Category Archives: Santa Clara County CA

One Bay Area county health officer says California is reopening too soon

Santa Clara health officer Sara Cody suggests California is reopening too soon

Politico, by Victoria Colliver, May 26, 2020
Sara Cody | AP Photo
Santa Clara Public Health Officer Sara Cody | AP Photo

OAKLAND — The local public health officer who led the nation’s first regional shelter-in-place order early in the Covid-19 pandemic sounded the alarm Tuesday on Gov. Gavin Newsom’s swift reopening plans, which now allow haircuts and church services.

After keeping the state largely in lockdown since March 19, Newsom has quickly advanced counties that meet certain criteria — now up to 47 out of 58 counties — through his reopening phases. Newsom announced Tuesday that barbers and hair salons can reopen in those 47 counties, a day after he said religious gatherings and protests could occur with up to 100 people.

“The pace at which the state has made these modifications is concerning to me,” Santa Clara Public Health Officer Sara Cody told the county Board of Supervisors at their Tuesday afternoon meeting, noting that other states have exercised more caution, including New Jersey, which limited such gatherings to 25 people, and New York, where no more than 10 are allowed.

Cody stressed to the board that at least a full incubation period of 14 days — and preferably 21 days — is needed to effectively gauge the impact of each step of the reopening process.

“The state modifications are being made without a real understanding of the consequences of what the last move has been, and with the possible serious effects for health and possible serious risks or an exponential growth in cases,” she told the board.

Hair salons and barbers are in the third phase of Newsom’s reopening plan, though nail and facial salons, which have more direct contact, still must remain closed.

The governor on Monday also allowed retailers statewide to resume in-store sales if allowed by their county; his previous guidance only allowed such business activities in counties that hit certain benchmarks.

Cody was most disturbed by Newsom’s actions to expand the number of people allowed to gather in public, a move she warned would overwhelm “our current ambitious and unprecedented effort” to establish a large network to track and trace the spread of the virus as the state reopens.

Not only did Cody lead six Bay Area counties in imposing the nation’s first shelter-in-place order on March 16, but she was also first to ban large gatherings such as concerts and pro sporting events earlier that month.

Just two weeks ago, Newsom, under pressure from mostly smaller counties that had relatively few or no cases of the coronavirus, allowed the first two counties — Butte and El Dorado — to move into the second phase of the state’s reopening plan, which involved curbside retail pickup and resuming mostly niche businesses like car washes and pet groomers.

But the number of counties given the green light quickly mushroomed to include many large counties, including Orange, Riverside, Sacramento and San Diego.

Santa Clara, along with most of the other central Bay Area counties, has opted not to move ahead, as had Los Angeles. But the Los Angeles Board of Supervisors on Tuesday announced plans to submit an application to reopen more quickly.

Newsom, during Tuesday’s press conference, was asked how state and local officials would be able to detect clusters of outbreaks given the pace of the reopening. He responded by touting the state’s stabilizing hospitalization rates, increased testing capacity and growing workforce of “contact tracers” who track down people who may have been exposed to the virus.

Cody said she wants to reopen Santa Clara County — but only when safe to do so. Santa Clara was one of the nation’s first hot spots for the virus but slowed the spread and was eventually overtaken in California by Los Angeles and other Southern California counties. Santa Clara reported 24 new cases out of a total of 2,675, and no new deaths beyond its total of 139.

“If our overall rate of transmission remains stable, we will be able to continue to ease our restrictions and safely reopen activities on a regular cadence with at least an incubation period between each phase,” Cody said.

Solano County Public Health should learn from Santa Clara on reporting of COVID-19 deaths

This is how they died: Santa Clara County releases information on every COVID-19 death

San Francisco Chronicle, by Joaquin Palomino , Matthias Gafni and  Erin Allday, May 26, 2020
Dr. Sara Cody, MD, right, Health Officer and Public Health Department Director, listens to San Jose Mayor Sam Liccardo speaking during a news conference about the shelter in place extension order in Santa Clara County on Tuesday, March 31, 2020, in San Jose, Calif. The Bay Area’s shelter-in-place order, which bans all non-essential trips outside the home and requires restaurants to operate only through takeout and delivery, will be extended until May 3.
Dr. Sara Cody, MD, right, Health Officer and Public Health Department Director, listens to San Jose Mayor Sam Liccardo speaking during a news conference about the shelter in place extension order in Santa Clara County… Photo: Tony Avelar / Special to the Chronicle

Health officials in Santa Clara County released detailed information Tuesday on every confirmed death from COVID-19, providing a thorough accounting of the human toll the disease has taken on the South Bay community.

