Health officer to Board of Supervisors: ‘No reason’ to believe coronavirus will end soon

Vallejo Times-Herald, by Nick Sestanovich, March 25, 2020

As Solano County nears the first full week of its shelter-at-home order in response to the ongoing global coronavirus pandemic, County Health Officer Dr. Bela Matyas delivered an update on how the county was responding at the Board of Supervisors’ Tuesday meeting.

To comply with social distancing guidelines at the federal, state and county levels, the meeting operated differently than it had in the past. It was closed to the public, the supervisors sat farther apart than usual and members of the public were able to deliver their comments through Cisco’s videoconferencing application Webex.

Chair Erin Hannigan remarked that it was a “very trying time” that impacted everyone’s lives, and she did not expect it to let up by April, May or even June. Nonetheless, she said everyone could do their part in ending the spread by maintaining the social distancing guidelines.

“We have to be thoughtful of how we conduct ourselves,” she said.

Matyas said the response has utilized people from several different departments. As of Monday, Matyas said there had been 21 confirmed cases of coronavirus in Solano, seven of which had been reported that day. Of the 21, nine were active cases and 12 had fully recovered. Seven of those nine had been hospitalized.

One issue Matyas noted was that the county had “very limited testing” but had been in close communication with the health care community since American evacuees from the Wuhan region were first brought to Travis Air Force Base in February.

“We are working with hospitals to identify those individuals that should be prioritized for testing so that we can stay on top of the outbreak as it impacts our health care infrastructure,” he said. Matyas echoed Hannigan’s earlier assertion that the outbreak will likely not be receding any time soon.

“We are, in all likelihood, only at the very beginning of this outbreak,” he said. “We have been dealing with the outbreak here in our county only for about the past month. There is no reason epidemiologically to believe it won’t be with us for another 4 to 6 months, possibly longer.”

Matyas said the more successful residents are with social distancing, the virus may stay longer but be less impactful over time.

Among the issues cited by Matyas were local health care workers’ access to protective equipment like masks, face shields and gloves.

“We don’t have yet what would be described as shortages in our county, but we’re all looking at the reality that if the pace of use continues at the current pace, we will run into problems going forward,” he said. “We’re going to have to reconsider how best to protect our health care workforce from this disease while they need to continue to be available to serve our communities.”

However, Matyas was optimistic that the manufacturing of such products has increased and the county has been able to release supplies from the state’s stockpile.

“If that can get us through the gap where manufacturing can catch up, then we should be OK,” he said.

Another issue Matyas noted was the limitations in testing, although he said the capacity for testing was improving.

“Our own laboratory has been able to double its testing capacity in the past couple of days,” he said.

However, Matyas said the problem was not technology but the availability of resources to perform the tests. He said county health workers were asking the state every day for additional access to testing equipment.

“We are doing much better than we were, but we’re not at a point yet where we can be freely testing everybody who we would like to test, never mind everybody who would like to be tested,” he said.

Matyas said the county was testing approximately 20 to 25 people each day, which has increased to between 40 and 60, and was working with hospitals to provide more samples to test more people on an ongoing basis. The county’s current focus was to protect health care centers and seniors.

“Those are, without a doubt, the individuals at greatest risk of a bad outcome,” Matyas said. “It is a reinforcement of what we already know, which is that we have to protect our fragile elderly from exposure.”

To that end, Matyas said county health officials were working with longterm care, assisted living and memory care facilities to create a barrier between public workers and patients.

Matyas also addressed the county’s approach to issuing a stay-at-home order, noting that Solano, Napa and Sonoma counties were “blindsided” when the six other counties issued “shelter- in-place” orders. He said part of the county’s initial hesitation to issue such an order was partly due to the impact on individuals most likely to be economically harmed by it, including small-business owners and employees of the service economy.

“These are also the same people we struggle with, with regard to health and equity all the time,” he said. “Enhancing that impact on them was not a trivial consideration, and it had to be part of our decision-making.”

Matyas said he also disagreed with applying the terminology of “shelter in place,” which is usually reserved for active shooter incidents, chemical spills and other scenarios where leaving home is forbidden. Under a “shelter-at-home” order, people can leave to buy groceries and get exercise, among other things. The order was finally issued on March 18.

Dr. Christine Wu, deputy public health officer, said the county was continuing to get guidelines out to the community by providing more links at its coronavirus webpage at*.   Among these links are a dashboard tracking the number of cases since the virus was first identified in Solano.

Supervisor Skip Thomson said he appreciated the presentation despite feeling the rollout of the county order took too long.

“How many more people got infected in those three days while we were figuring out ‘shelter-in-place’ (or) ‘stay-at-home’ policies?” he asked. “I appreciate everything that was done, but I think it was too slow in getting it out.”

Thomson asked if the goal was to test everyone or only those with symptoms. Matyas said it was dependent on what was available.

“While we have shortages, we have to prioritize and we have to make sure that we amply protect the health care environment,” he said.

As more testing became available, Matyas said there would be much fewer limitations but the county did not currently have the capacity to test everyone in the general public.

Supervisor Jim Spering asked how the coronavirus differed from past viruses. Matyas said the most challenging aspect was that it was a brand new virus.

“We have no history of exposure,” he said. “Influenza changes every year, and it’s why you need to be vaccinated against flu every year, but there is some generic protection against a new string from exposure to prior strings. There is none of that with this virus. Our bodies are generally naive to its existence.”

Spering also asked how the county would address potential issues resulting from the outbreak, including increased stress and possible cases of suicide or domestic violence.

“How are we addressing some of these other issues that are being created from this unemployment that we’re creating?” he asked.

Matyas said it was a major concern and one that was common during recessions.

“How we deal with it is to have our workforce continue to be vigilant and to react as quickly as possible to try to prevent it,” he said. “There is no silver bullet to how to deal with this…Most of the people currently affected are not people we typically interact with because they were employed and they were fine. They weren’t coming to us for services.”

Matyas said the county would work to make sure it is prepared to address such a crisis.

“We’re trying to do what we always do, better,” he said.

In other business, the board unanimously voted to appoint Thomson and John Vasquez to Vacaville’s working committee on homeless services.