Donning a homemade mask, Humboldt County Public Health Officer Dr. Teresa Frankovich answered questions from a few of Humboldt County’s local news outlets. Below is a summary of the questions and her responses.
The L.A Times recently covered a report by the California Department of Public Health titled, “California Department of Health, titled California SARS-CoV-2 Pandemic: Health Care Surge Crisis Care Guidelines, this state report lays out guidelines on who gets intensive care in the event that resources are limited and suggests, among other things, that giving younger patients priority over older patients is an ethical justification that “will give individuals equal opportunity to pass through stages of life.” Will Humboldt County be following these guidelines? (0:13)
Dr. Frankovich is aware of these guidelines and is “grateful” that the state provided them. She added that hospitals have their own guidelines they will follow and are guided by ethics committees who lay out the steps staff should take in such events.
“Our local partners are looking at all these ethical guidelines and hospitals do this all the time not because of the reasons here today with COVID, but because of other issues that come up around ethics in hospital settings,” Frankovich said. “[The state guidelines are] an important thing for us to be able to look at, but it does not determine what a hospital does.”
Based on the slides from Thursday’s public dialogue, we saw 40 percent mitigation with a peak later in the year. If the county eased just some of its shelter-in-place order, how would that change and what percent mitigation would it be? (2:02)
Dr. Frankovich called this the “million-dollar question,” and said that it is important for people to know that as we progress, it is difficult to predict what the future holds.
“We are going to have to be watching carefully to know what the impact is,” Frankovich said in regard to tinkering with preventative measures. “A lot of this is uncharted territory and [there is] massive importance of being able to monitor our population through testing, so we can know where we are in the curve.”
Are we looking into opening the county based on public health science or based on economic need and how are those balanced? (3:17)
Dr. Frankovich started this answer off with a sigh. She said public health and economic needs are not mutually exclusive.
“Public health uses [those] social determinants of health lens to look at everything which means it’s not only infection that we look at causing illness or death, it is also societal things,” Frankovich said pointing to economics, poverty and education as things that impact the health of an individual. “Health is integrated into all these things and we will be using all of that as we look at this going forward. And again, it’s a balancing act. We know there are consequences on both sides.”
How are officials going to enforce the facial covering order? (4:18)
Dr. Frankovich called facial coverings an “important tool” for combating COVID-19 and said they help keep the community safer when people are out and about. She said enforcement of this ordinance would primarily focus on educating the public about the benefits of wearing the masks.
Many essential employees are wondering if they are supposed to wear facial covering inside the building when at work, but still six feet apart? (5:06)
“Yes is the short answer to that,” Frankovich said while adjusting her own mask. “If you are in a shared work environment, masking helps to protect everyone working in that environment.”
We’re told that Humboldt County Public Health has set up a priority system for providers to follow when submitting COVID-19 tests with Priorities 1-3 tested at the Public Health Lab and Priority 4 samples sent to a corporate laboratory. Can you explain the criteria for each of these priority levels? (5:38)
Priority levels have been used throughout the entirety of the testing for COVID-19 patients.
“It is the only thing you can do, especially when you have limited resources,” Frankovich said.
The priority levels were initially based on Center for Disease Control guidelines, but those have changed once the county was able to build up its stockpile of tests. The state has since provided a guidance document for prioritizing testing and Humboldt Public Health is changing its system to be more inline with the state’s.
Dr. Frankovich gave examples for only two priority groups:
Priority 1 patients include hospitalizations, symptomatic healthcare workers, people who were in contact with known infections, potential cases in group-living situations and correctional facilities.
Priority 4 comprises low-risk, asymptomatic people and surveillance testing.
You said Wednesday that you expect it to become increasingly difficult to accurately report the number of COVID tests conducted on local residents and negative results moving forward. How might this complicate Public Health’s efforts to see more comprehensive testing and surveillance testing, which you said are components to incrementally reopening society moving forward? (7:08)
“What I can tell you is that the state has been working with Public Health overall on this because it really has to be a mandate for the companies to get that reporting in and so we have all been pushing to keep that reporting reliable and timely,” Frankovich said.
What are specific supply chain issues for each of the various COVID-19 testing components, from swabs to specific reagents, that have so far made it infeasible for the Humboldt County Public Health Laboratory to expand testing capacity to the point it can loosen testing criteria and test mildly symptomatic and even asymptomatic people? (8:23)
Dr. Frankovich stated there has been some difficulty in maintaining the supply of swabs and reagents for the testing. She said Governor Newsom’s task force has been a help in rerouting this.
“We have found in our own internal lab that we’ve had increasingly more reliable access to the reagents that we need and that’s really been an enormous help for us,” Frankovich said adding that Public Health has been in contact with the state in testing support. “We will report out as soon as we have further information on that.”