantly under-reported (particularly for January and early February). We do go back and update each of the line curves with date-appropriate data every time we post a new update to the dashboard.

I think it’s difficult for the public to understand in detail what we are experiencing when there are significant issues with data accuracy; we still have significant under-reporting of positive rapid antigen tests from long-term care facilities, from home testing and from pharmacy testing.

I hope to publish a local reflection on Dr. Matyas’ rather complicated explanation.  Stay tuned.  – R. S.


>Reference the Solano County COVID-19 Dashboard where you can hover a mouse or click on an item for additional information.  Note the tabs at top for “Summary, Demographics” and “Vaccines.”  Click here to go to today’s Solano County Dashboard.

See also my BENINDY ARCHIVE of daily Solano COVID updates (an excel spreadsheet).  I have also archived the hundreds of full CORONAVIRUS REPORTS posted here almost daily on the Benicia Independent since April 2020.

RETURN TO TOP

Dr. Matyas shares details on child’s COVID death

The child actually died a month ago, had been ill for a month before that, and had no underling health conditions

Solano health officer calls ‘tragic’ the death of infant to Covid-19

Fairfield Daily Republic, by Todd R. Hansen, December 21, 2021

FAIRFIELD — Solano County has reported the first death of a child due to Covid-19.

The infant, younger than 1 year old, died about a month ago and had been ill for about a month prior to that, Dr. Bela Matyas, the county public health officer, said in a phone interview Monday.

“It’s tragic,” he said.

It takes the total of Covid-related deaths to 342, the county reported.

The child “did not appear to have any underlying health conditions . . . and, of course, the child was not vaccinated,” Matyas said.

Children that young are not allowed to be immunized.

Matyas said the infant contracted the virus almost certainly by being exposed to someone with the disease, probably a family member or friend, and, he added, it was far more likely from someone who had not been vaccinated.

That is especially true if the person who transmitted the disease was asymptomatic and did not know he or she was infected.

While the Public Health Division is investigating in hopes of learning how the child was exposed, Matyas said a clear answer may not be possible.

“We may never know,” Matyas said.

The county reported 128 new coronavirus cases, 112 of which were from the past three days. It takes the total to 47,892.

The number of residents who were hospitalized Monday with the disease was 19, with six in intensive care units. That compares to 22 hospitalized Friday and five in the ICU, the county reported.

The 10-day daily case average was 37.7, up slightly from Friday’s report of 36.9.

Vaccination rates held steady at 66% of residents 5 or older being fully vaccinated and 77% of that population receiving at least one shot. There have been 84,334 booster shots administered, up from Friday’s total of 81,294, the county reported.

The report stated 18.7% of 5- to 11-year-olds have received a vaccination shot.

Fairfield added 36 new cases to take its total to 12,803. Vallejo added 33 for a new count of 13,950. Vacaville had 12,651 cases after 38 additions, the county reported.

Suisun City (3,390) added four new cases; Dixon (2,643) added nine; Benicia (1,660) added seven; Rio Vista (644) added one; and there were no new cases in the unincorporated area of the county (151), the report states.

The seven-day positivity testing rate was 5.4%, up from 5% Friday.

County public health officials do not post case updates on Tuesdays. The next update is scheduled late Wednesday afternoon.

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