The data, the most comprehensive to be published by a public health department in the Bay Area, provides the age, race, gender, residential ZIP code, cause of death and underlying health condition for all 139 people who have perished from the disease since the first documented casualty on Feb. 6.

Pneumonia, respiratory failure and acute respiratory distress syndrome were listed as a cause of death in more than three-fourths of the COVID-19 deaths. Other fatal complications included renal failure and cardiac arrest, adding to evidence that the disease can ravage not just the lungs but other systems.

More than half of the people who died from COVID-19 had hypertension as an underlying health condition, and about 40% had diabetes. Other common preexisting health issues included congestive heart failure, chronic kidney disease and coronary artery disease. Many had multiple comorbidities.

Sixteen people — or 12% — had no significant underlying health problems. Those individuals ranged in age from 54 to 82 years old. The youngest reported death was a 37-year-old man who had several comorbidities. Three people age 100 or older were among the deceased.

Roughly 40% of the people who died of COVID-19 resided in four ZIP codes that are mostly in East and Southeast San Jose — predominantly Latino and Asian communities that have been hit hard by the pandemic.

Santa Clara County Supervisor Dave Cortese welcomed the release of information, but said policy makers still need more to help restrain the spread of the virus.

“These are real human beings, real people and the report at least starts to present the loss of human life” in those terms, Cortese said. “I think that’s significant, but it’s just a small beginning as to where we need to go.”

The records were released Tuesday and include all deaths reviewed by the medical examiner-coroner, as well as those handled by private doctors in hospitals. County officials said they plan to eventually fold the information into their public data portal.

To date, Santa Clara County has provided a wealth of information related to the pandemic. Many other counties in California, including San Francisco, post only aggregate figures on coronavirus cases and deaths, making it difficult to find common threads that connect the people who have perished — a fact that has frustrated the public and researchers.

Click this image to view the 8-page report in PDF format. The report lists every death, including Date of Death, Location, Gender, Age, Race, Death Zip Code, Residential Zip Code, Cause of Death and Other Significant Condition.

George Rutherford, an infectious disease expert at UCSF, said the numbers seem to fit exactly what you’d expect from the disease. “It looks pretty much standard for mortality,” he said.

As in other counties in the Bay Area, the disease has hit some groups harder than others. Across Santa Clara County, Latino residents have died at a higher rate than any other race or ethnicity.

Victor Vasquez, director of organizing and policy at the advocacy group Somos Mayfair, said at the county supervisors meeting Tuesday that the stark disparities “continue to show how much systemic inequities exist for poor black, brown and Asian communities.”

While most of the people who have died of COVID-19 were in hospitals, nursing homes or skilled residential care facilities, nine people, or about 6%, died at home — a number that UC Berkeley infectious disease expert John Swartzberg found noteworthy.

“If somebody’s got COVID-19 they should get treated for it. There are good treatment options,” he said. “Clearly, some of it relates to people being scared to death to go into a hospital.”

Such data are dependent on scattered and inconsistent testing policies that make it difficult to understand the true scope of the pandemic. Judy Melinek, a Bay Area forensic pathologist, said that a lack of testing likely led to an “undercount” of COVID-19 deaths.

“The question I have is who is not on that list because they were not tested either because there was not sufficient COVID-19 testing at the time or they had no symptoms and weren’t tested,” Melinek said.

County Supervisor Cortese has asked the county to provide more information, including summary statistics on all deaths, not just those known to be caused by COVID-19.

“That will help inform where we should be focusing resources, where we’re having clusters within the community, and whether or not we’ve had unattributed deaths that are suspect,” he said. “I want the who, what, why, when and where.”

Joaquin Palomino, Matthias Gafni and Erin Allday are San Francisco Chronicle staff writers.